癌症相关认知障碍成人的认知再训练和功能治疗（CRAFT）：初步疗效研究。
Cognitive Retraining and Functional Treatment (CRAFT) for adults with cancer related cognitive impairment: a preliminary efficacy study.
机构信息
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.
出版信息
Support Care Cancer. 2023 Feb 7;31(3):152. doi: 10.1007/s00520-023-07611-y.
PURPOSE
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).
METHODS
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.
RESULTS
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).
CONCLUSIONS
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.
IMPLICATIONS FOR CANCER SURVIVORS
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.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov NCT04210778, December 26, 2019, retrospectively registered.
目的
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。
方法
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。
结果
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）。
结论
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。
对癌症幸存者的意义
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。
临床试验注册
ClinicalTrials.gov NCT04210778，2019 年 12 月 26 日，回顾性注册。
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