Adaptive conjunctive cognitive training (ACCT) in virtual reality for chronic stroke patients: a randomized controlled pilot trial

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  • dc.contributor.author Maier, Martina
  • dc.contributor.author Rubio Ballester, Belén
  • dc.contributor.author Leiva Bañuelos, Núria
  • dc.contributor.author Duarte Oller, Esther
  • dc.contributor.author Verschure, Paul F. M. J.
  • dc.date.accessioned 2020-06-10T07:07:36Z
  • dc.date.available 2020-06-10T07:07:36Z
  • dc.date.issued 2020
  • dc.description.abstract Background: Current evidence for the effectiveness of post-stroke cognitive rehabilitation is weak, possibly due to two reasons. First, patients typically express cognitive deficits in several domains. Therapies focusing on specific cognitive deficits might not address their interrelated neurological nature. Second, co-occurring psychological problems are often neglected or not diagnosed, although post-stroke depression is common and related to cognitive deficits. This pilot trial aims to test a rehabilitation program in virtual reality that trains various cognitive domains in conjunction, by adapting to the patient's disability and while investigating the influence of comorbidities. Methods: Thirty community-dwelling stroke patients at the chronic stage and suffering from cognitive impairment performed 30 min of daily training for 6 weeks. The experimental group followed, so called, adaptive conjunctive cognitive training (ACCT) using RGS, whereas the control group solved standard cognitive tasks at home for an equivalent amount of time. A comprehensive test battery covering executive function, spatial awareness, attention, and memory as well as independence, depression, and motor impairment was applied at baseline, at 6 weeks and 18-weeks follow-up. Results: At baseline, 75% of our sample had an impairment in more than one cognitive domain. The experimental group showed improvements in attention ([Formula: see text] (2) = 9.57, p < .01), spatial awareness ([Formula: see text] (2) = 11.23, p < .01) and generalized cognitive functioning ([Formula: see text] (2) = 15.5, p < .001). No significant change was seen in the executive function and memory domain. For the control group, no significant change over time was found. Further, they worsened in their depression level after treatment (T = 45, r = .72, p < .01) but returned to baseline at follow-up. The experimental group displayed a lower level of depression than the control group after treatment (Ws = 81.5, z = - 2.76, r = - .60, p < .01) and (Ws = 92, z = - 2.03, r = - .44, p < .05). Conclusions: ACCT positively influences attention and spatial awareness, as well as depressive mood in chronic stroke patients.
  • dc.description.sponsorship This study was supported by EIT Health ID 19277 (RGS@HOME) under H2020, SANAR (MINECO, TIN2013–44200), cDAC (ERC-2013-ADG-341196), and socSMCs (641321H2020-FETPROACT-2014).
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Maier M, Ballester BR, Leiva Bañuelos N, Duarte Oller E, Verschure PFMJ. Adaptive conjunctive cognitive training (ACCT) in virtual reality for chronic stroke patients: a randomized controlled pilot trial. J Neuroeng Rehabil. 2020 Mar 6; 17(1):42. DOI: 10.1186/s12984-020-0652-3
  • dc.identifier.doi http://dx.doi.org/10.1186/s12984-020-0652-3
  • dc.identifier.issn 1743-0003
  • dc.identifier.uri http://hdl.handle.net/10230/44941
  • dc.language.iso eng
  • dc.publisher BioMed Central
  • dc.relation.ispartof Journal of NeuroEngineering and Rehabilitation. 2020 Mar 6; 17(1):42
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/641321
  • dc.relation.projectID info:eu-repo/grantAgreement/ES/1PE/TIN2013–44200
  • dc.rights Copyright © The Author(s). 2020. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Cognitive deficits
  • dc.subject.keyword Depression
  • dc.subject.keyword Rehabilitation
  • dc.subject.keyword Stroke
  • dc.subject.keyword Virtual reality
  • dc.title Adaptive conjunctive cognitive training (ACCT) in virtual reality for chronic stroke patients: a randomized controlled pilot trial
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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