Abstract
BackgroundEvidence-based cognitive rehabilitation programs for brain tumor patients are not widely available, despite the high need. We aimed to evaluate the effects of a tablet-based cognitive rehabilitation program on cognitive performance, cognitive complaints, fatigue, and psychological distress in primary brain tumor patients following neurosurgery. Also, attrition, adherence and patient satisfaction with the program were evaluated.MethodsAdults with presumed low-grade glioma and meningioma were recruited before surgery. Three months thereafter, participants were allocated to the intervention group or waiting-list control group using minimization. The 10-week eHealth app ReMind, based on the effective face-to-face intervention, consisted of psychoeducation, strategy-training and attention retraining. Performance-based cognitive outcomes and patient-reported outcomes were assessed before surgery and 3, 6 and 12 months thereafter. Mean scores, percentages of cognitively impaired individuals and reliable change indices (RCIs) were compared between groups.ResultsSixty-two out of 183 eligible patients were randomized. Of the people who declined, 56% reported that participation would to be too burdensome. All participants found a tablet-app suitable for delivery of cognitive rehabilitation and 90% rated the program as “good” or “excellent”. Performance-based cognitive outcomes and patient-reported outcomes did not significantly differ in group means over time nor RCIs between the intervention (final n = 20) and control group (final n = 25).ConclusionsRecruitment at this early stage was difficult, resulting in limited statistical power. No significant effects were demonstrated, while adherence and satisfaction with the eHealth program were good. In clinical practice, ReMind may be helpful, if timing would be adapted to patients’ needs.
Highlights
Cognitive deficits are common in adults with primary brain tumors [1,2,3,4,5,6]
72% of the controls, and decline was observed in 10% vs. 20% respectively. In this randomized controlled trial (RCT), the effects of a tablet-based cognitive rehabilitation program starting three months after neurosurgery were evaluated in 49 adults with low-grade glioma and meningioma
Adherence rates were adequate, with participants completing on average 85% of the strategy training and 91% of the retraining. 90% of participants rated the program as “good” or “excellent”, and 95% indicated that they would recommend the program to other brain tumor patients
Summary
Cognitive deficits are common in adults with primary brain tumors [1,2,3,4,5,6]. The few studies that have been conducted on cognitive rehabilitation in adults with brain tumors demonstrated. Evidence-based cognitive rehabilitation programs for brain tumor patients are not widely available, despite the high need. We aimed to evaluate the effects of a tablet-based cognitive rehabilitation program on cognitive performance, cognitive complaints, fatigue, and psychological distress in primary brain tumor patients following neurosurgery. Performance-based cognitive outcomes and patient-reported outcomes were assessed before surgery and 3, 6 and 12 months thereafter. Performance-based cognitive outcomes and patient-reported outcomes did not significantly differ in group means over time nor RCIs between the intervention (final n = 20) and control group (final n = 25). ReMind may be helpful, if timing would be adapted to patients’ needs
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