Cognitive Retraining and Functional Treatment (CRAFT) for adults with cancer related cognitive impairment: a preliminary efficacy study

Abstract

Purpose To examine the preliminary efficacy of Cognitive Retraining and Functional Treatment (CRAFT) combining remote computerized cognitive training (CCT) and occupation-based treatment in adults with cancer-related cognitive impairment (CRCI). Methods Three-armed randomized controlled trial including 74 individuals with CRCI, randomized into 12 weeks of either CRAFT, CCT alone, or treatment-as-usual. Assessments evaluating participation in daily life, perceived cognition, cognitive performance, quality-of-life, and treatment satisfaction were administered at baseline, post-intervention, and 3-month follow-up. Results Significant time × group interactions in favor of the CRAFT and CCT groups were found for participation in daily life ( F 2,34 = 5.31, p = .01, eta = .238), perceived cognition ( F 2,34 = 4.897, p = .014, eta = .224), and cognitive performance on speed of processing test ( F = 5.678, p = .009, eta = .289). The CRAFT group demonstrated significantly larger clinically meaningful gains on participation in daily life (chi-square = 6.91, p = .032) and significantly higher treatment satisfaction. All treatment gains were maintained at a 3-month follow-up ( n = 32). Conclusions CCT and CRAFT were found to have a positive impact on participation and cognitive outcomes among individuals with CRCI. The CRAFT showed an additional advantage in improving self-chosen occupation-based goals suggesting that a combination of cognitive training with occupation-based intervention has a positive synergistic effect resulting in “real world” health benefits. Implications for cancer survivors A combination of cognitive training with occupation-based intervention has a positive effect resulting in clinically meaningful improvements in participation in daily life, objective cognitive performance, and subjective cognitive impairment. Clinical trial registration: ClinicalTrials.gov NCT04210778, December 26, 2019, retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-023-07611-y.

Cancer-Related Cognitive Dysfunction: A Narrative Review for Clinical Practice

“…In a recent three-arm study, 74 patients were randomised to computer-assisted training with or without an occupational therapy approach versus no specific therapy. The intervention arms were significantly superior to the control arm in improving cognitive function, while the addition of occupational therapy further improved participation in daily life [32]. In a French study, the neuropsychologically assisted web-based training programme RehaCom ® was investigated and found to be significantly superior to home-based self-therapy using a workbook (paper-pencil method) [33].…”