Authors: (including presenting author): :
Li YS, Chan KC, Po TF, Hui N
Affiliation: :
Occupational Therapy Department, United Christian Hospital
Keyword 1: :
Virtual Reality (VR)
Keyword 2: :
Cognitive Rehabilitation
Keyword 3: :
Smart Technologies
Keyword 4: :
Advanced Technologies
Keyword 5: :
Smart Hospital
Keyword 6: :
Activities of Daily Living (ADL) and Instrumental-ADL (IADL) training
Introduction: :
Cognitive impairment is a prevalent neuropsychiatric condition characterized by deficits in memory, attention, executive function etc., frequently resulting in diminished functional independence and reduced quality of life. Conventional Cognitive Active Lifestyle (CALS) Groups deliver structured interventions encompassing cognitive training, functional skill development, psychosocial support, and behavioral management. Although clinically effective, these approaches are largely unidirectional and limited in providing immersive practice opportunities. With advances in technology, smart devices are incorporated into patient care such as Virtual Reality (VR) devices and smart tablets and computers. These devices provide patient-centered interactive training while boosting training quality and efficiency.
Objectives: :
This pilot study aims to investigate the effectiveness of S-CALS program on improving cognitive function, ADL and IADL function of MCI patients.
Methodology: :
Smart Cognitive Active Lifestyle (S-CALS) Program has emerged as an evolution of CALS, integrating the use of advanced technologies rehabilitation tools such as Virtual Reality (VR) and smart rehabilitation technology. VR includes a series of realistic, simulated practice of IADL training with immediate feedback. Smart rehabilitation technologies involve the use of tablets, computers, mobile phones to provide comprehensive cognitive games. Collectively, S-CALS represent a technologically enriched intervention to provide a more interactive and advanced cognitive rehabilitation to MCI patients.
This study began from September to November 2025 in OT department at Pamela Youde Polyclinic. It employed a pre–post clinical outcome measure design. Patients with MCI features (i.e. HK-MoCA score 11–22/30), who achieved independence in ADL and required assistance in IADL (i.e. FAST stage ≤ 4) were eligible for recruitment.
All participants received 6 sessions of “S-CALS Program” with each session last for 1 hour. The FAST was selected to evaluate the progression and staging of dementia; AMT and HK-MoCA were selected to evaluate cognitive functions; the Modified Barthel Index (MBI) and Lawton IADL score were selected to assess functional performance. All pre-post outcomes data comparisons were conducted using the Wilcoxon Signed-Rank Test.
Result & Outcome: :
A total of 16 patients were recruited and completed the program, with a mean age of 80 years old (SD=6.89), in which 37.5% of patients had previously been diagnosed as MCI. The average number of sessions attended were 6 (SD=0). Upon program completion, improvement in overall cognitive function and IADL function were noted. Regarding cognitive function, a significant improvement in mean HK-MoCA by 1.75 score (Z=2.306, P=0.022) and mean AMT by 0.687 score (Z=2.00, P=0.045) were noted. Improvement in sustained attention, orientation and naming were observed in most of the cases. For functional performance, a significant improvement in mean Lawton IADL by 1 score (Z=2.275 P=0.023). Improvement in transportation, shopping, money management sub-scales were observed in most of the cases while mean MBI by 0.333 score (Z=1.342, P=0.371), which was approaching statistical significance.
Considering patient’s satisfaction, a mean satisfaction score of 4.2 out of 5 is rated, expressing high appreciations towards use of advanced technology on S-CALS Program. However, some elderlies also expressed difficulties in using VR technology, smart tablets and computers.
The S-CALS Program demonstrates clinical benefits for MCI patients through diverse training modalities, enhanced patient-centered care, and improved rehabilitation efficiency and quality. This study highlights the potential of smart technology in developing robust, holistic, and individualized rehabilitation programs from diagnosis to treatment. Larger-scale studies incorporating control groups are recommended for further validation.
