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Cognitive Rehabilitation (cognitive + rehabilitation)
Selected AbstractsEFNS guidelines on cognitive rehabilitation: report of an EFNS task forceEUROPEAN JOURNAL OF NEUROLOGY, Issue 9 2005Members of the Task Force on Cognitive Rehabilitation Disorders of language, spatial perception, attention, memory, calculation and praxis are a frequent consequence of acquired brain damage [in particular, stroke and traumatic brain injury (TBI)] and a major determinant of disability. The rehabilitation of aphasia and, more recently, of other cognitive disorders is an important area of neurological rehabilitation. We report here a review of the available evidence about effectiveness of cognitive rehabilitation. Given the limited number and generally low quality of randomized clinical trials (RCTs) in this area of therapeutic intervention, the Task Force considered, besides the available Cochrane reviews, evidence of lower classes which was critically analysed until a consensus was reached. In particular, we considered evidence from small group or single cases studies including an appropriate statistical evaluation of effect sizes. The general conclusion is that there is evidence to award a grade A, B or C recommendation to some forms of cognitive rehabilitation in patients with neuropsychological deficits in the post-acute stage after a focal brain lesion (stroke, TBI). These include aphasia therapy, rehabilitation of unilateral spatial neglect (ULN), attentional training in the post-acute stage after TBI, the use of electronic memory aids in memory disorders, and the treatment of apraxia with compensatory strategies. There is clearly a need for adequately designed studies in this area, which should take into account specific problems such as patient heterogeneity and treatment standardization. [source] Bilateral activation of the prefrontal cortex after strategic semantic cognitive trainingHUMAN BRAIN MAPPING, Issue 4 2006Eliane C. Miotto Abstract The prefrontal cortex (PFC) has been implicated in the ability to apply semantic organizational strategies during verbal encoding and episodic learning. However, there has been no direct evidence demonstrating which specific areas in the PFC are engaged after cognitive training using semantic organizational strategies in healthy adult human subjects. In this study, we investigated the effects of semantic strategic training on brain activity and changes in behavioral performance, after cognitive training, using functional MRI (fMRI). There was a significant activation in bilateral dorsolateral prefrontal (DLPF) and orbitofrontal (OFC) areas after cognitive training. These results demonstrate the engagement of bilateral DLPF and OFC cortex during strategic memory processes, particularly when mobilization and effort of effective use of strategies are required. The functional adaptations observed here may also shed light on some of the processes underlying recovery with cognitive rehabilitation in patient populations with brain injury. Hum Brain Mapp, 2005. © 2005 Wiley-Liss, Inc. [source] A randomized, two-year study of the efficacy of cognitive intervention on elderly people: the Donostia Longitudinal StudyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2008Cristina Buiza Abstract Background Research on non-pharmacological therapies (cognitive rehabilitation) in old age has been very limited, and most has not considered the effect of interventions of this type over extended periods of time. Objective To investigate a new cognitive therapy in a randomized study with elderly people who did not suffer cognitive impairment. Methods The efficacy of this therapy was evaluated by means of post-hoc analysis of 238 people using biomedical, cognitive, behavioural, quality of life (QoL), subjective memory, and affective assessments. Results Scores for learning potential and different types of memory (working memory, immediate memory, logic memory) for the treatment group improved significantly relative to the untreated controls. Conclusions The most significant finding in this study was that learning potential continued at enhanced levels in trained subjects over an intervention period lasting two years, thereby increasing rehabilitation potential and contributing to successful ageing. Copyright © 2007 John Wiley & Sons, Ltd. [source] Occupational therapists use of cognitive interventions for clients with Alzheimer's diseaseOCCUPATIONAL THERAPY INTERNATIONAL, Issue 1 2010Alexandra Robert Abstract The aim of this study was to establish a profile of occupational therapy practice for cognitive interventions for clients with Alzheimer's disease (AD) in an urban setting. Seventy-four occupational therapists working with older adults with AD in diverse settings in the city of Montreal were randomly selected and were sent a self-administered questionnaire by mail. Sixty-five (87.8%) therapists responded. Findings indicated that 52.3% of occupational therapists are performing cognitive interventions with persons with AD. Of those, 82.4% report using cognitive rehabilitation, 61.8% using cognitive stimulation and 50.0% using cognitive training. Intervention use varied across settings and differed according to severity of AD. The sessions are usually provided individually and often include the client's caregiver. Generalizability of the results is limited to urban areas, and possible differences in service provision should be taken into consideration. Further research is needed to measure the effectiveness of these interventions provided by occupational therapists and to compare occupational therapy practices in urban and rural areas. Copyright © 2009 John Wiley & Sons, Ltd. [source] Evaluating the efficacy of tele-cognitive rehabilitation for functional performance in three case studiesOCCUPATIONAL THERAPY INTERNATIONAL, Issue 1 2003Dr Sing-Fai Tam PhD Associate Professor Abstract Traumatic brain injury (TBI) is one of the main causes of long-term disability, and its rehabilitation is a challenge to the healthcare team. Tele-rehabilitation, through using advancements in networking and tailor-made software, has been developed and applied to the cognitive rehabilitation of persons with brain injury in the present study. Tele-cognitive rehabilitation uses customized online computer software as a treatment mode. The online treatment software is operated on an interactive tele-communication platform , for example, video conferencing with screen sharing. Through implementing the tele-cognitive rehabilitation activities, therapists can help clients to practise and thus improve their cognitive skills through using the treatment software successfully. Moreover, hypermedia programming techniques allow the therapist to adjust the software to meet the client's treatment needs, so that the treatment is appropriate to his/her functional levels and living environment. Also the software can customize immediate visual, auditory and personalized feedback to motivate the client and training can be set at the right pace for the client's needs. The present study aimed to evaluate the effectiveness and perceived efficacy of the newly developed customized tele-cognitive rehabilitation programme for three subjects with traumatic brain injury through using single-case and qualitative research design. The cognitive factors investigated in this pilot study were, respectively, Chinese word recognition, prospective memory and semantic memory. The subjects had undergone a recruitment process with stipulated screening criteria. A single case experimental design (ABA reversal/withdrawal design) consisted of a no-intervention baseline phase (A), an intervention phase (B) and a no-intervention withdrawal phase (A). There were six sessions in each phase, making a total of 18 sessions. Tele-cognitive rehabilitation software was tailor-made according to each subject's cognitive functional needs. To monitor the change in cognitive functions, variables were tapped by tailor-made assessment and qualitative questionnaires through interviews, and they were then used to explore subjects' opinions of the programme and to test the treatment efficacy of the tele-cognitive rehabilitation programme. Finally, the relationships among the three phases were analysed through visual analysis and trend line analysis by means of the split-middle method. The three persons with brain injury showed improving trends and levels of specific cognitive performance during the treatment phase. Qualitative findings were analysed and confirmed the efficacy of the treatment module. The tele-cognitive rehabilitation approach was well received by subjects. The authors suggest that further replication studies of this kind should be conducted in the future and that more subjects should be recruited to improve the generalizability of the results. Copyright © 2003 Whurr Publishers Ltd. [source] Exploring the role of face processing in facial emotion recognition in schizophreniaACTA NEUROPSYCHIATRICA, Issue 6 2009Paola Rocca Objective: Impairment in emotion perception represents a fundamental feature of schizophrenia with important consequences in social functioning. A fundamental unresolved issue is the relationship between emotion perception and face perception. The aim of the present study was to examine whether facial identity recognition (Identity Discrimination) is a factor predicting facial emotion recognition in the context of the other factors, known as contributing to emotion perception, such as cognitive functions and symptoms. Methods: We enrolled 58 stable schizophrenic out-patients and 47 healthy subjects. Facial identity recognition and emotion perception were assessed with the Comprehensive Affect Testing System. Different multiple regression models with backward elimination were performed in order to discover the relation of each significant variable with emotion perception. Results: In a regression including the six significant variables (age, positive symptomatology, Identity Discrimination, attentive functions, verbal memory-learning, executive functions) versus emotion processing, only attentive functions (standardised , = 0.264, p = 0.038) and Identity Discrimination (standardised , = 0.279, p = 0.029) reached a significant level. Two partial regressions were performed including five variables, one excluding attentive functions and the other excluding Identity Discrimination. When we excluded attentive functions, the only significant variable was Identity Discrimination (standardised , = 0.278, p = 0.032). When we excluded Identity Discrimination, both verbal memory-learning (standardised , = 0.261, p = 0.042) and executive functions (standardised , = 0.253, p = 0.048) were significant. Conclusions: Our results emphasised the role of face perception and attentional abilities on affect perception in schizophrenia. We additionally found a role of verbal memory-learning and executive functions on emotion perception. The relationship between those above-mentioned variables and emotion processing could have implications for cognitive rehabilitation. [source] Training of attention and memory deficits in children with acquired brain injuryACTA PAEDIATRICA, Issue 2 2010N Madsen Sjö Abstract This pilot study concerns cognitive rehabilitation of children with acquired brain injury (ABI). Aim:, The aim is threefold; to determine (1) whether the Amsterdam Memory and Attention Training for Children (AMAT-C) programme for children with ABI can be integrated in the child's school, (2) whether supervision in the school-setting maintains the child's motivation throughout the training programme and (3) whether positive changes in memory, attention and executive functions are found with this implementation of the training method. Methods:, Seven children with memory and/or attention deficits after ABI were trained with AMAT-C. Measures used were programme evaluation questions, neuropsychological tests and a questionnaire concerning executive functions. Results:, Overall, children, parents and trainers were satisfied with the programme and the children were motivated throughout the programme. The children showed significant improvements in neuropsychological subtests, primarily in tests of learning and memory. No overall change in executive functions was noted. Conclusion:, Provision of AMAT-C training and supervision at the child's school appears to ensure (1) satisfaction with the programme, (2) sustaining of motivation and (3) improvements in learning and memory. [source] | ||||||||||