New tools for cognitive and motor rehabilitation: development and clinical validation

Nervous system disorders are associated with cognitive and motor deficits, and are responsible for the highest disability rates and global burden of disease. Their recovery paths are vulnerable and dependent on the effective combination of plastic brain tissue properties, with complex, lengthy and expensive neurorehabilitation programs. This work explores two lines of research, envisioning sustainable solutions to improve treatment of cognitive and motor deficits. Both projects were developed in parallel and shared a new sensible approach, where low-cost technologies were integrated with common clinical operative procedures. The aim was to achieve more intensive treatments under specialized monitoring, improve clinical decision-making and increase access to healthcare. The first project (articles I – III) concerned the development and evaluation of a web-based cognitive training platform (COGWEB), suitable for intensive use, either at home or at institutions, and across a wide spectrum of ages and diseases that impair cognitive functioning. It was tested for usability in a memory clinic setting and implemented in a collaborative network, comprising 41 centers and 60 professionals. An adherence and intensity study revealed a compliance of 82.8% at six months and an average of six hours/week of continued online cognitive training activities. The second project (articles IV – VI) was designed to create and validate an intelligent rehabilitation device to administer proprioceptive stimuli on the hemiparetic side of stroke patients while performing ambulatory movement characterization (SWORD). Targeted vibratory stimulation was found to be well tolerated and an automatic motor characterization system retrieved results comparable to the first items of the Wolf Motor Function Test. The global system was tested in a randomized placebo controlled trial to assess its impact on a common motor rehabilitation task in a relevant clinical environment (early post-stroke). The number of correct movements on a hand-to-mouth task was increased by an average of 7.2/minute while the probability to perform an error decreased from 1:3 to 1:9. Neurorehabilitation and neuroplasticity are shifting to more neuroscience driven approaches. Simultaneously, their final utility for patients and society is largely dependent on the development of more effective technologies that facilitate the dissemination of knowledge produced during the process. The results attained through this work represent a step forward in that direction. Their impact on the quality of rehabilitation services and public health is discussed according to clinical, technological and organizational perspectives. Such a process of thinking and oriented speculation has led to the debate of subsequent hypotheses, already being explored in novel research paths.

Desenvolvimento de um sistema para planeamento e controlo da produção

Atualmente o sector industrial está inserido num mercado cada vez mais competitivo, onde é exigida uma estratégia empresarial que possa garantir a sua permanência e destaque no atual mercado. Por esta razão, um planeamento e controlo da produção adequado torna-se essencial para o bom funcionamento de uma empresa. Através destes sistemas é possível atuar de forma positiva na produção, rentabilizando-se o sector produtivo da empresa que contribui para o aumento da qualidade de serviço e também para o crescimento económico da empresa. Com um planeamento da produção adequado, uma organização dispondo das mesmas capacidades, é capaz de produzir quantidades iguais num menor intervalo de tempo. Por outro lado, um controlo da produção preciso é imprescindível para o fornecimento da informação correta quando necessária. No sentido de otimização, uma empresa apresentou algumas sugestões de melhoria a nível do planeamento e controlo da produção. Este trabalho surge assim com o intuito de dar resposta às propostas apresentadas. Para tal, no desenvolvimento desta dissertação, criou-se uma ferramenta dotada de dois algoritmos e um sistema de controlo para aquisição de informação de forma automatizada. Em suma, o sistema proposto apresenta a capacidade de construção de boas soluções para o planeamento, conciliada com um sistema de aquisição de dados bastante prático e e caz. Mantendo sempre a exibilidade necessária para um sistema deste género.