School of Rehabilitation, Capital Medical University, Beijing, China.
Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China.
J Alzheimers Dis. 2024;100(3):999-1015. doi: 10.3233/JAD-240356.
The current application effects of computerized cognitive intervention are inconsistent and limited to hospital rehabilitation settings.
To investigate the effect of mobile intelligent cognitive training (MICT) on patients with post-stroke cognitive impairment (PSCI).
This study was a multicenter, prospective, open-label, blinded endpoint, cluster-randomized controlled trial (RCT). 518 PSCI patients were stratified and assigned to four rehabilitation settings, and then patients were randomized into experimental and control groups in each rehabilitation setting through cluster randomization. All patients received comprehensive management for PSCI, while the experimental group additionally received MICT intervention. Treatment was 30 minutes daily, 5 days per week, for 12 weeks. Cognitive function, activities of daily living (ADL), and quality of life (QOL) were assessed before the treatment, at weeks 6 and 12 post-treatment, and a 16-week follow-up.
Linear Mixed Effects Models showed patients with PSCI were better off than pre-treatment patients on each outcome measure (p < 0.05). Additionally, the improvement of these outcomes in the experimental group was significantly better than in the control group at week 6 post-treatment and 16-week follow-up (p < 0.05). The rehabilitation setting also affected the cognitive efficacy of MICT intervention in improving PSCI patients, and the degree of improvement in each outcome was found to be highest in hospital, followed by community, nursing home, and home settings.
Long-term MICT intervention can improve cognition, ADL, and QOL in patients with PSCI, with sustained effects for at least one month. Notably, different rehabilitation settings affect the cognitive intervention efficacy of MICT on PSCI patients. However, this still needs to be further determined in future studies.
目前计算机认知干预的应用效果不一致，仅限于医院康复环境。
研究移动智能认知训练（MICT）对脑卒中后认知障碍（PSCI）患者的影响。
本研究为多中心、前瞻性、开放标签、盲终点、整群随机对照试验（RCT）。将 518 例 PSCI 患者分层并分配到 4 个康复环境中，然后通过整群随机化将每个康复环境中的患者随机分为实验组和对照组。所有患者均接受 PSCI 的综合管理，实验组在此基础上接受 MICT 干预。治疗为每天 30 分钟，每周 5 天，共 12 周。在治疗前、治疗后第 6 周和第 12 周以及 16 周随访时评估认知功能、日常生活活动（ADL）和生活质量（QOL）。
线性混合效应模型显示，PSCI 患者在每个结局测量上均优于治疗前（p＜0.05）。此外，实验组在治疗后第 6 周和 16 周随访时这些结局的改善明显优于对照组（p＜0.05）。康复环境也影响 MICT 干预对 PSCI 患者认知疗效，在每个结局的改善程度上，医院的改善程度最高，其次是社区、养老院和家庭。
长期 MICT 干预可改善 PSCI 患者的认知、ADL 和 QOL，且效果至少持续 1 个月。值得注意的是，不同的康复环境会影响 MICT 对 PSCI 患者的认知干预效果。然而，这仍需要在未来的研究中进一步确定。
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