Abstract
Objectives: To determine the effectiveness of computer-assisted cognitive rehabilitation and compare the patterns of cognitive function recovery occurring in both traumatic brain injury (TBI) and stroke. Methods: A total of 62 patients were finally enrolled, consisting of 30 with TBI and 32 with stroke. The patients received 30 sessions of computer-assisted cognitive rehabilitation (Comcog) five times per week. Each session lasted for 30 min. Before and immediately after cognitive rehabilitation, all patients were evaluated by computerized neuropsychological test (CNT), Mini-Mental State Examination (MMSE), and modified Barthel index (MBI). Results: We analyzed the differences between pre- and post-cognitive rehabilitation in each TBI and stroke group. Significant differences were observed in MMSE, MBI, and some CNT contents, including digit span forward, verbal learning, verbal learning delayed recall, visual span forward, visual span backward, visual learning, trail making test A and B, and intelligence quotient (IQ) in the TBI group (p < 0.05). In the stroke group, in addition to significant differences that appeared in the TBI group, additional significant differences in the digit span backward, visual learning delayed recall, auditory continuous performance test (CPT), visual CPT, and card sorting test. We compared the difference values at pre- and post-cognitive rehabilitation for cognitive recovery between the TBI and stroke groups. All contents, except the digital span forward, visual learning, word-color test, and MMSE, had greater mean values in the stroke group; and thus, statistically significant higher values were observed in the visual span forward and card sorting test (p < 0.05). Conclusion: Most evaluation results showed improvement and the evaluation between the TBI and stroke groups also showed significant differences in cognitive functions in addition to more CNT contents, which significantly change in the stroke group. The stroke group showed a high difference value in most CNT contents. Therefore, those with stroke in the focal brain region tend to have better cognitive function recovery after a computer-assisted cognitive rehabilitation than those with TBI, which could cause diffuse brain damage and post-injury inflammation.
Highlights
Sex, duration from disease onset to the initial computerized neuropsychological test (CNT) evaluation, duration of cognitive rehabilitation by computer-assisted cognitive rehabilitation (Comcog), initial MiniMental State Examination (MMSE) and initial modified Barthel index (MBI)
We compared the difference in values at pre- and post-cognitive rehabilitation for cognitive recovery traumatic brain injury (TBI) and stroke groups
Previous results have been obtained for differences in cognitive function impairment or recovery between TBI and stroke [24,41,42]. Those who have strokes in the focal brain region tend to be better for cognitive function recovery after computer-assisted cognitive rehabilitation than TBI patients in CNT subcategories
Summary
The impaired cognitive function becomes an obstacle that devestates both patients and caregivers and is an obstacle to the rehabilitation program [3], it exerts a detrimental effect on the degree of functional status and disability [4]. Cognitive rehabilitation is necessary for the effective management of acquired brain injuries. Cognitive rehabilitation was started for patients with brain injuries during World. Two main categories have been established in cognitive rehabilitation techniques, conventional (paper/pencil exercises) and computerized rehabilitation. Both cognitive rehabilitation techniques retrain the patient’s attention and concentration, visual processing, language, memory, reasoning and problem solving, and executive function deficits [7,8,9,10]. Conventional methods are manual exercises with the therapist, whereas computerized rehabilitation uses game-like programs, multimedia and informatics resources with specific hardware and software systems [11,12,13,14,15]
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