Oliveri Massimiliano, Bagnato Sergio, Rizzo Silvia, Imbornone Emilia, Giustiniani Andreina, Catania Angela, Turriziani Patrizia
Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy.
Rehabilitation Department, Unit of Neurophysiology and Unit for Severe Acquired Brain Injuries, Giuseppe Giglio Foundation, Cefalù, Italy.
Restor Neurol Neurosci. 2023;41(3-4):103-113. doi: 10.3233/RNN-231305.
Cognitive dysfunctions after a brain stroke have a huge impact on patients' disability and activities of daily living. Prism adaptation (PA) is currently used in patients with right brain damage to improve lateralized spatial attentional deficits. Recent findings suggest that PA could also be useful for rehabilitation of other cognitive functions.
In the present study, we tested for the efficacy on cognitive rehabilitation of a novel device in which the procedure of prism adaptation is digitized and followed by cognitive training of attention and executive functions using serious games.
Thirty stroke patients were randomly assigned to two groups: an experimental group of 15 patients, which performed the experimental rehabilitation training using the novel device in 10 consecutive daily sessions; a control group of 15 patients, which performed the routine cognitive training in 10 consecutive daily sessions. Both groups were tested before and after the rehabilitation program on neuropsychological tests (digit and spatial span forward and backward, attentional matrices, Stroop task) and on functional scales (Barthel index and Beck Anxiety Index).
The main results showed that only patients who received the experimental rehabilitation training improved their scores on tests of digit span forward, spatial span backward, attentional matrices and Stroop. Moreover, patients of the experimental but not of the control group showed a significant correlation between improvement on some tasks (mainly spatial span backward) and improvement on activities of daily living as well as with reduction of anxiety levels.
These results suggest that combining digital PA with cognitive training using serious games may be added in clinical settings for cognitive rehabilitation of stroke patients, with beneficial effects extending in promoting independency in activities of daily living and reduction of psychiatric symptoms.
脑卒中后的认知功能障碍对患者的残疾程度和日常生活活动有巨大影响。棱镜适应(PA)目前用于右脑损伤患者,以改善侧向空间注意力缺陷。最近的研究结果表明,PA对其他认知功能的康复也可能有用。
在本研究中,我们测试了一种新型设备对认知康复的疗效,该设备将棱镜适应程序数字化,随后使用严肃游戏进行注意力和执行功能的认知训练。
30例脑卒中患者被随机分为两组:15例患者的实验组,连续10天每天使用该新型设备进行实验性康复训练;15例患者的对照组,连续10天每天进行常规认知训练。两组在康复计划前后均接受神经心理学测试(数字和空间顺背和倒背跨度、注意力矩阵、斯特鲁普任务)和功能量表(巴氏指数和贝克焦虑指数)测试。
主要结果表明,只有接受实验性康复训练的患者在数字顺背跨度、空间倒背跨度、注意力矩阵和斯特鲁普测试中的得分有所提高。此外,实验组而非对照组的患者在某些任务(主要是空间倒背跨度)的改善与日常生活活动的改善以及焦虑水平的降低之间存在显著相关性。
这些结果表明,在临床环境中,可将数字PA与使用严肃游戏的认知训练相结合,用于脑卒中患者的认知康复,其有益效果可扩展到促进日常生活活动的独立性和减轻精神症状。