School of Psychological Sciences, Monash Unviersity, Clayton, Australia.
J Rehabil Med. 2019 May 13;51(5):343-351. doi: 10.2340/16501977-2540.
Memory deficits are common after stroke, yet remain a high unmet need within the community. The aim of this phase II randomized controlled trial was to determine whether group compensatory or computerized cognitive training approaches were effective in rehabilitating memory following stroke.
A parallel, 3-group, single-blind, randomized controlled trial was used to compare the effectiveness of a compensatory memory skills group with restorative computerized training on functional goal attainment. Secondary outcomes explored change in neuropsychological measures of memory, subjective ratings of prospective and everyday memory failures and ratings of internal and external strategy use.
A total of 65 community dwelling survivors of stroke were randomized (24: memory group, 22: computerized cognitive training, and 19: wait-list control). Participants allocated to the memory group reported significantly greater attainment of memory goals and internal strategy use at 6-week follow-up relative to participants in computerized training and wait-list control conditions. However, groups did not differ significantly on any subjective or objective secondary outcomes.
Preliminary evidence shows that memory skills groups, but not computerized training, may facilitate achievement of functional memory goals for community dwelling survivors of stroke. These findings require further replication, given the modest sample size, subjective nature of the outcomes and the absence of objective eligibility for inclusion.
脑卒中后常出现记忆障碍,但在社区中仍存在高度未满足的需求。本 II 期随机对照试验旨在确定团体补偿性或计算机认知训练方法在脑卒中后康复记忆方面是否有效。
采用平行、3 组、单盲、随机对照试验,比较补偿性记忆技能组与恢复性计算机训练对实现功能目标的有效性。次要结局指标包括记忆的神经心理学测量、前瞻性和日常记忆失败的主观评分以及内部和外部策略使用的评分的变化。
共有 65 名居住在社区的脑卒中幸存者被随机分配(24 名:记忆组、22 名:计算机认知训练组和 19 名:候补名单对照组)。与计算机训练组和候补名单对照组相比,分配到记忆组的参与者在 6 周随访时报告在实现记忆目标和内部策略使用方面有显著更大的改善。然而,各组在任何主观或客观的次要结局上均无显著差异。
初步证据表明,记忆技能组而非计算机训练可能有助于实现社区居住的脑卒中幸存者的功能性记忆目标。鉴于样本量较小、结局的主观性以及缺乏客观纳入标准,这些发现需要进一步复制。