Jeon Hyeonwoo, Kim Doo Young, Park Si-Woon, Lee Bum-Suk, Han Hyeong-Wook, Jeon Namo, Kim Minsong, Kang Mingu, Kim Suebeen
Department of Rehabilitation Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.
International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.
Front Neurol. 2025 Jan 15;15:1450977. doi: 10.3389/fneur.2024.1450977. eCollection 2024.
One of the possible treatment options for patient with cognitive dysfunction is cognitive telerehabilitation. Previous systematic reviews on cognitive telerehabilitation have focused on specific disease groups and the analysis of intervention methods did not differentiate between traditional face-to-face cognition treatment and usual care. In this systematic review, we aim to analyze randomized controlled trials (RCTs) that compare telerehabilitation with face-to-face treatment or usual care for improving cognitive function in elderly individuals with cognitive dysfunction or patients with acquired brain injury.
We conducted this systematic review following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). In this systematic review, we searched 7 electronic databases (PubMed, Cochrane, EMbase, CINAHL, Web of Science, Scopus, KMbase) to identify relevant studies published through December 10, 2024. We conducted a meta-analysis to assess the quality of the studies and synthesize the evidence. Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method.
Finally, 16 studies were included in the analysis. For comparing telerehabilitation with face-to-face cognition treatment, the meta-analysis included 2 RCTs for global cognition (immediate outcome), 2 RCTs for attention (immediate outcome), 2 RCTs for visuospatial function (immediate outcome). For comparing telerehabilitation with usual care, the meta-analysis included 7 RCTs for global cognition (immediate outcome), 3 RCTs for global cognition (persistence outcome), 4 RCTs for attention (immediate outcome), 3 RCTs for executive function (immediate outcome), 3 RCTs for working memory (immediate outcome), 3 RCTs for visuospatial function (immediate outcome).
Telerehabilitation has been shown to be more effective than usual care in improving global cognitive function, and its effectiveness is not inferior to that of traditional face-to-face cognitive treatment. By overcoming the limitations of traditional cognition rehabilitation and providing continuous treatment, telerehabilitation can offer effective treatment in specific situations.
认知功能障碍患者的一种可能治疗选择是认知远程康复。先前关于认知远程康复的系统评价集中在特定疾病群体上，并且干预方法的分析没有区分传统面对面认知治疗和常规护理。在本系统评价中，我们旨在分析比较远程康复与面对面治疗或常规护理以改善认知功能障碍老年人或获得性脑损伤患者认知功能的随机对照试验（RCT）。
我们按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行了本系统评价。在本系统评价中，我们检索了7个电子数据库（PubMed、Cochrane、EMbase、CINAHL、Web of Science、Scopus、KMbase），以识别截至2024年12月10日发表的相关研究。我们进行了荟萃分析以评估研究质量并综合证据。使用推荐分级、评估、制定和评价（GRADE）方法评估证据的确定性。
最终，16项研究纳入分析。在比较远程康复与面对面认知治疗时，荟萃分析纳入了2项关于整体认知（即时结果）的RCT、2项关于注意力（即时结果）的RCT、2项关于视觉空间功能（即时结果）的RCT。在比较远程康复与常规护理时，荟萃分析纳入了7项关于整体认知（即时结果）的RCT、3项关于整体认知（持续结果）的RCT、4项关于注意力（即时结果）的RCT、3项关于执行功能（即时结果）的RCT、3项关于工作记忆（即时结果）的RCT、3项关于视觉空间功能（即时结果）的RCT。
远程康复已被证明在改善整体认知功能方面比常规护理更有效，其有效性不低于传统面对面认知治疗。通过克服传统认知康复的局限性并提供持续治疗，远程康复可以在特定情况下提供有效的治疗。
