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Evidence summaries

Cognitive Rehabilitation for Memory Deficits after Stroke

Stroke patients might possibly benefit from cognitive rehabilitation in the short term (minimum of 4 weeks) but not in the longer term (minimum of 3 months), but the evidence is insufficient. Level of evidence: "D"

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in patients, interventions and outcomes), imprecise results (few patients in each comparison) and indirectness (short follow-up time).

Summary

A Cochrane review [Abstract] 1 included 13 studies with a total of 514 subjects. The mean ages of patients ranged from 31 years to 68 years, and the mean time since stroke ranged from less than one month to 91 months. The structure and contents of the treatment programmes were diverse. As a control group, 7 studies used standard rehabilitation or usual care, one used a waiting list, two used alternative forms of memory rehabilitation and 3 used placebo. There was a significant effect of treatment on subjective reports of memory in the short term (4 weeks to 5 months, SMD 0.36, 95% CI 0.08 to 0.64; 7 studies, n=215), but not the long term (3 months to 7 months, SMD 0.31, 95% CI -0.02 to 0.64; 3 studies, n=249). The SMD for the subjective reports of memory had small to moderate effect sizes.The results do not show any significant effect of memory rehabilitation on performance in objective memory tests, mood, functional abilities, or quality of life.

Clinical comments

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    References

    • das Nair R, Cogger H, Worthington E et al. Cognitive rehabilitation for memory deficits after stroke. Cochrane Database Syst Rev 2016;9():CD002293. [PubMed]

Primary/Secondary Keywords