NSI
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Questions and Answers

What is the correct way to set up the patient's profile in NSI?

  • First name is their birth year and last name is their full name
  • First name is their first two letters of the first name and first letter of the last name, last name is their birth year
  • First name is their last name and last name is their birth year
  • First name is their birth year, last name is the first two letters of the first name and first letter of the last name (correct)

    • How are the basic 4 of NSI?

  • Proactive, Reactive, Saccades 2, Tachistoscope
  • Reactive, Rotator 3, Saccades 2, Tachistoscope
  • Proactive, Saccades 1, Geoboard, Metronome
  • Proactive, Reactive, Saccades 1, Tachistoscope (correct)

    • Who does Geoboard help?

  • Patients with depression
  • Patients with eye pain
  • Patients with fatigue
  • Patients with dyslexia (correct)

    • Which would not be a way to increase difficulty for NSI?

    <p>Increase the size of the stimuli</p> Signup and view all the answers

    Which NSI section do we not use?

    <p>OPtokinetics 1</p> Signup and view all the answers

    During Go - no go, what must you click during set up if you want the patient to press on the outside of the center box if the two stimuli are different

    <p>Match</p> Signup and view all the answers

    During Tachistoscope, if you select "verbal" during the set up the patient will have to ....?

    <p>Hear words and tap them back in the same order they heard them</p> Signup and view all the answers

    Which is the hardest NSI thing for the patient to perform?

    <p>Depends on the patient</p> Signup and view all the answers

    How many levels of difficulty are there in the Wii balance exercise sections?

    <p>3</p> Signup and view all the answers

    What does selecting 'Trails' on the TV during the exercise do?

    <p>Records the pathway the patient is taking to get to the correct stimuli</p> Signup and view all the answers

    What does it indicate when the stimuli turn red during the balance exercises?

    <p>The patient has targeted a specific area for the right duration</p> Signup and view all the answers

    How is the time spent on each target determined during the exercise?

    <p>By the rehab choosing the setting during set up</p> Signup and view all the answers

    To get most stimuli in one quadrant, during set up you must

    <p>Press all of the quadrants except the one you want, the one you want will be white</p> Signup and view all the answers

    What happens if the stimuli persistence feature is enabled?

    <p>The stimuli will remain visible after being tapped</p> Signup and view all the answers

    Which exercise involves the patient recalling the position of a dot before indicating its location?

    <p>Memory Saccades</p> Signup and view all the answers

    What is the average timing for a tachistoscope session?

    <p>It is generally ran for about 2 min at a time.</p> Signup and view all the answers

    What is the N-Back (N-1) exercise?

    <p>You have the patient name the stimuli one behind the current one on the screen</p> Signup and view all the answers

    When preparing to start the balance targeting exercise, what must the rehab professional click in the LARP or RALP plane?

    <p>Empty squares</p> Signup and view all the answers

    Study Notes

    NSI Setup

    • Load patient profile, creating a new one if necessary, with a first name as the birth year and last name as the first two letters of the first name and first letter of the last name.
    • Turn on headphones and have the patient wear them.
    • Place the patient on a balance board that challenges but is not too difficult.
    • Adjust the distance between the patient and the TV so they can touch the top two corners of the screen without difficulty.

    Basic Training

    • Four primary modules in NSI: Proactive, Reactive, Saccade 1, and Tachistoscope.
    • Proactive Module
      • 25-35 stimuli, adjustable session length.
      • Central Fixation: patient taps the middle if it flashes, causing a distraction.
      • Stimuli type: default is circles, can be changed to numbers and letters.
      • Stimuli size: adjustable based on patient's visibility.
      • Location: generally both, but can be set to Central for young children or as instructed by doctors.
    • Reactive Module
      • Time: 0.1-0.2 seconds faster than Proactive module.
      • Settings are the same as Proactive module.
    • Saccade 1 Module
      • 20-30 stimuli, adjustable session length.
      • Central fixation: patient taps the middle if it flashes, causing a distraction.
      • Stimuli persistence: if enabled, stimuli don't disappear when tapped, and patient receives audio feedback.
      • Reverse sequence: if enabled, the stimuli order is reversed.
      • Stimuli size: adjustable based on patient's visibility.
    • Tachistoscope Module
      • Time: adjustable session length, generally 2 minutes.
      • Audio/verbal: one set of each.

    Advanced Training

    • Auditory/Visual Module (NSI Metronome)
      • Change settings to 1 minute, 60 BPM, auditory/visual, and level 2.
      • Patient taps circles in sync with anticipated beats, with green, red, and white circles as feedback.
      • Patient performs 4-4-8 breathing exercise simultaneously.
    • Visual Motor - Geoboard Module
      • Patient reproduces diagrams on the screen by drawing.
      • Start with simple diagrams and gradually increase difficulty.
      • Flip images horizontally or vertically to increase challenge.
    • Rotator 3 Module
      • Similar to Saccade 1, with a spinning background.
      • Adjust direction and speed as desired.
      • Patient tilts head to the right for counterclockwise (CCW) and left for clockwise (CW).
    • Memory Saccades Module
      • Patients remember location of dots and touch the correct location.
      • Memory Saccades 1 has three parts, and Memory Saccades 2 has two parts with auditory or visual distractors.
    • Quadrant Loading Module
      • Choose where stimuli will go on the screen.
      • Oftentimes, specific quadrants are weighted, e.g., 65 up and 65 right.
    • Dual Tasking Module
      • Patient performs cognitive tasks while standing on the balance board.
      • Tasks include math problems, rhyming with words, or synonyms/antonyms.

    Balance Training

    • Vestibular Balance Module
      • Select "Exp. 1 - Vestibular-Balance" and "Limits of Stability".
      • Set up the Wii Balance Board and ensure it's connected and ready.
      • Patient stands on the board and follows the red target, holding balance until it moves to a new spot.
      • Adjust time on target, difficulty level, and provide Trail feedback.
    • Balance Targeting Module
      • Select "Exp. 5 Balance Targeting" and "Balance Targeting 1".
      • Set up the Wii Balance Board and ensure it's connected and ready.
      • Choose stimuli type (circles, letters, or numbers) and set time on target.
      • Patient moves to targets following the stimuli sequence, with Trail feedback.
      • Rehab clicks squares in a LARP or RALP plane to select targets.

    Core Stability Training

    • Press lower back firmly onto the table to eliminate any arch or gap, ensuring proper alignment.
    • Focus on breathing deeply into the core rather than raising shoulders or tensing the neck.
    • Maintain form throughout the exercise; if form degrades due to fatigue, stop and take a rest.
    • Progression is key: once a position can be held for one minute without losing form, advance to a more challenging variation as demonstrated in the training video.

    NSI Setup

    • Patient profiles: New profiles use the birth year as first name and first two letters of first name plus first letter of last name as last name.
    • Patient engagement: Patients wear headphones and stand on a suitably challenging balance board.
    • TV setup: Patients should be able to reach and touch the top corners of the screen comfortably.

    Basic Training Modules

    • Proactive Module:

      • Session duration: Typically involves 25 to 35 stimuli.
      • Central fixation: If enabled, patients tap the middle circle when it flashes.
      • Stimuli types: Default is circles, often changed to letters/numbers alternating hands.
      • Visibility: Adjust stimuli size if needed.
      • Location settings: Usually both sides; children may require central position.

    • Reactive Module:

      • Timing: Adjust session speed to be 0.1 to 0.2 seconds faster than proactive results.

    • Saccade 1 Module:

      • 20 to 30 stimuli per session.
      • Central fixation function similar to proactive.
      • Stimuli persistence indicates correct tapping via sound only.
      • Option for reverse sequence and size adjustments for visibility.

    • Tachistoscope Module:

      • Duration typically set for 2 minutes.
      • Includes both audio and verbal stimuli sets.

    Advanced Training

    • Auditory/Visual Training (NSI Metronome):

      • Timing set for 1 minute with 60 BPM initially.
      • Patient taps circles with anticipated beat; colored circles indicate timing accuracy.
      • Incorporates 4-4-8 breathing during exercise; adjust BPM based on accuracy.

    • Visual Motor (Geoboard):

      • Patient reproduces diagrams, starting easy and progressing in difficulty based on performance.

    • Rotator 3 Module:

      • Involves spinning backgrounds; adjust speed and direction as instructed.

    • Memory Saccades:

      • Patients memorize dot positions and respond based on auditory/visual distractions.
      • Encourages cognitive retention while performing physical tasks.

    • Quadrant Loading:

      • Focuses on specific quadrants for stimuli, indicated by therapy instructions.

    • Dual Tasking:

      • Involves simultaneous tasks, enhancing cognitive and balance integration using dual challenges.

    Balance Training

    • Vestibular Balance:

      • Use "Exp. 1 – Vestibular-Balance" for monitoring stability.
      • Ensure Wii Balance board is ready and provide adequate space for patient movement.
      • Select "Trails" for visual feedback on patient movement accuracy.

    • Balance Targeting:

      • Utilize “Exp. 5 Balance Targeting” to help patients target various stimuli types (circles, letters, numbers).
      • Posture monitoring is crucial; ensure safety during back target exercises.
      • Time settings dictate duration of target engagement; adjust based on patient needs.

    NSI Overview

    • The Neurosensorimotor Integrator (NSI) is a system used for therapeutic training of patients.
    • NSI modules include proactive, reactive, saccade 1, and tachistoscope, with advanced training options available.

    NSI Setup

    • Create patient profiles using birth years and initials for names.
    • Patients must wear headphones and stand on a manageable balance board.
    • Position patients at an optimal distance from the TV by ensuring they can reach the screen's corners.

    Basic Training Modules

    • Proactive Module

      • Session length: 25 to 35 stimuli.
      • Central fixation requires tapping the middle when the light flashes.
      • Adjustable stimuli type and size to accommodate patient needs.

    • Reactive Module

      • Adjust the response time to be slightly faster than the proactive setting.

    • Saccades 1 Module

      • Session length: 20 to 30 stimuli.
      • Can enable fixation, persistence, and reverse sequence for added challenge.

    • Tachistoscope Module

      • Typical session duration is 2 minutes.
      • Includes both audio and verbal stimuli for engagement.

    Advanced Training Techniques

    • Auditory/Visual Training:

      • Settings include 1 minute duration, 60 BPM, with simultaneous four-part breathing exercises.
      • Accuracy over 80% allows for BPM adjustments to increase difficulty.

    • Visual Motor Tasks:

      • Geoboard tasks involve reproducing diagrams, increasing complexity over time.
      • Rotator 3 trains saccadic movements against a spinning background with varying tilt directions.

    • Memory Saccades:

      • The first exercise requires memorizing dot locations, and the second incorporates auditory or visual distractions.

    • Quadrant Loading & Dual Tasking:

      • Customize stimuli locations and challenge patients with dual tasks like math problems while balancing.

    Balance Training Techniques

    • Vestibular Balance:

      • Select "Exp. 1 - Vestibular-Balance" for limits of stability and utilize a Wii Balance Board.
      • Choose target timing and levels of difficulty, observing patient posture to prevent falls.

    • Balance Targeting:

      • Select "Exp. 5 Balance Targeting," using trails for navigation.
      • Time spent on each target can be customized along with the stimuli type (circles, letters, numbers).
      • Use LARP or RALP planes for initial stimuli selection, progressing when targets light up.

    Important Considerations

    • Ensure the patient's comfort and ability to complete tasks without undue difficulty.
    • Always pay attention to the patient’s posture during exercises to maintain safety.
    • Gradually increase difficulty based on the patient’s performance and comfort level.

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    Description

    This quiz is about setting up the Neurosensorimotor Integrator (NSI) for a patient, including creating a patient profile, preparing the headphones and balance board, and determining the ideal distance for the patient. It's an essential step in the NSI process. Test your knowledge of the setup procedure!

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