Effectiveness of cognitive skill remediation in acute stroke patients.
The purpose of this study was to determine whether a cognitive skills remediation program could help acute stroke patients regain important thinking skills. Patients in a community hospital stroke program were pre-tested in three skill areas--visual scanning, visual-spatial orientation, and time judgment--and randomly assigned to a treatment (n = 16) or control (n = 17) group. The treatment group received cognitive skill retraining on a one-to-one basis for 30 minutes per day, 3 days per week, for 3 weeks. The retraining involved the use of paper and pencil tasks, simple cuing procedures, positive reinforcement, and immediate feedback. Although the control group did not receive this treatment, conventional therapies continued for both groups. Patients receiving treatment had overall and separate skill improvement scores that were significantly higher than those for control patients. The implications of this type of treatment program are discussed.
The effectiveness of occupational therapy for cognitive impairment post-stroke remains unclear. The potential benefits of cognitive retraining delivered as part of occupational therapy on improving basic daily activity function or specific cognitive abilities, or both, of people who have had a stroke cannot be supported or refuted by the evidence included in this review. More research is required.