Development of a computer-based cognitive training game and usage feasibility with Thai stroke patients
Authors:   Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai Province, Thailand, Tungjan Patchanee , Corrado Riccardo ,   Department of Information and Communications Technology, American University of Phnom Penh, Phnom Penh, Cambodia., Munkhetvit Peeraya ,   Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai Province, Thailand.
Published: March 2022

Background: Cognitive impairments are common sequelae found in patients after a stroke event, leading them to necessitate long-term care. Currently, there are two common cognitive approaches, namely conventional intervention, and technology-based intervention, with the latter having become extensively used, especially in developed countries. In a developing country like Thailand, there is still a clear lack of usage of computer-based cognitive training and there is still a lack of research focus on investigating the feasibility of its usage with Thai stroke patients. Objectives: This study aimed to develop a computer-based cognitive training game and investigate its feasibility for being used with Thai stroke patients Materials and methods: This study was a developmental research design consisting of two phases. Phase one involved the development, content validity, and pilot use of our computer-based cognitive training game. The game contents were examined by three experts, who are occupational therapists with more than 5 years of experience with cognitive rehabilitation for stroke patients, to assure content validity. Phase two instead, involved the process of investigating the feasibility of using the newly developed computer-based cognitive training games with Thai stroke patients. Participants in this study were stroke patients with cognitive impairments identified with the Mental State Examination (MSET10) and who were familiar with the technology. Fourteen participants were asked to rate their overall experience with the newly developed game, the design, the convenience aspects, and the portability of the training material, by using The Test of Satisfaction on Computer-based Cognitive Game. Demographic characteristics and user experiences were analyzed by descriptive statistics. Results: The newly developed computer-based cognitive training game, called CoWMeG, is a game-like training using simulated real-life activities whose design is based on the Thai ecosystem, and it consists of ten games. The game's contents involve working memory tasks, such as verbal, visuospatial, executive, and process speed skills-related tasks. Each game was designed to have different difficulty levels with each level consisting of three subsequential screen pages (i.e., instruction, playing, and scoring screen pages). Most of the participants rated their user experiences with CoWMeG as very satisfied, corresponding to 84.2 percent of the total answers on satisfaction. Conclusion: In accordance with the obtained results, the newly developed computer-based cognitive training game, named CoWMeG, may represent a feasible tool to be used with Thai stroke patients who have cognitive impairments.