Effectiveness of innovative executive function training: Horse- Racing Group (an activity with variable-ratio schedules reinforcement) for people with mild cognitive impairment: A Pilot Study

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Abstract Description
Abstract ID :
HAC263
Submission Type
Authors (including presenting author) :
CHIU YH(1), LEUNG LF Teresa(1)(2)
Affiliation :
(1)Occupational Therapy Department, Prince of Wales Hospital
Introduction :
The prevalence of MCI ranges from 3% to 19% in people older than 65 years old (Simon, Yokomizo, & Bottino, 2012). Executive function (EF) is found to be significantly declined in people with MCI (Albert, 2011). EF training may be time-consuming and needs prolonged concentration. Adding reinforcing elements to a potentially boring task may enhance the intrinsic motivation and make the task more interesting. Horse racing is a game with variable-ratio schedules reinforcement. The reinforcement (winning the game) is given after variable amount of non-reinforced responses. Due to lack of cognitive training in Prince of Wales Hospital (PWH) target mainly in EF of patients with MCI, horse-racing group may be an alternative training program.
Objectives :
The aim of this study was to evaluate the effectiveness of Horse-Racing group for people with mild cognitive impairment (MCI)
Methodology :
Horseracing group has been organized regularly in the OT Department of PWH since May of 2016. Patients attended a 60-min training session once a week for 6 weeks and home based training for 8 weeks. Patients in the waiting list of the horse-racing group attended 6 computer training session (60 minutes each session once a week) and 8 week home based training with tablet. A total of 30 OT progress reports of the people with MCI who graduated in this program before Jan, 2019 were selected by convenient sampling. Pre-group assessment, post-group assessment and 8-week follow-up assessment of each OT progress report were extracted for analysis During the assessments, executive functions of the patients were measured by Digit Span (DS), Color Trail Test (CTT), Clock Drawing Test (CDT), Key Search Test (KST) and Frontal Assessment Battery (FAB)
Result & Outcome :
15 patients completed computer training (age 70.8 [5.9] years, 48% female) and 15 patients completed horse-racing group (age 70.7 [5.5] years, 45% female) with MCI (MoCA score between 7th and 16th percentile) were reviewed. Both Horse-Racing group and computer training had statistically significant higher scores in DS, CDT and FAB in post intervention assessment but no statistically significant improvement showed in CTT and KST. The improvements in DS, CDT and FAB were maintained after 8 weeks in Horse-Racing group but not in computer group. Most of the patients showed good compliance in home program after horse-racing group The Horse-Racing group may be an effective alternative training for people with MCI. Future studies with more comprehensive outcome measures may help to form evidence-based cognitive training for patients with MCI.
Occupational Therapist II

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