Login Register Cart 0
Generic placeholder image

Current Psychiatry Research and Reviews

Editor-in-Chief

ISSN (Print): 2666-0822
ISSN (Online): 2666-0830

Back
Journal Home About Journal Editorial Board Current Issue Volumes/Issues
Subscribe
Systematic Review Article

Post Stroke Rehabilitation Using Computer-based Cognitive Intervention (CBCI): A Systematic Review

Author(s): Sudhi Kulshrestha, Manju Agrawal, Ajai K. Singh and Dinkar Kulshreshtha*

Volume 16, Issue 2, 2020

Page: [93 - 102] Pages: 10

DOI: 10.2174/2666082216999200622135105

Price: $65

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.

Keywords: Cognitive impairment, stroke, cognition, CBCI, cognitive rehabilitation, dysfunction.

« Previous Next »
Graphical Abstract

[1]
Banerjee TK, Das SK. Fifty years of stroke researches in India. Ann Indian Acad Neurol 2016; 19(1): 1-8.
[http://dx.doi.org/10.4103/0972-2327.168631] [PMID: 27011621]
[2]
Global Health Estimates 2016: Disease burden by Cause, Age, Sex, by Country and by Region, 2000-2016. Geneva, World Health Organization 2018. Available from: http://www.who.int/healthinfo/global burden disease/en/cited
[3]
Donkor ES. Stroke in the 21st centuries: a snapshot of the burden, epidemiology, and quality of life. Stroke Res Treat 2018; Article ID 3238165.
[http://dx.doi.org/10.1155/2018/3238165] [PMID: 30598741]
[4]
Pandian JD, Sudhan P. Stroke epidemiology and stroke care services in India. J Stroke 2013; 15(3): 128-34.
[http://dx.doi.org/10.5853/jos.2013.15.3.128] [PMID: 24396806]
[5]
Young J, Forster A. Review of stroke rehabilitation. BMJ 2007; 334(7584): 86-90.
[http://dx.doi.org/10.1136/bmj.39059.456794.68] [PMID: 17218714]
[6]
Arene N, Hidler J. Understanding motor impairment in the paretic lower limb after a stroke: a review of the literature. Top Stroke Rehabil 2009; 16(5): 346-56.
[http://dx.doi.org/10.1310/tsr1605-346] [PMID: 19903653]
[7]
Wagle J, Farner L, Flekkøy K, et al. Early post-stroke cognition in stroke rehabilitation patients predicts functional outcome at 13 months. Dement Geriatr Cogn Disord 2011; 31(5): 379-87.
[http://dx.doi.org/10.1159/000328970] [PMID: 21720162]
[8]
Donnellan C, Hickey A, Hevey D, O’Neill D. Effect of mood symptoms on recovery one year after stroke. Int J Geriatr Psychiatry 2010; 25(12): 1288-95.
[http://dx.doi.org/10.1002/gps.2482] [PMID: 21086539]
[9]
Hilari K. The impact of stroke: are people with aphasia different to those without? Disabil Rehabil 2011; 33(3): 211-8.
[http://dx.doi.org/10.3109/09638288.2010.508829] [PMID: 20712416]
[10]
Hunter SM, Crome P. Hand function and stroke. Rev Clin Gerontol 2002; 12: 68-81.
[http://dx.doi.org/10.1017/S0959259802012194]
[11]
Khan S, Leung E, Jay WM. Stroke and visual rehabilitation. Top Stroke Rehabil 2008; 15(1): 27-36.
[http://dx.doi.org/10.1310/tsr1501-27] [PMID: 18250071]
[12]
Jehkonen M, Laihosalo M, Kettunen JE. Impact of neglect on functional outcome after stroke: a review of methodological issues and recent research findings. Restor Neurol Neurosci 2006; 24(4-6): 209-15.
[PMID: 17119299]
[13]
Cumming TB, Marshall RS, Lazar RM. Stroke, cognitive deficits, and rehabilitation: still an incomplete picture. Int J Stroke 2013; 8(1): 38-45.
[http://dx.doi.org/10.1111/j.1747-4949.2012.00972.x] [PMID: 23280268]
[14]
Tatemichi TK, Desmond DW, Stern Y, Paik M, Sano M, Bagiella E. Cognitive impairment after stroke: frequency, patterns, and relationship to functional abilities. J Neurol Neurosurg Psychiatry 1994; 57(2): 202-7.
[http://dx.doi.org/10.1136/jnnp.57.2.202] [PMID: 8126506]
[15]
Mohd Zulkifly MF, Ghazali SE, Che Din N, Singh DK, Subramaniam P. Review of risk factors for cognitive impairment in stroke survivors. Sci World J 2016; 20163456943
[http://dx.doi.org/10.1155/2016/3456943] [PMID: 27340686]
[16]
Cicerone KD, Dahlberg C, Kalmar K, et al. Evidence-based cognitive rehabilitation: recommendations for clinical practice. Arch Phys Med Rehabil 2000; 81(12): 1596-615.
[http://dx.doi.org/10.1053/apmr.2000.19240] [PMID: 11128897]
[17]
Merriman NA, Sexton E, McCabe G, et al. Addressing cognitive impairment following stroke: systematic review and meta-analysis of non-randomised controlled studies of psychological interventions. BMJ Open 2019; 9(2)e024429
[http://dx.doi.org/10.1136/bmjopen-2018-024429] [PMID: 30819706]
[18]
Pedersen PM, Jorgensen HS, Nakayama H, et al. General cognitive function in acute stroke: The Copenhagen Stroke Study. J Neurol Rehabil 1996; 10(3): 153-8.
[http://dx.doi.org/10.1177/154596839601000302]
[19]
Galski T, Bruno RL, Zorowitz R, Walker J. Predicting length of stay, functional outcome, and aftercare in the rehabilitation of stroke patients. The dominant role of higher-order cognition. Stroke 1993; 24(12): 1794-800.
[http://dx.doi.org/10.1161/01.STR.24.12.1794] [PMID: 8248957]
[20]
Zinn S, Dudley TK, Bosworth HB, Hoenig HM, Duncan PW, Horner RD. The effect of poststroke cognitive impairment on rehabilitation process and functional outcome. Arch Phys Med Rehabil 2004; 85(7): 1084-90.
[http://dx.doi.org/10.1016/j.apmr.2003.10.022] [PMID: 15241754]
[21]
Faria AL, Andrade A, Soares LI, Badia SB. Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients. J Neuroeng Rehabil 2016; 13(1): 96.
[http://dx.doi.org/10.1186/s12984-016-0204-z] [PMID: 27806718]
[22]
Engstad RT, Engstad TT, Davanger S, Wyller TB. Executive function deficits following stroke. Tidsskr Nor Laegeforen 2013; 133(5): 524-7.
[http://dx.doi.org/10.4045/tidsskr.12.0686] [PMID: 23463064]
[23]
Lindsay P, Bayley M, Hellings C, et al. Canadian best practice recommendations for stroke care (updated 2008). CMAJ 2008; 179(12): S1-S25.
[http://dx.doi.org/10.1503/cmaj.081148.R2]
[24]
Rohde D, Williams D, Gaynor E, et al. Secondary prevention and cognitive function after stroke: a study protocol for a 5-year follow-up of the ASPIRE-S cohort. BMJ Open 2017; 7(3)e014819
[http://dx.doi.org/10.1136/bmjopen-2016-014819]] [PMID: 28348196]
[25]
Tsaousides T, Gordon WA. Cognitive rehabilitation following traumatic brain injury: assessment to treatment. Mt Sinai J Med 2009; 76(2): 173-81.
[http://dx.doi.org/10.1002/msj.20099] [PMID: 19306374]
[26]
Martin M, Clare L, Altgassen AM, Cameron MH, Zehnder F. Cognition-based interventions for healthy older people and people with mild cognitive impairment. Cochrane Database Syst Rev 2011; (1): CD006220
[http://dx.doi.org/10.1002/14651858.CD006220.pub2]] [PMID: 21249675]
[27]
Gates N, Valenzuela M. Cognitive exercise and its role in cognitive function in older people. Curr Psychiatry Rep 2010; 12(1): 20-7.
[28]
Svaerke K, Niemeijer M, Mogensen J, Christensen H. The effects of computer-based cognitive rehabilitation in patients with visuospatial neglect following stroke: a systematic review. Top Stroke Rehabil 2019; 26(3): 214-25.
[http://dx.doi.org/10.1080/10749357.2018.1556963] [PMID: 30570451]
[29]
Lin SH, Dionne TP. Interventions to improve movement and functional outcomes in adult stroke rehabilitation: review and evidence summary. J Particip Med 2018; 10(1)e3
[http://dx.doi.org/10.2196/jopm.8929]
[30]
De Luca R, Leonardi S, Spadaro L, et al. Improving cognitive function in patients with stroke: can computerized training be the future? J Stroke Cerebrovasc Dis 2018; 27(4): 1055-60.
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2017.11.008] [PMID: 29221967]
[31]
Ge S, Zhu Z, Wu B, McConnell ES. Technology-based cognitive training and rehabilitation interventions for individuals with mild cognitive impairment: a systematic review. BMC Geriatr 2018; 18(1): 213.
[http://dx.doi.org/10.1186/s12877-018-0893-1] [PMID: 30219036]
[32]
Kueider AM, Parisi JM, Gross AL, Rebok GW. Computerized cognitive training with older adults: a systematic review. PLoS One 2012; 7(7)e40588
[http://dx.doi.org/10.1371/journal.pone.0040588] [PMID: 22792378]
[33]
Moher D, Liberati A, Tetzlaff J, Altman DG. PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151(4): 264-9.
[http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00135] [PMID: 19622511]
[34]
Åkerlund E, Esbjörnsson E, Sunnerhagen KS, Björkdahl A. Can computerized working memory training improve impaired working memory, cognition and psychological health? Brain Inj 2013; 27(13-14): 1649-57.
[http://dx.doi.org/10.3109/02699052.2013.830195] [PMID: 24087909]
[35]
Björkdahl A, Akerlund E, Svensson S, Esbjörnsson E. A randomized study of computerized working memory training and effects on functioning in everyday life for patients with brain injury. Brain Inj 2013; 27(13-14): 1658-65.
[http://dx.doi.org/10.3109/02699052.2013.830196] [PMID: 24131298]
[36]
Lundqvist A, Grundström K, Samuelsson K, Rönnberg J. Computerized training of working memory in a group of patients suffering from acquired brain injury. Brain Inj 2010; 24(10): 1173-83.
[http://dx.doi.org/10.3109/02699052.2010.498007] [PMID: 20715888]
[37]
Westerberg H, Jacobaeus H, Hirvikoski T, et al. Computerized working memory training after stroke-a pilot study. Brain Inj 2007; 21(1): 21-9.
[http://dx.doi.org/10.1080/02699050601148726] [PMID: 17364516]
[38]
Prokopenko SV, Mozheyko EY, Petrova MM, et al. Correction of post-stroke cognitive impairments using computer programs. J Neurol Sci 2013; 325(1-2): 148-53.
[http://dx.doi.org/10.1016/j.jns.2012.12.024] [PMID: 23312291]
[39]
Lin ZC, Tao J, Gao YL, Yin DZ, Chen AZ, Chen LD. Analysis of central mechanism of cognitive training on cognitive impairment after stroke: resting-state functional magnetic resonance imaging study. J Int Med Res 2014; 42(3): 659-68.
[http://dx.doi.org/10.1177/0300060513505809] [PMID: 24722262]
[40]
Yoo C, Yong MH, Chung J, Yang Y. Effect of computerized cognitive rehabilitation program on cognitive function and activities of living in stroke patients. J Phys Ther Sci 2015; 27(8): 2487-9.
[http://dx.doi.org/10.1589/jpts.27.2487] [PMID: 26355244]
[41]
Cho HY, Kim KT, Jung JH. Effects of computer assisted cognitive rehabilitation on brain wave, memory and attention of stroke patients: a randomized control trial. J Phys Ther Sci 2015; 27(4): 1029-32.
[http://dx.doi.org/10.1589/jpts.27.1029] [PMID: 25995548]
[42]
Park IS, Yoon JG. The effect of computer-assisted cognitive rehabilitation and repetitive transcranial magnetic stimulation on cognitive function for stroke patients. J Phys Ther Sci 2015; 27(3): 773-6.
[http://dx.doi.org/10.1589/jpts.27.773] [PMID: 25931728]
[43]
Ressner P, Niliu P, Berankova D, et al. Computer-assisted cognitive rehabilitation in stroke and Alzheimer’s disease. J Neurol Neurophysiol 2014; 5: 6.
[http://dx.doi.org/10.4172/2155-9562.1000260]
[44]
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(1): 191.
[http://dx.doi.org/10.1186/s13063-018-2577-8] [PMID: 29566766]
[45]
Li K, Robertson J, Ramos J, Gella S. Computer-based cognitive retraining for adults with chronic acquired brain injury: a pilot study. Occup Ther Health Care 2013; 27(4): 333-44.
[http://dx.doi.org/10.3109/07380577.2013.844877] [PMID: 24102589]
[46]
Hellgren L, Samuelsson K, Lundqvist A, Borsbo B. Computerized training of working memory for patients with acquired brain injury. J APMR 2015; 96(10): 48-9.
[47]
Gauggel S, Niemann T. Evaluation of a short-term computer-assisted training programme for the remediation of attentional deficits after brain injury: a preliminary study. Int J Rehabil Res 1996; 19(3): 229-39.
[http://dx.doi.org/10.1097/00004356-199609000-00004] [PMID: 8910125]
[48]
Sturm W, Fimm B, Cantagallo A, et al. Specific computerized attention training in stroke and traumatic brain-injured patients: a European multicenter efficacy study. Z Neuropsychol 2003; 14(4): 283-92.
[http://dx.doi.org/10.1024/1016-264X.14.4.283]
[49]
Fernandez E, Bergado Rosado JA, Rodriguez Perez D, Salazar Santana S, Torres Aguilar M, Bringas ML. Effectiveness of a computer-based training program of attention and memory in patients with acquired brain damage. Behav Sci (Basel) 2017; 8(1): 4.
[http://dx.doi.org/10.3390/bs8010004] [PMID: 29301194]
[50]
Zucchella C, Capone A, Codella V, et al. Assessing and restoring cognitive functions early after stroke. Funct Neurol 2014; 29(4): 255-62.
[PMID: 25764255]
[51]
Hayes S, Donnellan C, Stokes E. Executive dysfunction post-stroke: an insight into the perspectives of physiotherapists. Disabil Rehabil 2015; 37(20): 1817-24.
[http://dx.doi.org/10.3109/09638288.2014.980915] [PMID: 25374045]
[52]
Alashram AR, Annino G, Padua E, Romagnoli C, Mercuri NB. Cognitive rehabilitation post traumatic brain injury: a systematic review for emerging use of virtual reality technology. J Clin Neurosci 2019; 66: 209-19.
[http://dx.doi.org/10.1016/j.jocn.2019.04.026] [PMID: 31085075]
[53]
Cicerone KD, Langenbahn DM, Braden C, et al. Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Arch Phys Med Rehabil 2011; 92(4): 519-30.
[http://dx.doi.org/10.1016/j.apmr.2010.11.015] [PMID: 21440699]
[54]
Delgado LC, Restrepo Ochoa DA. La práctica neuro psicológica asistida por computadora: un escenario para el diálogo interdisciplinario entre la tecnología y las neurociencias. Rev CES Psicol 2009; 2: 79-90.
[55]
Wilms I, Malá H. Indirect versus direct feedback in computer-based prism adaptation therapy. Neuropsychol Rehabil 2010; 20(6): 830-53.
[http://dx.doi.org/10.1080/09602011.2010.492711] [PMID: 20818577]
[56]
Nordvik JE, Walle KM, Nyberg CK, et al. Bridging the gap between clinical neuroscience and cognitive rehabilitation: the role of cognitive training, models of neuroplasticity and advanced neuroimaging in future brain injury rehabilitation. NeuroRehabilitation 2014; 34(1): 81-5.
[http://dx.doi.org/10.3233/NRE-131017] [PMID: 24284460]
[57]
Page ZE, Barrington S, Edwards J, Barnett LM. Do active video games benefit the motor skill development of non-typically developing children and adolescents: a systematic review. J Sci Med Sport 2017; 20(12): 1087-100.
[http://dx.doi.org/10.1016/j.jsams.2017.05.001] [PMID: 28600111]
[58]
van de Ven RM, Schmand B, Groet E, Veltman DJ, Murre JMJ. The effect of computer-based cognitive flexibility training on recovery of executive function after stroke: rationale, design and methods of the TAPASS study. BMC Neurol 2015; 15(144): 144.
[http://dx.doi.org/10.1186/s12883-015-0397-y] [PMID: 26286548]
[59]
Baltaduonienė D, Kubilius R, Mingaila S. Computer - based cognitive rehabilitation for cognitive functions after stroke. Czech and Slovak Neurology and Neurosurgery 2018; 81(3): 269-77.
[60]
Stevens E. What stroke patients can benefit from computer-based cognitive rehabilitation? Unpublished master’s thesis 2014.

Rights & Permissions Print Cite
Article Metrics
57
© 2024 Bentham Science Publishers | Privacy Policy