The Effectiveness of Computer-Assisted Cognitive Rehabilitation and the Degree of Recovery in Patients with Traumatic Brain Injury and Stroke

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.

Does Non-Immersive Virtual Reality Improve Attention Processes in Severe Traumatic Brain Injury? Encouraging Data from a Pilot Study

“…In fact, VR has been used successfully to stimulate attention processes following TBI [ 27 , 28 , 29 , 30 ]. Besides, the current literature reported that information and communication technologies and PC-based solutions, such as serious games, software-dedicated CR, VR simulations, or other computer-mediated approaches, have an enormous impact to promote the intensity and personalization of APT, using ecological and motivational tasks [ 31 , 32 ]. Among rehabilitative virtual systems, the VRRS-EVO (Khymeia, Padua, Italy) has an intuitive and simplified interface thanks to “remote touch”, which allows the immediate management of all its functions, offering an augmented feedback to the patients.…”

Inpatient Rehabilitation Falls: Comparing Patients With Traumatic Brain Injury Versus Patients With Stroke

“…The scale assesses five items, physical limitation (scored 0 or 2), mental state (0 or 3), pharmacological treatment (0 or 2), invasive procedures (0 or 2), and risk factors (0 or 1), and therefore ranges from 0 to 10, with the higher the score, the higher the risk of falls. It was categorized into three risk levels: 0–1 (low), 2–3 (mild), and 4 or more (high) (Lefroy et al, 1992). The construct validity was assessed using factor analysis by Thompson (1984), who reported that CRBRS items reflect two dimensions of dependency: capacity for self-care and ability to walk.…”

“…Traumatic brain injuries are a major cause of disabilities among male adults younger than 45 years, whereas strokes generally appear after the age of 45 years (Castor & El Massioui, 2018). The pattern and degree of cognitive impairment recovery in patients with stroke and TBI may differ (Jung et al, 2021).…”

Study protocol for a non-randomised controlled trial: Community-based occupational therapy intervention on mental health for people with acquired brain injury (COT-MHABI)

“…The following have been identified as the main ones: (i) the inclusion of various aetiologies of ABI as a generalised concept, when the clinics presented by the patients may differ considerably [62]; (ii) the difficulty of knowing the influence of the different treatments that the patients in the control group may receive; (iii) the variability in the different conceptions of the construct "mental health" and its implications in the design of the protocol itself as well as in the practice on the quality of professional support that this population profile receives; (iv) due to the technical particularities of the research proposal, the therapist delivering the intervention and subsequently analysing a large part of the data is the same person, which may lead to biases in the results; (v) the heterogeneity in terms of the range of time after ABI in which the intervention takes place, as both groups have a wide range. This is because, at present, this is the first time that this type of support initiative is being provided in this region; so, patients are not screened according to the time of acquisition of the brain injury but by the importance of the current condition and their personal, occupational, social, and family issues.…”