School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, 91240, Jerusalem, Israel.
Department of Neurology and Oncology, The Gaffin Center for Neuro-Oncology, Sharett Institute for Oncology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, 91120, Jerusalem, Israel.
Support Care Cancer. 2023 Feb 7;31(3):152. doi: 10.1007/s00520-023-07611-y.
To examine the preliminary efficacy of Cognitive Retraining and Functional Treatment (CRAFT) combining remote computerized cognitive training (CCT) and occupation-based treatment in adults with cancer-related cognitive impairment (CRCI).
Three-armed randomized controlled trial including 74 individuals with CRCI, randomized into 12 weeks of either CRAFT, CCT alone, or treatment-as-usual. Assessments evaluating participation in daily life, perceived cognition, cognitive performance, quality-of-life, and treatment satisfaction were administered at baseline, post-intervention, and 3-month follow-up.
Significant time × group interactions in favor of the CRAFT and CCT groups were found for participation in daily life (F = 5.31, p = .01, eta = .238), perceived cognition (F = 4.897, p = .014, eta = .224), and cognitive performance on speed of processing test (F = 5.678, p = .009, eta = .289). The CRAFT group demonstrated significantly larger clinically meaningful gains on participation in daily life (chi-square = 6.91, p = .032) and significantly higher treatment satisfaction. All treatment gains were maintained at a 3-month follow-up (n = 32).
CCT and CRAFT were found to have a positive impact on participation and cognitive outcomes among individuals with CRCI. The CRAFT showed an additional advantage in improving self-chosen occupation-based goals suggesting that a combination of cognitive training with occupation-based intervention has a positive synergistic effect resulting in "real world" health benefits.
A combination of cognitive training with occupation-based intervention has a positive effect resulting in clinically meaningful improvements in participation in daily life, objective cognitive performance, and subjective cognitive impairment.
ClinicalTrials.gov NCT04210778, December 26, 2019, retrospectively registered.
研究认知再训练和功能治疗（CRAFT）联合远程计算机认知训练（CCT）和基于职业的治疗在癌症相关认知障碍（CRCI）成人中的初步疗效。
这是一项包括 74 名 CRCI 患者的三臂随机对照试验，将他们随机分为 12 周的 CRAFT、单独 CCT 或常规治疗。在基线、干预后和 3 个月随访时，评估了日常生活参与度、感知认知、认知表现、生活质量和治疗满意度。
CRAFT 和 CCT 组在日常生活参与度（F=5.31，p=.01，eta=0.238）、感知认知（F=4.897，p=.014，eta=0.224）和处理速度测试的认知表现（F=5.678，p=.009，eta=0.289）方面均显示出显著的时间×组交互作用。CRAFT 组在日常生活参与度（卡方=6.91，p=.032）和治疗满意度方面表现出显著更大的临床有意义的改善。所有治疗效果均在 3 个月随访时得以维持（n=32）。
CCT 和 CRAFT 对 CRCI 患者的参与和认知结果有积极影响。CRAFT 在改善自我选择的基于职业的目标方面显示出额外的优势，这表明认知训练与基于职业的干预相结合具有积极的协同效应，从而带来“现实世界”的健康益处。
认知训练与基于职业的干预相结合具有积极的效果，可带来日常生活参与度、客观认知表现和主观认知障碍方面具有临床意义的改善。
ClinicalTrials.gov NCT04210778，2019 年 12 月 26 日，回顾性注册。
