A systematic review of cognitive interventions to improve functional ability in people who have cognitive impairment following stroke.
OBJECTIVE
Cognitive impairment is a frequent consequence of stroke and can impact the ability of people who have had a stroke to perform everyday activities. There are a number of intervention strategies that various health professionals may use when working with people who have cognitive impairment post stroke. The purpose of this systematic review was to determine whether interventions for people with cognitive impairment after a stroke improve their functional performance of basic and/or instrumental activities of daily living (ADL).


METHODS
Searches were performed in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, PsycBITE, OTseeker, and Dissertation Abstracts. Studies were eligible for inclusion if they were a randomised controlled trial or quasi-randomised controlled trial that evaluated an intervention that focused on providing cognitive retraining to adults with clinically defined stroke and confirmed cognitive impairment and measured functional ability, either basic or instrumental ADL, as either a primary or secondary outcome measure.


RESULTS
Four studies, involving a total of 376 participants, were included in this review. There was no statistically significant difference between groups on basic ADL performance in any of the four studies or on instrumental ADL in the one study that measured this.


CONCLUSIONS
There were not an adequate number of high quality trials to be able to make recommendations that support or refute the use of specific cognitive retraining interventions to improve functional outcomes following a stroke. More research is required before conclusions can be made about the effect of cognitive interventions on functional outcomes post stroke.
Hoffmann
Tammy
T
Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Bennett
Sally
S
Koh
Chia-Lin
CL
McKenna
Kryss
K
D000203:Activities of Daily Living; D003072:Cognition Disorders / Q000209:etiology* / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy; D006801:Humans; D012648:Self Care; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation