Abstract
IntroductionCognitive deficits are frequent after coronary artery bypass graft (CABG) surgery and consequently could lead to a decrease in quality of life. This is the first study that has been conducted with the aim of examining the efficacy of a computerized cognitive rehabilitation therapy (CCRT) in improving quality of life in patients after CABG surgery.MethodsIn this study, an interventional trial with pre-, post-, and follow-up assessments in active (CCRT), active control and control groups was conducted. Seventy-five patients after CABG surgery were selected and assigned to the groups (n = 25 for each group). CCRT consists of four modules of attention, working memory, response inhibition and processing speed training with graded schedule in 20-min sessions three times per week within 8 weeks. Cognitive functions (attention and working memory) were assessed by the tests of continuous performance, Flanker, useful field of view and digit span at three time points: pre- and post-intervention (T0 and T1) and 6-month follow-up (T2). Quality of life was assessed by the SF-36 questionnaire at the same time points. The CCRT group received the cognitive rehabilitation for 2 months, active control group received a sham version of CCRT in an equal time duration and control group did not receive any cognitive intervention.ResultsRepeated measures analysis of variance (ANOVA) revealed a time by group interaction on cognitive functions, with CCRT producing a significant improvement at T1 (p < 0.01) and these improvements were maintained at T2. Moreover, in CCRT and active control groups, quality of life (QoL) improved at T1 and these improvements remained stable throughout follow-up (T2). However, improvement of QoL in CCRT group was greater than improvement of QoL in the other two groups at T1. Pearson’s correlation analysis shows a positive correlation between QoL improvement and sustained attention and working memory enhancement (p < 0.05).ConclusionCognitive rehabilitation can lead to a significant improvement in the cognitive functions that have been trained in patients receiving CABG. Interestingly enough, cognitive rehabilitation can also improve quality of life in patients after CABG surgery and this improvement is maintained for at least 6 months.
Highlights
Cognitive deficits are frequent after coronary artery bypass graft (CABG) surgery and could lead to a decrease in quality of life
Patients were included in the study if they were 40–80 years of age, scheduled for a first CABG surgery without concomitant surgery, capable of perception of the research purpose, able to give informed consent before any study, able to speak in Persian with study personnel, able to read and write and work with computer and participate in concurrent standard routine rehabilitation during the trial
Baseline analysis showed no significant difference in terms of demographic variables (p > 0.05), clinical variables (p > 0.05), cognitive functions (p > 0.05), and quality of life (QoL) (p > 0.05) measures between the three groups (Table 1) and there was no significant correlation between QoL and cognitive functions among all participants
Summary
Cognitive deficits are frequent after coronary artery bypass graft (CABG) surgery and could lead to a decrease in quality of life. This is the first study that has been conducted with the aim of examining the efficacy of a computerized cognitive rehabilitation therapy (CCRT) in improving quality of life in patients after CABG surgery. The aims of CABG surgery are to reduce previous symptoms of patients with coronary disease such as discomfort from chest pain (Yang et al, 2015), reduce the risk of heart attack, increase patient’s chance of living longer (Harris et al, 2013) and improve quality of life (QoL) (Järvinen et al, 2003; Panagopoulou et al, 2006; Kaur et al, 2013). The importance of the health-related QoL is significant in patients after the CABG surgery (Lee et al, 2015)
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