A novel digital approach for post-stroke cognitive deficits: a pilot study

Abstract

Background: 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. Objective: 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. Methods: 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). Results: 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. Conclusions: 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.

Prismatic adaptation coupled with cognitive training as novel treatment for developmental dyslexia: a randomized controlled trial

“…We acknowledge as a critical study limitation the unfeasibility of separating the independent effects of PA against serious games on cognitive and reading outcomes. However, the study protocol was undertaken as such based on the evidence that patients with enduring post-stroke problems in executive functioning improved with PA plus serious games treatment only but not when receiving serious games training alone 84 . Moreover, PA and serious games have been further combined because they differently intervene on attentional processes.…”

“…Immediately after rPA, participants performed seven ‘serious games’, i.e., tablet games which tap into attention, inhibition, working memory, and problem solving. Further details of the tasks are given in Supplementary Materials (see also 84 ). By combining simulation, entertainment, and learning, serious games simulate specific activities to improve cognitive skills.…”