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Nadina B Lincoln - One of the best experts on this subject based on the ideXlab platform.

  • Cognitive Rehabilitation for spatial neglect following stroke
    Cochrane Database of Systematic Reviews, 2013
    Co-Authors: Audrey Bowen, Christine Hazelton, Alex Pollock, Nadina B Lincoln
    Abstract:

    Background Unilateral spatial neglect causes difficulty attending to one side of space. Various Rehabilitation interventions have been used but evidence of their benefit is lacking. Objectives To assess whether Cognitive Rehabilitation improves functional independence, neglect (as measured using standardised assessments), destination on discharge, falls, balance, depression/anxiety and quality of life in stroke patients with neglect measured immediately post-intervention and at longer-term follow-up; and to determine which types of interventions are effective and whether Cognitive Rehabilitation is more effective than standard care or an attention control. Search methods We searched the Cochrane Stroke Group Trials Register (last searched June 2012), MEDLINE (1966 to June 2011), EMBASE (1980 to June 2011), CINAHL (1983 to June 2011), PsycINFO (1974 to June 2011), UK National Research Register (June 2011). We handsearched relevant journals (up to 1998), screened reference lists, and tracked citations using SCISEARCH. Selection criteria We included randomised controlled trials (RCTs) of Cognitive Rehabilitation specifically aimed at spatial neglect. We excluded studies of general stroke Rehabilitation and studies with mixed participant groups, unless more than 75% of their sample were stroke patients or separate stroke data were available. Data collection and analysis Two review authors independently selected studies, extracted data, and assessed study quality. For subgroup analyses, review authors independently categorised the approach underlying the Cognitive intervention as either 'top-down' (interventions that encourage awareness of the disability and potential compensatory strategies) or 'bottom-up' (interventions directed at the impairment but not requiring awareness or behavioural change, e.g. wearing prisms or patches). Main results We included 23 RCTs with 628 participants (adding 11 new RCTs involving 322 new participants for this update). Only 11 studies were assessed to have adequate allocation concealment, and only four studies to have a low risk of bias in all categories assessed. Most studies measured outcomes using standardised neglect assessments: 15 studies measured effect on activities of daily living (ADL) immediately after the end of the intervention period, but only six reported persisting effects on ADL. One study (30 participants) reported discharge destination and one study (eight participants) reported the number of falls. Eighteen of the 23 included RCTs compared Cognitive Rehabilitation with any control intervention (placebo, attention or no treatment). Meta-analyses demonstrated no statistically significant effect of Cognitive Rehabilitation, compared with control, for persisting effects on either ADL (five studies, 143 participants) or standardised neglect assessments (eight studies, 172 participants), or for immediate effects on ADL (10 studies, 343 participants). In contrast, we found a statistically significant effect in favour of Cognitive Rehabilitation compared with control, for immediate effects on standardised neglect assessments (16 studies, 437 participants, standardised mean difference (SMD) 0.35, 95% confidence interval (CI) 0.09 to 0.62). However, sensitivity analyses including only studies of high methodological quality removed evidence of a significant effect of Cognitive Rehabilitation. Additionally, five of the 23 included RCTs compared one Cognitive Rehabilitation intervention with another. These included three studies comparing a visual scanning intervention with another Cognitive Rehabilitation intervention, and two studies (three comparison groups) comparing a visual scanning intervention plus another Cognitive Rehabilitation intervention with a visual scanning intervention alone. Only two small studies reported a measure of functional disability and there was considerable heterogeneity within these subgroups (I² > 40%) when we pooled standardised neglect assessment data, limiting the ability to draw generalised conclusions. Subgroup analyses exploring the effect of having an attention control demonstrated some evidence of a statistically significant difference between those comparing Rehabilitation with attention control and those with another control or no treatment group, for immediate effects on standardised neglect assessments (test for subgroup differences, P = 0.04). Authors' conclusions The effectiveness of Cognitive Rehabilitation interventions for reducing the disabling effects of neglect and increasing independence remains unproven. As a consequence, no Rehabilitation approach can be supported or refuted based on current evidence from RCTs. However, there is some very limited evidence that Cognitive Rehabilitation may have an immediate beneficial effect on tests of neglect. This emerging evidence justifies further clinical trials of Cognitive Rehabilitation for neglect. However, future studies need to have appropriate high quality methodological design and reporting, to examine persisting effects of treatment and to include an attention control comparator.

  • The Cochrane Library - Cognitive Rehabilitation for spatial neglect following stroke.
    The Cochrane database of systematic reviews, 2013
    Co-Authors: Audrey Bowen, Christine Hazelton, Alex Pollock, Nadina B Lincoln
    Abstract:

    Background Unilateral spatial neglect causes difficulty attending to one side of space. Various Rehabilitation interventions have been used but evidence of their benefit is lacking. Objectives To assess whether Cognitive Rehabilitation improves functional independence, neglect (as measured using standardised assessments), destination on discharge, falls, balance, depression/anxiety and quality of life in stroke patients with neglect measured immediately post-intervention and at longer-term follow-up; and to determine which types of interventions are effective and whether Cognitive Rehabilitation is more effective than standard care or an attention control. Search methods We searched the Cochrane Stroke Group Trials Register (last searched June 2012), MEDLINE (1966 to June 2011), EMBASE (1980 to June 2011), CINAHL (1983 to June 2011), PsycINFO (1974 to June 2011), UK National Research Register (June 2011). We handsearched relevant journals (up to 1998), screened reference lists, and tracked citations using SCISEARCH. Selection criteria We included randomised controlled trials (RCTs) of Cognitive Rehabilitation specifically aimed at spatial neglect. We excluded studies of general stroke Rehabilitation and studies with mixed participant groups, unless more than 75% of their sample were stroke patients or separate stroke data were available. Data collection and analysis Two review authors independently selected studies, extracted data, and assessed study quality. For subgroup analyses, review authors independently categorised the approach underlying the Cognitive intervention as either 'top-down' (interventions that encourage awareness of the disability and potential compensatory strategies) or 'bottom-up' (interventions directed at the impairment but not requiring awareness or behavioural change, e.g. wearing prisms or patches). Main results We included 23 RCTs with 628 participants (adding 11 new RCTs involving 322 new participants for this update). Only 11 studies were assessed to have adequate allocation concealment, and only four studies to have a low risk of bias in all categories assessed. Most studies measured outcomes using standardised neglect assessments: 15 studies measured effect on activities of daily living (ADL) immediately after the end of the intervention period, but only six reported persisting effects on ADL. One study (30 participants) reported discharge destination and one study (eight participants) reported the number of falls. Eighteen of the 23 included RCTs compared Cognitive Rehabilitation with any control intervention (placebo, attention or no treatment). Meta-analyses demonstrated no statistically significant effect of Cognitive Rehabilitation, compared with control, for persisting effects on either ADL (five studies, 143 participants) or standardised neglect assessments (eight studies, 172 participants), or for immediate effects on ADL (10 studies, 343 participants). In contrast, we found a statistically significant effect in favour of Cognitive Rehabilitation compared with control, for immediate effects on standardised neglect assessments (16 studies, 437 participants, standardised mean difference (SMD) 0.35, 95% confidence interval (CI) 0.09 to 0.62). However, sensitivity analyses including only studies of high methodological quality removed evidence of a significant effect of Cognitive Rehabilitation. Additionally, five of the 23 included RCTs compared one Cognitive Rehabilitation intervention with another. These included three studies comparing a visual scanning intervention with another Cognitive Rehabilitation intervention, and two studies (three comparison groups) comparing a visual scanning intervention plus another Cognitive Rehabilitation intervention with a visual scanning intervention alone. Only two small studies reported a measure of functional disability and there was considerable heterogeneity within these subgroups (I² > 40%) when we pooled standardised neglect assessment data, limiting the ability to draw generalised conclusions. Subgroup analyses exploring the effect of having an attention control demonstrated some evidence of a statistically significant difference between those comparing Rehabilitation with attention control and those with another control or no treatment group, for immediate effects on standardised neglect assessments (test for subgroup differences, P = 0.04). Authors' conclusions The effectiveness of Cognitive Rehabilitation interventions for reducing the disabling effects of neglect and increasing independence remains unproven. As a consequence, no Rehabilitation approach can be supported or refuted based on current evidence from RCTs. However, there is some very limited evidence that Cognitive Rehabilitation may have an immediate beneficial effect on tests of neglect. This emerging evidence justifies further clinical trials of Cognitive Rehabilitation for neglect. However, future studies need to have appropriate high quality methodological design and reporting, to examine persisting effects of treatment and to include an attention control comparator.

  • Cognitive Rehabilitation for attention deficits following stroke.
    The Cochrane database of systematic reviews, 2013
    Co-Authors: Tobias Loetscher, Nadina B Lincoln
    Abstract:

    Many survivors of stroke complain about attentional impairments, such as diminished concentration and mental slowness. However, the effectiveness of Cognitive Rehabilitation for improving these impairments is uncertain. To determine whether (1) people receiving attentional treatment show better outcomes in their attentional functions than those given no treatment or treatment as usual, and (2) people receiving attentional treatment techniques have a better functional recovery, in terms of independence in activities of daily living, mood and quality of life, than those given no treatment or treatment as usual. We searched the Cochrane Stroke Group Trials Register (October 2012), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library October 2012), MEDLINE (1948 to October 2012), EMBASE (1947 to October 2012), CINAHL (1981 to October 2012), PsycINFO (1806 to October 2012), PsycBITE and REHABDATA (searched October 2012) and ongoing trials registers. We screened reference lists and tracked citations using Scopus. We included randomised controlled trials (RCTs) of Cognitive Rehabilitation for impairments of attention for people with stroke. The primary outcome was measures of global attentional functions, and secondary outcomes were measures of attention domains, functional abilities, mood and quality of life. Two review authors independently selected trials, extracted data and assessed trial quality. We included six RCTs with 223 participants. All six RCTs compared Cognitive Rehabilitation with a usual care control. Meta-analyses demonstrated no statistically significant effect of Cognitive Rehabilitation for persisting effects on global measures of attention (two studies, 99 participants; standardised mean difference (SMD) 0.16, 95% confidence interval (CI) -0.23 to 0.56; P value = 0.41), standardised attention assessments (two studies, 99 participants; P value ≥ 0.08) or functional outcomes (two studies, 99 participants; P value ≥ 0.15). In contrast, a statistically significant effect was found in favour of Cognitive Rehabilitation when compared with control for immediate effects on measures of divided attention (four studies, 165 participants; SMD 0.67, 95% CI 0.35 to 0.98; P value < 0.0001) but no significant effects on global attention (two studies, 53 participants; P value = 0.06), other attentional domains (six studies, 223 participants; P value ≥ 0.16) or functional outcomes (three studies, 109 participants; P value ≥ 0.21).Thus there was limited evidence that Cognitive Rehabilitation may improve some aspects of attention in the short term, but there was insufficient evidence to support or refute the persisting effects of Cognitive Rehabilitation on attention, or on functional outcomes in either the short or long term. The effectiveness of Cognitive Rehabilitation remains unconfirmed. The results suggest there may be a short-term effect on attentional abilities, but future studies need to assess the persisting effects and measure attentional skills in daily life. Trials also need to have higher methodological quality and better reporting.

  • Cognitive Rehabilitation for attention deficits following stroke
    Cochrane Database of Systematic Reviews, 2013
    Co-Authors: Tobias Loetscher, Nadina B Lincoln
    Abstract:

    Background Many survivors of stroke complain about attentional impairments, such as diminished concentration and mental slowness. However, the effectiveness of Cognitive Rehabilitation for improving these impairments is uncertain. Objectives To determine whether (1) people receiving attentional treatment show better outcomes in their attentional functions than those given no treatment or treatment as usual, and (2) people receiving attentional treatment techniques have a better functional recovery, in terms of independence in activities of daily living, mood and quality of life, than those given no treatment or treatment as usual. Search methods We searched the Cochrane Stroke Group Trials Register (October 2012), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library October 2012), MEDLINE (1948 to October 2012), EMBASE (1947 to October 2012), CINAHL (1981 to October 2012), PsycINFO (1806 to October 2012), PsycBITE and REHABDATA (searched October 2012) and ongoing trials registers. We screened reference lists and tracked citations using Scopus. Selection criteria We included randomised controlled trials (RCTs) of Cognitive Rehabilitation for impairments of attention for people with stroke. The primary outcome was measures of global attentional functions, and secondary outcomes were measures of attention domains, functional abilities, mood and quality of life. Data collection and analysis Two review authors independently selected trials, extracted data and assessed trial quality. Main results We included six RCTs with 223 participants. All six RCTs compared Cognitive Rehabilitation with a usual care control. Meta-analyses demonstrated no statistically significant effect of Cognitive Rehabilitation for persisting effects on global measures of attention (two studies, 99 participants; standardised mean difference (SMD) 0.16, 95% confidence interval (CI) -0.23 to 0.56; P value = 0.41), standardised attention assessments (two studies, 99 participants; P value ≥ 0.08) or functional outcomes (two studies, 99 participants; P value ≥ 0.15). In contrast, a statistically significant effect was found in favour of Cognitive Rehabilitation when compared with control for immediate effects on measures of divided attention (four studies, 165 participants; SMD 0.67, 95% CI 0.35 to 0.98; P value < 0.0001) but no significant effects on global attention (two studies, 53 participants; P value = 0.06), other attentional domains (six studies, 223 participants; P value ≥ 0.16) or functional outcomes (three studies, 109 participants; P value ≥ 0.21). Thus there was limited evidence that Cognitive Rehabilitation may improve some aspects of attention in the short term, but there was insufficient evidence to support or refute the persisting effects of Cognitive Rehabilitation on attention, or on functional outcomes in either the short or long term. Authors' conclusions The effectiveness of Cognitive Rehabilitation remains unconfirmed. The results suggest there may be a short-term effect on attentional abilities, but future studies need to assess the persisting effects and measure attentional skills in daily life. Trials also need to have higher methodological quality and better reporting.

  • Cognitive Rehabilitation for spatial neglect following stroke.
    The Cochrane database of systematic reviews, 2007
    Co-Authors: Audrey Bowen, Nadina B Lincoln, M Dewey
    Abstract:

    Unilateral spatial neglect is a failure to attend to one side of space. Various strategies have been used to treat these problems but evidence of their benefit has been lacking. To determine the effects of Cognitive Rehabilitation for spatial neglect following stroke as measured on impairment and disability level assessments, and destination on discharge from hospital. To determine whether any effects persist at follow-up assessment. We searched the Cochrane Stroke Group Trials Register (last searched February 2001), MEDLINE (1966-December 2000), EMBASE (1980-February 2001), CINAHL (1983-January 2001), PSYCLIT and CLINPSYCH (1974-February 2001). We handsearched relevant journals, screened reference lists from relevant articles and tracked citations using SCISEARCH. Controlled trials of Cognitive Rehabilitation for spatial neglect in stroke. Studies with mixed patient groups were excluded unless more than 75% of their sample were stroke patients or separate stroke data were available for stroke patients. Two reviewers independently selected trials, extracted data, and assessed trial quality. We included 15 studies with 400 participants. A large number of different outcome measures were reported. Only six studies included a measure of disability and only four (111 participants) investigated persisting effects on any outcome. There was evidence that Cognitive Rehabilitation resulted in significant and persisting improvements in performance on impairment level assessments, although this varied depending on the test used. There was insufficient evidence to confirm or exclude an effect of Cognitive Rehabilitation at the level of disability or on destination following discharge from hospital. There is some evidence that Cognitive Rehabilitation for spatial neglect improves performance on some impairment level tests but its effect on disability is unclear. Further well-designed RCTs are warranted as well as basic research to develop valid outcome measures.

Audrey Bowen - One of the best experts on this subject based on the ideXlab platform.

  • Cognitive Rehabilitation for spatial neglect following stroke
    Cochrane Database of Systematic Reviews, 2013
    Co-Authors: Audrey Bowen, Christine Hazelton, Alex Pollock, Nadina B Lincoln
    Abstract:

    Background Unilateral spatial neglect causes difficulty attending to one side of space. Various Rehabilitation interventions have been used but evidence of their benefit is lacking. Objectives To assess whether Cognitive Rehabilitation improves functional independence, neglect (as measured using standardised assessments), destination on discharge, falls, balance, depression/anxiety and quality of life in stroke patients with neglect measured immediately post-intervention and at longer-term follow-up; and to determine which types of interventions are effective and whether Cognitive Rehabilitation is more effective than standard care or an attention control. Search methods We searched the Cochrane Stroke Group Trials Register (last searched June 2012), MEDLINE (1966 to June 2011), EMBASE (1980 to June 2011), CINAHL (1983 to June 2011), PsycINFO (1974 to June 2011), UK National Research Register (June 2011). We handsearched relevant journals (up to 1998), screened reference lists, and tracked citations using SCISEARCH. Selection criteria We included randomised controlled trials (RCTs) of Cognitive Rehabilitation specifically aimed at spatial neglect. We excluded studies of general stroke Rehabilitation and studies with mixed participant groups, unless more than 75% of their sample were stroke patients or separate stroke data were available. Data collection and analysis Two review authors independently selected studies, extracted data, and assessed study quality. For subgroup analyses, review authors independently categorised the approach underlying the Cognitive intervention as either 'top-down' (interventions that encourage awareness of the disability and potential compensatory strategies) or 'bottom-up' (interventions directed at the impairment but not requiring awareness or behavioural change, e.g. wearing prisms or patches). Main results We included 23 RCTs with 628 participants (adding 11 new RCTs involving 322 new participants for this update). Only 11 studies were assessed to have adequate allocation concealment, and only four studies to have a low risk of bias in all categories assessed. Most studies measured outcomes using standardised neglect assessments: 15 studies measured effect on activities of daily living (ADL) immediately after the end of the intervention period, but only six reported persisting effects on ADL. One study (30 participants) reported discharge destination and one study (eight participants) reported the number of falls. Eighteen of the 23 included RCTs compared Cognitive Rehabilitation with any control intervention (placebo, attention or no treatment). Meta-analyses demonstrated no statistically significant effect of Cognitive Rehabilitation, compared with control, for persisting effects on either ADL (five studies, 143 participants) or standardised neglect assessments (eight studies, 172 participants), or for immediate effects on ADL (10 studies, 343 participants). In contrast, we found a statistically significant effect in favour of Cognitive Rehabilitation compared with control, for immediate effects on standardised neglect assessments (16 studies, 437 participants, standardised mean difference (SMD) 0.35, 95% confidence interval (CI) 0.09 to 0.62). However, sensitivity analyses including only studies of high methodological quality removed evidence of a significant effect of Cognitive Rehabilitation. Additionally, five of the 23 included RCTs compared one Cognitive Rehabilitation intervention with another. These included three studies comparing a visual scanning intervention with another Cognitive Rehabilitation intervention, and two studies (three comparison groups) comparing a visual scanning intervention plus another Cognitive Rehabilitation intervention with a visual scanning intervention alone. Only two small studies reported a measure of functional disability and there was considerable heterogeneity within these subgroups (I² > 40%) when we pooled standardised neglect assessment data, limiting the ability to draw generalised conclusions. Subgroup analyses exploring the effect of having an attention control demonstrated some evidence of a statistically significant difference between those comparing Rehabilitation with attention control and those with another control or no treatment group, for immediate effects on standardised neglect assessments (test for subgroup differences, P = 0.04). Authors' conclusions The effectiveness of Cognitive Rehabilitation interventions for reducing the disabling effects of neglect and increasing independence remains unproven. As a consequence, no Rehabilitation approach can be supported or refuted based on current evidence from RCTs. However, there is some very limited evidence that Cognitive Rehabilitation may have an immediate beneficial effect on tests of neglect. This emerging evidence justifies further clinical trials of Cognitive Rehabilitation for neglect. However, future studies need to have appropriate high quality methodological design and reporting, to examine persisting effects of treatment and to include an attention control comparator.

  • The Cochrane Library - Cognitive Rehabilitation for spatial neglect following stroke.
    The Cochrane database of systematic reviews, 2013
    Co-Authors: Audrey Bowen, Christine Hazelton, Alex Pollock, Nadina B Lincoln
    Abstract:

    Background Unilateral spatial neglect causes difficulty attending to one side of space. Various Rehabilitation interventions have been used but evidence of their benefit is lacking. Objectives To assess whether Cognitive Rehabilitation improves functional independence, neglect (as measured using standardised assessments), destination on discharge, falls, balance, depression/anxiety and quality of life in stroke patients with neglect measured immediately post-intervention and at longer-term follow-up; and to determine which types of interventions are effective and whether Cognitive Rehabilitation is more effective than standard care or an attention control. Search methods We searched the Cochrane Stroke Group Trials Register (last searched June 2012), MEDLINE (1966 to June 2011), EMBASE (1980 to June 2011), CINAHL (1983 to June 2011), PsycINFO (1974 to June 2011), UK National Research Register (June 2011). We handsearched relevant journals (up to 1998), screened reference lists, and tracked citations using SCISEARCH. Selection criteria We included randomised controlled trials (RCTs) of Cognitive Rehabilitation specifically aimed at spatial neglect. We excluded studies of general stroke Rehabilitation and studies with mixed participant groups, unless more than 75% of their sample were stroke patients or separate stroke data were available. Data collection and analysis Two review authors independently selected studies, extracted data, and assessed study quality. For subgroup analyses, review authors independently categorised the approach underlying the Cognitive intervention as either 'top-down' (interventions that encourage awareness of the disability and potential compensatory strategies) or 'bottom-up' (interventions directed at the impairment but not requiring awareness or behavioural change, e.g. wearing prisms or patches). Main results We included 23 RCTs with 628 participants (adding 11 new RCTs involving 322 new participants for this update). Only 11 studies were assessed to have adequate allocation concealment, and only four studies to have a low risk of bias in all categories assessed. Most studies measured outcomes using standardised neglect assessments: 15 studies measured effect on activities of daily living (ADL) immediately after the end of the intervention period, but only six reported persisting effects on ADL. One study (30 participants) reported discharge destination and one study (eight participants) reported the number of falls. Eighteen of the 23 included RCTs compared Cognitive Rehabilitation with any control intervention (placebo, attention or no treatment). Meta-analyses demonstrated no statistically significant effect of Cognitive Rehabilitation, compared with control, for persisting effects on either ADL (five studies, 143 participants) or standardised neglect assessments (eight studies, 172 participants), or for immediate effects on ADL (10 studies, 343 participants). In contrast, we found a statistically significant effect in favour of Cognitive Rehabilitation compared with control, for immediate effects on standardised neglect assessments (16 studies, 437 participants, standardised mean difference (SMD) 0.35, 95% confidence interval (CI) 0.09 to 0.62). However, sensitivity analyses including only studies of high methodological quality removed evidence of a significant effect of Cognitive Rehabilitation. Additionally, five of the 23 included RCTs compared one Cognitive Rehabilitation intervention with another. These included three studies comparing a visual scanning intervention with another Cognitive Rehabilitation intervention, and two studies (three comparison groups) comparing a visual scanning intervention plus another Cognitive Rehabilitation intervention with a visual scanning intervention alone. Only two small studies reported a measure of functional disability and there was considerable heterogeneity within these subgroups (I² > 40%) when we pooled standardised neglect assessment data, limiting the ability to draw generalised conclusions. Subgroup analyses exploring the effect of having an attention control demonstrated some evidence of a statistically significant difference between those comparing Rehabilitation with attention control and those with another control or no treatment group, for immediate effects on standardised neglect assessments (test for subgroup differences, P = 0.04). Authors' conclusions The effectiveness of Cognitive Rehabilitation interventions for reducing the disabling effects of neglect and increasing independence remains unproven. As a consequence, no Rehabilitation approach can be supported or refuted based on current evidence from RCTs. However, there is some very limited evidence that Cognitive Rehabilitation may have an immediate beneficial effect on tests of neglect. This emerging evidence justifies further clinical trials of Cognitive Rehabilitation for neglect. However, future studies need to have appropriate high quality methodological design and reporting, to examine persisting effects of treatment and to include an attention control comparator.

  • Cognitive Rehabilitation for spatial neglect following stroke.
    The Cochrane database of systematic reviews, 2007
    Co-Authors: Audrey Bowen, Nadina B Lincoln, M Dewey
    Abstract:

    Unilateral spatial neglect is a failure to attend to one side of space. Various strategies have been used to treat these problems but evidence of their benefit has been lacking. To determine the effects of Cognitive Rehabilitation for spatial neglect following stroke as measured on impairment and disability level assessments, and destination on discharge from hospital. To determine whether any effects persist at follow-up assessment. We searched the Cochrane Stroke Group Trials Register (last searched February 2001), MEDLINE (1966-December 2000), EMBASE (1980-February 2001), CINAHL (1983-January 2001), PSYCLIT and CLINPSYCH (1974-February 2001). We handsearched relevant journals, screened reference lists from relevant articles and tracked citations using SCISEARCH. Controlled trials of Cognitive Rehabilitation for spatial neglect in stroke. Studies with mixed patient groups were excluded unless more than 75% of their sample were stroke patients or separate stroke data were available for stroke patients. Two reviewers independently selected trials, extracted data, and assessed trial quality. We included 15 studies with 400 participants. A large number of different outcome measures were reported. Only six studies included a measure of disability and only four (111 participants) investigated persisting effects on any outcome. There was evidence that Cognitive Rehabilitation resulted in significant and persisting improvements in performance on impairment level assessments, although this varied depending on the test used. There was insufficient evidence to confirm or exclude an effect of Cognitive Rehabilitation at the level of disability or on destination following discharge from hospital. There is some evidence that Cognitive Rehabilitation for spatial neglect improves performance on some impairment level tests but its effect on disability is unclear. Further well-designed RCTs are warranted as well as basic research to develop valid outcome measures.

Annalena Venneri - One of the best experts on this subject based on the ideXlab platform.

  • Cognitive Rehabilitation in Parkinson's Disease: A Systematic Review.
    Journal of Parkinson's disease, 2018
    Co-Authors: Hamad Alzahrani, Annalena Venneri
    Abstract:

    Introduction: Cognitive impairments are the most common non-motor symptoms in Parkinson’s Disease (PD). These symptoms have a negative impact on patients’ quality of life and daily living activities. This review will focus on published articles that investigated the efficacy of Cognitive Rehabilitation in PD. Objectives: To review the existing literature on the efficacy of Cognitive Rehabilitation in PD and highlight the most effective form of intervention to prevent Cognitive decline. This review will also point out any limitations and provide directions for future research. Methods: Published articles available in the Web of Science and PubMed databases up to November 2017 were reviewed for possible inclusion. We identified 15 articles that examined the effects of Cognitive Rehabilitation in PD and met inclusion criteria. Results: The main outcomes of this review indicated that, although previous studies used different Cognitive Rehabilitation methodologies, all studies reported Cognitive improvements on at least one Cognitive domain. Additionally, the most frequent Cognitive domains showing improvements are executive functions and attention. Conclusion: This review reports the outcomes of studies that examined the effectiveness of Cognitive Rehabilitation in PD. It also points out the limitations of the studies indicating the limited availability of follow up data on the long-term effects of Cognitive interventions. The review also highlights the fact that some of the studies did not include a PD group who did not undergo training. There remains, therefore, a need for longitudinal studies to investigate the potential long term benefits of Cognitive training. In addition, future investigations should examine whether any disease characteristics such as disease stage, degree of Cognitive impairment and/or the dominant side (right/left) or specific motor symptoms (rigidity/tremor) influence treatment efficacy.

  • Cognitive Rehabilitation in multiple sclerosis: A systematic review
    Journal of the Neurological Sciences, 2015
    Co-Authors: Micaela Mitolo, Annalena Venneri, Iain D. Wilkinson, Basil Sharrack
    Abstract:

    Abstract Background Cognitive impairment is a common clinical feature of multiple sclerosis (MS) at both the earlier and later stages of the disease, and has a significant impact on patients' functional status and quality of life. The need to address this deficit should be taken into account in clinical practice and research studies. Objective To conduct an updated systematic review of all published studies of Cognitive Rehabilitation interventions in people with MS, including studies with methodological shortcomings, to highlight major strengths and weaknesses in the field and to provide directions for future research. Search methods We searched electronic databases (PubMed and Web of Science) for articles published in English up until January 2014. The reference lists of all identified articles were also searched to complete the initial list of references. Data extraction Articles were categorized into outcome measures: cognition, imaging, mood, fatigue, quality of life and self-perceived Cognitive deficits. All articles were reviewed independently and assessed according to predetermined criteria. Results A total of 33 studies met the inclusion criteria of which 4 were of Level II-1 and none was Level I. Although the majority of these studies reported some improvements in Cognitive abilities (N = 31), the evidence which has been reported in the literature remains inconclusive and no definite conclusions can be drawn about the effect of different types of interventions on Cognitive Rehabilitation outcomes (recommendation C). Conclusions This review identified conflicting findings in the published literature about the effectiveness of various forms of Cognitive Rehabilitation techniques used in patients with MS. Studies with more rigorous methodology are therefore needed to clarify which form of Cognitive Rehabilitation may lead to greater clinical improvement.

Jennie Ponsford - One of the best experts on this subject based on the ideXlab platform.

  • Current practice of Cognitive Rehabilitation following traumatic brain injury: An international survey.
    Neuropsychological rehabilitation, 2019
    Co-Authors: Clare Nowell, Marina Downing, Peter Bragge, Jennie Ponsford
    Abstract:

    Traumatic brain injury (TBI) is a global public health issue, frequently resulting in impairments in the Cognitive domains of attention, information processing speed, memory, executive function, and communication. Despite the importance of rehabilitating Cognitive difficulties, and the release of clinical practice guidelines (CPGs) for Cognitive Rehabilitation, little is known about current clinician practice. This study aimed to explore current international clinician practice of Cognitive Rehabilitation. One hundred and fifteen English-speaking allied health professionals, including neuropsychologists and occupational therapists, from 29 countries outside Australia, were surveyed online about their current practice and reflections on Cognitive Rehabilitation. Both Cognitive retraining and functional compensation approaches to Cognitive Rehabilitation were commonly utilized. Clinicians mostly targeted deficits in attention and executive functioning with retraining interventions, whilst memory deficits were mostly targeted with compensatory interventions. Clinicians were aware of and utilized various resources for Cognitive Rehabilitation, including CPGs. Clinicians considered the client's social support network, client engagement and motivation in Rehabilitation, multidisciplinary team collaboration, and goal setting and implementation as highly impactful factors on the success of Cognitive Rehabilitation interventions. Whilst practice is broadly consistent with current CPG recommendations, addressing facilitating factors can further optimize client outcomes and quality of life following TBI.

  • Cognitive Rehabilitation Following Traumatic Brain Injury: A Survey of Current Practice in Australia
    Brain Impairment, 2018
    Co-Authors: Marina Downing, Peter Bragge, Jennie Ponsford
    Abstract:

    Background and Objective: As Cognitive impairments represent the greatest impediment to participation following moderate–severe traumatic brain injury (TBI), Cognitive Rehabilitation is vital. Several sets of guidelines for Cognitive Rehabilitation have been published, including INCOG in 2014. However, little is known about current practice by therapists working with individuals with TBI. This study aimed to characterise current Cognitive Rehabilitation practices via an online survey of therapists engaged in Rehabilitation in individuals with TBI.Method: The survey documented demographic information, current Cognitive Rehabilitation practice, resources used to inform Cognitive Rehabilitation, and reflections on Cognitive Rehabilitation provided.Results: The 221 Australian respondents were predominantly occupational therapists, neuropsychologists, and speech pathologists with an average 9 years of clinical experience in Cognitive Rehabilitation and TBI. Cognitive retraining and compensatory strategies were the most commonly identified approaches used in Cognitive Rehabilitation. Executive functioning was mostly targeted for retraining, whereas memory was targeted with compensatory strategies. Attentional problems were less frequently addressed. Client self-awareness, family involvement, team collaboration, and goal-setting were seen as important ingredients for success.Conclusion: Clinical practice of Cognitive Rehabilitation in Australia is broadly consistent with guidelines. However, addressing the impediments to its delivery is important to enhance the quality of life for individuals with TBI.

M Dewey - One of the best experts on this subject based on the ideXlab platform.

  • Cognitive Rehabilitation for spatial neglect following stroke.
    The Cochrane database of systematic reviews, 2007
    Co-Authors: Audrey Bowen, Nadina B Lincoln, M Dewey
    Abstract:

    Unilateral spatial neglect is a failure to attend to one side of space. Various strategies have been used to treat these problems but evidence of their benefit has been lacking. To determine the effects of Cognitive Rehabilitation for spatial neglect following stroke as measured on impairment and disability level assessments, and destination on discharge from hospital. To determine whether any effects persist at follow-up assessment. We searched the Cochrane Stroke Group Trials Register (last searched February 2001), MEDLINE (1966-December 2000), EMBASE (1980-February 2001), CINAHL (1983-January 2001), PSYCLIT and CLINPSYCH (1974-February 2001). We handsearched relevant journals, screened reference lists from relevant articles and tracked citations using SCISEARCH. Controlled trials of Cognitive Rehabilitation for spatial neglect in stroke. Studies with mixed patient groups were excluded unless more than 75% of their sample were stroke patients or separate stroke data were available for stroke patients. Two reviewers independently selected trials, extracted data, and assessed trial quality. We included 15 studies with 400 participants. A large number of different outcome measures were reported. Only six studies included a measure of disability and only four (111 participants) investigated persisting effects on any outcome. There was evidence that Cognitive Rehabilitation resulted in significant and persisting improvements in performance on impairment level assessments, although this varied depending on the test used. There was insufficient evidence to confirm or exclude an effect of Cognitive Rehabilitation at the level of disability or on destination following discharge from hospital. There is some evidence that Cognitive Rehabilitation for spatial neglect improves performance on some impairment level tests but its effect on disability is unclear. Further well-designed RCTs are warranted as well as basic research to develop valid outcome measures.