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Context: The best current evidence supports the effectiveness of neuromuscular training in reducing the risk of injury; however, the rate of anterior cruciate ligament (ACL) injuries is still high. Neurocognitive training (NT) has successfully improved biomechanical risk factors, but they have been considered in only a few studies. Objective: To review the literature to determine the effect of NT on biomechanical risk factors related to ACL injury in athletes. Evidence Acquisition: We searched PubMed, Google Scholar, Scopus, Science Direct, and the Physiotherapy Evidence Database from inception to August 2011. We included randomized controlled trials that used motor learning approaches and injury prevention programs to investigate kinematic and kinetic risk factors related to ACL injury. The quality of each clinical trial study was evaluated by the Physiotherapy Evidence Database scale. The eligibility criteria were checked based on the PICOS (population, intervention, comparison, outcome, and study type) framework. Evidence Synthesis: A total of 9 studies were included in the final analysis. Motor learning approaches include internal and external focus of attention, dual tasks, visual motor training, self-control feedback, differential learning, and linear and nonlinear pedagogy, combined with exercise programs. In most of the studies that used NT, a significant decrease in knee valgus; tibial abduction and external rotation; ground reaction force; and an increase in knee-, trunk-, hip-, and knee-flexion moment was observed. Conclusion: In classical NT, deviation from the ideal movement pattern especially emphasizing variability and self-discovery processes is functional in injury prevention and may mitigate biomechanical risk factors of ACL injuries in athletes. Practitioners are advised to use sport-specific cognitive tasks in combination with neuromuscular training to simulate loads of the competitive environment. This may improve ACL injury risk reduction and rehabilitation programs. [ABSTRACT FROM AUTHOR]

The aim of this systematic review, meta-analysis, and meta-regression was to examine the effects of virtual reality–based training on global cognition and executive function compared with conventional training or information-based treatment in older adults, regardless of cognitive level. A systematic literature search was conducted using four databases. A total of 31 randomized controlled trials were identified. Pooled effect sizes were calculated, the risk of bias was assessed, and evidence was graded. The primary analyses showed a small but statistically significant effect of virtual reality–based training compared with control on global cognition (Hedges' g 0.42, 95% confidence interval [0.17, 0.68], I2 = 70.1%, n = 876, 20 randomized controlled trials, low evidence) and executive function (Hedges' g 0.35, 95% confidence interval [0.06, 0.65], I2 = 68.4%, n = 810, 16 randomized controlled trials, very low evidence). Meta-regression yielded inconclusive results. Virtual reality–based training may be more effective than control in improving cognition in older adults; however, more high-quality studies are needed. [ABSTRACT FROM AUTHOR]

Introduction Military service members (SMs) with mild traumatic brain injury (mTBI or concussion) frequently report cognitive and behavioral difficulties. Currently, military clinical guidelines recommend clinician-run, manualized cognitive rehabilitation (CR) to treat these symptoms; however, it is unclear whether this approach adequately addresses the unique needs of warfighters. Computerized cognitive training (CCT) programs represent an innovative, promising approach to treating cognitive difficulties; however, whether these programs can effectively remediate cognitive impairment in individuals with mTBI remains unclear. Materials and Methods A total of 65 SMs with a history of at least 1 diagnosed mTBI were recruited from a military hospital. Participants received 1 of 2 interventions: Clinician-run, manualized CR (Study of Cognitive Rehabilitation Effectiveness [SCORE]; n  = 37), consisting of 60 total intervention hours over 6 weeks, or CCT (n  = 28), in which participants trained with either a commercial CCT (n  = 14) or noncommercial CCT (n  = 14), for a total of 12 hours over 4 weeks. Participants were assessed pre- and postintervention, using a combination of self-report and objective outcome measures: Key Behaviors Change Inventory (KBCI), a self-report measure of functional difficulties; Paced Auditory Serial Addition Test (PASAT), an objective cognitive assessment that measures both information processing speed and sustained and divided attention; and Symbol Digit Modalities Test (SDMT), an objective cognitive assessment that measures information processing speed. Results Mixed ANOVA revealed no interaction effect between intervention type and time (pre- and postassessment) on the PASAT (P  = .643, ηp2 = 0.003), SDMT (P  = .423, ηp2 = 0.010), or KBCI (P  = .434, ηp2 = 0.010); however, there was a significant within-group main effect (time) on all 3 outcome measures (PASAT P  < .001, ηp2 = 0.54; SDMT P  < .001, ηp2 = 0.25; and KBCI P  = .001, ηp2 = 0.15). On average, participants showed improvement over baseline on the PASAT (SCORE delta = 6.98, SD = 7.25, P  < .001; CCT delta = 7.79, SD = 6.45, P  < .001), SDMT (SCORE delta = 4.62, SD = 8.82, P  = .003; CCT delta = 6.58, SD = 10.81, P  = .003), and KBCI (SCORE delta = −3.22, SD = 7.09, P  = .009; CCT delta = −2.00, SD = 4.72, P  = .033). Additional analysis comparing the relative effectiveness of the 2 different CCTs revealed that while training with either program resulted in improved performance on the PASAT (P  < .001, ηp2 = 0.627), SDMT (P  = .003, ηp2 = 0.286), and KBCI (P  = .036, ηp2 = 0.158), there was no interaction effect of CCT program type and change over time for any measure (PASAT P  = .102, ηp2 = 1.00; SDMT P  = .317, ηp2 = 0.038; and KBCI P  = .719, ηp2 = 0.005). Conclusions We showed that CCT programs do not differ in efficacy compared to clinician-run, manualized CR for treating symptoms associated with mTBI; however, exploratory analyses suggest that each approach may have distinct advantages for treating specific symptoms. Additionally, we showed that the improvement in the CCT intervention did not differ between those who trained using the commercial program vs. those who trained with the noncommercial program. [ABSTRACT FROM AUTHOR]

Impaired self-awareness impacts outcomes for individuals with brain injury. Self-awareness is a complex construct, with little known about how its presentation differs across diagnostic groups, or how brain injury-related changes are expressed by individuals in the early phase post-brain injury. This study aims to identify differences and similarities in patterns of self-awareness between patients with different brain injury diagnoses, and provide a clinical account of how individuals with ABI describe changes to themselves arising from brain injury. This is a mixed methods retrospective cohort study involving an audit of medical files that included extraction of data from the Self-Awareness of Deficits Interview. Quantitative and qualitative techniques were used to analyse data from 173 participants. Individuals identified a range of brain injury-related impairments across domains, with greatest difficulty noted with linking impairments to functional implications and setting realistic goals. There were similarities and distinct differences in the expression of changes across diagnostic groups. Two main themes that aligned with self-awareness theory were identified from the data: 1/ Development of self-awareness; and 2/ Dimensions of self-awareness. These interrelated themes demonstrated the multifaceted nature of the clinical presentation of self-awareness, and highlight the need for an individualized approach to cognitive rehabilitation. [ABSTRACT FROM AUTHOR]

Introduction: The present study examined the efficacy of a CogSMART-based program in improving cognitive and emotional functioning in a clinic-based sample of Veterans presenting with cognitive concerns and history of mental health diagnoses. Method: Forty Veterans (Mage = 61.2 years, 85% male) completed a weekly CogSMART-based group program as well as a battery of neuropsychological and psychological measures at both pre- and post-group evaluations. Participants met DSM-5 criteria for at least one mental health diagnosis. Results: Significant improvements on global cognition as well as measures of learning/memory and attention were observed from pre- to post-group (p <.05, cohen's d range =.48–1.01). As many as 33.3% of participants showed significant improvement, depending on the cognitive domain. Significant overall improvements were observed in depression symptoms and life satisfaction (p <.01, cohen's d =.67 and.59, respectively). Over one-third of the sample demonstrated a reliable improvement in depressive symptoms, 25% in anxiety symptoms, and 18% in life satisfaction. Conclusions: Among individuals with mental health diagnosis but without major neurocognitive disorders, CogSMART-based interventions may be an effective treatment for improving aspects of cognition, depression, and life satisfaction. [ABSTRACT FROM AUTHOR]

Despite the use of digital communication technologies in neurocognitive rehabilitation has been widely used in face-to-face interventions, the difficulties of using ICT-based tools to provide rehabilitation services and the unfamiliarity of the neuropsychologists with internet interventions limited the use of these kinds of interventions in their clinical practices. The lockdown and mitigating measures associated with the COVID-19 pandemic, on the other hand, forced the use of at-distance and online interventions as a means to mitigate the impact of those measures on the mental health and rehabilitation processes of people with neurological disorders. Overall, little is known about the perspectives of patients with acquired neurological conditions about rehabilitation services delivered at distance. Therefore, the main goal of this study was to explore the perceptions that patients with neurological disorders have on at-distance online neurocognitive rehabilitation, namely during the COVID-19 pandemic. Sixteen patients with acquired neurological conditions attending an online neurocognitive rehabilitation program in a Portuguese rehabilitation center filled in an online questionnaire during the mandatory lockdown. The results of this study highlight the potential of delivering rehabilitation services at distance, presenting its advantages and limitations from patients' perspectives, as well as suggestions for improving both neurorehabilitation processes and the online rehabilitation platform used. [ABSTRACT FROM AUTHOR]

The article describes the case of a 59-year old Japanese man diagnosed with cerebellar cognitive affective syndrome (CCAS) caused by cerebellar atrophy associated with Wallerian degeneration after pontine haemorrhage. The patient demonstrated psychiatric symptoms, slow gait, configuration apraxia, cognitive and motor decline, decline in intelligence quotient and function. Symptoms of CCAS include motor deficits, decreased blood flow in the posterior cerebellar lobes and functional impairment.

Background: Computerized cognitive training (CCT) has been proposed as a potential therapy for cognitive decline. One of the benefits of CCT is a transfer effect, but its mechanism on the memory domain is unclear. This study aimed to investigate the transfer effect of non‐memory multidomain CCT on the memory domain and its neural basis in patients with mild cognitive impairment (MCI) through a randomized controlled trial. Methods: Patients with MCI recruited from memory clinics were randomly assigned to either the CCT or the control group. The CCT group received multidomain CCT training excluding memory training, while the control group read educational books with learning‐based quizzes twice a week for 8 weeks. Participants underwent memory tests yielding a composite score, other cognitive domain tests, non‐cognitive scales, and resting‐state functional magnetic resonance imaging (rsfMRI), at baseline and after intervention. Within‐ and between‐group comparisons, group × time interactions, and seed‐to‐voxel analyses in memory‐involving brain networks were performed. Results: The CCT group showed improvement over the control group in memory domain (Group × time, F = 5.87, P = 0.03, η2 = 0.31), which was related with the increased connectivity in the hippocampal‐frontal and fusiform‐occipital network. No other cognitive and non‐cognitive symptoms differed between groups after adjusting for covariates. Conclusion: Eight weeks of multidomain CCT without memory training improved memory function and restored functional network in the hippocampal and medial temporal region in MCI patients. These results can provide evidence for the transferring ability of CCT on memory functioning with its neural basis. [ABSTRACT FROM AUTHOR]

Importance: Occupational therapy practitioners play an important role in addressing the impairments, occupational performance, and participation needs of adults living with and beyond cancer. Objective: These Practice Guidelines aim to assist occupational therapy practitioners, educators, and researchers in applying evidence and expert opinion to occupational therapy practice across the cancer continuum of care, including identifying gaps in care. Key focus areas include psychosocial function, fatigue, cognition, pain, sleep, and physical activity. These guidelines can serve as a reference for policymakers, health care professionals, health care managers, regulators, third-party payers, and managed care organizations to manage, reimburse, and set policy. Method: We examined, synthesized, and integrated the results of systematic reviews, supporting literature, and expert opinion to develop and provide clinical recommendations for practice in the care of adults living with and beyond cancer. Results: Sixteen systematic reviews with moderate to strong strength of evidence published between 2019 and 2022 served as the foundation for these Practice Guidelines. Conclusions and Recommendations: To support symptom management for adults living with and beyond cancer, occupational therapy practitioners can consider using psychosocial interventions for anxiety, depression, posttraumatic growth, and overall psychological distress. Practitioners can consider using physical activity interventions for cancer-related fatigue, cognitive performance, and sleep. Practitioners could also consider using interventions for cognition, pain management, and self-management for the improvement of cancer-related symptoms. Plain-Language Summary: These Practice Guidelines provide strong and moderate levels of evidence for occupational therapy practitioners to support adults living with and beyond cancer. They provide specific guidance for addressing pain, cancer-related fatigue, cancer-related cognitive impairments, psychosocial well-being, sleep, and physical activity. The guidelines also include case examples and an infographic to support occupational therapy practitioners in integrating evidence to support interventions in cancer care, and they highlight gaps and expert opinions in practice for continued clinically relevant research. These Practice Guidelines will assist occupational therapy practitioners, educators, and researchers in applying evidence and expert opinion to practice across the cancer continuum of care, including identifying gaps in care. [ABSTRACT FROM AUTHOR]

Ecological momentary assessment (EMA) is a methodological approach to studying intraindividual variation over time. This study aimed to use EMA to determine the variability of cognition in individuals with chronic stroke, identify the latent classes of cognitive variability, and examine any differences in daily activities, social functioning, and neuropsychological performance between these latent classes. Participants (N = 202) with mild-to-moderate stroke and over 3-month post-stroke completed a study protocol, including smartphone-based EMA and two lab visits. Participants responded to five EMA surveys daily for 14 days to assess cognition. They completed patient-reported measures and neuropsychological assessments during lab visits. Using latent class analysis, we derived four indicators to quantify cognitive variability and identified latent classes among participants. We used ANOVA and Chi-square to test differences between these latent classes in daily activities, social functioning, and neuropsychological performance. The latent class analysis converged on a three-class model. The moderate and high variability classes demonstrated significantly greater problems in daily activities and social functioning than the low class. They had significantly higher proportions of participants with problems in daily activities and social functioning than the low class. Neuropsychological performance was not statistically different between the three classes, although a trend approaching statistically significant difference was observed in working memory and executive function domains. EMA could capture intraindividual cognitive variability in stroke survivors. It offers a new approach to understanding the impact and mechanism of post-stroke cognitive problems in daily life and identifying individuals benefiting from self-regulation interventions. [ABSTRACT FROM AUTHOR]

Concussion, also known as mild traumatic brain injury (mTBI), is a condition with unique ties to military service. Service members (SMs) are inherently at a higher risk for concussive injuries due to the intense physical training environment and combat operational tempo required to serve. The Traumatic Brain Injury Center of Excellence (TBICoE) is the US Department of Defense authority on this condition and provides a thorough approach to management of concussion and associated symptom sequela.This article seeks to review the TBICoE approach to the management and rehabilitation of military SMs with mTBI, and highlight resources available to military medical providers.The authors reviewed evidence and TBICoE resources to provide this comprehensive overview of the TBICoE approach to management and rehabilitation of concussion in military SMs.A progressive return to activity protocol in conjunction with symptom-guided management of common post-concussive sequelae, including headache, vestibular and oculomotor issues, sleep dysfunction, cognitive rehabilitation, and behavioral health comorbidities are essential for concussion management in the acute, post-acute and chronic phases of injury.The TBICoE approach to the rehabilitation of military SMs is comprehensive, and includes initial management with a stepwise return to duty protocol and an objective return to duty screening. The mainstays of treatment for SMs with post-acute and chronic post-concussion symptoms are headache management, vestibular and oculomotor rehabilitation, sleep interventions, cognitive rehabilitation, and early intervention for behavioral health comorbidities. These evidence-based strategies may be applied in the treatment of SMs in the US and internationally. [ABSTRACT FROM AUTHOR]

The ability to organize and memorize the unfolding of events over time is a fundamental feature of cognition, which develops concurrently with the maturation of the brain. Nonetheless, how temporal processing evolves across the lifetime as well as the links with the underlying neural substrates remains unclear. Here, we intend to retrace the main developmental stages of brain structure, function, and cognition linked to the emergence of timing abilities. This neurodevelopmental perspective aims to untangle the puzzling trajectory of temporal processing aspects across the lifetime, paving the way to novel neuropsychological assessments and cognitive rehabilitation strategies. A new neurodevelopmental perspective of temporal processing aiming to untangle the puzzling trajectory of temporal processing's aspects throughout the lifetime. [ABSTRACT FROM AUTHOR]

The importance of night sleep for maintaining good physical and cognitive health is well documented as well as its negative changes during aging. Since Mild Cognitive Impairment (MCI) patients bear additional disturbances in their sleep, this study aimed at examining whether there are potential mixed effects of sleep and afternoon time of day (ToD) on the storage, processing, and updating components of working memory (WM) capacity in older adults with MCI. In particular, the study compared patients' performance in the three working memory components, in two-time conditions: "early in the morning and after night sleep", and "in the afternoon and after many hours since night sleep". The Working Memory Capacity & Updating Task from the R4Alz battery was administered twice to 50 older adults diagnosed with MCI. The repeated measures analysis showed statistically significant higher performance in the morning condition for the working memory updating component (p < 0.001). Based on the findings, it seems that the afternoon ToD condition negatively affects tasks with high cognitive demands such as the WM updating task in MCI patients. These findings could determine the optimal timing for cognitive rehabilitation programs for MCI patients and the necessary sleep duration when they are engaged in cognitively demanding daily activities. [ABSTRACT FROM AUTHOR]

Background: Alzheimer’s disease (AD), the most common form of dementia, is a progressive neurodegenerative disorder that predominantly affects the elderly population. Traditional assessment methods, including neuropsychological tests like the MMSE, have been the cornerstone of AD diagnosis for decades. These methods are grounded in a wealth of research and clinical experience, providing a robust framework for understanding the cognitive deficits of AD. The evolution of AD assessment and rehabilitation has recently been tackled with the introduction of Virtual Reality (VR) technologies. Objectives: To evaluate the use of storytelling and reminiscence therapy in virtual reality programs as a complementary and enhancing modality alongside standard assessment and rehabilitation for Alzheimer’s patients. To explore how regular interaction with VR narratives can slow cognitive decline or improve relevant features of cognitive functioning over the time. To propose a new assessment and rehabilitative tool based on the use of VR and digital storytelling. Method: A comparative analysis of Standard Neuropsychological Approaches and Virtual Reality Interventions in patients with Alzheimer disorder was carried out. A literature overview on the empirical studies between 2019 and 2024 was conducted. Results: We propose a new VR-based setup mediated by the use of storytelling for the assessment and recovery of AD. Conclusion: The employment of storytelling within VR programs for the assessment and rehabilitation of Alzheimer’s disease can positively impact both the cognitive and emotional realms of patients, with beneficial outcomes on caregivers’ and families’ burden. The successful implementation of this approach requires careful consideration of accessibility, data interpretation, and standard validation protocols. [ABSTRACT FROM AUTHOR]

In the global context, advancements in technology and science have rendered virtual, augmented, and mixed-reality technologies capable of transforming clinical care and medical environments by offering enhanced features and improved healthcare services. This paper aims to present a mixed reality-based system to control a robotic wheelchair for people with limited mobility. The test group comprised 11 healthy subjects (six male, five female, mean age 35.2 ± 11.7 years). A novel platform that integrates a smart wheelchair and an eye-tracking-enabled head-mounted display was proposed to reduce the cognitive requirements needed for wheelchair movement and control. The approach's effectiveness was demonstrated by evaluating our system in realistic scenarios. The demonstration of the proposed AR head-mounted display user interface for controlling a smart wheelchair and the results provided in this paper could highlight the potential of the HoloLens 2-based innovative solutions and bring focus to emerging research topics, such as remote control, cognitive rehabilitation, the implementation of patient autonomy with severe disabilities, and telemedicine. [ABSTRACT FROM AUTHOR]

Background: The current application effects of computerized cognitive intervention are inconsistent and limited to hospital rehabilitation settings. Objective: To investigate the effect of mobile intelligent cognitive training (MICT) on patients with post-stroke cognitive impairment (PSCI). Methods: 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. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

Heart failure can lead to cognitive impairment that is estimated to be present in over a quarter of patients. It is important to intervene at a cognitive level to promote brain plasticity through cognitive training programs. Interventions transformed by technology offer the promise of improved cognitive health for heart failure patients. This review was conducted on studies evaluating the role of cognitive rehabilitation in patients with heart failure. We examined clinical trials involving patients with heart failure. Our search was performed on Pubmed, Web of Science and Cochrane library databases. Of the initial 256 studies, 10 studies met the inclusion criteria. Cognitive rehabilitation training has important implications for the treatment and prevention of cognitive decline in heart failure patients with significant recovery for delayed recall memory and a significant time effect for total recall memory and delayed, psychomotor speed and IADL performance. It is important to include the assessment of cognitive functioning in the routine clinical examinations of patients with heart failure, discover the relationship between cognitive function and heart failure, and target cognitive rehabilitation programs that promote brain plasticity. [ABSTRACT FROM AUTHOR]

Background: Executive function is a high‐level set of cognitive processes related to goal‐directed behaviors including two conceptual subtypes of hot (emotional) and cold (cognitive) executive function (to abbreviate EF). EF deficits in attention deficit hyperactivity disorder (ADHD) leads to significant social impairments in the home, school, and community. Today the type and the extent of executive function defects in ADHD are still debated in studies. We aimed to evaluate hot and cold executive function among medication‐naive children with ADHD, with and without oppositional defiant disorder (ODD). Methods: Forty‐five children including suffering ADHD with ODD (n = 15), without ODD (n = 15), or typically developed (TD, n = 15) participated in this cross‐sectional study (the age of children was between 7 and 12 years old). The Child Symptom Inventory‐4 (CSI‐4) was used to screen behavioral and emotional symptoms. Wechsler Adult Intelligence Scale‐Revised‐Digit Span Task (WAIS‐R‐DST), Corsi Block Task (CBT), and Wisconsin Card Sorting Test (WCST) were used for assessing cold executive function. Assessing hot executive function was done with Delay Discounting Task (DDT) and Iowa Gambling Task (IGT). Results: Evaluating the cold executive function, total WAIS‐R‐DST score, Backward DST, total CBT score, and Backward CBT were significantly lower among ADHD than TD groups (p < 0.05). Assessing the hot executive function showed that the score of DDT and IGT was significantly lower among ADHD than TD groups (p < 0.05). Conclusion: Both hot and cold executive functions are defective in children with ADHD, while the comorbid of ODD has no significant effect. We suggest the clinicians to consider cognitive rehabilitation interventions as a necessary treatment modality for ADHD patients. [ABSTRACT FROM AUTHOR]

Background: The increase in cases of mild cognitive impairment (MCI) underlines the urgency of finding effective methods to slow its progression. Given the limited effectiveness of current pharmacological options to prevent or treat the early stages of this deterioration, non-pharmacological alternatives are especially relevant. Objective: To assess the effectiveness of a cognitive-motor intervention based on immersive virtual reality (VR) that simulates an activity of daily living (ADL) on cognitive functions and its impact on depression and the ability to perform such activities in patients with MCI. Methods: Thirty-four older adults (men, women) with MCI were randomized to the experimental group (n = 17; 75.41 ± 5.76) or control (n = 17; 77.35 ± 6.75) group. Both groups received motor training, through aerobic, balance and resistance activities in group. Subsequently, the experimental group received cognitive training based on VR, while the control group received traditional cognitive training. Cognitive functions, depression, and the ability to perform activities of daily living (ADLs) were assessed using the Spanish versions of the Montreal Cognitive Assessment (MoCA-S), the Short Geriatric Depression Scale (SGDS-S), and the of Instrumental Activities of Daily Living (IADL-S) before and after 6-week intervention (a total of twelve 40-minutes sessions). Results: Between groups comparison did not reveal significant differences in either cognitive function or geriatric depression. The intragroup effect of cognitive function and geriatric depression was significant in both groups (p < 0.001), with large effect sizes. There was no statistically significant improvement in any of the groups when evaluating their performance in ADLs (control, p = 0.28; experimental, p = 0.46) as expected. The completion rate in the experimental group was higher (82.35%) compared to the control group (70.59%). Likewise, participants in the experimental group reached a higher level of difficulty in the application and needed less time to complete the task at each level. Conclusions: The application of a dual intervention, through motor training prior to a cognitive task based on Immersive VR was shown to be a beneficial non-pharmacological strategy to improve cognitive functions and reduce depression in patients with MCI. Similarly, the control group benefited from such dual intervention with statistically significant improvements. Trial registration: ClinicalTrials.gov NCT06313931; https://clinicaltrials.gov/study/NCT06313931. [ABSTRACT FROM AUTHOR]

The relationship between a patient and their therapist plays a crucial role in patient engagement. While Computerized Cognitive Training (CCT) may assist in preserving cognitive skills in cases of aging, dementia or acquired brain injuries, its effectiveness has not been definitively proven. Improving user engagement, acceptance, and software usability could aid in addressing this issue. The present study aims to identify potential obstacles and facilitators by examining the perspectives of rehabilitation professionals on the current usage of CCT software. Semi-structured interviews were conducted with 16 rehabilitation professionals, familiar with a CCT software. The data were transcribed and followed by an independent iterative thematic analysis. Two major themes were identified: (1) facilitating factors and (2) difficulties related to use. The main obstacles were difficulties related to the computerized nature of the exercises, technology use, understanding the software and general learning difficulties. The main facilitators were the ecological and novel nature of the exercises, and the adaptability of the difficulty levels. The complexity of the CCT presents challenges for its usage by rehabilitation professionals, which in turn can impede patient utilization as well. To address this issue and promote sustainable use of the software, providing instruction delivery to facilitate learning and understanding of the CCT is essential. Additionally, creating a standardized foundation that therapists can refer to for guidance may also aid in optimizing the software's usage. It is recommended to utilize a model for CCT acceptability and acceptance in developing these solutions to enhance patient engagement. Computerized Cognitive Training (CCT) may help sustain cognitive skills or delay its decline due to causes such as aging, dementia or acquired brain injuries. User engagement, user acceptance and software usability could help address these issues. The relationship between a patient and their therapist plays a crucial role in patient engagement. Difficulties related to using and understanding a CCT software could affect behavioral intention/use. Rehabilitation professionals may face difficulties using CCT software, which could in turn, hinder patient utilization. Facilitating learning and understanding of the software through instruction delivery to increase acceptance could respond to the existing obstacles. A model for CCT acceptability/acceptance may be useful for improving the development of these solutions, to optimize patient engagement. Creating a standardized foundation for therapists to refer to could help optimize usage of CCT software. [ABSTRACT FROM AUTHOR]

Introduction: The rising prevalence of stroke in sub-Saharan Africa necessitates the exploration of the role of occupational therapy in rehabilitation of stroke. In the southern African country of South Africa, occupational therapy aligns with healthcare policies and laws, and this article presents a review of synthesized evidence of occupational therapy intervention in stroke care and rehabilitation. Method: Rapid review methodology was used to develop a research question about cerebrovascular accident- intervention by occupational therapists., The Cochrane Library and MEDLINE databases were searched for relevant articles published between 2018 and 2023. Twenty four articles met the inclusion criteria and were analysed according to quantitative and qualitative parameters. Results: Evidence of occupational therapy intervention with post-stroke upper limb impairment was found in 37,5% of articles. Occupational therapy for global improvement in function, cognitive rehabilitation, balance, social participation, work, and leisure comprised 45,8% of articles, and one article each reported evidence for occupational therapy addressing ADL and caregiver interventions. Conclusion: Evidence from the past five years reflect diverse occupational therapy interventions with clients with stroke. Gaps in recent evidence remain in relation to context-specific interventions, especially from low- and middle-income countries. Implications for practice Occupational therapists adopt a holistic approach to stroke rehabilitation, tailoring interventions to address the multifaceted needs and goals of individual stroke survivors. The effectiveness of individualised, occupation-based approaches across various domains are highlighted. * Therapists stay informed and up to date about emerging technologies and evidence-based practice to enhance their effectiveness in stroke rehabilitation. * This review provides evidence of the prevalence of upper limb impairments post-stroke, which will enable therapists to be well-versed in the diverse intervention approaches for upper limb rehabilitation as outlined in the literature reviewed, including technologies like Brain Computer Interface, Mental Practice, Mirror Therapy, and Action Observation Therapy. * Occupational therapy is vital in addressing cognitive impairments in stroke survivors, and practitioners can apply the evidence provided on interventions such as Virtual Reality and computer-assisted cognitive rehabilitation that have shown promise in improving cognition and ADL. [ABSTRACT FROM AUTHOR]

This paper presents a conceptual framework for the development of serious games aimed at cognitive rehabilitation in older adults. Following Jabareen's methodology, a literature review was conducted to identify concepts and theories that are relevant in this field. The resulting framework comprises the use of virtual reality, integration of physical activity, incorporation of social interaction features, adaptability of difficulty levels, and customization of game content. The interconnections between these concepts and underlying cognitive theories, such as the cognitive reserve hypothesis and the scaffolding theory of aging and cognition, are highlighted. As we are in the early stages of our research, our goal is to introduce and test novel interpretations of current knowledge within this conceptual framework. Additionally, the practical implications of the conceptual framework are discussed, including its strengths and limitations, as well as its relevance for future research and clinical practice in the field of cognitive rehabilitation. It is hoped that this framework will provide a guide for the design and implementation of effective interventions to improve cognitive health and well-being in the older adult population. [ABSTRACT FROM AUTHOR]

Background: Traditional meta-analysis offers only direct comparative evidence. The optimal cognitive training for poststroke cognitive impairment (PSCI) remains largely undetermined. Objectives: This study aims to assess and compare the effectiveness of selected cognitive training methods for PSCI patients and to identify and rank the most effective intervention programs. Methods: Searches were conducted in PubMed, Embase, Cochrane Library, Web of science, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and China Biomedical Database for randomized controlled trials up to September 30, 2023. Two researchers independently performed literature screening, data extraction, and quality assessment. Network meta-analysis was utilized to synthesize the main findings. The primary outcome focused on the intervention's impact on subjective cognitive function, with secondary outcomes including effects on activities of daily living, motor function, and functional independence. This study is registered with PROSPERO (CRD42023463282). Results: Fifty eligible randomized controlled trials were identified, revealing eight distinct interventions. These interventions collectively demonstrate efficacy in enhancing cognition. Traditional cognitive training significantly improves overall cognitive function, daily living function, motor function, and functional independence. In Loewenstein Occupational Therapy Cognitive Assessment, Barthel Index, Fugl-Meyer Assessment, and Functional Independence Measure scales, a combination of computer-based and traditional cognitive training outperformed the conventional control group MD = 29.97 (95%CI: 16.3, 44.2), MD = 18.67 (95%CI: 9.78, 27.45), MD = 28.76 (95%CI: 5.46, 51.79) and MD = 42.2 (95%CI: 5.25, 78.99). In the MMSE scale, virtual reality cognitive training combined with traditional training was most effective MD = 8.01 (95%CI: 3.6, 12.4). On the MoCA scale, the combination of exercise and cognitive training showed superior results MD = 6.68 (95%CI: 2.55, 10.78). Only the combined computer-based and traditional cognitive training, as well as traditional cognitive training alone, significantly enhanced functional independence, with no notable differences in other pairwise interventions. Conclusion: The network meta-analysis suggests that augmenting traditional training with other modalities may enhance overall effectiveness. Specifically, interventions incorporating computer-based cognitive training appear to surpass other methods in improving cognition, daily living function, motor skills, and functional independence. The findings of this network meta-analysis provide evidence-based guidance for clinical decision-making. [ABSTRACT FROM AUTHOR]

Individuals diagnosed with liver cirrhosis typically experience a variety of symptoms. Decompensation, a critical stage in the disease’s progression, is characterized by the emergence of prominent clinical signs. These signs typically include ascites, bleeding tendencies, hepatic encephalopathy, and jaundice. Furthermore, it is noteworthy that regions in the sensorimotor cortex responsible for practical and gnostic functions are closely situated within the parieto-occipital part of the cortex. Liver cirrhosis may also have an impact on this aspect of human motor function. The main objective of the study is to compare the gnostic function and stereognostic function in individuals with liver cirrhosis and those in a healthy population. The patients included in our registry, known as RH7, were enrolled in our study. The first group consisted of 74 liver cirrhosis patients (including 25 women and 49 men). The control group consisted of a 63 healthy population (including 23 women and 40 and men). Both groups underwent both the Petrie and kinaesthesia tests. The results of the Petrie test, which compared healthy participants with those with liver cirrhosis, indicate that the healthy population achieved a significant difference in both right and left upper limb compared to those with liver cirrhosis patients (p< 0.05). The healthy population showed a significant difference compared to liver cirrhosis patients in the kinesthesia test (p< 0.05), except for the second attempt with the left upper limb (p= 0.267). According to the LFI, there was no significant difference in either upper limb during both the initial and second attempts of Petrie test (p> 0.05). Patients with liver cirrhosis exhibited significantly poorer gnostic functions compared to the healthy population. This condition also leads to notable impairments in motor functions, affecting both the precision and coordination of movements. Despite these deficits, frailty alone does not appear to be an indicator of worsened gnostic or stereognostic functions. Therefore, while liver cirrhosis has a clear negative impact on motor and cognitive abilities, the presence of frailty does not necessarily exacerbate these specific cognitive deficits. This distinction is crucial for clinical assessments and interventions targeting motor and cognitive rehabilitation in patients with liver cirrhosis. [ABSTRACT FROM AUTHOR]

Amidst population aging and lifestyle shifts, the incidence of neurological disorders such as stroke and Alzheimer's disease is increasing, profoundly affecting patients' cognitive functions and everyday life. Conventional cognitive rehabilitation approaches often necessitate substantial time and manpower, yet their outcomes remain uncertain. Although computer-assisted cognitive rehabilitation offers convenience, it can be somewhat monotonous in its experience. Virtual reality (VR) technology has introduced a novel pathway for cognitive rehabilitation, enhancing personalization and outcome assessment through tailored immersive environments and real-time data recording. This paper aims to survey the application of VR in cognitive rehabilitation, examining its impact on improving memory, attention, motor function, and social skills. A systematic review methodology was employed, following PRISMA guidelines, to identify and analyze relevant studies from 2010 to 2023. Recognizing that patients with different conditions have varying needs for the immersive and social aspects of VR, we propose the Multi-Dimensional VR Cognitive Rehabilitation Theory Model (MD-VRCRTM). This model categorizes cognitive rehabilitation technologies into six primary types: individual immersive, individual semi-immersive, individual non-immersive, multiplayer immersive, multiplayer semi-immersive, and multiplayer non-immersive rehabilitation systems. This categorization aims to cater to the specific requirements of various patients. For instance, individuals with autism spectrum disorder (ASD) may benefit more from multiplayer VR applications to enhance social skills; those with Parkinson's disease (PD) might profit from immersive VR to facilitate motor function recovery; stroke and traumatic brain injury (TBI) patients may require highly immersive VR experiences to boost concentration and treatment efficacy; and Alzheimer's disease (AD) patients may be better suited to non-immersive or semi-immersive VR to minimize cognitive load and receive cognitive stimulation. [ABSTRACT FROM AUTHOR]

Background: The heightened risk of dementia resulting from multiple comorbid conditions calls for innovative strategies. Engaging in physical and cognitive activities emerges as a protective measure against cognitive decline. This protocol aims to discuss a multidomain intervention targeting individuals with dementias secondary to cerebrovascular or other medical diseases, emphasizing an often underrepresented demographic. Methods: This study primary objectives are: a) to identify patients affected by Neurocognitive disorder due to vascular disease or multiple etiologies (screening and diagnostic phase) and b) to evaluate the effectiveness of distinct rehabilitation protocols (intervention phase): motor training alone, paper-based cognitive rehabilitation combined with motor training, digital-based cognitive rehabilitation coupled with motor training. Discussion: Identifying cognitive impairment beyond rigid neurological contexts can facilitate timely and targeted interventions. This protocol strives to address the complex interplay of cognitive decline and comorbidities through a multidimensional approach, providing insights that can shape future interventions and enhancing overall well-being in this vulnerable population. Trial registration: The study has been registered on July 13, 2023 with the ClinicalTrials.gov NCT05954741 registration number (https://classic.clinicaltrials.gov/ct2/show/NCT05954741). [ABSTRACT FROM AUTHOR]

Background: Augmentative and Alternative Communication (AAC) improved communicative skills in adults with post-stroke aphasia demonstrating the effectiveness in speech disorders and consequent improvement of patients' communication skills. This study aimed to report the efficacy of AAC in the rehabilitation of cognitive disorders and to estimate how the changes in cognitive and communicative functions could enhance the quality of life in patients affected by severe acquired brain injury. Methods: Three patients with pontine cerebral ischemia, traumatic brain injury (TBI), and meningioma expressed in the posterior cranial fossa, respectively, were submitted to rehabilitative training with AAC for 6 months. Patients underwent to neuropsychological and mood evaluations at the beginning of AAC treatment (T0) and after rehabilitative training (T1). Results: The results support the efficacy of AAC in the improvement of cognitive functions, particularly in memory, attention, and language domains. In addition, we described also an improvement in the quality of life and a decrease in depressive symptoms. Conclusions: The AAC seems to be an important rehabilitative technique for the recovery of cognitive functions with a consequent effect in improvement of psychological aspects and quality of life in patients with Acquired Brain Injury (ABI). [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has increased the demand for home rehabilitation services, leading to the development and rising demand for cognitive rehabilitation apps. However, a comprehensive analysis of the content and effectiveness of these apps is needed. This study systematically reviewed and analyzed the literature on mobile apps for cognitive rehabilitation. One researcher and an external expert conducted the study selection, data extraction, and quality assessment following the PRISMA Checklist 2020 guidelines. Our review of 18 studies identified 8 randomized controlled trials (RCTs) (44.44%) of high quality and 10 non-RCT studies (55.56%) of moderate quality. Overall, 16 of the 18 studies (88.88%) demonstrated positive clinical implications for cognitive function after using cognitive rehabilitation apps. Eight studies showed a correlation between app use and improved cognitive function, and four highlighted the potential for cognitive function evaluation through apps. All studies employed various occupational therapy (OT) intervention approaches, with prevention being the most common (100%), followed by establishment and restoration (83.33%), maintenance (77.77%), and creation and promotion (38.88%). This study clinically validates the effectiveness of cognitive rehabilitation mobile applications from an occupational therapy perspective. [ABSTRACT FROM AUTHOR]

Introduction: Progress in magnetic resonance imaging (MRI) technology and analyses is improving our comprehension of multiple sclerosis (MS) pathophysiology. These advancements, which enable the evaluation of atrophy, microstructural tissue abnormalities, and functional plasticity, are broadening our insights into the effectiveness and working mechanisms of motor and cognitive rehabilitative treatments. Areas covered: This narrative review with selected studies discusses findings derived from the application of advanced MRI techniques to evaluate structural and functional neuroplasticity modifications underlying the effects of motor and cognitive rehabilitative treatments in people with MS (PwMS). Current applications as outcome measure in longitudinal trials and observational studies, their interpretation and possible pitfalls and limitations in their use are covered. Finally, we examine how the use of these techniques could evolve in the future to improve monitoring of motor and cognitive rehabilitative treatments. Expert commentary: Despite substantial variability in study design and participant characteristics in rehabilitative studies for PwMS, improvements in motor and cognitive functions accompanied by structural and functional brain modifications induced by rehabilitation can be observed. However, significant enhancements to refine rehabilitation strategies are needed. Future studies in this field should strive to implement standardized methodologies regarding MRI acquisition and processing, possibly integrating multimodal measures. This will help identifying relevant markers of treatment response in PwMS, thus improving the use of rehabilitative interventions at individual level. The combination of motor and cognitive strategies, longer periods of treatment, as well as adequate follow-up assessments will contribute to enhance the quality of evidence in support of their routine use. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) frequently gives rise to depressive and anxiety symptoms, but these are often undertreated. This study investigated the effect of mindfulness-based cognitive therapy (MBCT) and cognitive rehabilitation therapy (CRT) on psychological outcomes and quality of life (QoL), and whether they mediate treatment effects on MS-related cognitive problems. Methods: This randomized controlled trial included MS patients with cognitive complaints (n = 99) and compared MBCT (n = 32) and CRT (n = 32) to enhanced treatment as usual (n = 35). Baseline, post-treatment and 6-months follow-up assessments included patient-reported outcome measures (PROMS) and cognitive outcomes (self-reported and neuropsychological assessment). PROMS concerned psychological symptoms, well-being, QoL, and daily life function. Linear mixed models indicated intervention effects on PROMS and mediation effects of PROMS on cognitive outcomes. Results: MBCT positively affected depressive symptoms (Cohen's d (d) = −0.46), fatigue (d = −0.39), brooding (d = −0.34), mindfulness skills (d = 0.49), and mental QoL (d = −0.73) at post-treatment. Effects on mindfulness skills remained significant 6 months later (d = 0.42). CRT positively affected depressive symptoms (d = −0.46), mindfulness skills (d = 0.37), and mental QoL (d = −0.45) at post-treatment, but not at 6-month follow-up. No effects on anxiety, well-being, self-compassion, physical QoL, and daily life function were found. Treatment effects on self-reported, but not objective, cognition were mediated by psychological symptoms and mindfulness skills. Conclusions: MBCT and CRT reduced a wide array of psychological symptoms and improved mental QoL. These improvements seemed to impact self-reported cognitive problems after both treatments, whereas objective cognitive improvements after MBCT seemed independent of improvement in psychological symptoms. Future studies should investigate long-term sustainability of these beneficial effects. Trial registration: The trial was prospectively registered in the Dutch Trial registry on 31 May 2017 (NL6285; https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6459). [ABSTRACT FROM AUTHOR]

COB-MS is an eight-session, Cognitive Occupation-Based programme for people with both MS and cognitive difficulty – designed to enhance cognition and daily functioning, through a combination of goal-setting, cognitive strategy engagement, group activities, home-practice activities and one-on-one sessions. This research aims to investigate the acceptability of COB-MS from the perspective of people living with MS, as well as the occupational therapists who facilitated the programme. Two content analyses were conducted on interview data from (n = 11) COB-MS participants and (n = 8) COB-MS facilitators. Thematic analysis was also conducted on the participant interview data. Through a, primary, content analysis, participants reported that the COB-MS provided both a positive experience and quality resources. Qualitative improvement and utilisation of their learning beyond completion of the intervention were also identified. Four themes were identified via, secondary, thematic analysis: (1) Group interaction within COB-MS was vital; (2) Online COB-MS had positive and negative effects on participation; (3) COB-MS as a provider of clarity; and (4) Using learned strategies after the completion of COB-MS. Recommendations for future administration are provided. Findings suggest COB-MS acceptability, as well as appropriateness and feasibility, indicative of progression to a definitive trial in future research. ISRCTN: ISRCTN11462710. Registered on 9 September 2019. Cognitive difficulties associated with multiple sclerosis (MS) impact on daily life activities and are considered invisible MS symptoms. This invisibility and the lack of acknowledgement of such symptoms often adds to the distress experienced by people with MS. Occupational therapists are well-placed to address the daily-life impacts of cognitive difficulties in MS. The COB-MS is an occupation-focused intervention that aims to enhance daily function. The intervention was found to be well-accepted well by people with MS and occupational therapists and can feasibly be delivered in clinical practice. [ABSTRACT FROM AUTHOR]

Following a traumatic brain injury (TBI), meal preparation may become challenging as it involves multiple cognitive abilities and sub-tasks. To support this population, the Cognitive Orthosis for coOKing (COOK) was developed in partnership with an alternative residential resource for people with severe TBI. However, little is known about the usability of this technology to support people with TBI living in their own homes. A usability study was conducted using a mixed-methods single-case design with a 35-year-old man with severe TBI living alone at home. The number of assistances provided, time taken and the percentage of unnecessary actions during a meal preparation task were documented nine times to explore the usability of COOK. Interviews were also conducted with the participant to document his satisfaction with COOK. Potential benefits were explored via the number of meals prepared per week. The usability of COOK was shown to be promising as the technology helped the participant prepare complex meals, while also reducing the number of assistances needed and the percentage of unnecessary actions. However, several technical issues and contextual factors influenced the efficiency and the participant's satisfaction with COOK. Despite improving his self-confidence, COOK did not help the participant prepare more meals over time. This study showed that COOK was easy to use and promising, despite technical and configuration issues. Results suggest the importance of further technological developments to improve COOK's usability and fit with the needs of people with TBI living in their own homes. Cognitive Orthosis for coOKing (COOK) is a promising technology to support people with TBI when preparing meals within their homes, though usability issues need to be corrected. Factors such as current meal-preparation related habits, expectations and availability of technical support were found to influence the usability of COOK. Various questions to consider in future studies involving an assistive technology for cognition to support meal preparation were identified. [ABSTRACT FROM AUTHOR]

This study investigated the effect of Cognitive Rehabilitation Training (CRT) on executive functions, problem solving, and attention in students with a specific learning disorder (SLD). Forty-two SLD students from the third to sixth grade (8–12 years old) were randomly assigned to 16 sessions of CRT (n = 21) or to a control (n = 21) group. Executive functions were assessed by the Behavior Rating Inventory of Executive Function (2nd ed.), problem solving by the Tower of London test, and attention by the Stroop test. Analyses of variance and post-hoc analyses revealed that there were significant improvements in the CRT group in most aspects of executive functions, problem solving, and attention, and these improvements were maintained over a two-month follow-up. These findings suggest that a CRT program may have positive implications for cognitive functioning and may provide preliminary support for alternative therapeutic interventions for use in children with SLD. [ABSTRACT FROM AUTHOR]

Objective Autism is one of the most common neurodevelopmental disorders. It causes problems in social cognition, communication, and understanding of self and others’ feelings, and has a negative effect on the quality of a person’s life. The present study determines the effectiveness of the Cogniplus cognitive training program on the social cognition (theory of mind (ToM) of children with autism spectrum disorder (ASD). Materials & Methods In a semi-experimental study with a pre-test, post-test design, and a control group with a two-month follow-up, 65 children (44 male and 21 female) from 6 to 11 years old with ASD were selected based on the convenience sampling method from individuals referred to one of autism rehabilitation centers in Shahr-e-Ray City, Iran. They were assessed by the autism spectrum screening questionnaire (ASSQ). Overall, 50 children (33 male and 17 female) with a score of 19 and above on the autism spectrum screening questionnaire were diagnosed with high-functioning autism. They entered into the study according to the inclusion criteria as follows: having speech ability, the absence of motor or intellectual disability, and visual and hearing impairments. Meanwhile, they were matched based on their age. They were randomly and equally assigned to two experimental and control groups. The parents completed the ToM test. The experimental group participated individually in 20 sessions (twice a week, 30 min per session), in the Cogniplus cognitive training program, but the control group only received mainstream services (occupational therapy, speech therapy, art therapy, and music therapy). The parents completed the ToM test in the last session and two months follow-up. The data were analyzed by the correlation analysis, analysis of regression, and generalized estimating equations in the SPSS software, version 27. Results The results of generalized estimating equations analysis showed that the Cogniplus cognitive training program improved social cognition (total, first level, and second level of ToM). Meanwhile, the β coefficient showed that 2.9, 3.08, and 0.96 of the variations, respectively, in the ToM levels as the first, the second, and the total, in children with ASD who received Cogniplus cognitive training program. Also, the variations lasted after a two-month follow-up. Conclusion Considering the positive effect of the Cogniplus cognitive training program on social cognition, the use of the Cogniplus cognitive training program can solve the need for therapists who have new cognitive insight into training. Also, the implementation of such programs can help to improve the social cognition of children with autism disorder with high functioning in real-life situations. [ABSTRACT FROM AUTHOR]

Background: The use of immersive Virtual Reality (VR) in stroke rehabilitation appears to be promising for the improvement of motor and cognitive functions. Methods: The purpose of this pilot study was to investigate the suitability, usability and safety of VR applications that combine motor and cognitive training. Patients suffering from stroke in a subacute phase, and with Mini Mental State Examination (MMSE) ≥18/30, participated in the study. In the context of the REACT project, two IVR applications were designed and created, combining the use of motor and cognitive skills. Full immersion was achieved using the Head Mounted Display (HMD) Oculus Rift S. The intervention lasted for 4 weeks. The Suitability Evaluation Questionnaire (SEQ) was used for measurements. Values are expressed in the median (25th75th percentile). Results: Four patients [age: 64.5(61.0-69.5) years, gender:1 female / 3 male] in the 3rd -14th week of rehabilitation were finally included. Overall, the patient's SEQ score was 61(55-63). No adverse effects were reported, only one patient reported mild confusion 5.0(4.8-5.0) in one assessment. No differences were found in the comparison between first and second evaluation [61(58-62) vs 61(48- 64), p>0.05]. Conclusions: The primary results of this study show that the equipment is usable, safe, and suitable for use in the rehabilitation of patients with stroke in the early stages of rehabilitation. However, more large-scale studies are needed to investigate the validity and effects of VR applications in the neurorehabilitation of various disorders. [ABSTRACT FROM AUTHOR]

Abstract Background The increase in cases of mild cognitive impairment (MCI) underlines the urgency of finding effective methods to slow its progression. Given the limited effectiveness of current pharmacological options to prevent or treat the early stages of this deterioration, non-pharmacological alternatives are especially relevant. Objective To assess the effectiveness of a cognitive-motor intervention based on immersive virtual reality (VR) that simulates an activity of daily living (ADL) on cognitive functions and its impact on depression and the ability to perform such activities in patients with MCI. Methods Thirty-four older adults (men, women) with MCI were randomized to the experimental group (n = 17; 75.41 ± 5.76) or control (n = 17; 77.35 ± 6.75) group. Both groups received motor training, through aerobic, balance and resistance activities in group. Subsequently, the experimental group received cognitive training based on VR, while the control group received traditional cognitive training. Cognitive functions, depression, and the ability to perform activities of daily living (ADLs) were assessed using the Spanish versions of the Montreal Cognitive Assessment (MoCA-S), the Short Geriatric Depression Scale (SGDS-S), and the of Instrumental Activities of Daily Living (IADL-S) before and after 6-week intervention (a total of twelve 40-minutes sessions). Results Between groups comparison did not reveal significant differences in either cognitive function or geriatric depression. The intragroup effect of cognitive function and geriatric depression was significant in both groups (p

Aim: To evaluate the acceptability of two co-designed mobile applications Mit Sygehus [a knowledge-based solution] and Genoptræn.dk [a self-training solution] to support a cross-sectoral, person-centred and empowering stroke rehabilitation. Setting: The applications were implemented and tested throughout two stroke rehabilitation trajectories in Southern Denmark, comprising two acute, two sub-acute and two municipal stroke rehabilitation settings. Methods, participants and analysis: A process evaluation focusing on acceptability was conducted. Individual and dyadic interviews were performed with ten stroke survivors (three women and seven men, aged 50-84) with moderate stroke and seven significant others (five women and two men, aged 50-78) post-rehabilitation. A constructivist Grounded Theory analysis was used to explore what, why, when, and how the apps worked or did not work throughout the stroke rehabilitation trajectory and if adaptions were needed. Results: Participants found that Mit Sygehus provided adequate and sufficient knowledge and was easy to use, however, acceptability of Mit Sygehus declined throughout the rehabilitation process. Also, knowledge on 'return-to-work' and 're-gaining driver's license/permission to drive' needed to be developed. The content in Genoptræn.dk was perceived as acceptable, through content being person-centred, motivating and meaningful. Genoptræn.dk furthermore, supported the transfer between rehabilitation settings, provided a sense of progress throughout the rehabilitation process, facilitated positive habits regarding self-training, and relieved the burden on significant others. Genoptræn.dk was perceived most acceptable in the sub-acute rehabilitation setting and declined when rehabilitation continued in the municipal setting. Conclusion: Stroke survivors and their significant others found Mit Sygehus and Genoptræn.dk acceptable to support cross-sectoral, person-centred and empowering stroke rehabilitation, however acceptability declined throughout the rehabilitation process. Further investigations are required to determine how cognitive rehabilitation can play a greater role in app-supported stroke rehabilitation and how the need for more long-term follow-up can be supported. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a significant cause of morbidity and mortality worldwide. Cognitive impairments following TBI are the most disabling and prevalent after-effects. These impairments have substantial and lasting implications on an individual's daily functioning and quality of life. In the acute and chronic phases after TBI, they can affect various cognitive domains, including attention, executive functions, learning and memory, language, perceptual-motor function, and social cognition. The significance of these cognitive deficits is underscored by their association with difficulties in vocational reintegration, social interactions, and overall independence. Furthermore, the long-term consequences of TBI-related cognitive deficits extend to increased risk for mood disorders. Addressing these challenges necessitates practical assessment and management. Comprehensive neuropsychological assessments play a pivotal role in diagnosing and characterizing cognitive deficits. In addition to medication, cognitive rehabilitation therapy suggests using rehabilitation methods such as cognitive training, compensatory strategies, and assistive technologies. By recognizing the substantial impact of cognitive impairments post-TBI and implementing evidence-based techniques, clinicians and caregivers can optimize recovery and enhance the quality of life for those affected. This article aims to provide an overview of the epidemiology, pathophysiology, assessment, rehabilitation approaches, and challenges of cognitive impairment in patients with TBI.

Abstract Introduction Cognitive rehabilitation for brain injury using hypnosis has received little attention. Methods Here, we report on self-defined treatment goals and sleep-related outcomes from a randomized actively controlled trial of 49 patients with chronic cognitive sequelae following acquired brain injury. Patients were randomized to two groups, who initially received hypnotic suggestions either from a classical hypnosis tradition (“targeted”) or from a mindfulness tradition (“non-targeted”). Patients set self-defined goals for their everyday lives. Results After eight sessions, patients reported outcomes (PROs) indicated large improvements with “same” (13%), “better” (44%), “much better” (18%), or “not a problem anymore” (25%). The reported “not a problem anymore” was exclusively reported following hypnosis, not mindfulness. After a 7-week follow-up period both groups experienced a decrease in their need for sleep (~ 55 min/day). Exploratory factor analysis showed that only improvement on objective but not subjective measures (e.g. Working Memory Index, Trail Making Test, and the European Brain Injury Questionnaire scored by a relative) reflected a latent improvement factor. This indicates that subjective reports following hypnotic suggestions should be interpreted cautiously. Conclusion Based on our findings and converging evidence, we conclude that hypnosis is a promising method in cognitive neurorehabilitation following acquired brain injury, although further high-quality randomized controlled trials are required.

The aim of this research was to investigate the efficacy of cognitive rehabilitation in enhancing academic achievement, cognitive flexibility, and selective attention in students with specific learning disabilities. This applied study employed a semi-experimental design with pretest-posttest, a quantitative research method, and an experimental and control group. The population included all elementary school pupils who were referred to learning disability centers in Zanjan during the academic year 2021-2022. A total of 40 participants (22 boys and 18 girls) were randomly assigned to the experimental and control groups (each group, 20 participants). The selection was conducted through convenience sampling. The control group was placed on a waiting list, while the experimental group received 12 sessions of cognitive rehabilitation interventions. The Stroop and Wisconsin Card Sorting Tests were employed to capture data, which were subsequently analyzed using SPSS24 and repeated measures analysis. The findings showed that after cognitive rehabilitation, the level of selective attention, cognitive flexibility, and academic achievement of the participants increased significantly. Selective attention, cognitive flexibility, and academic achievement were significantly different between the experimental and control groups in the pretest, posttest, and follow-up (P

Background: Attention and response inhibition is one of the problems of dysgraphia students whose treatment has not been paid much attention, so it requires new psychological interventions including cognitive rehabilitation. Aims: The present study was conducted with the aim of determining the effectiveness of cognitive rehabilitation on the attention and response inhibition of dysgraphia students. Methods: The current research was semi-experimental with a pre-test and post-test design with a follow-up period with a control group. The research population included all second and third grade female students with dysgraphia in the 15th district of Tehran in the academic year of 2021-2022, who were referred to Sharq Counseling Center from regular schools. 14 people were selected by multi-stage cluster random sampling; and they were randomly placed in two experimental and control groups and answered Yaqoubi et al.'s dysgraphia diagnostic questionnaires (2021), Mandy Brackencamp's selective attention, concentration and effort test (2002) and Bruno-Nero Hoffman test (1984). Then the experimental group received the Aram Nejati attention and memory rehabilitation training program (2017) for 10 sessions of 60 minutes, but only school training was provided to the control group. After the training sessions, the post-test was conducted. Analysis of variance with repeated measures was used to analyze the data. Results: The results showed that cognitive rehabilitation training was effective in improving attention and response inhibition of dysgraphia students compared to the control group. These results continued in the follow-up period(p< 0/01). Conclusion: Based on the results, counselors and experts can use cognitive rehabilitation training to improve attention and inhibit response of dysgraphia students.

Background and objectives: Neurocognitive deficits in bipolar disorder (BD) have a negative impact on the quality of life, even during the euthymic phase. And many studies conducted to improve cognitive deficits in bipolar disorder. This systematic review aims to summarize studies on cognitive rehabilitation (CR) conducted in bipolar patients and evaluate its impact on neurocognitive deficits. The primary objective is to explore how CR interventions can enhance cognitive functioning, treatment outcomes, and overall quality of life in this population. Methods: A comprehensive search was conducted on PubMed, Google Scholar, Scopus, Embase, and PsycINFO databases from 1950 to 2023, following the 2015 PRISMA-P guidelines, using search terms related to BD and CR. Results: The initial search yielded 371 titles across the five databases. After applying inclusion and exclusion criteria through screening, a total of 23 articles were included in the study. The selected articles evaluated verbal memory, attention, executive functions, and social cognition. Conclusion: The findings suggest that CR can be an effective treatment approach for bipolar patients, aimed at enhancing their cognitive abilities, treatment outcomes, and overall quality of life. The primary finding of this study indicates that cognitive-behavioral therapy (CBT) protocols, skill training, and homework exercises, which offer a daily structure, social support, and opportunities for exchanging coping strategies, are more effective in enhancing cognitive functions. However, it is important to acknowledge the notable limitations of this review. Firstly, we did not assess the methodological rigor of the included studies. Additionally, there was a lack of detailed analysis regarding specific cognitive rehabilitation approaches that adhere to core CR principles, resulting in increased heterogeneity within the reviewed studies.