Efficacy of a Training on Executive Functions in Potentiating Rehabilitation Effects in Stroke Patients

Abstract

Cognitive impairment after a stroke has a direct impact on patients’ disability. In particular, impairment of Executive Functions (EFs) interferes with re-adaptation to daily life. The aim of this study was to explore whether adding a computer-based training on EFs to an ordinary rehabilitation program, regardless of the specific brain damage and clinical impairment (motor, language, or cognitive), could improve rehabilitation outcomes in patients with stroke. An EF training was designed to have minimal motor and expressive language demands and to be applied to a wide range of clinical conditions. A total of 37 stroke patients were randomly assigned to two groups: a training group, which performed the EF training in addition to the ordinary rehabilitation program (treatment as usual), and a control group, which performed the ordinary rehabilitation exclusively. Both groups were assessed before and after the rehabilitation program on neuropsychological tests covering multiple cognitive domains, and on functional scales (Barthel index, Functional Independence Measure). The results showed that only patients who received the training improved their scores on the Attentional Matrices and Phonemic Fluency tests after the rehabilitation program. Moreover, they showed a greater functional improvement in the Barthel scale as well. These results suggest that combining an EF training with an ordinary rehabilitation program potentiates beneficial effects of the latter, especially in promoting independence in activities of daily living.

Executive Function Poststroke: Concepts, Recovery, and Interventions

“…93 Other studies report significant differences in improvements on selected measures of working memory, inhibition, cognitive flexibility, and abstract reasoning. 94–97…”

“…93 Other studies report significant differences in improvements on selected measures of working memory, inhibition, cognitive flexibility, and abstract reasoning. [94][95][96][97] Additional studies have examined cognitive training in combination with interventions designed to augment cognitive training outcomes. Two studies have examined a combination of aerobic exercise and cognitive training compared to either intervention alone, a sham condition, or no intervention and reported significantly greater changes in either working memory or abstract reasoning.…”

Bayesian modeling disentangles language versus executive control disruption in stroke

“…As a litmus test of model quality, the posterior predictive checks confirmed the adequate fit of our estimated MIMO prediction model. The variation was described by how individual lesion atom expressions explained differences in cognitive performance outcomes in patients 48 , albeit with different achieved performances across the target cognitive scores (coefficient of determination R 2 ranged from 0.11 to 0.49 for phonemic fluency and MMSE, respectively, Fig. 2A ).…”

“…Stroke often severely affects cognition and can cause loss of language and executive functions. [2][3][4] These cognitive faculties are crucial for interpersonal interaction in everyday life. Language is a key ability for communication uniquely developed in humans, including production and comprehension abilities.…”

Analysis of Verbal Language from the Theory of Human Movement as a Complex System

“…Other practical implications are found in the sciences of rehabilitation and human movement. Human movement has a potential mediator in the rehabilitation of language disorders in its different modalities [40,41], just as language expressions have the potential to mediate in the rehabilitation of human movement deficiencies [42,43], and aspects supported by the shared resource theory between motor and cognitive control [6][7][8]. Likewise, this analytical approach offers inputs for physical education and conditioning processes with the participation of language [44,45].…”