Effect of a combined approach to cognitive rehabilitation in post-stroke patients

This study aims to investigate the effects of a combined therapy comprising a combination of computer-based cognitive rehabilitation with traditional rehabilitation techniques on cognitive functions in post-stroke patients suffering from a mild-to-moderate degree of cognitive impairment and to compare the results with a group of patients not receiving such therapy.

Methods:
33 post-stroke patients fulfilling exclusion/ inclusion criteria were allocated according to travel distance from the treatment centre to either the treatment (N = 19) or control group (N = 14). Cognitive rehabilitation was performed in 60-min-long sessions held twice a week for 12 weeks. Mini-Mental State Examination (MMSE) and Addenbrook Cognitive Examination –  Revised (ACE-R) tests were performed at the beginning of the treatment, retests were performed approximately 16 weeks later and the results, including ACE-R subscores as secondary endpoints, were analysed.

Results:
In the treatment group, statistically significant improvement (p < 0.05) was detected in MMSE, ACE-R, and in ACE-R subtests Memory, Verbal fluency and Language, while only the Memory subtest recorded statistically significant improvement in the control group. However, due to the small number of patients, we only present the results as trends indicating that a study on a larger cohort is needed. Hence, a sample size for a future study required for proper assessment of the effects of combined approach cognitive rehabilitation was calculated, the resulting group size is 334 patients.

Conclusions:
A combination of computer-based rehabilitation and traditional rehabilitation techniques in patients suffering from mild-to-moderate cognitive impairment as a result of stroke led to a statistically significant improvement in MMSE and ACE-R tests and in ACE-R Memory, Verbal fluency and Language subtests. However, due to a small number of patients, we only present these results as trends.