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Rodríguez-Rajo P, García-Rudolph A, Sánchez-Carrión R, Aparicio-López C, Enseñat-Cantallops A, García-Molina A. Computerized social cognitive training in the subacute phase after traumatic brain injury: A quasi-randomized controlled trial. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:540-553. [PMID: 35196474 DOI: 10.1080/23279095.2022.2042693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To assess the usefulness of a computerized tasks module designed for the rehabilitation of social cognition (SC) in acquired brain injury. METHODS Quasi-randomized controlled trial (ClinicalTrials.gov:NCT03479970) involving 45 patients with moderate-severe traumatic brain injury (TBI) in a subacute inpatient rehabilitation hospital. The experimental group (n = 28) received treatment with a computerized SC module in combination with a non-SC module. The control group (n = 26) only received a treatment with non-SC module. RESULTS Intragroup comparisons showed that the experimental group had better results for all SC measures, except for International Affective Picture System (IAPS). The control group improved for Facial Expressions of cEmotion-Stimuli and Tests (FEEST) and Moving Shapes Paradigm (MSP), showing no changes with respect to pretreatment in IAPS, MSP and Reading the Mind in the Eyes Test (RMET). Intergroup comparisons did not present differences between the two groups for pretreatment measures. Post-treatment comparison showed that the experimental group obtained better results for RMET than the control group. CONCLUSION The computerized SC module was useful for the rehabilitation of SC in patients with moderate-severe TBI in the subacute phase. The group that received combined rehabilitative treatment (SC + non-SC) obtained better results for SC than the group that received treatment intended only for non-SC.
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Affiliation(s)
- P Rodríguez-Rajo
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A García-Rudolph
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - R Sánchez-Carrión
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - C Aparicio-López
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - A Enseñat-Cantallops
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
| | - A García-Molina
- Institut Guttmann, Institut Universitari de Neurorehabilitació, Affiliated to the Universitat Autònoma de Barcelona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain
- Facultad de Psicología, Centro de Estudios en Neurociencia Humana y Neuropsicología, Universidad Diego Portales, Santiago de Chile, Chile
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Robledo-Castro C, Castillo-Ossa LF, Corchado JM. Artificial Cognitive Systems Applied in Executive Function Stimulation and Rehabilitation Programs: A Systematic Review. ARABIAN JOURNAL FOR SCIENCE AND ENGINEERING 2022; 48:2399-2427. [PMID: 36185593 PMCID: PMC9516512 DOI: 10.1007/s13369-022-07292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/11/2022]
Abstract
This article presents a systematic review of studies on cognitive training programs based on artificial cognitive systems and digital technologies and their effect on executive functions. The aim has been to identify which populations have been studied, the characteristics of the implemented programs, the types of implemented cognitive systems and digital technologies, the evaluated executive functions, and the key findings of these studies. The review has been carried out following the PRISMA protocol; five databases have been selected from which 1889 records were extracted. The articles were filtered following established criteria, to give a final selection of 264 articles that have been used for the purposes of this study in the analysis phase. The findings showed that the most studied populations were school-age children and the elderly. The most studied executive functions were working memory and attentional processes, followed by inhibitory control and processing speed. Many programs were commercial, customizable, gamified, and based on classic tasks. Some more recent initiatives have begun to incorporate user-machine interfaces, robotics, and virtual reality, although studies on their effects remain scarce. The studies recognize multiple benefits of computerized neuropsychological stimulation and rehabilitation programs for executive functions in different age groups, but there is a lack of studies in specific population sectors and with more rigorous research designs. Supplementary Information The online version contains supplementary material available at 10.1007/s13369-022-07292-5.
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Affiliation(s)
- Carolina Robledo-Castro
- Currículo, Universidad y Sociedad Research Group, Universidad del Tolima, Calle 42 1-02, 730006299 Ibagué, Colombia
- Ingeniería del Software Research Group, Universidad Autónoma de Manizales, Antigua Estación del Ferrocarril, 170001 Manizales, Colombia
| | - Luis F. Castillo-Ossa
- Ingeniería del Software Research Group, Universidad Autónoma de Manizales, Antigua Estación del Ferrocarril, 170001 Manizales, Colombia
- Inteligencia Artificial Research Group, Universidad de Caldas, Calle 65 26-10, 170002 Manizales, Colombia
- Departamento de Ingeniería Indutrial, Universidad Nacional de Colombia Sede Manizales, Campus La Nubia, 170001 Manizales, Colombia
| | - Juan M. Corchado
- BISITE Research Group, University of Salamanca, Calle Espejo s/n, 37007 Salamanca, Spain
- Air Institute, IoT Digital Innovation Hub, 37188 Salamanca, Spain
- Department of Electronics, Information and Communication, Osaka Institute of Technology, 535-8585 Osaka, Japan
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Vaucheret Paz E, Giacchino M, Leist M, Chirilla C, Petracca L, Agosta G. [Telerehabilitation of Subjects with Neurodevelopmental Disorders During Confinement due to COVID-19]. REVISTA COLOMBIANA DE PSIQUIATRIA 2022:S0034-7450(22)00028-2. [PMID: 35600217 PMCID: PMC9112035 DOI: 10.1016/j.rcp.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 03/07/2022] [Indexed: 06/15/2023]
Abstract
Introduction Social distancing measures due to the COVID-19 pandemic prevented many children with neurodevelopmental disorders from accessing face-to-face treatments. Telerehabilitation grew at this time as an alternative therapeutic tool. In this study we analysed remote cognitive rehabilitation in neurodevelopmental disorders. Methods This was a prospective, quasi-experimental (before-after) study that included 22 patients (mean age 9.41 years) with neurodevelopmental disorders who had telerehabilitation for over six months. Results After six months of telerehabilitation, a statistically significant improvement was found with a large effect size in these areas: attention (sustained, selective and divided), executive functions (verbal and visual working memory, categorisation, processing speed), visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia) and language (comprehensive and expressive). On the Weiss Functional Impairment Scale, all areas (family, learning and school, self-concept, activities of daily living, risk activities) improved with statistical significance. We found a positive correlation between the number of sessions and the improvement observed in executive functions (visual working memory, processing speed), attention (sustained attention, divided attention) and visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia). We did not find statistical significance between the family structure and the number of sessions carried out. A high degree of perception of improvement and satisfaction was observed in the parents. Conclusions Telerehabilitation is a safe alternative tool which, although it does not replace face-to-face therapy, can achieve significant cognitive and functional improvements in children with neurodevelopmental disorders.
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Affiliation(s)
- Esteban Vaucheret Paz
- Servicio de Neurología Infantil, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Mariana Giacchino
- Servicio de Neurología Infantil, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Mariana Leist
- Servicio de Neurología Infantil, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Claudia Chirilla
- Servicio de Neurología Infantil, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Luciana Petracca
- Servicio de Neurología Infantil, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Guillermo Agosta
- Servicio de Neurología Infantil, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Gibson E, Koh CL, Eames S, Bennett S, Scott AM, Hoffmann TC. Occupational therapy for cognitive impairment in stroke patients. Cochrane Database Syst Rev 2022; 3:CD006430. [PMID: 35349186 PMCID: PMC8962963 DOI: 10.1002/14651858.cd006430.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Cognitive impairment is a frequent consequence of stroke and can impact on a person's ability to perform everyday activities. Occupational therapists use a range of interventions when working with people who have cognitive impairment poststroke. This is an update of a Cochrane Review published in 2010. OBJECTIVES To assess the impact of occupational therapy on activities of daily living (ADL), both basic and instrumental, global cognitive function, and specific cognitive abilities in people who have cognitive impairment following a stroke. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, four other databases (all last searched September 2020), trial registries, and reference lists. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials that evaluated an intervention for adults with clinically defined stroke and confirmed cognitive impairment. The intervention needed either to be provided by an occupational therapist or considered within the scope of occupational therapy practice as defined in the review. We excluded studies focusing on apraxia or perceptual impairments or virtual reality interventions as these are covered by other Cochrane Reviews. The primary outcome was basic activities of daily living (BADL) such as dressing, feeding, and bathing. Secondary outcomes were instrumental ADL (IADL) (e.g. shopping and meal preparation), community integration and participation, global cognitive function and specific cognitive abilities (including attention, memory, executive function, or a combination of these), and subdomains of these abilities. We included both observed and self-reported outcome measures. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies that met the inclusion criteria, extracted data, and assessed the certainty of the evidence. A third review author moderated disagreements if consensus was not reached. We contacted trial authors for additional information and data, where available. We assessed the certainty of key outcomes using GRADE. MAIN RESULTS: We included 24 trials from 11 countries involving 1142 (analysed) participants (two weeks to eight years since stroke onset). This update includes 23 new trials in addition to the one study included in the previous version. Most were parallel randomised controlled trials except for one cross-over trial and one with a two-by-two factorial design. Most studies had sample sizes under 50 participants. Twenty studies involved a remediation approach to cognitive rehabilitation, particularly using computer-based interventions. The other four involved a compensatory and adaptive approach. The length of interventions ranged from 10 days to 18 weeks, with a mean total length of 19 hours. Control groups mostly received usual rehabilitation or occupational therapy care, with a few receiving an attention control that was comparable to usual care; two had no intervention (i.e. a waiting list). Apart from high risk of performance bias for all but one of the studies, the risk of bias for other aspects was mostly low or unclear. For the primary outcome of BADL, meta-analysis found a small effect on completion of the intervention with a mean difference (MD) of 2.26 on the Functional Independence Measure (FIM) (95% confidence interval (CI) 0.17 to 4.22; P = 0.03, I2 = 0%; 6 studies, 336 participants; low-certainty evidence). Therefore, on average, BADL improved by 2.26 points on the FIM that ranges from 18 (total assist) to 126 (complete independence). On follow-up, there was insufficient evidence of an effect at three months (MD 10.00, 95% CI -0.54 to 20.55; P = 0.06, I2 = 53%; 2 studies, 73 participants; low-certainty evidence), but evidence of an effect at six months (MD 11.38, 95% CI 1.62 to 21.14, I2 = 12%; 2 studies, 73 participants; low-certainty evidence). These differences are below 22 points which is the established minimal clinically important difference (MCID) for the FIM for people with stroke. For IADL, the evidence is very uncertain about an effect (standardised mean difference (SMD) 0.94, 95% CI 0.41 to 1.47; P = 0.0005, I2 = 98%; 2 studies, 88 participants). For community integration, we found insufficient evidence of an effect (SMD 0.09, 95% CI -0.35 to 0.54; P = 0.68, I2 = 0%; 2 studies, 78 participants). There was an improvement of clinical importance in global cognitive functional performance after the intervention (SMD 0.35, 95% CI 0.16 to 0.54; P = 0.0004, I2 = 0%; 9 studies, 432 participants; low-certainty evidence), equating to 1.63 points on the Montreal Cognitive Assessment (MoCA) (95% CI 0.75 to 2.52), which exceeds the anchor-based MCID of the MoCA for stroke rehabilitation patients of 1.22. We found some effect for attention overall (SMD -0.31, 95% CI -0.47 to -0.15; P = 0.0002, I2 = 20%; 13 studies, 620 participants; low-certainty evidence), equating to a difference of 17.31 seconds (95% CI 8.38 to 26.24), and for executive functional performance overall (SMD 0.49, 95% CI 0.31 to 0.66; P < 0.00001, I2 = 74%; 11 studies, 550 participants; very low-certainty evidence), equating to 1.41 points on the Frontal Assessment Battery (range: 0-18). Of the cognitive subdomains, we found evidence of effect of possible clinical importance, immediately after intervention, for sustained visual attention (moderate certainty) equating to 15.63 seconds, for working memory (low certainty) equating to 59.9 seconds, and thinking flexibly (low certainty), compared to control. AUTHORS' CONCLUSIONS The effectiveness of occupational therapy for cognitive impairment poststroke remains unclear. Occupational therapy may result in little to no clinical difference in BADL immediately after intervention and at three and six months' follow-up. Occupational therapy may slightly improve global cognitive performance of a clinically important difference immediately after intervention, likely improves sustained visual attention slightly, and may slightly increase working memory and flexible thinking after intervention. There is evidence of low or very low certainty or insufficient evidence for effect on other cognitive domains, IADL, and community integration and participation. Given the low certainty of much of the evidence in our review, more research is needed to support or refute the effectiveness of occupational therapy for cognitive impairment after stroke. Future trials need improved methodology to address issues including risk of bias and to better report the outcome measures and interventions used.
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Affiliation(s)
- Elizabeth Gibson
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Chia-Lin Koh
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Sally Eames
- Community and Oral Health Innovation and Research Centre, Metro North Hospital and Health Service, Brisbane, Australia
| | - Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
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Voelbel GT, Lindsey HM, Mercuri G, Bushnik T, Rath J. The effects of neuroplasticity-based auditory information processing remediation in adults with chronic traumatic brain injury. NeuroRehabilitation 2021; 49:267-278. [PMID: 34420987 DOI: 10.3233/nre-218025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Adults with chronic traumatic brain injury (TBI) may experience long-term deficits in multiple cognitive domains. Higher-order functions, such as verbal memory, are impacted by deficits in the ability to acquire verbal information. OBJECTIVE This study investigated the effects of a neuroplasticity-based computerized cognitive remediation program for auditory information processing in adults with a chronic TBI. METHODS Forty-eight adults with TBI were randomly assigned to an intervention or control group. Both groups underwent a neuropsychological assessment at baseline and post-training. The Intervention group received 40 one-hour cognitive training sessions with the Brain Fitness Program. RESULTS The intervention group improved in performance on measures of the Woodcock-Johnson-III Understanding Directions subtest and Trail Making Test Part-A. They also reported improvement on the cognitive domain of the Cognitive Self-Report Questionnaire. CONCLUSIONS The present study demonstrated that a neuroplasticity-based computerized cognitive remediation program may improve objective and subjective cognitive function in adults with TBI several years post-injury.
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Affiliation(s)
- Gerald T Voelbel
- Department of Occupational Therapy, New York University, New York, NY, USA.,Department of Rehabilitation Medicine, Rusk Rehabilitation at NYU Langone Health, New York, NY, USA
| | - Hannah M Lindsey
- Department of Psychology, New York University, New York, NY, USA.,Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Giulia Mercuri
- Department of Psychology, New York University, New York, NY, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA
| | - Tamara Bushnik
- Department of Rehabilitation Medicine, Rusk Rehabilitation at NYU Langone Health, New York, NY, USA
| | - Joseph Rath
- Department of Rehabilitation Medicine, Rusk Rehabilitation at NYU Langone Health, New York, NY, USA
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Nijmeijer SE, van Tol MJ, Aleman A, Keijzer M. Foreign Language Learning as Cognitive Training to Prevent Old Age Disorders? Protocol of a Randomized Controlled Trial of Language Training vs. Musical Training and Social Interaction in Elderly With Subjective Cognitive Decline. Front Aging Neurosci 2021; 13:550180. [PMID: 33986653 PMCID: PMC8111015 DOI: 10.3389/fnagi.2021.550180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: With aging comes a reduction of cognitive flexibility, which has been related to the development of late-life depression and progression of general cognitive decline. Several factors have been linked to attenuating such decline in cognitive flexibility, such as education, physical exercise and stimulating leisure activities. Speaking two or more languages has recently received abundant attention as another factor that may build up cognitive reserve, thereby limiting the functional implications of compromised cognition that accompany old age. With the number of older adults reaching record levels, it is important to attenuate the development of old-age disorders. Learning to speak a foreign language might offer a powerful tool in promoting healthy aging, but up to date effect studies are sparse. Here, the protocol that forms the foundation of the current study is presented. The present study aims to: (1) examine the effects of a foreign language training on cognitive flexibility and its neural underpinnings, and on mental health; and (2) assess the unique role of foreign language training vs. other cognitive or social programs. Method: One-hundred and ninety-eight Dutch elderly participants reporting subjective cognitive decline are included and randomized to either a language intervention, a music intervention, or a social control intervention. During 3 to 6 months, the language group learns English, the music group learns to play the guitar and the social group participates in social meetings where art workshops are offered. At baseline, at a 3-month follow-up, and at 6 months after termination of the training program, clinical, cognitive and brain activity measurements (combined EEG and fNIRS methods) are taken to assess cognitive flexibility and mental health. Discussion: This is the first trial addressing combined effects of language learning in elderly on cognition, language proficiency, socio-affective measures, and brain activity in the context of a randomized controlled trial. If successful, this study can provide insights into how foreign language training can contribute to more cognitively and mentally healthy years in older adulthood. Clinical Trial Registration: The trial is registered at the Netherlands Trial Register, July 2, 2018, trial number NL7137. https://www.trialregister.nl/trial/7137.
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Affiliation(s)
- Saskia E. Nijmeijer
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marie-José van Tol
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - André Aleman
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Merel Keijzer
- English Linguistics and English as a Second Language, Bilingualism and Aging Lab, University of Groningen, Groningen, Netherlands
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Kulshrestha S, Agrawal M, Singh AK, Kulshreshtha D. Post Stroke Rehabilitation Using Computer-based Cognitive Intervention (CBCI): A Systematic Review. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2020. [DOI: 10.2174/2666082216999200622135105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Cognitive impairment as a consequence of stroke is a major cause affecting
the patient’s functional independence, activity participation, daily living skills, and occupation. Almost
75% of post-stroke patients are diagnosed with significant cognitive impairment, which includes
problems with attention, orientation, memory, language, and perception. Along with effective
pharmaceutical cures, cognitive intervention as a part of rehabilitation approaches that may prevent,
delay, or treat cognitive impairment is becoming increasingly important. Many studies have reported
improvement in cognitive functions of post-stroke patients after using computer-based cognitive
intervention (CBCI). CBCI can be an effective add-on to available rehabilitation programs.
Objective:
This article provides reviews related to relevant literature and, represents a structure to
specify the efficacy of CBCI for the rehabilitation of post-stroke patients for future research.
Methods:
We searched many search engines namely MEDLINE, Web of Science, clinical key and
The Cochrane Library, for studies investigating the effect of cognitive intervention based on a computer
program for post-stroke patients. The results of selected studies were summarized. Total 19
publications from January 2007 to January 2019 are included in this review. The search terms entered
were a combination of these search areas that defined (1) the population as adults who had suffered
a stroke and cognitive dysfunction, (2) intervention search term included cognitive abilities, cognitive
training, and computer-based training; computer-based cognitive intervention for rehabilitation.
Results:
The results after computer-based training showed improvement in various cognitive functions
such as; memory, attention and executive functions of post-stroke patients. However, a significant
difference between the study groups has not been observed in all the studies. Most studies analyzed
in this research project indicated that such interventions might contribute to the improvement
of cognitive function, especially attention concentration and memory. Of the 19 kinds of research
that discussed CBCI outcomes 18 found significant improvements for one or more cognitive functions.
When the effect size for CBCI was reported, effects were large in comparison to other traditional
cognitive interventions of post-stroke patients.
Conclusion:
Studies related to cognitive functions strongly support CBCI except few have reported
a significant difference. The review of all the studies suggests that CBCI may help to change the
functional aspect of post-stroke patients by improving their cognitive functions. In this field, it is a
challenge to conduct well designed and sufficiently powered studies due to low budgets availability,
the limited number of available patients, heterogeneity of the population, and ethical considerations.
Future studies should examine all the challenges, limitations, and valuable insights into the study
and emphasize the need for a carefully designed computer-based cognitive intervention program for
the future. Future studies should target to compare CBCI with active and passive control conditions
and include a larger sample size.
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Affiliation(s)
- Sudhi Kulshrestha
- Amity Institute of Behavioral and Allied Sciences, Amity University, Lucknow, India
| | - Manju Agrawal
- Amity Institute of Behavioral and Allied Sciences, Amity University, Lucknow, India
| | - Ajai K. Singh
- Department of Neurology, Dr. Ram ManoharLohia Institute of Medical Sciences, Lucknow, India
| | - Dinkar Kulshreshtha
- Department of Neurology, Dr. Ram ManoharLohia Institute of Medical Sciences, Lucknow, India
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Kelly ME. The Potential of a Relational Training Intervention to Improve Older Adults' Cognition. Behav Anal Pract 2020; 13:684-697. [PMID: 32953397 PMCID: PMC7471216 DOI: 10.1007/s40617-020-00415-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Behavioral gerontology rarely focuses on improving older adults' cognitive function. This gap in the literature should be addressed, as our aging population means that greater numbers of older adults are experiencing cognitive decline and reduced functional independence. If cognitive training interventions are to be socially significant, they should target improvements in core executive functions (EFs) that are critical for everyday cognition and functioning independence. Evidence from the cognitive sciences suggests that a cognitive training intervention targeting "relational knowledge" and "cognitive flexibility," which are core EFs, could translate to improvements in cognition and functioning for older adults. Behavioral researchers, interested in the effects of relational training on cognition, have shown a relationship between complex and flexible arbitrarily applicable relational responding (AARRing) and improved performance on measures of intelligence in children and young adults. However, data examining the impact of AARRing on the cognition of older adults are lacking. This article suggests that complex and flexible AARRing may be synonymous with the aforementioned EFs of relational knowledge and cognitive flexibility, and that a behaviorally oriented relational training intervention might improve cognition and functioning for healthy older adults or those experiencing cognitive decline. The article initially presents a brief overview of research in behavioral gerontology and older adult cognition, followed by a detailed explanation of how training complexity and flexibility in AARRing could result in improvements in core EFs. Specific suggestions for designing a relational training intervention and assessing relevant outcomes are provided.
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Affiliation(s)
- Michelle E. Kelly
- National College of Ireland, Mayor Street Lower, IFSC, Dublin, Ireland
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9
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Ekechukwu END, Olowoyo P, Nwankwo KO, Olaleye OA, Ogbodo VE, Hamzat TK, Owolabi MO. Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries-A Systematic Review. Front Neurol 2020; 11:337. [PMID: 32695058 PMCID: PMC7336355 DOI: 10.3389/fneur.2020.00337] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/07/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Given the limited healthcare resources in low and middle income countries (LMICs), effective rehabilitation strategies that can be realistically adopted in such settings are required. Objective: A systematic review of literature was conducted to identify pragmatic solutions and outcomes capable of enhancing stroke recovery and quality of life of stroke survivors for low- and middle- income countries. Methods: PubMed, HINARI, and Directory of Open Access Journals databases were searched for published Randomized Controlled Trials (RCTs) till November 2018. Only completed trials published in English with non-pharmacological interventions on adult stroke survivors were included in the review while published protocols, pilot studies and feasibility analysis of trials were excluded. Obtained data were synthesized thematically and descriptively analyzed. Results: One thousand nine hundred and ninety six studies were identified while 347 (65.22% high quality) RCTs were found to be eligible for the review. The most commonly assessed variables (and outcome measure utility) were activities of daily living [75.79% of the studies, with Barthel Index (37.02%)], motor function [66.57%; with Fugl Meyer scale (71.88%)], and gait [31.12%; with 6 min walk test (38.67%)]. Majority of the innovatively high technology interventions such as robot therapy (95.24%), virtual reality (94.44%), transcranial direct current stimulation (78.95%), transcranial magnetic stimulation (88.0%) and functional electrical stimulation (85.00%) were conducted in high income countries. Several traditional and low-cost interventions such as constraint-induced movement therapy (CIMT), resistant and aerobic exercises (R&AE), task oriented therapy (TOT), body weight supported treadmill training (BWSTT) were reported to significantly contribute to the recovery of motor function, activity, participation, and improvement of quality of life after stroke. Conclusion: Several pragmatic, in terms of affordability, accessibility and utility, stroke rehabilitation solutions, and outcome measures that can be used in resource-limited settings were found to be effective in facilitating and enhancing post-stroke recovery and quality of life.
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Affiliation(s)
- Echezona Nelson Dominic Ekechukwu
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu, Nigeria
- LANCET Physiotherapy and Wellness and Research Centre, Enugu, Nigeria
| | - Paul Olowoyo
- Department of Medicine, Federal Teaching Hospital, Ido Ekiti, Nigeria
- College of Medicine and Health Sciences, Afe Babalola University, Ado Ekiti, Nigeria
| | - Kingsley Obumneme Nwankwo
- Stroke Control Innovations Initiative of Nigeria, Abuja, Nigeria
- Fitness Global Consult Physiotherapy Clinic, Abuja, Nigeria
| | - Olubukola A Olaleye
- Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Talhatu Kolapo Hamzat
- Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mayowa Ojo Owolabi
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
- University College Hospital, Ibadan, Nigeria
- Blossom Specialist Medical Centre, Ibadan, Nigeria
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10
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Prayoga DH, Aridamayanti BG, Trisnawati I, Ronalia MF. Telerehabilitation System in Nursing Post Stroke - A Systematic Review. JURNAL NERS 2020. [DOI: 10.20473/jn.v14i3.17017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Stroke is currently the main cause of disability worldwide. Telerehabilitation is a rehabilitation approach that can be used to repair the damage to motor, sensory and cognitive functions. This can also substantially reduce the travel time for the health workers and therefore increase the number of patients who are consulted in a day.Method: A search using specific keywords was done in both the journal articles and in the database. In total, 119 articles were from Scopus, 45 articles were from PubMed, 87 articles were from Science Direct, 52 articles were from EBSCO and 97 articles were from Proquest. There were 15 articles that matched the inclusion criteria. Most of the available literature only refers to short-term results and most of the research is of low quality.Result: Evidence of the relative effectiveness was found in the types of videos, VR, cellphones and computer use. The location of the network support and technological progress are still obstacles that must be addressed immediately. Based on the current scientific evidence, only a few telerehabilitation methods can be recommended for wider use.Conclusion: The telerehabilitation system can provide long-term therapy, meet the patient needs and save the health resources needed to minimize the severity of the patients’ condition. The application of telerehabilitation is used by the nurses to optimize their role in improving patient health and telerehabilitation will answer the problem of penetrating the distance dimension.
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11
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Mochizuki-Kawai H, Kotani I, Mochizuki S, Yamakawa Y. Structured Floral Arrangement Program Benefits in Patients With Neurocognitive Disorder. Front Psychol 2018; 9:1328. [PMID: 30123151 PMCID: PMC6085549 DOI: 10.3389/fpsyg.2018.01328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/10/2018] [Indexed: 01/18/2023] Open
Abstract
We attempted to clarify positive benefits in cognitive abilities and motivation during our cognitive intervention [structured floral arrangement (SFA) program] for patients with neurocognitive disorder due to stroke, traumatic brain injury (TBI), and other related disorders. In this SFA program, participants are required to arrange cut flowers and leaves on absorbent foam according to an instruction sheet. In a previous study of patients with schizophrenia, our SFA program encouraged participants and contributed to stimulating their visuospatial process and memory. Here, 27 patients with neurocognitive disorders participated in this study. Sixteen patients were assigned to an SFA-treated group and participated in six sessions during two phases plus to daily activities. Eleven non-treated patients engaged only daily activities during the same period. We compared Apathy Scale scores and neuropsychological scores between the SFA-treated and non-treated patients. Their mean attendance rate was more than 90% during the two phases. SFA-treated patients copied a Rey–Osterrieth complex figure more accurately than non-treated patients (p < 0.05) during the later intervention phase, whereas during the earlier phase, accuracy was comparable between treated and non-treated groups. In the SFA-treated group, recall scores also improved (p < 0.01), and the positive outcomes were maintained for about 3 months (p < 0.05). The Apathy Scale scores did not show significant change in either the SFA-treated or non-treated groups. Our present results suggest that the SFA program encouraged continuous participation to cognitive intervention and was useful for ameliorating dysfunctions in visuospatial memory and recognition in patients with neurocognitive disorder.
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Affiliation(s)
- Hiroko Mochizuki-Kawai
- Institute of Vegetable and Floriculture Science, National Agriculture and Food Research Organization, Tsukuba, Japan
| | - Izumi Kotani
- Graduate School of Humanities and Social Sciences, University of Tsukuba, Tsukuba, Japan
| | | | - Yuriko Yamakawa
- Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
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12
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Gil-Pagés M, Solana J, Sánchez-Carrión R, Tormos JM, Enseñat-Cantallops A, García-Molina A. A customized home-based computerized cognitive rehabilitation platform for patients with chronic-stage stroke: study protocol for a randomized controlled trial. Trials 2018; 19:191. [PMID: 29566766 PMCID: PMC5863836 DOI: 10.1186/s13063-018-2577-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/06/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Stroke patients usually suffer primary cognitive impairment related to attention, memory, and executive functions. This impairment causes a negative impact on the quality of life of patients and their families, and may be long term. Cognitive rehabilitation has been shown to be an effective way to treat cognitive impairment and should be continued after hospital discharge. Computerized cognitive rehabilitation can be performed at home using exercise programs that advance with predetermined course content, interval, and pace. We hypothesize that computerized rehabilitation might be improved if a program could customize course content and pace in response to patient-specific progress. The present pilot study is a randomized controlled double-blind crossover clinical trial aiming to study if chronic stroke patients with cognitive impairment could benefit from cognitive training through a customized tele-rehabilitation platform ("Guttmann, NeuroPersonalTrainer"®, GNPT®). METHODS/DESIGN Individuals with chronic-stage stroke will be recruited. Participants will be randomized to receive experimental intervention (customized tele-rehabilitation platform, GNPT®) or sham intervention (ictus.online), both with the same frequency and duration (five sessions per week over 6 weeks). After a washout period of 3 months, crossover will occur and participants from the GNPT® condition will receive sham intervention, while participants originally from the sham intervention will receive GNPT®. Patients will be assessed before and after receiving each treatment regimen with an exhaustive neuropsychological battery. Primary outcomes will include rating measures that assess attention difficulties, memory failures, and executive dysfunction for daily activities, as well as performance-based measures of attention, memory, and executive functions. DISCUSSION Customized cognitive training could lead to better cognitive function in patients with chronic-stage stroke and improve their quality of life. TRIAL REGISTRATION NCT03326349 . Registered 31 October 2017.
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Affiliation(s)
- Macarena Gil-Pagés
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Javier Solana
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Rocío Sánchez-Carrión
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Jose M. Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Antonia Enseñat-Cantallops
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Alberto García-Molina
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
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13
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The influence of computer-based cognitive flexibility training on subjective cognitive well-being after stroke: A multi-center randomized controlled trial. PLoS One 2017; 12:e0187582. [PMID: 29145410 PMCID: PMC5690615 DOI: 10.1371/journal.pone.0187582] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 10/21/2017] [Indexed: 12/20/2022] Open
Abstract
Background Stroke can result in cognitive complaints that can have a large impact on quality of life long after its occurrence. A number of computer-based training programs have been developed with the aim to improve cognitive functioning. Most studies investigating their efficacy used only objective outcome measures, whereas a reduction of subjective cognitive complaints may be equally important for improving quality of life. A few studies used subjective outcome measures but were inconclusive, partly due to methodological shortcomings such as lack of proper active and passive control groups. Objective The aim of the current study was to investigate whether computer-based cognitive flexibility training can improve subjective cognitive functioning and quality of life after stroke. Methods We performed a randomized controlled double blind trial (RCT). Adults (30–80 years old) who had a stroke 3 months to 5 years ago, were randomly assigned to either an intervention group (n = 38), an active control group (i.e., mock training; n = 35), or a waiting list control group (n = 24). The intervention and mock training consisted of 58 half-hour sessions within 12 weeks. The primary subjective outcome measures were cognitive functioning (Cognitive Failure Questionnaire), executive functioning (Dysexecutive Functioning Questionnaire), quality of life (Short Form Health Survey), instrumental activities of daily living (IADL; Lawton & Brody IADL scale), and participation in society (Utrecht Scale for Evaluation of Rehabilitation-Participation). Secondary subjective outcome measures were recovery after stroke, depressive symptoms (Hospital Anxiety Depression Scale—depression subscale), fatigue (Checklist Individual Strength—Fatigue subscale), and subjective cognitive improvement (exit list). Finally, a proxy of the participant rated the training effects in subjective cognitive functioning, subjective executive functioning, and IADL. Results and conclusions All groups improved on the two measures of subjective cognitive functioning and subjective executive functioning, but not on the other measures. These cognitive and executive improvements remained stable 4 weeks after training completion. However, the intervention group did not improve more than the two control groups. This suggests that improvement was due to training-unspecific effects. The proxies did not report any improvements. We, therefore, conclude that the computer-based cognitive flexibility training did not improve subjective cognitive functioning or quality of life after stroke.
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14
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Buitenweg JIV, van de Ven RM, Prinssen S, Murre JMJ, Ridderinkhof KR. Cognitive Flexibility Training: A Large-Scale Multimodal Adaptive Active-Control Intervention Study in Healthy Older Adults. Front Hum Neurosci 2017; 11:529. [PMID: 29209183 PMCID: PMC5701641 DOI: 10.3389/fnhum.2017.00529] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 10/18/2017] [Indexed: 11/23/2022] Open
Abstract
As aging is associated with cognitive decline, particularly in the executive functions, it is essential to effectively improve cognition in older adults. Online cognitive training is currently a popular, though controversial method. Although some changes seem possible in older adults through training, far transfer, and longitudinal maintenance are rarely seen. Based on previous literature we created a unique, state-of-the-art intervention study by incorporating frequent sessions and flexible, novel, adaptive training tasks, along with an active control group. We created a program called TAPASS (Training Project Amsterdam Seniors and Stroke), a randomized controlled trial. Healthy older adults (60–80 y.o.) were assigned to a frequent- (FS) or infrequent switching (IS) experimental condition or to the active control group and performed 58 half-hour sessions over the course of 12 weeks. Effects on executive functioning, processing- and psychomotor speed, planning, verbal long term memory, verbal fluency, and reasoning were measured on four time points before, during and after the training. Additionally, we examined the explorative question which individual aspects added to training benefit. Besides improvements on the training, we found significant time effects on multiple transfer tasks in all three groups that likely reflected retest effects. No training-specific improvements were detected, and we did not find evidence of additional benefits of individual characteristics. Judging from these results, the therapeutic value of using commercially available training games to train the aging brain is modest, though any apparent effects should be ascribed more to expectancy and motivation than to the elements in our training protocol. Our results emphasize the importance of using parallel tests as outcome measures for transfer and including both active and passive control conditions. Further investigation into different training methods is advised, including stimulating social interaction and the use of more variable, novel, group-based yet individual-adjusted exercises.
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Affiliation(s)
| | | | - Sam Prinssen
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Jaap M J Murre
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - K Richard Ridderinkhof
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
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15
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van de Ven RM, Buitenweg JIV, Schmand B, Veltman DJ, Aaronson JA, Nijboer TCW, Kruiper-Doesborgh SJC, van Bennekom CAM, Rasquin SMC, Ridderinkhof KR, Murre JMJ. Brain training improves recovery after stroke but waiting list improves equally: A multicenter randomized controlled trial of a computer-based cognitive flexibility training. PLoS One 2017; 12:e0172993. [PMID: 28257436 PMCID: PMC5336244 DOI: 10.1371/journal.pone.0172993] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 02/11/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Brain training is currently widely used in an attempt to improve cognitive functioning. Computer-based training can be performed at home and could therefore be an effective add-on to available rehabilitation programs aimed at improving cognitive functioning. Several studies have reported cognitive improvements after computer training, but most lacked proper active and passive control conditions. OBJECTIVE Our aim was to investigate whether computer-based cognitive flexibility training improves executive functioning after stroke. We also conducted within-group analyses similar to those used in previous studies, to assess inferences about transfer effects when comparisons to proper control groups are missing. METHODS We conducted a randomized controlled, double blind trial. Adults (30-80 years old) who had suffered a stroke within the last 5 years were assigned to either an intervention group (n = 38), active control group (i.e., mock training; n = 35), or waiting list control group (n = 24). The intervention and mock training consisted of 58 half-hour sessions within a 12-week period. Cognitive functioning was assessed using several paper-and-pencil and computerized neuropsychological tasks before the training, immediately after training, and 4 weeks after training completion. RESULTS AND CONCLUSIONS Both training groups improved on training tasks, and all groups improved on several transfer tasks (three executive functioning tasks, attention, reasoning, and psychomotor speed). Improvements remained 4 weeks after training completion. However, the amount of improvement in executive and general cognitive functioning in the intervention group was similar to that of both control groups (active control and waiting list). Therefore, this improvement was likely due to training-unspecific effects. Our results stress the importance to include both active and passive control conditions in the study design and analyses. Results from studies without proper control conditions should be interpreted with care.
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Affiliation(s)
- Renate M. van de Ven
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | | | - Ben Schmand
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Justine A. Aaronson
- Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
| | - Tanja C. W. Nijboer
- Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Experimental Psychology, Utrecht University, Utrecht, The Netherlands
| | | | - Coen A. M. van Bennekom
- Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
| | - Sascha M. C. Rasquin
- Adelante-Zorggroep, Maastricht University, Caphri, Rehabilitation Medicine, Maastricht, The Netherlands
| | - K. Richard Ridderinkhof
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Brain & Cognition (ABC), University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap M. J. Murre
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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16
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Wu P, Zhou YM, Zeng F, Li ZJ, Luo L, Li YX, Fan W, Qiu LH, Qin W, Chen L, Bai L, Nie J, Zhang S, Xiong Y, Bai Y, Yin CX, Liang FR. Regional brain structural abnormality in ischemic stroke patients: a voxel-based morphometry study. Neural Regen Res 2016; 11:1424-1430. [PMID: 27857744 PMCID: PMC5090843 DOI: 10.4103/1673-5374.191215] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2016] [Indexed: 02/05/2023] Open
Abstract
Our previous study used regional homogeneity analysis and found that activity in some brain areas of patients with ischemic stroke changed significantly. In the current study, we examined structural changes in these brain regions by taking structural magnetic resonance imaging scans of 11 ischemic stroke patients and 15 healthy participants, and analyzing the data using voxel-based morphometry. Compared with healthy participants, patients exhibited higher gray matter density in the left inferior occipital gyrus and right anterior white matter tract. In contrast, gray matter density in the right cerebellum, left precentral gyrus, right middle frontal gyrus, and left middle temporal gyrus was less in ischemic stroke patients. The changes of gray matter density in the middle frontal gyrus were negatively associated with the clinical rating scales of the Fugl-Meyer Motor Assessment (r = -0.609, P = 0.047) and the left middle temporal gyrus was negatively correlated with the clinical rating scales of the nervous functional deficiency scale (r = -0.737, P = 0.010). Our findings can objectively identify the functional abnormality in some brain regions of ischemic stroke patients.
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Affiliation(s)
- Ping Wu
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Yu-mei Zhou
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Fang Zeng
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Zheng-jie Li
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Lu Luo
- China Academy of Chinese Medical Sciences, World Federation of Acupuncture-Moxibustion Societies, Beijing, China
| | - Yong-xin Li
- Institute of Clinical Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Wei Fan
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Li-hua Qiu
- Radiology Department, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Wei Qin
- Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi’an, Shaanxi Province, China
| | - Lin Chen
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Lin Bai
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Juan Nie
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - San Zhang
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Yan Xiong
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Yu Bai
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Can-xin Yin
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
| | - Fan-rong Liang
- Acupuncture and Tuina School/Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
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17
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Fang Y, Tao Q, Zhou X, Chen S, Huang J, Jiang Y, Wu Y, Chen L, Tao J, Chan CC. Patient and Family Member Factors Influencing Outcomes of Poststroke Inpatient Rehabilitation. Arch Phys Med Rehabil 2016; 98:249-255.e2. [PMID: 27475119 DOI: 10.1016/j.apmr.2016.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate how family members' attitudes toward functional regain, and patients' knowledge and intention of independence influence poststroke rehabilitation. DESIGN Cross-sectional study. SETTING Three rehabilitation inpatient settings. PARTICIPANTS Younger (n=79) and older (n=84) poststroke patients, along with their family members (spouses, n=104; children, n=59). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Custom-designed questionnaires were used to tap into the patients' knowledge about rehabilitation (Patient's Rehabilitation Questionnaire-Knowledge About Rehabilitation) and intention of independence (Patient's Rehabilitation Questionnaire-Intention of Independence), and family members' attitudes toward patients in performing basic activities of daily living (BADL) (Family Member Attitudes Questionnaire-BADL) and instrumental activities of daily living (Family Member Attitudes Questionnaire-instrumental activities of daily living). The rehabilitation outcomes included gains in motor, cognitive, and emotional functions, and self-care independence, measured with common clinical instruments. RESULTS The Family Member Attitudes Questionnaire-BADL predicted cognitive outcome and the Patient's Rehabilitation Questionnaire-Intention of Independence predicted motor outcome for both groups. Differential age-related effects were revealed for the Patient's Rehabilitation Questionnaire-Intention of Independence in predicting emotional outcome only for the younger group, and self-care independence only for the older group. CONCLUSIONS Patients' intention of independence positively affected motor recovery, while family members' positive attitudes promoted cognitive regain. The findings suggested plausible age-related differences in how patients' intentions affect emotion versus self-care independence outcomes. Future studies should explore strategies for promoting positive attitudes toward independence among patients and family members during poststroke rehabilitation.
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Affiliation(s)
- Yunhua Fang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Fujian Key Laboratory of Exercise Rehabilitation, Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China
| | - Qian Tao
- Department of Psychology, School of Medicine, Jinan University, Guangzhou, China; Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiaoxuan Zhou
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Fujian Key Laboratory of Exercise Rehabilitation, Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China
| | - Shanjia Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Fujian Key Laboratory of Exercise Rehabilitation, Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Fujian Key Laboratory of Exercise Rehabilitation, Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China
| | - Yingping Jiang
- Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine, Urumqi Municipality, China
| | - Yi Wu
- The Affiliated Huashan Hospital of Fudan University, Shanghai, China
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Fujian Key Laboratory of Exercise Rehabilitation, Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China; Affiliated Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China; Fujian Key Laboratory of Exercise Rehabilitation, Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China; Affiliated Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Chetwyn C Chan
- Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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