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计算机辅助认知康复对脑卒中后认知障碍的影响:系统评价和荟萃分析。

The effects of computer-assisted cognitive rehabilitation on cognitive impairment after stroke: A systematic review and meta-analysis.

机构信息

Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China.

Mingjiang Teachers College, Fuzhou, China.

出版信息

J Clin Nurs. 2022 May;31(9-10):1136-1148. doi: 10.1111/jocn.16030. Epub 2021 Aug 29.

Abstract

OBJECTIVES

To determine the effectiveness of computer-assisted cognitive rehabilitation in improving cognitive function in patients with post-stroke cognitive impairment.

BACKGROUND

In recent years, computer-assisted cognitive rehabilitation has been accepted as a good substitute or supplement for traditional cognitive rehabilitation. Some clinical randomised controlled trials have been carried out, but no relevant systematic evaluations have been performed. Therefore, we conducted a systematic review of studies involving computer-assisted cognitive rehabilitation to provide evidence-based data for its promotion and application.

METHODS

Nine databases (Cochrane Library, PubMed, Web of Science, Embase, OVID, Wanfang Data, CNKI, VIP and SinoMed databases) were systematically searched. Randomised controlled trials that assessed computer-assisted cognitive rehabilitation for patients with post-stroke cognitive impairment were included. Two reviewers appraised the risks of bias through the Cochrane Collaboration's tool and performed the meta-analysis, including the assessment of heterogeneity. We follow the PRISMA 2020 guidelines.

RESULTS

Thirty-two studies comprising 1837 participants were included. Compared with conventional therapy alone, the addition of computer-assisted cognitive rehabilitation significantly improved the global cognition of patients, evaluated using the Montreal cognitive assessment, mini-mental state examination and Loewenstein occupational therapy cognitive assessment (p < .01 for all tests). The therapy also significantly improved activities of daily living, assessed using the Barthel index, modified Barthel index and functional independence measure (p < .05 for all tests).

CONCLUSION

Computer-assisted cognitive rehabilitation significantly improved the cognitive function and activities of daily living of patients with post-stroke cognitive impairment.

RELEVANCE TO CLINICAL PRACTICE

Computer-assisted cognitive rehabilitation can be a valuable technique for cognitive rehabilitation after stroke. It is advantageous for improving patient cognition and restoring the overall functional state of patients. Moreover, the research findings can provide suggestions and inspiration for researchers to implement the proposal, which is conducive to the design of more rigorous and high-quality randomised controlled trials.

摘要

目的

确定计算机辅助认知康复在改善卒中后认知障碍患者认知功能方面的有效性。

背景

近年来,计算机辅助认知康复已被接受为传统认知康复的良好替代或补充方法。已经开展了一些临床随机对照试验,但尚未进行相关的系统评价。因此,我们对涉及计算机辅助认知康复的研究进行了系统评价,为其推广和应用提供了基于证据的数据。

方法

系统检索了 Cochrane 图书馆、PubMed、Web of Science、Embase、OVID、万方数据、中国知网、维普和中国生物医学文献服务系统等 9 个数据库。纳入评估计算机辅助认知康复对卒中后认知障碍患者影响的随机对照试验。两位评价者使用 Cochrane 协作工具评估偏倚风险,并进行荟萃分析,包括异质性评估。我们遵循 PRISMA 2020 指南。

结果

共纳入 32 项研究,包括 1837 名参与者。与单纯常规治疗相比,计算机辅助认知康复显著改善了蒙特利尔认知评估、简易精神状态检查和洛文斯顿作业疗法认知评估的患者整体认知(所有测试 p <.01)。该疗法还显著改善了日常生活活动能力,评估指标包括巴氏指数、改良巴氏指数和功能独立性评定(所有测试 p <.05)。

结论

计算机辅助认知康复显著改善了卒中后认知障碍患者的认知功能和日常生活活动能力。

临床意义

计算机辅助认知康复是卒中后认知康复的一种有价值的技术。它有利于改善患者认知能力和恢复患者的整体功能状态。此外,研究结果可为研究人员实施该方案提供建议和启示,有助于设计更严格、高质量的随机对照试验。

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