医学
心理干预
康复
随机对照试验
物理疗法
认知
物理医学与康复
荟萃分析
认知康复治疗
冲程(发动机)
日常生活活动
作者
Mairéad O' Donoghue,Siobhan Leahy,Pauline Boland,Rose Galvin,John McManus,Sara Hayes
出处
期刊:Stroke
[Ovid Technologies (Wolters Kluwer)]
日期:2022-02-03
标识
DOI:10.1161/strokeaha.121.034218
摘要
Background: Despite the prevalence of cognitive impairment poststroke, there is uncertainty regarding interventions to improve cognitive function poststroke. This systematic review and meta-analysis evaluate the effectiveness of rehabilitation interventions across multiple domains of cognitive function. Methods: Five databases were searched from inception to August 2019. Eligible studies included randomized controlled trials of rehabilitation interventions for people with stroke when compared with other active interventions or standard care where cognitive function was an outcome. Results: Sixty-four randomized controlled trials (n=4005 participants) were included. Multiple component interventions improved general cognitive functioning (MD, 1.56 [95% CI, 0.69–2.43]) and memory (standardized MD, 0.49 [95% CI, 0.27–0.72]) compared with standard care. Physical activity interventions improved neglect (MD, 13.99 [95% CI, 12.67–15.32]) and balance (MD, 2.97 [95% CI, 0.71–5.23]) compared with active controls. Noninvasive brain stimulation impacted neglect (MD, 20.79 [95% CI, 14.53–27.04) and functional status (MD, 14.02 [95% CI, 8.41–19.62]) compared with active controls. Neither cognitive rehabilitation (MD, 0.37 [95% CI, −0.94 to 1.69]) nor occupational-based interventions (MD, 0.45 [95% CI, −1.33 to 2.23]) had a significant effect on cognitive function compared with standard care. Conclusions: There is some evidence to support multiple component interventions, physical activity interventions, and noninvasive brain stimulation improving cognitive function poststroke. Findings must be interpreted with caution given the overall moderate to high risk of bias, heterogeneity of interventions, and outcome measures across studies.
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