Efficacy Of Cognitive Rehabilitation Research Articles

Cognitive Rehabilitation Approaches to Traumatic Brain Injury: A Review of Efficacy and Outcomes

Cognitive rehabilitation is a critical component of intervention for many individuals with both short- and long-term impairments associated with traumatic brain injury (TBI). By focusing on major cognitive domains, emotional processing, and behavioral strategies, clinicians use cognitive rehabilitation to improve cognitive related functional outcomes, quality of life, and social relationships. Cognitive rehabilitation is traditionally divided into restorative and compensatory approaches, though increasingly combined approaches within the larger medical, multidisciplinary team are being incorporated and explored. Literature related to cognitive rehabilitation within the TBI population continues to be needed in order to assist clinicians in developing evidence-based intervention protocols and therapy plans. This paper details current approaches to cognitive rehabilitation and provides an updated review of the literature associated with the efficacy of cognitive rehabilitation. Reviewed evidence supports the use of cognitive rehabilitation to improve multiple cognitive domains, including attention, memory, executive function, and metacognitive skills. The long-term outcomes of continued cognitive rehabilitation services post-TBI are not as comprehensively documented as the relative short-term outcomes. The efficacy of cognitive rehabilitation is impacted by patient-specific variables, timing and intensity of treatment. This paper concludes with noted information related to the limitations of the current evidence of cognitive rehabilitation, including study design concerns, and reduced generalizability of the relevant research.

Efficacy of Cognitive Rehabilitation on Functional Outcomes & Quality of Life in Parkinson’s Patients

Efficacy of Cognitive Rehabilitation on Functional Outcomes & Quality of Life in Parkinson’s Patients

Telemedicine and Virtual Reality for Cognitive Rehabilitation: A Roadmap for the COVID-19 Pandemic.

The current COVID-19 pandemic presents unprecedented new challenges to public health and medical care delivery. To control viral transmission, social distancing measures have been implemented all over the world, interrupting the access to routine medical care for many individuals with neurological diseases. Cognitive disorders are common in many neurological conditions, e.g., stroke, traumatic brain injury, Alzheimer's disease, and other types of dementia, Parkinson's disease and parkinsonian syndromes, and multiple sclerosis, and should be addressed by cognitive rehabilitation interventions. To be effective, cognitive rehabilitation programs must be intensive and prolonged over time; however, the current virus containment measures are hampering their implementation. Moreover, the reduced access to cognitive rehabilitation might worsen the relationship between the patient and the healthcare professional. Urgent measures to address issues connected to COVID-19 pandemic are, therefore, needed. Remote communication technologies are increasingly regarded as potential effective options to support health care interventions, including neurorehabilitation and cognitive rehabilitation. Among them, telemedicine, virtual reality, augmented reality, and serious games could be in the forefront of these efforts. We will briefly review current evidence-based recommendations on the efficacy of cognitive rehabilitation and offer a perspective on the role of tele- and virtual rehabilitation to achieve adequate cognitive stimulation in the era of social distancing related to COVID-19 pandemic. In particular, we will discuss issues related to their diffusion and propose a roadmap to address them. Methodological and technological improvements might lead to a paradigm shift to promote the delivery of cognitive rehabilitation to people with reduced mobility and in remote regions.

Cognitive rehabilitation for people with mild to moderate dementia

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the effects of cognitive rehabilitation on everyday functioning and other outcomes for people with mild to moderate dementia, and on outcomes for caregivers To identify and explore factors that may be associated with the efficacy of cognitive rehabilitation.

Efficacy of Cognitive Rehabilitation in Alzheimer Disease: A 1-Year Follow-Up Study.

The benefit of cognitive rehabilitation (CR) for patients with early-stage Alzheimer disease (AD) remains difficult to assess. An observational, prospective study was conducted in a sample of 52 patients with AD included in a clinical, individualized CR program. Cognitive rehabilitation consisted of 1 weekly session during 3 months at home, followed by 1 monthly contact for 9 months. Rehabilitation techniques were used by experienced therapists to adapt activities important for the patient. Evaluation of patient's dependence in activities and objective and subjective caregiver's burden was performed with a research quantitative scale immediately after the intervention and at 6-month and 1-year follow-up. Analyses with repeated measure analysis of variance showed decreased patient's dependence for adapted activities at 3 months, 6 months, and 1 year. Objective and subjective percentage of caregiver's burden was also decreased at all evaluations with our research functional scale, while there was no change on Zarit's burden scale. Global cognition slightly decreased over 1 year. This observational study in a clinical setting is in line with the benefit of CR for patients with mild AD reported in recent randomized controlled trials. The benefit obtained for adapted activities remained after 1 year, even if global cognition declined. Moreover caregiver's burden related to all individually relevant daily activities (from a list of 98) evaluated within the CR program was decreased after 1 year. Those preliminary results emphasize the importance of choice for the measurement instrument to report CR efficacy and claim for further validation of such tools.

Mechanisms of functional improvement through cognitive rehabilitation in schizophrenia

Whereas the efficacy of cognitive rehabilitation in schizophrenia is widely known, studies examining mechanisms for functional improvement are still scarce. The aim of the study was to examine the mediational mechanisms through which cognitive rehabilitation improves functioning in schizophrenia. One hundred and eleven schizophrenia patients were randomly assigned to either a 4-month cognitive rehabilitation group or an active control group. Patients underwent a neurocognitive battery (including processing speed, verbal memory, working memory and executive functioning) and social cognition assessment (emotion perception, theory of mind and social perception). Functioning was assessed by the combined use of a performance-based instrument, the UCSD Performance-based Skills Assessment (UPSA) and an observer-rated instrument, the Global Assessment of Functioning (GAF). The trial was registered in clinicaltrials.gov (NCT02796417). Multiple mediational analyses revealed that the effect of cognitive rehabilitation on functional improvement was partially mediated by changes in processing speed and verbal memory, but not by the domains of social cognition and negative symptoms. More specifically, verbal memory partially mediated the treatment's effect on performance-based functioning (UPSA), whereas processing speed acted as a partial mediator for observer-rated functioning (GAF). The effect of rehabilitation on functioning did not take place through all the domains that showed significant improvement. Verbal memory and processing speed emerged as the most crucial factors. However, these complex interactions need further research.

Efficacy of cognitive rehabilitation in Parkinson's disease.

Efficacy of cognitive rehabilitation in Parkinson's disease.

Efficacy of cognitive rehabilitation using computer software with individuals living with schizophrenia: A randomized controlled trial in Japan.

Cognitive impairment is common in schizophrenia, and is associated with poor psychosocial functioning. Previous studies had inconsistently shown improvement in cognitive functions with cognitive remediation therapy. This study examined whether cognitive remediation is effective in improving both cognitive and social functions in schizophrenia in outpatient settings that provide learning-based psychiatric rehabilitation. This study is the first randomized controlled trial of cognitive remediation in Japan. Study participants were individuals with schizophrenia from 6 outpatient psychiatric medical facilities who were randomly assigned either a cognitive remediation program or treatment as usual. The cognitive remediation intervention includes Cognitive training using computer software (CogPack; Japanese version) administered twice a week and a weekly group over 12 weeks and was based on the Thinking Skills for Work program. Most study participants were attending day treatment services where social skills training, psychoeducation for knowledge about schizophrenia, group activities such as recreation and sport, and other psychosocial treatment were offered. Cognitive and social functioning were assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) and Life Assessment Scale for Mentally Ill (LASMI) at pre- and postintervention. Of the 60 people with schizophrenia enrolled, 29 were allocated to the cognitive remediation group and 31 were allocated to the treatment as usual group. Processing speed, executive function, and the composite score of the BACS showed significantly greater improvement for the cognitive remediation group than the treatment as usual group. In addition, there was significant improvement in interpersonal relationships and work skills on the LASMI for the cognitive remediation group compared with the treatment as usual group. Changes from pretreatment to posttreatment in verbal fluency and interpersonal relationships were significantly correlated, as well as changes in attention and work skills. The present findings showed that providing cognitive remediation on addition to psychiatric rehabilitation contributed to greater improvement in both cognitive and social functioning than psychiatric rehabilitation alone. Cognitive remediation may enhance the efficacy of psychiatric rehabilitation improving social functioning. (PsycINFO Database Record

Research Highlights: Application of functional neuroimaging to evaluating the efficacy of cognitive rehabilitation in neurological populations

Research Highlights: Application of functional neuroimaging to evaluating the efficacy of cognitive rehabilitation in neurological populations

Computer-assisted rehabilitation of attention in patients with multiple sclerosis: results of a randomized, double-blind trial

Background: There is controversial information on the efficacy of cognitive rehabilitation in multiple sclerosis (MS). Objective: The objective of this paper is to test a home-based computerized program for retraining attention dysfunction in MS. Methods: Relapsing–remitting patients who failed > 2 tests of attention on an extensive neuropsychological battery were randomized to specific or nonspecific computerized training (ST, n-ST), in one-hour sessions, twice a week for three months. Outcome measures included neuropsychological assessment, depression, fatigue, everyday activities and a visual analogue scale assessing attentive performance (VAS). Assessments were repeated after the interventions and after a further three months. Statistical analysis included the analysis of variance (ANOVA) for repeated measures. Results: Eighty-eight out of 102 randomized patients completed the study (69 women, age 40.9 ± 11.5 years, disease duration 13.0 ± 8.7 years, Expanded Disability Status Scale score 2.7 ± 1.5). Fifty-five patients were randomized to ST, 33 to n-ST. A benefit of the ST was observed on the Paced Auditory Serial Addition Test (p < 0.002). However, patient self-report did not reveal differences between ST and n-ST patient groups. Conclusion: Although our program trained different attention components, we could detect some improvements exclusively on tasks of sustained attention. Moreover, patient self-perceived results may be independent of the training program.

Cognitive rehabilitation in Multiple sclerosis

Cognitive impairments are frequent in Multiple sclerosis (MS). However, most studies about efficacy of cognitive rehabilitation interventions have been criticized in terms of methods and/or design. The aim of this study is to evaluate the efficacy of cognitive rehabilitation in MS patients with a cognitive intervention (ProCogSEP* program), compared to a control intervention (discussion program). Twenty MS patients have completed this simple blind study: 10 patients followed 13 sessions (2 hours) of the ProCog-SEP1 program. Ten other patients followed 13 sessions (2 hours) of a discussion program (Control Group). All patients underwent neuropsychological assessment, before and after their program, in order to evaluate cognitive functions. Two neuropsychologists respectively assessed the patients and conducted the group sessions. Compared to its own baseline, ProCog-SEP Group show improvements in verbal memory [free recall (p = .02), learning (p = .002)], in visual memory [free (p = .05) and delayed recall (p = .007)], in working-memory (p = .03), in verbal fluency (p = .05) and in language (p = .01). Inter group analysis show a benefit of cognitive program mainly in verbal and visual memory, and in verbal fluencies. These results support the interest of a cognitive therapeutic management of MS patients.

Neuropsychological Consequences of Cancer and Cancer Treatment

Abstract Purpose : This review paper was written to facilitate greater understanding of functional cognitive deficits associated with cancer and cancer treatment. Rehabilitation of patients with cancer also has been considered in this review to raise awareness of this potentially underserved population. Method : A review of the literature pertaining to cognitive effects of cancer and cancer therapy was conducted. Results and Conclusions : A growing literature suggests the phenomenon popularly called “chemo brain” results from dysfunction of frontal-subcortical networks and manifests as deficits of executive functioning (e.g., reasoning, decision-making, resource allocation), processing speed, inhibition, and goal-oriented behaviors. Further research is needed, however, to attribute clearly these broad cognitive side effects to the disease process and each of several treatments and to establish the efficacy of cognitive rehabilitation for patients with cancer.

Efficacy of cognitive rehabilitation in patients with mild cognitive impairment treated with cholinesterase inhibitors

Individuals who have Mild Cognitive Impairment (MCI) may be in a transitional stage between aging and Alzheimer's disease (AD). The high rate of conversion from MCI to AD makes early treatment an important clinical issue. Recent evidence suggests that cognitive training intervention may reduce the rate of progression to AD. To evaluate the efficacy of a NeuroPsychological Training (TNP) in patients with MCI who are treated with cholinesterase inhibitors (ChEIs), compared with patients MCI treated only with ChEIs and patients not treated, in a longitudinal, one year follow-up study. One year longitudinal and retrospective comparison study of neuropsychological performances in 59 subjects affected by Mild Cognitive Impairment (MCI) according to Petersen's criteria. Fifteen subjects were randomised to receive TNP plus cholinesterase inhibitors; 22 subjects cholinesterase inhibitors alone and 22 subjects no treatment. All the subjects referring memory complaints, corroborated by an informant, underwent a multidimensional assessment concerning neuropsychological, behavioural and functional characteristics, at baseline and after one year follow-up. Subjects without treatment maintained their cognitive, functional and behavioural status after one year; patients treated only with ChEIs improved in depressive symptoms whereas subjects treated with TNP and ChEIs showed significant improvements in different cognitive areas, such as memory, abstract reasoning and in behavioural disturbances, particularly depressive symptoms. A long-term TNP in ChEIs-treated MCI subjects induces additional cognitive and mood benefits.

Cognitive training in home environment

Primary objective: To examine the efficacy of cognitive rehabilitation in the patient's home or vocational environment.Research design: Pre–post-follow-up design.Methods and procedures: Ten outpatients with acquired attention and memory problems received cognitive training three times weekly, for 3 weeks. They received individual attention training with Attention Process Training, training for generalization for everyday activities and education in compensatory strategies for self-selected cognitive problems. Treatment effects were evaluated with neuropsychological and occupational therapy instruments before and after the training and after 3 months on impairment, activity and participation levels.Main outcomes and results: The results indicated a positive effect on some measures on impairment level, but no differences on activity or participation levels at follow-up.Conclusions: The study indicates that home-based cognitive training improves some attentional and memory functions and facilitates learning of strategies. Future controlled studies are needed to confirm the results and analyse the efficacy of different aspects of home-based training.

3. Rehabilitation interventions: Cognitive, behavioral, and community reentry

Miller MA, Burnett DM, McElligott JM. Congenital and acquired brain injury. 3. Rehabilitation interventions: cognitive, behavioral, and community reentry. Arch Phys Med Rehabil 2003;84 Suppl 1:S12-7. This self-directed learning module highlights the cognitive and psychosocial adjustment aspects of brain injury. It is part of the chapter on congenital and acquired brain injury in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article focuses specifically on evaluation and treatment of mood and behavioral impairments after brain injury, treatment of cognitive impairments, efficacy of cognitive rehabilitation, psychosocial impact of a traumatic brain injury on families, and resources available for community reintegration. Overall Article Objective: To summarize the psychosocial and cognitive impact of brain injury in children and adults.

The efficacy of cognitive rehabilitation: What do we remediate and when : Connie Dunse and Lisa Lowe (Tampa General Rehabilitation Center)

The efficacy of cognitive rehabilitation: What do we remediate and when : Connie Dunse and Lisa Lowe (Tampa General Rehabilitation Center)

Functional outcome assessment of adults with traumatic brain injury.

The treatment of cognitive communicative impairments that occur due to traumatic brain injury is a relatively new field. There is a need for more empirical evidence supporting the efficacy of cognitive rehabilitation. Fortunately, the number of studies in this area have continued to grow over the past few years. The purpose of this article is to provide current information regarding the assessment of functional outcomes after traumatic brain injury using the theoretical framework of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH), which was developed by the World Health Organization (WHO).

Memory training and multiple sclerosis: A case study

Multiple sclerosis (MS) is a progressive neurological disorder often accompanied by significant cognitive deficits. Some research suggests that recent memory is the most commonly affected cognitive ability in MS. However, there is only one empirical investigation examining the efficacy of cognitive rehabilitation in individuals with MS. We report the application of a memory training program to remediate memory deficits in a patient with MS. The program focused on teaching mnemonic strategies to increase list learning ability and ability to recall names of faces. Results suggested that memory training improved visual and verbal memory abilities. The most marked improvement was present on tests assessing verbal memory abilities. These results contribute to a growing body of literature indicating that teaching mnemonic strategies is one method of improving memory functioning in individuals with mild to moderate memory impairment.

The efficacy of cognitive rehabilitation with mildly closed head injured patients with premorbid high achievement functioning

The efficacy of cognitive rehabilitation with mildly closed head injured patients with premorbid high achievement functioning

The efficacy of cognitive rehabilitation: What do we remediate and when

The efficacy of cognitive rehabilitation: What do we remediate and when