The rise of online content services has revolutionised TV viewing and music consumption in recent years. And in neuro-rehab too, it is changing approaches and patient interactions.

Leading the way in this new world order is NeuronUP – an online platform which is helping rehabilitation professionals across the globe to drive better outcomes from their patients.

The tool features more than 10,000 activities, classified into 40+ different cognitive processes and areas of occupation; with new materials released every fortnight.

CEO and founder Iñigo Fernández de Piérola set up the company based on his experiences as a neuropsychologist and his work with patients with neuro-deficits, including those caused by brain injury. In the years preceding its 2011 launch, recognition had grown of the need to carry out more ecological neuropsychological assessment (Tirapu, 2017).

There was a movement towards more “ecological, motivational and personalised content in the process of cognitive stimulation and rehabilitation”, allowing clinicians to better assess the accurate functional condition of individuals, NeuronUP states.

Cognitive functions are interrelated, and interdependent on a functional and anatomical level, the company explains.

When daily tasks are carried out, neural combinations that recruit specific neuropsychological processes to perform it are put into play.

NeuronUP’s goal is to identify these processes and design useful and relevant activities for neuropsychological rehabilitation, occupational therapy and speech language therapy.

An initial collection of materials was released in 2012, which has since evolved into a multi-faceted tool used by professionals across the globe to help patients with cognitive deficits.

But in a world where brain training ranges from mainstream fad to seriously researched approaches, Fernández de Piérola cautions that the platform is nothing without professional input.

Iñigo Fernández de Piérola, founder and CEO of NeuronUP.

“The material by itself does nothing. The patient is not going to improve his memory in six weeks, pressing a button on a tablet for example, he or she needs to be guided by a professional.

“If the professional is bad, the platform isn ́t going to do magic.”

Ongoing work continues among professionals using the platform, exploring the cognitive processes within specific conditions, such as MS, acquired brain injury, Parkinson’s and forms of dementia.

This research will then shape future content.

The platform, says Fernández de Piérola, is used in many different ways by professionals – often influenced by varying country-to-country approaches.

“Here in Spain we can’t tell someone in Australia how to work with their patient.

“Professionals have the ability to adapt the materials of the platform to their interventions in many different ways, always according to the needs of each specific patient.

“The platform can either be used in the clinic, or the patient can log into it from home and work through a session the professional has created ahead of time, via its ‘NeuronUP2GO’ option.

“So, there is a lot of variety in terms of how that professional wants to work and there is really no set way to use it.

“It really depends on the individual’s needs and we help to make the professional ́s job easier.”

User-friendliness is crucial in enabling patients to access intense therapy at home, whether they can do it themselves or with the assistance of family members.

“It’s created with the idea that they can log in and the materials are ready to go and they can work through that intense therapy.”

Common feedback from professionals is that the platform saves them time, enables them to better plan sessions and increases patient motivation.

“Our focus will continue to be on creating new materials. Just like Netflix is a platform for video content, we want to continue being a source for good neuro-rehab and cognitive stimulation materials. Also, we want to add extra features to compliment the platform.”

Surprisingly for an online service, these features include paper resources which many professionals still prefer to use.

But there are also advanced technical additions planned, including virtual and augmented reality content.

The company is also developing a series of content focused on the link between neuropsychology and emotion – “an underdeveloped aspect of neuropsychology,” according to Fernández de Piérola.

“It’s early days but we’re currently working on a social cognition part of this, looking at how we can move from that to something that helps people with social challenges.”

But the company says its most significant development in coming years will be implementing greater use of the 150 million+ pieces of data it has related to neuro-rehab interventions.

“We are currently analysing this data and aim to put it to use in modelling future content. We want to be able to predict cases and develop content that could help professionals to do so too.”

NeuronUP’s content is increasingly being used in research projects around the world.

Among them was a study by the University Hospital of Tenerife, presented at the European Congress of Neurology in 2018.

MS patients received 24 sessions of “computer assisted” cognitive treatment through NeuronUp. Significant improvements in verbal memory, delayed visual memory, working memory and semantic fluency were noted.

Also, MRI analysis showed a 0.7 per cent increase in the global grey matter volume in most patients.

There was also a decrease in certain problems within learning and memory processes, suggesting that cognitive therapy improves cognitive performance; and may induce structural and functional changes in the brains of MS patients (Plata-Belle et al, 2018).

The platform is currently used in over 25 countries spanning 1,000+ facilities and 4,000 professionals.

Around 40,000 patients have now had access to its content. Part of its overriding appeal, says Fernández de Piérola, is its personalised approach.

“It’s important that the content is relevant to the patient. Something that motivates them. So, we have over 10,000 activities and a lot of these can be personalised.

“For example, in a word search you could add in the name of a patient’s favourite football player, or the name of their grandchildren.

“This personalised approach extends to the provision of one-to-one webinars for professionals using the platform. It gives the client the possibility to interact with the NeuronUP team at almost any time.

“We love it when our clients interact with us. We want them to check out the new content and tell us how it is affecting their clients.

“We love to get suggestions as well, if we can create something that will be useful in your practice, we ́ll do it!”