What is RehaCom?
RehaCom is a comprehensive and sophisticated system of software for computer-assisted cognitive rehabilitation. This practical tool assists the therapist in the rehabilitation of cognitive disorders that affect specific aspects of attention, concentration, memory, perception, activities of daily living and much more.
By solving tasks, brain processes will be activated and important brain functions will be improved or restored. Successful training means that the user will be better able to cope with the challenges of everyday life. RehaCom can be used even at a very acute stage of injury - and remains relevant through all stages of recovery. Training modules can easily be selected based on a cognitive assessment or by using the growing number of Screening Modules.
Training in mother tongue
The software has about 30 modules and is also available in 27 other native languages, so patients can work in their mother tongue. The software is auto-adaptive so the difficulty level will rise and fall depending on the performance of the patient.
After a period of therapy inside a facility, the patient can also be supervised at home, over the internet, by using RehaCom’s remote supervised training option.
What are the main benefits of RehaCom?
For the Clinician
Rooted In Science
The system has been developed by and for neuropsychologists over the last 20 years. Although it feels like a game, it is rooted in science and clinically proven.
Multiple Language Options
The software is available in 27 languages at no extra cost, so clients can train in their native language. About 30 modules are available in the English language.
The procedures cover all stages of rehabilitation. Training can start as soon as possible after ABI and continue all the way through rehabilitation.
The modules cover all cognitive deficits including attention, reaction, memory, and higher executive functions. This means deficits can be targeted and specifically trained.
The system is auto-adaptive, meaning the activity will get harder or easier depending on the performance of the client. This ensures steady progression and reduces frustration for the client.
RehaCom offers a number of Screening Modules to detect impairments and recommend corresponding cognitive training modules. Regular screening can also help show progression and provide detailed reporting.
Supervised training over the internet is available with Internet licenses. You can prescribe a training programme and monitor your clients remotely.
Maximise Therapy Time
Reinforce therapy strategies using RehaCom modules. It will enable you to work more efficiently with your clients and after a number of sessions, they can even work alone.
For the Patient
Improved Cognitive Function
With consistent use the patient will see clear improvement in areas of cognitive deficit. Many tasks will reinforce the strategies of their therapist and maximise their recovery.
The software is adaptable to the patient. They can work in their native language, allow for visual deficits and even use familiar stimuli - such as family images - within the training.
RehaCom can be used remotely with therapist supervision over the internet. This means they can continue working on modules and reinforcing therapy strategies outwith their regular sessions, improving their recovery.
The modules auto-adapt to the patient’s success. When they find a task difficult they will find it gets easier until they can cope. If it is relatively easy the software will introduce a little more challenge and prevent boredom.
How does RehaCom work?
RehaCom has evolved to become the leading European tool for computer-based cognitive rehabilitation, with over 95% of German rehabilitation clinics using RehaCom every day! This is not a brain training tool for amusement - although it is engaging to use. It was designed by clinicians and engineers to deliver real-world benefits for users with cognitive issues following a brain injury.
With RehaCom you can have an unlimited number of Therapist and Client profiles. Clients can be assigned to multiple therapists as required. You only need some basic information to create a profile but there is scope to add much more if required. Once you have created a Client Profile you might want to try one or two Screening Modules to get an idea of their current status and get suggestions for starting modules.
There is a number of screening modules available for use, and these are improving and expanding on each release. Each screening module lasts around 15mins, so you may not want to test all of them in one go. We generally recommend beginning with Alertness screening as it points towards any attention deficits, which are the cornerstone of cognitive function.
The screening module begins with an example and a practice session to make sure the client understands the task. Once this is complete the screening will begin. After screening the results page will show you where the client’s performance sits against aged matched norms. This gives a helpful indication as to the severity of the deficit and advises on the particular training module to be used. You can link directly to the training module from the results screen.
There are about 30 training modules available in English, and this number is steadily growing. Once the therapist knows which module to select they can double click on the icon and select a number of variables from the Parameters screen. Including:
There are additional module specific variables available including:
Once the therapist is satisfied the client can begin training (with or without setup instructions from the RehaCom system). As the training goes on, the task will become easier or harder depending on the client’s performance. This means that it can remain challenging without becoming frustrating. Training can always be paused or instructions repeated if necessary.
Once the training is complete the therapist can review the session from the Results screen. There is a wealth of data included that becomes more rich as the software is used more frequently. The data can be presented in a variety of ways including charts, graphs and comparisons. The most commonly read results are:
By analysing the data thoroughly the therapist is able to identify particular weaknesses e.g. noticing auditory stimuli, and address this further in the training.
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Which English training modules does RehaCom offer?
The RehaCom system has been developed by and for neuropsychologists. Each module has been designed to train a specific deficit. Years of research, testing and adapting have gone into making this the most deficit specific software on the market. The design may look simplistic but this is intentional. Any extra, unimportant stimuli may affect the performance of the client. There are no sudden or negative stimuli that could upset or frighten a patient. This gives the patient the best chance for success. This is a nurturing and supportive system. Each module begins at Level 1 which can be used even at the most acute stages of recovery. Modules can progress upwards of 50 levels and remain challenging all the way through recovery. Each module is adaptable through its own specific set of parameters giving you incredible control.
Attention disorders are very common in both neurological and psychiatric patients and affect all areas of life. While in everyday life a uniform concept is assumed and spoken of as "attention", science distinguishes between various subfunctions, such as alertness, sustained attention and selective attention. Depending on the disease or damage localization in the brain, different attention functions can be disturbed and require specific training.
Symptoms from attention deficit disorder, chronic fatigue syndrome, depression. Aim: to increase intrinsic alertness, causing attention to be entirely cognitively controlled. It is necessary to improve the phasic alertness first, and then proceed to work on intrinsic alertness. For early phases of rehabilitation, this module can be used as a criterion for driving suitability or as supplementary training for clients with Neglect; aged 6 and above.
The client's task is to observe a realistic street scenario and react quickly after a stimulus appears. The maximum response time can be set with two preselectable variants. RehaCom recognizes right, missed, and false reactions.
The client will see objects (vehicles, animals, people, etc.) appearing in their line of sight. As the level increases, the complexity increases as well. The stimuli appears in different points on the screen (centrally, laterally, etc.). This produces a demand on anticipation and intrinsic reactivity similar to real life scenarios. Clients should train at least 10 mins (recommended).
Reduced reaction speed (e.g. as a result of stroke, ischemia dementia, craniocerebral trauma, tumor development, etc.) mostly occurs in diffuse brain damage as well as in frontal and prefrontal lesions. Suitable for persons aged 8 and up.
The task is to press the corresponding reaction button as fast as possible whenever a relevant stimulus - a traffic sign - is shown on the screen.
During the learning phase, the client has to memorize traffic signs and the corresponding reaction buttons. During the training phase, relevant traffic signs are presented to the client who must react within a certain time interval. In higher difficulty levels also irrelevant traffic signs, which require no reaction, are shown.
Impairment of responsiveness after cerebral lesions, disorders of selective attention performances, disturbances of visual and acoustic discrimination, cognition, and/ or behavioral performance. Suitable for persons aged 8 and up. The module is less suitable for persons with severe ametropia (visual refractive error) or poor hearing.
Responsiveness is trained using simple reactions, simple choice, and multiple choice reactions with visual and/ or acoustic stimuli. The training contains either only visual (module 1) or visual and acoustic stimuli (module 2). After a stimulus has appeared, the client must press a particular button on the RehaCom panel as fast as possible. During acquisition phase, the client memorizes the assignment of relevant stimuli to corresponding buttons. Reaction speed and accuracy are measured and evaluated.
More than 200 visual stimuli and 6 acoustic stimuli in 3 variations each are included in the training. The therapist can add visual and acoustic stimuli (pictures and sounds) through the integrated program editor.
The training is indicated for clients with problems maintaining attention performance under the condition of a stimuli with a relatively low density over a longer period of time.
The client’s task is comparing the objects on the conveyor belt, which pass by with varying spaces between them, with the original object. Objects on the conveyor belt that do not correspond to the originals must be sorted out. In the beginning of the training, the density (number of total objects) and the number of objects that need to be sorted out is rather high, however, it decreases during the course of training.
Pictures with specific, real objects are available in 9 levels. Each original object comes with 3 modifications (differentiations in colour, outline and object details). The belt’s direction of flow and speed are adjustable.
The training is indicated for clients with problems maintaining attention performance under the condition of a stimuli with a relatively high frequency and an increasing number of reaction choices over a longer period of time.
As in module Vigilance 2, the client’s task is comparing the objects on the conveyor belt. Objects which do not match the original ones must be sorted out. Contrary to the training Vigilance 2, the stimuli density (number of total objects) and the percentage of objects that need to be sorted out, are increased.
Graphic pools with specific, real objects are available in 9 levels. Each original object comes with 3 modifications (differentiations in colour, outline and object details). Adapting the difficulty is affected by the number and resemblance of the objects, the increasing stimulus interval as well as the number of wrong objects. The belt’s direction of flow and speed are adjustable.
All disorders of visual and spatial perception, especially clients with parietal lobe lesions and/or neglect.
This module consists of nine different tasks, which differ greatly from each other depending on spatial perceptive performances. Usually the training is carried out by comparing and adapting a spatial property to a reference object. The following performances can be trained: position estimation, angle estimation, relations estimation, one- and two-dimensional size estimation, parallelism estimation, length estimation, lines splitting and velocity and distance estimation.
Multiple photorealistic and everyday graphics are available for each task. The short-term memory for spatial perception is trained in higher levels by fading out the reference object. The reconstruction must then be performed from memory.
For treatment of cognitive disorders, especially of spatial perception functions. In addition, the module can be used to continue attention training on a high level. By using non-verbal material, the client can work with the module even with restrictions in language and understanding words. The training is less suitable for clients with severe intellectual impairment or distinct attention deficit disorder. Suitable for persons aged 10 and up.
Training Task and Training Material
In the upper half of the screen, a three-dimensional object is shown. In the lower half, three to six objects are shown which are more or less similar to each other depending on the level of difficulty. The client has to find the object below which matches exactly the object in the upper half of the screen. All objects on the screen can be rotated in three dimensions and thus can be viewed from all sides. As training material, a total of 432 3D objects in 67 groups are available.
Loss of performance in visual-constructive tasks, items of the position-in-space-exploration as well as in spatial orientation in clients with damages of the frontal lobe and with right hemispheric temporal and parietal damage. The training is indicated for clients with lesions in this area, with diffuse brain damage or low intellectual abilities. The training is less suitable for clients with severe intellectual impairment or distinct attention deficit disorder.
On the screen, several objects are displayed which have to be compared to an object on the edge of the screen. The client has to find the object matching the “comparison picture” in every detail. Regarding the corresponding picture in the matrix, the “comparison picture” in the plane is rotated.
Geometric figures like triangles, squares, hexagons, etc. are used as objects. In high levels of difficulty, the training material becomes more complex up to concrete objects and maps.
Attention disorders (functionally and organically caused) after acquired brain damage. They are found in 80% of all persons affected by stroke, TBI, diffuse organic brain impairments (e.g. caused by chronic alcohol abuse or intoxication), as well as in other diseases of the central nervous system. Suitable for clients with disorders in attention and concentration and for children aged 11 and up.
A picture shown separately on the screen has to be compared to a matrix of pictures. The client must find the picture in the matrix matching exactly the “comparison picture”.
A total of 77 picture pools are available, each with 16 colored illustrations. All pictures are optimized concerning visibility and differentiability. According to parameter settings, either concrete objects (fruits, animals, faces etc.), geometric objects (circles, rectangles, and triangles of different size and order) or letters and numbers are displayed.
Disorders in divided attention occur with almost all diffuse brain damages (caused by e.g. intoxication or alcohol abuse) as well as with local damage of the right hemisphere, especially of parietal parts. Affected clients have difficulties in focusing attention to multiple objects at the same time. Also suitable for children aged 11 and up.
On the lower part of the screen, a driver’s cabin is shown. Thus, the client can observe the railway like looking through the windscreen of the driver’s cab. He must react to the elements of the cabin and to relevant objects on the railway.
The driver’s panel contains a speedometer, a so-called “Deadman’s lamp” and the “emergency stop lamp”. On the speedometer, a “target speed” is set that the client must keep. As soon as a lamp lights up, the client has to press the corresponding button on the RehaCom Panel (e.g. the stop button). If a relevant object appears on the railway, the client also has to react to it (e.g. stopping at a red signal).
Disturbances in focussing on certain aspects of a task, such as reacting quickly to relevant stimuli while ignoring irrelevant stimuli. This occurs in 80% of all patients after stroke, TBI, diffuse organic brain impairment (e.g. as a result of chronic alcohol abuse or intoxication) as well as in other diseases of the central nervous system. Also suitable for children aged 10 and up without significant developmental deficits.
Training Task and Training Material
On the screen, the view through the windscreen of a car as well as at the car’s dashboard is simulated. On the left, the speedometer is shown. A green area marks the speed the client should drive. For accelerating the car, you push the arrow key up, for slowing down push the arrow key down. There is a display for the way to go and for the expired time. The aim is to drive a certain distance within a limited time. Irrelevant as well as relevant objects move towards the user. Additionally acoustic stimuli are presented.
Constructional apraxia is mainly caused by parietal lesions. For managing the tasks constructive abilities, attention and memory performances are needed. Therefore, these cognitive functions are also demanded and trained. The training is indicated for clients with light or medium performance loss in the visuo-constructive field or with generalised functional disorders. This performance decrease is often found in diffuse organic brain damage caused by intoxications, alcohol abuse, etc. The training is particularly suitable for clients with serious apraxia, amnesia, and concentration disturbances.
The training is made like a puzzle. At the beginning of a task, a picture is shown with which the client has to memorise as many details as possible. Once the client presses the OK button or after a defined time, the picture is divided into a certain number of puzzle pieces and has to be reconstructed.
For this module, photographs and drawings are used, e.g. houses, faces, everyday objects or paintings. The pictures appear on the screen in very high resolution.
Impairment of memory occurs both after brain damage and after psychiatric illness. A distinction is made between different forms of memory (e.g. working, short-term, long-term memory). In most cases, the absorption and permanent storage of new information is disturbed, while the retrieval of already stored information is preserved. For affected patients, memory deficits often have serious consequences. These can be reduced by training, but above all by teaching compensation strategies.
Disorders of the working memory after brain damage due to stroke or TBI. The training module can be used for training the visuo-spatial sketchpad for short-term storage of visual impressions, for training the phonological loop for storing nonverbal information, and for training the central executive for linking information to the long-term memory. Since non-verbal material is used, the training is suitable for persons aged 10 and up.
The client has to memorize and manipulate an increasing number of cards. The content to be memorized can be presented visually or acoustically. Initially, the client only has to memorize the items. In higher levels, additional tasks influence the memory process. Thus, this task trains not only the working memory, but also accompanying abilities such as problem solving, reasoning, deductive reasoning, speech comprehension, calculation performances, and intelligence.
For the training, a complete deck is used. Training material is completed by diverse distractors on the cards, animated distractors for training the resistance to interference as well as graphics for increasing the performance feedback.
The training is suitable for clients with light and moderately severe disorders of learning abilities.
The task is to memorise terms that are displayed on the monitor. These are either presented as pictures or as words. With the help of an offered learning strategy (visualisation and storage on a body route, or visualised writing of a word) the terms have to be memorised and recognised after a simple distraction task.
Approx. 200 objects are displayed as high-resolution photos or words in 18 levels. The two different learning strategies are taught as tutorials.
All memory disorders or impairments for verbal and nonverbal contents. Amnestic syndromes can be observed for all diffuse cerebro-organic diseases (dementia, intoxications, chronic alcohol abuse, etc.) as well as for all left-sided or bilateral lesions of the medial or basolateral limbic lemniscus. Furthermore, vascular diseases, TBI or brain tumors in prefrontal, temporal or parietal cortical areas can lead to memory deficits.
In the so-called “memorizing phase”, a variable number of cards (depending on the level of difficulty) with concrete pictures or geometric figures are displayed on the screen. The client has to memorize the position of the pictures. After a preset time – or manually by pressing the OK button – the pictures of the matrix are hidden (turned face down). The client must find the picture matching the one indicated on the right side of the screen.
Altogether, 464 pictures of concrete objects, geometric figures, and letters are available. The number of simultaneously displayed cards varies from 3 to a maximum of 16.
Suitable for clients with visual prosopagnosia where the ability to recognize faces and to connect meaningful associations to them is impaired or lost. The problem can also be related to memory components that are responsible for remembering faces. The training is indicated for all clients with right-sided or bilateral lesion of the temporal lobe of different aetiology in which the mentioned impairments are observed.
During "learning phase", the client has to memorize a specific number of faces. Then they must pick these faces out of a ‘line-up’ of different faces. In higher levels of difficulty, a name and a profession are also shown. The client has the task now to find out the face associated with the name or the profession.
A total of 47 persons have been photographed from four different directions. The pictures reach photo quality. It is possible to add photos from the client’s environment via an integrated editor.
Impairment of vocabulary and reduced recognition performance, especially for clients with beginning amnestic syndrome. This occurs in persons with diffuse cerebroorganic damage and left hemispheric or bilateral lesion (especially of the limbic lemniscus with damage of the thalamic parts). Also suitable for clients with functionally caused impairments and for children aged 11 and up.
During the "learning phase", the client has to memorize a list of words (from 1 up to 10 words). With an increasing level of difficulty, the number of words in the list as well as the difficulty of the words grows. The words presented during the “learning phase” must then be selected from a number of different (irrelevant) words.
The words appear big and clearly visible on the screen. The movement of the words across the screen happens continually and fluently. The speed of the words “rolling by” can be adapted.
All memory disorders (especially disorders of the working memory) for verbal and nonverbal contents. The training module is also suitable for clients with impaired ability to name objects as well as with difficulties in conceptual classification (organically or functionally caused). With average vocabulary, this module is applicable for persons aged 11 and up.
At the beginning, pictures of concrete objects are shown. The client has to memorize the terms of these objects. The client completes the “learning phase” by pressing the OK button. After that, different terms move by on the screen from the left to the right. Whenever the term for an object shown during the learning phase passes through the marked area, the client must press the OK button.
About 200 pictures of concrete objects are used, of which 100 objects have a high classification safety. It is possible to adjust the speed of the terms moving by. This ensures that clients (and children) with a different speed of reading can use this module for training.
Disorders or impairments of the short-term or mediumterm verbal memory. They might occur in almost all diffuse brain damage (dementia, alcohol abuse, etc.) as well as in bilateral or left-hemispheric lesions of different aetiology. The training can also be used to improve memory performance in children aged 11 and up.
A short story is shown on the screen. The client should memorize as many details of the story as possible (names, numbers, events, objects). The learning phase is completed by pressing the OK button. After that, the client must answer questions about the content of the story.
More than 80 short stories are available. Depending on the setting, either the computer or the therapist selects a story for the client. An extension of the pool of stories is possible by using an integrated editor.
Executive Functions Training
Executive functions is a collective term for various higher order mental processes associated with action planning or goal-oriented behavior. Patients with deficits in the executive functions show difficulties in planning and adhering to rules, often have little sense of social norms and problems in suppressing undesirable behaviour. Executive functions are closely linked to the frontal brain. Neurological diseases or injuries of the frontal brain as well as psychiatric diseases (e.g. schizophrenia) show abnormalities here.
Deficits in working memory and difficulties in concept development and action planning as a result of TBI, stroke, cerebral tumor surgery or cerebral haemorrhage. The module can also be used for maintaining the mental performance of elderly people as well as for children aged 11 and up. Not suitable for clients with attention deficits.
Client gets a shopping list of articles that he has to look for in a supermarket and put into a trolley. When all articles are in the trolley, the client can leave the supermarket by using the “cash” button. Beyond a certain level of difficulty, additional demands are made on the client’s mathematical abilities (a certain amount of money is specified, the products are marked with prices, etc.).
The training module currently uses more than 100 articles illustrated photo-realistically (food, household objects, etc.). These articles appear on shelves from which the client must choose them. The training programme disposes of a voice output, which means all articles are named when selected.
Two shops can be chosen: supermarket or hardware store.
Disorders of cognitive functions, especially of planning skills. The ability to plan and to organise everyday life is one of the most complex human skills. It can be affected by any brain damage, especially by damages of frontal structures or diffuse cerebral damages. The module Plan a Vacation can also be used for training memory skills. It is not recommended in very heavy amnestic disorders. The presence of a therapist is strongly recommended for seriously impaired clients.
The training task is to prioritize a list of tasks in optimal order. For this purpose, a map is shown on the screen with different buildings and roads from bird’s-eye view. Clients have to “visit” one building after another according to their time schedule and enter them in their diary. There are three different request types:
- Note priority
- Minimise travelling time
- Maximise the number of completed tasks
Plan a Vacation provides an almost endless number of different tasks since new combinations of tasks can be generated randomly.
Acquired damage of the frontal lobe, where impairments in abstract logical thinking can be observed. Those losses of performance often occur in clients with chronic alcohol abuse, dementia, and stroke, as well as schizophrenia. The training can also be used for children aged 12 and up, provided that they are capable of comprehending simple abstract-logical conclusions.
From several symbols (pool of answers), the client has to find out the one that correctly continues a given sequence of symbols.
A sequence of symbols (circles, triangles, squares, etc.) of different shape, color, and size are displayed on the screen being in a regular relation to each other. If the answer is wrong, special pieces of information about the type of error (shape, color, and/or size) are given.
Impairments of arithmetic cognitive skills. Disorders of cognitive functions can be diverse. They range from reduced basal disorders when estimating sizes and quantities to problems in applying basic arithmetic operations and difficulties in solving complex mathematic problems.
The training has a high diversity of tasks. The client starts with simple comparisons of size or quantity and with sorting tasks. After that, basic arithmetic operations adding and subtracting are trained, both mentally and in writing. In higher levels of difficulty, the client is instructed in very realistic situations to handle money. He has to offer the exact amount of money, give change or check their own change. Finally, multiplication and division tasks are available.
Size and quantity tasks are trained using pictures of simple objects until the client passes on to calculations with numbers. Written addition and subtraction is shown in small numbers in the carry over. For money handling pictures of realistic banknotes and coins are used.
Visual Field Training
Visual field failures are frequent side effects after stroke or hypoxic brain damage. The visual information is transmitted from the eye via the optic nerve and via the visual radiation to the occipital lobe for processing. If these nerve tracts are damaged, the required visual information no longer arrives there and cannot be processed - resulting in a visual field failure. Those affected have particular difficulties with reading and visual orientation. Targeted training can significantly reduce the effects on everyday life.
Impairments in visual exploration on one half of the visual field. They often occur in neglects or extended cerebral infarcts in the area of distribution of the middle or posterior cerebral artery. Other organic brain disorders can also cause these functional impairments. Suitable for persons aged 8 and up.
The client can see a horizon on the screen with a very simple structured landscape. In the middle of the screen, a big sun is displayed. At irregular intervals, an object appears left or right of the sun. Whenever the client notices an object, he has to press the corresponding reaction button (left or right arrow key of the RehaCom Panel).
On the screen, a horizontal line is visible. At easier levels, a sun is indicated in the middle for a better orientation of the client. In irregular temporal intervals, different objects or symbols, e.g. animals, cars, bikes, motorcycles etc., appear on the horizontal line. At higher levels of difficulty, the symbols become smaller, the horizon disappears, and additional deflecting stimuli are shown and fade again.
The training is recommended for clients with homonymous visual field impairments, impaired visual exploration or visual neglect.
There are four different types of tasks. In the task „Search for missing numbers“, numbers scattered around the screen must be searched one after the other and the missing numbers must be identified. In „Search objects“, certain objects embedded in scenes must be found and clicked on. In the task „Search and count object“, the number of presented objects must be determined. The task „Superimposed figures“ is used for training the detailed analysis. Simple figures are presented superimposed. The patient must decide which basic forms the superimposed figure consists of.
There are many detailed images and scenes available for the „Find object“ and „Find and Count objects“ tasks. The task „Superimposed figures“ contains many simple geometric figures that are differently colored or black.
Neurological visual impairments such as Hemianopia and resulting perception, processing disorders, reading and attention problems, and visual neglect.
A fixation point is displayed on the screen. When a light stimulus appears, the client should respond by pressing a key (mouse click, keyboard, etc.). The client has to react when the fixation point changes colour and respond to every visible light stimulus. If the client misses a stimulus, it will disappear, and then reappear.
The light stimulus is displayed by using a specific algorithm. The stimuli will move and appear in different positions on the screen, including close to, and over, the border of the impaired side of the visual field. Repeated and intensive activation of this area will encourage a positive change in the visual field over time. Audio feedback/signals will provide feedback to help sustain the client’s attention. RESE is auto-adaptive, changing the difficulty according to the client’s performance. It is recommended to use the chin rest to stabilise the head, maintaining a consistent distance from the screen.
Human movement is based on the coordination of different motor, visual and proprioceptive systems. In numerous everyday "fine motor" activities such as using cutlery or tools, the exact coordination of eyes, head and hands is essential. During motor activity, visual control plays an essential role - especially in the learning stage of movement sequences. Brain damage to the motor or sensory area, but also to the spatial or visual system, can result in serious difficulties of visuomotor function.
Damages of the motor cortex (frontal lobe) causing deficits in the control of fine motor skills. They can be observed most clearly in coordination disorders of hand and finger movements. In many cerebro-organic diseases and damages, e.g. cerebral insults, haemorrhage, spacious tumours, craniocerebral trauma, etc., visuo-motor functions are also affected. The training is indicated for all disorders of fine motor skills.
On the screen, a circular disc (rotor type abstract) and a dot are shown differing strongly from each other due to different colours. The client has to move the dot into the circular disk by means of the joystick or mouse. Then the disk starts moving along an unpredictable track. The client tries to follow the movement with the joystick (represented by the dot). In “rotor type concrete”, e.g. a flower is used instead of the circular disk and a beetle or a bee replaces the dot.
For operating the training, a huge circular disk describing a given movement, and a dot that can be moved with the joystick or mouse, are used. In order to make the training more variable and interesting especially for children, 25 pairs of pictures are used as rotor/cursor in the “concrete” mode.
Which screening modules does RehaCom offer?
The RehaCom Screening modules were created to assist therapists in choosing which training modules to best use with their clients. RehaCom is a therapy tool so the screenings are not intended to replace comprehensive diagnostics, but rather guide the therapist into prescribing the most effective module for their deficit - based against any deviation from the norms. The results of the screenings are displayed graphically along a bar chart which shows your client’s results alongside aged matched norms. You are also able to dig much deeper into the specifics of the task - although this is not necessary to do. If the screening has identified a deficit, RehaCom will recommend a training module to commence with. Screenings can be performed every few weeks to measure progress and to adjust the prescription if necessary.
In this module the tonic alertness, the phasic alertness, and intrinsic alertness are measured. The first stage of the test is to measure the response time while the user has to push a button as soon as a fully filled square appears on the screen. In the second stage, response time to the same visual stimulus is measured while a signal sound is heard before the square appears. The client has to wait until the square appears on the screen to push the button, not reacting on the sound.
Selective Attention (GONT)
This screening measures the ability to react fast on certain stimuli and to inhibit reactions on other (GoNogo paradigm). In everyday life it is essential to suppress reactions in favour of internally controlled behavior. The mean reaction times and errors are recorded.
The field of vision can be examined binocularly or monocularly using the screening campimetry. In contrast to the three-dimensional perimetry, the campimetry is two-dimensional. In the test, stimuli appear on the screen at random intervals at different positions. While the client keeps his gaze fixed on a central point on the screen, he should perceive these stimuli and confirm them as quickly as possible with the answer button. To control the fixation, the fixation point changes its colour or shape at irregular intervals. The change of colour should also be confirmed as quickly as possible with the answer key. Before performing the test, parameters such as screen size, distance from eye to screen, size of the measuring matrix, as well as the eye to be tested, can be set.
Divided Attention (GEAT)
In this module the client has to solve a visual and an auditive task simultaneously. One trial contains 80 visual stimuli with about 15 % relevant stimuli as well as 160 auditive stimuli with approximately 10 % relevant stimuli. For a visual as well as an auditive stimulus, the client has to push the same button on the keyboard. Both tasks start at the same time.
Working Memory (PUME)
In this module, it will be determined the visual-spatial memory span and the visual-spatial memory function. It is also used for testing the implicit visual-memory learning and the working memory.
Spatial Numbers Search (NUQU)
In this module basal cognitive performance and selective attention are tested. In addition the test can be used for screening a visual neglect. The basal cognitive performance is associated in literature with perceptual speed. By selective attention is meant the ability to turn themselves to the relevant stimulus of a stimuli constellation and ignore irrelevant stimuli of this constellation, over a short time period. This task is deduced from the well-known “Digits-Connection-Test” developed by Oswald and Roth 1987.
Memory For Words (WOMT)
This screening measures the client’s ability to memorise and recognise words. Firstly, the client is shown two words at the same time and must indicate whether the words are different or identical. In the second stage, the client will be shown one word at a time on the screen. The client must indicate whether this is the first time the word has appeared, or whether it has appeared before. This module requires the client to use their long-term memory and recognition methods to complete successfully.
Logical Reasoning (LOGT)
This screening measures the client’s ability to complete a sequence. It examines if the client can identify irregularities and is able to draw logical conclusions. Visual material similar to intelligence tests used by Weiss, Cattell, Horn Sturm and Melchers is used. A visual sequence of four blocks will be displayed on the screen. They must complete the sequence correctly by selecting a 5th block from the options available. This screening is an important part of executive function diagnostics.
Visual Field (VITE)
This screening measures the visual field and fixation accuracy of the client. In many hospitals, clinics and outpatient facilities, assessment of the visual field is difficult. This module provides them with an accurate tool. The client will be asked to focus on a circle in the centre of the screen. He must indicate when he sees that circle fills with colour. He must also indicate when a line appears from this circle with another circle on its end. He must not react if there is no circle at the end of the line. The results can be printed as a visual field map.
Who can use RehaCom?
RehaCom is used extensively by neuropsychologists, occupational therapists and clinicians in rehabilitation centres, hospitals and clinics (both public and private). RehaCom is now used in 95 % of German rehabilitation clinics and extensively across the globe including most of Europe and Asia.
Increasingly RehaCom is being used over the internet. Therapists can prescribe modules for their patients to do, monitor progress and change their tasks using remote supervision. This is particularly favoured by Occupational Therapists working in the community who have a wide area to cover, or wish to enhance their patient’s therapy.
RehaCom has a wide range of applications but is used most commonly by those with acquired brain injury, including stroke. It can be used from the most acute stages, all the way through their recovery. RehaCom can also be useful for those with MS, ADHD, Depression and Visual Field difficulties.
There are no contraindications to using the RehaCom system.
Which experiences with RehaCom exist?
Report by Mr B., 1+ Year RehaCom User
Mr. B, 58, suffered a stroke in March 2009, while working in the office of his sign company. He was rushed to the local hospital, and admitted into the intensive stroke unit. After 4 weeks he began inpatient treatment at a neurarehab centre.
Initial screening indicated deficits in Attention/Concentration and Visual Field. A therapy plan was developed, including training with specific RehaCom therapy modules, thirty minutes per day, four times a week. Mr. B commented ,"I feel like cells in the affected area of my brain are starting to reconnect". After 5 months, Mr.
B returned home, and the RehaCom tool went with him. "lt's like physical exercise - you have to do it regularly or you become unfit. lt's the same with the brain - even more so once you have had a stroke. 'Use it or lose it', as they say."
Mr. B now trains daily at home with RehaCom. His therapist reviews his progress remotely, and updates his therapy regimen every 2 weeks. His concentration and attention have improved dramatically, and he can now watch TV and even read books. When asked if he would recommend RehaCom to others, he smiles: "Absolutely! Without question. I have tried several brain-training products , but none with this advanced capability, and matched to my particular weaknesses".
Reflecting back, Mr. B says, "At first I was depressed when I started working with RehaCom - I couldn't complete even the lowest level exercises. But then I started flying through the difficulty levels, and I became more and more enthusiastic. I think the depression at first was just a natural consequence of RehaCom forcing me to recognize my limits."
Report by C. Wartenberg., 12-Year RehaCom User
Magdeburg Neurological Rehabilitiation Center
Our center offers a wide range of inpatient and outpatient therapies for neurological rehabilitation. Upon intake, cognitive deficits are assessed and a cognitive rehab therapy plan is developed. Most of the patients show deficits in attention, concentration, memory, visual neglect, executive functions, spatial and visual perception, and other visual field deficits. All of these can be trained using the RehaCom software.
The clinic has 7 therapy computers, plus a projector for visual field training. After an introduction, patients work independently with RehaCom. Training can be customized to the specific deficits and abilities of any patient, and the software tracks performance for each task, adjusting the level of difficulty accordingly. The therapist monitors the training, and can work with multiple patients at once, concentrating on those who need the most support.
Training results are saved automatically and reviewed afterwards. For patients with more severe impairments, we provide individual training. With an experienced therapist, the RehaCom software can be used to train numeraus, very basic cognitive functions.
Our RehaCom database is stored on a network server, so patients can work at any therapy station in the clinic. Patient data and training results are instantly available, and each training session begins where the last one left off. The new training results are then stored in the centralized database.
I have worked with RehaCom now for 12 years. and during that time I have watched the system develop. The company has always been open to suggestions, and looking for ways to improve the software. Patients with cognitive disorders are a difficult clientele, but of all systems I know, RehaCom is the most customizable to our patients needs.
How can I get to know RehaCom?
NYU Langone Health is the first facility in the USA to use the RehaCom Home Training of HASOMED GmbH. The project at the medical education and research institution is led by Prof. Leigh Elkins Charvet.
Under the theme “Innovative Rehabilitation in Asia Oceania”, the diverse disciplines of Physical & Rehabilitation Medicine from the present to the future will be in focus. With emphasis on innovation, distinguished speakers, professionals and researchers from various countries will present their latest findings from on-going and completed clinical trials.
Which version of RehaCom is current?
RehaCom is currently available in version 6.9. With this version, the various training modules have been changed and the functional errors have been fixed.
System requirements for RehaCom 6.9
Intel Core i3, i5, i7 6th generation or equivalent
4 GB RAM
DirectX 10.1, Intel HD530 or higher (at least 2 GB graphics memory)
100 GB free
Size according to patient requirements; minimum resolution 1024 x 768 px for step size 100 %, with a font size of 120 % 1024 pixels are required vertically
to install the software (alternatively via USB/network)
RehaCom panel, RehaCom keyboard
Printer, Mouse, Speaker
Which product options of RehaCom are available?
Depending on the country you are based there may be a number of different package configurations available to you. The main thing to consider when you want to use RehaCom is whether you wish to use it online to remotely supervise your clients. The main differences are:
- Usually stored on a panel or dongle
- Fixed term unlimited use
- Unlimited therapists and clients
- No remote training ability
- Activated by code over the server
- Available on a Pay-As-You-Go basis
- Unlimited therapists and clients
- Full remote training and supervision ability
There are also complementary products for use with the RehaCom system:
A special custom panel or type of keyboard to allow clients with severe motor impairments to use the software and interact with the computer.
Intended for visual field related training is the chin rest. This product allows the client to stay in a comfortable and reproducible position in front of the monitor, therefore maintaining the same viewpoint throughout the training session.
If you would like more information about RehaCom or purchase options, please contact our sales partners in your area.
What are the frequently asked questions about RehaCom (FAQ)?
Before you install a new version or update, you must back up the RehaCom database.
You can reach the database backup through System → Backup → Backup / Restore.
We recommend that you back up the RehaCom database periodically.
You can reach the database backup through System → Backup / Restore
Then select Backup or Restore from the tabs on the pop up.
If you are connected to the internet you can update your current version through Help → Update RehaCom.
Firstly, remove and reconnect the dongle from the computer. Then check if the correct license mode is selected by going to "System" -> "License
mode" -> “Licensing via patient’s panel or dongle" to select the dongle driver. If this does not resolve the issue, see below.
With Installation DVD
Remove the dongle from your PC. Insert the RehaCom DVD into your computer's DVD drive. The DVD should autostart in your PC. Click "RehaCom installation". The "RehaCom Setup" window opens. Click the button "dongle driver" and follow the installation instructions.
If the autostart function of your computer is disabled, right-click on your DVD drive and select "Open". You will now see the contents of the RehaCom DVD. Scroll down and open the file "RSetup" (application) with a double click. It opens the "RehaCom Setup" window. Click the button "dongle driver" and follow the installation instructions.
Even if there is an alert that the driver is already installed, you should continue with the installation. After installation is complete, the computer should be restarted and the dongle reconnected to the PC. When you restart RehaCom you should go to "System" -> "License mode" -> “Licensing via patient’s panel or dongle" to select the dongle driver.
Without Installation DVD
If you do not have an installation DVD please contact your local distributor.
Plug the panel into a USB port on your computer. Restart the computer. Restart RehaCom.
Then check that the correct license mode is selected by going to "System" -> "License mode" -> “Licensing via patient’s panel or dongle" to select the panel driver.
If this does not resolve the issue see below.
With Installation DVD
If the panel is still not recognised, insert the RehaCom DVD into your computer's disc drive and run automatic hardware detection ("Start" in the Windows menu bar -> "Settings" -> "Control Panel" -> " Hardware ").
Restart RehaCom. Select "System" -> "license mode" -> "Licensing via patient’s panel or dongle".
Without Installation DVD
If you do not have an installation DVD please contact your local distributor.
You can find the manual for each of the therapy modules:
- at the RehaCom Media Center below
- in the library under Manuals
- on RehaCom DVD in "...Manualsdirectory English"
- after installation in RehaCom folder (AUFM, GESI, VIGI ...) on your hard drive
- in RehaCom itself you can find help by pressing F1, or using the help button on any screen
Your trial has ended or licenses have expired
After the trial period has ended, or you have used all of the time available on your licenses, you will only be able to access a limited portion of the software. You must now purchase a license in order to access the full software. You can check the status of your licenses by going to "System" -> “License"
Your dongle/panel is not connected
Ensure that your license dongle or panel is connected to your computer. Then, in the RehaCom startup window select "System" and then "licensing mode". Now select "Licensing on patient's keyboard or dongle".
If you do not have a RehaCom panel, you can use your own keyboard as an input. The appropriate keys are marked in the image below. For some modules you may also use the mouse or touchscreen as an input. You can select this in the module Parameters, or check the module Help for details.
With some modules it is possible to use your own image an text files. You should refer to the Module Help for information.
Memory for Faces/Physiognomic memory:
You can edit or change a person's name, occupation, telephone number, gender, and the associated images. You do this in RehaCom main window by selecting the therapy module "Face Memory", click on "Parameters" then click "Edit".
You can include your own "stories". Select the module from the main window, then “Parameters”, then “Edit”.
You can edit a great deal within this module.You can edit or add to both the questions and answers, as well as integrate your own pictures or sound files.
If you want to use your own pictures, please contact Support for information.