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1.
Article in Russian | MEDLINE | ID: mdl-38884436

ABSTRACT

OBJECTIVE: To study the efficiency of the neuropsychological rehabilitation of patients with mild cognitive impairments. MATERIAL AND METHODS: The study included 103 elderly people, aged 59 to 88 years, including 90 women and 13 men with subjective complaints of memory loss (ICD-10: F06.70; F06.71; F06.78; F06.79). Participants were divided into experimental group (n=43) and comparison group (n=42). The estimated impact was the rehabilitation program «The psychosocial therapy and neurocognitive rehabilitation of elderly patients with cognitive impairments¼, within which the principle of complex stimulation of various parameters of the cognitive sphere was used in rehabilitation work with patients in the experimental group in accordance with the «Memory Clinic¼ program. The study was conducted using randomized, equalized comparison groups, and the principle of «triple-blind¼ research. Non-parametric statistics (SPSS) methods were used to assess differences. RESULTS: A significant difference between the comparison and experimental groups has been identified, primarily in relation to high-level mental processes associated with the function of the third structural-functional block according to A.R. Luria. After the training, the number of correct answers significantly increased (t(42)=-2.67, p<0.001) in the experimental group, while in the comparison group the indicator did not change (t(41)=0.50, p=0.617). The number of false alarms in the experimental group decreased significantly (t(42)=2.13, p=0.039). CONCLUSION: The results confirm the leading role of these processes in the hierarchy of mental functions, which suggests that they should primarily be targets of rehabilitation interventions.


Subject(s)
Cognitive Dysfunction , Humans , Male , Female , Aged , Middle Aged , Cognitive Dysfunction/rehabilitation , Aged, 80 and over , Cognition/physiology , Cognitive Behavioral Therapy/methods , Neuropsychological Tests , Memory Disorders/rehabilitation , Memory Disorders/etiology , Cognitive Training
2.
Am J Occup Ther ; 78(4)2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38801676

ABSTRACT

IMPORTANCE: This pilot study evaluates a remote strategy-based intervention for individuals with multiple sclerosis who experience everyday memory impairments. The intervention can potentially inform cognitive rehabilitation for this population. OBJECTIVE: To investigate the feasibility and efficacy of an intervention (TELE-Self-GEN) to determine whether it can alleviate everyday memory impairments of individuals with multiple sclerosis. DESIGN: Pretest-posttest. SETTING: Community. PARTICIPANTS: Ten adults with multiple sclerosis. INTERVENTION: Six synchronous treatment sessions were delivered online via Zoom. The treatment protocol embedded a memory strategy (self-generated learning) within a metacognitive framework, including self-awareness and self-management strategies. The treatment emphasizes when and how self-generation should be used. OUTCOME: Measurements assessed feasibility and participants' satisfaction with the intervention and its delivery method, as well as memory, everyday memory, and functional performance. RESULTS: Participants expressed high satisfaction with the virtual treatment, highlighting its convenience as a key factor. Treatment resulted in improvements in memory performance, perceived memory ability in daily life, and functional performance. CONCLUSIONS AND RELEVANCE: Results provide initial proof of concept in the utilization of a remotely delivered, strategy-based treatment approach to improve memory performance and functional abilities. The pilot data support a larger randomized clinical trial of the TELE-self-GEN. Plain-Language Summary: The results of this pilot study highlight the promising potential of TELE-self-GEN for people with multiple sclerosis (MS), who face memory challenges every day. This remotely delivered, strategy-based occupational therapy treatment approach, TELE-self-GEN, has the potential to significantly improve functional memory. The study participants reported improvements in their memory performance, perceived memory ability in daily life, and functional performance. These encouraging results serve as a foundation for more extensive clinical trials using TELE-self-GEN for people with MS.


Subject(s)
Memory Disorders , Multiple Sclerosis , Occupational Therapy , Humans , Multiple Sclerosis/rehabilitation , Multiple Sclerosis/complications , Pilot Projects , Memory Disorders/rehabilitation , Female , Male , Middle Aged , Occupational Therapy/methods , Adult , Patient Satisfaction , Activities of Daily Living , Feasibility Studies
3.
Trials ; 25(1): 11, 2024 Jan 02.
Article in English | MEDLINE | ID: mdl-38167204

ABSTRACT

OBJECTIVES: Establishment of effective evidence-based interventions in rehabilitation of working memory (WM) deficits after acquired brain injury (ABI) is sorely needed. Despite robust evidence for the efficiency of clinical hypnosis in a wide range of clinical conditions, and improved understanding of mechanisms underlying its effects, the potential of clinical hypnosis in cognitive rehabilitation is underexplored. A recent study has shown large effects of hypnotic suggestion on WM capacity following ABI. This randomized controlled trial aims to evaluate and explore the replicability of these findings and examine the generalization of treatment effects. The study will also explore possible mechanisms of change. METHODS: Ninety patients will be recruited from the Sunnaas Rehabilitation Hospital. Inclusion criteria are nonprogressive ABI, minimum 12-month post-injury, ongoing WM deficits, and age between 18 and 67 years. Patients will be randomized to either (a) an intervention group receiving four weekly 1-h sessions with induction and hypnosis, (b) an active control group receiving four weekly 1-h sessions of induction and mindfulness, or (c) a passive control group without intervention. The targeted procedure consists of suggestions about enhancing WM functions, for example through the instantiation of preinjury WM capacity in the present using age regression or through visualizations of brain plasticity. The non-targeted suggestions contain no explicit mention of ABI- or WM-related abilities. Each participant will be assessed at baseline, immediately after intervention, and 6 months after baseline. The primary outcome is the WM index from WAIS-IV and self- and informant-reported WM subscale from BRIEF-A, a questionnaire exploring executive functioning in everyday life. Secondary outcomes include a cognitive composite score derived from tests measuring processing speed, executive functions, learning capacity and memory, and self-reported measures of emotional distress, quality of life, and community integration. Exploratory measures include self-rated ABI and WM-related self-efficacy. DISCUSSION: Rehabilitation of impaired WM after ABI has hitherto yielded limited transfer effects beyond the training material, i.e., improvement effects on everyday WM capacity, and clinical trials of new interventions are thus warranted. Long-standing empirical evidence demonstrates that hypnosis is an effective therapeutic technique in a wide range of conditions, and recent exploratory research has suggested a high efficacy of hypnosis in improving WM capacity in patients with ABI. However, these extraordinary findings need replication in studies applying scientifically rigorous designs. If successful, our ambition is to provide recommendations and materials to implement hypnotic suggestion as an adjunct treatment following ABI. Study findings may inform future studies exploring the use of clinical hypnosis in other areas of rehabilitation, such as mild TBI, and in other neurological conditions where WM deficit is prominent. TRIAL REGISTRATION: ClinicalTrials.gov NCT05287542. Registered on March 2022 PROTOCOL VERSION: Protocol version 2.0, December 2023.


Subject(s)
Brain Injuries , Memory, Short-Term , Humans , Adolescent , Young Adult , Adult , Middle Aged , Aged , Quality of Life , Brain Injuries/psychology , Executive Function , Memory Disorders/rehabilitation , Randomized Controlled Trials as Topic
4.
NeuroRehabilitation ; 52(4): 663-666, 2023.
Article in English | MEDLINE | ID: mdl-37125577

ABSTRACT

BACKGROUND: Memory disturbance is common in people with multiple sclerosis (pwMS). Currently, a range of memory rehabilitation approaches alone or as a component of cognitive rehabilitation is utilized clinically. OBJECTIVE: To evaluate the effectiveness of memory rehabilitation in improving health outcomes (memory, cognitive function, functional ability, quality of life) in pwMS. METHODS: A summary of the Cochrane Review "Memory rehabilitation for people with multiple sclerosis" by Taylor et al from a rehabilitation perspective. RESULTS: The review included 44 studies (with 2714 participants). The memory rehabilitation approaches varied amongst the included primary studies for memory retraining techniques (computerized programs, training using internal and external memory aids, etc.). Overall, the risk of bias amongst the included trials was low. The findings suggest high-certainty evidence for a beneficial effect of memory rehabilitation in improving subjective memory at intermediate- (1-6 months) and longer-term (> 6 months); and moderate-certainty evidence at immediate post-intervention. The evidence of the effect of memory rehabilitation on other outcomes showed mixed results. CONCLUSION: The evidence suggests some beneficial effects of memory rehabilitation in improving subjective memory and quality of life in pwMS. However, further evidence is required for the evaluation of memory strategies for other outcomes.


Subject(s)
Multiple Sclerosis , Humans , Activities of Daily Living , Memory Disorders/etiology , Memory Disorders/rehabilitation , Multiple Sclerosis/rehabilitation , Outcome Assessment, Health Care , Quality of Life
5.
J Head Trauma Rehabil ; 38(1): 83-102, 2023.
Article in English | MEDLINE | ID: mdl-36594861

ABSTRACT

INTRODUCTION: Memory impairments affecting encoding, acquisition, and retrieval of information after moderate-to-severe traumatic brain injury (TBI) have debilitating and enduring functional consequences. The interventional research reviewed primarily focused on mild to severe memory impairments in episodic and prospective memory. As memory is a common focus of cognitive rehabilitation, clinicians should understand and use the latest evidence. Therefore, the INCOG ("International Cognitive") 2014 clinical practice guidelines were updated. METHODS: An expert panel of clinicians/researchers reviewed evidence published since 2014 and developed updated recommendations for intervention for memory impairments post-TBI, a decision-making algorithm, and an audit tool for review of clinical practice. RESULTS: The interventional research approaches for episodic and prospective memory from 2014 are synthesized into 8 recommendations (6 updated and 2 new). Six recommendations are based on level A evidence and 2 on level B. In summary, they include the efficacy of choosing individual or multiple internal compensatory strategies, which can be delivered in a structured or individualized program. Of the external compensatory strategies, which should be the primary strategy for severe memory impairment, electronic reminder systems such as smartphone technology are preferred, with technological advances increasing their viability over traditional systems. Furthermore, microprompting personal digital assistant technology is recommended to cue completion of complex tasks. Memory strategies should be taught using instruction that considers the individual's functional and contextual needs while constraining errors. Memory rehabilitation programs can be delivered in an individualized or mixed format using group instruction. Computer cognitive training should be conducted with therapist guidance. Limited evidence exists to suggest that acetylcholinesterase inhibitors improve memory, so trials should include measures to assess impact. The use of transcranial direct current stimulation (tDCS) is not recommended for memory rehabilitation. CONCLUSION: These recommendations for memory rehabilitation post-TBI reflect the current evidence and highlight the limitations of group instruction with heterogeneous populations of TBI. Further research is needed on the role of medications and tDCS to enhance memory.


Subject(s)
Brain Injuries, Traumatic , Brain Injuries , Chronic Traumatic Encephalopathy , Transcranial Direct Current Stimulation , Humans , Brain Injuries/rehabilitation , Acetylcholinesterase , Cognitive Training , Brain Injuries, Traumatic/psychology , Memory Disorders/etiology , Memory Disorders/rehabilitation
6.
Neuropsychol Rehabil ; 33(2): 226-238, 2023 Mar.
Article in English | MEDLINE | ID: mdl-34753415

ABSTRACT

Studies investigating the efficacy of errorless learning (EL), a rehabilitation method in which the occurrence of errors during learning are eliminated, have predominantly involved patients with memory impairment. However, the most recent perspective on the underlying mechanism of EL explicitly takes executive processes into account. The aim of this study was to investigate whether EL of object locations is beneficial for memory performance compared to trial-and-error learning (TEL) in patients with acquired brain injury (ABI) experiencing executive deficits (N = 15) and matched healthy controls (N = 15). Participants completed an EL and TEL condition of a computerized spatial learning task, in which the location of everyday objects had to be memorized. The number of errors made during learning was predetermined, varying from 0 (EL condition) to 1, 2, 3, 4 or 5 errors (TEL condition). Results showed a beneficial effect of EL on memory performance in both ABI patients and controls (p < .001), but this advantage was not larger in ABI patients compared to controls and was not moderated by the amount of errors made during learning.


Subject(s)
Brain Injuries , Learning , Humans , Brain Injuries/complications , Brain Injuries/rehabilitation , Memory Disorders/etiology , Memory Disorders/rehabilitation , Cognition
7.
Neuropsychol Rehabil ; 33(8): 1411-1429, 2023 Sep.
Article in English | MEDLINE | ID: mdl-35930245

ABSTRACT

Functional memory impairment following acquired brain injury can lead to decreased independence. External memory aids such as smartphones can be highly effective compensation tools, but cognitive deficits may create barriers to implementation in daily life. The present study examined predictors of real-world use of mobile calendar applications for memory compensation in an acquired brain injury sample. A retrospective chart review was completed from an outpatient rehabilitation program, extending 15 years into the past, yielding data from 34 eligible participants. All participants demonstrated skill learning of the calendar function in their digital device and subsequently completed the generalization phase of training, which is focused on real-world implementation (measured through prospective memory tasks). The results showed that the length of time required for skill learning of mobile calendars (event entry or responding to alerts) was not predictive of the duration of generalization training. Initial training performance for responding to alerts, but not event entry, was a significant predictor of the duration of generalization training needed to complete the program. A secondary analysis with a subset of the data revealed that individuals with additional executive deficits took significantly longer to complete generalization training compared to those with a more focal memory impairment.


Subject(s)
Brain Injuries , Cognitive Dysfunction , Mobile Applications , Humans , Retrospective Studies , Learning , Cognitive Dysfunction/complications , Brain Injuries/rehabilitation , Memory Disorders/rehabilitation
8.
Behav Brain Res ; 414: 113502, 2021 09 24.
Article in English | MEDLINE | ID: mdl-34331969

ABSTRACT

Neuronal death and synaptic loss are major pathogensis of Alzheimer's disease (AD), which may be related to the ionic glutamate receptors abnormality. Ionic glutamate receptors are important postsynaptic membrane receptors that regulate excitatory synaptic transmission and are also major component of the postsynaptic density. Beta-Amyloid (Aß) attacks ionic glutamate receptors to reduce synaptic efficacy and synaptic plasticity, resulting in neuronal death and synaptic loss. The current study aimed to investigate whether exercise-ameliorated AD was associated with changes in ionic glutamate receptors. Transgenic APP/PS1 mice (TgAPP/PS1) and age-matched littermate wild mice were divided into wild type control group, wild type exercise group, transgenic control group and transgenic exercise group. The mice in exercise groups were subjected to treadmill training for 12 weeks. The results showed that 12-week treadmill exercise improved the spatial learning and memory abilities of TgAPP/PS1 mice. Moreover, exercise decreased the contents of Aß40, Aß42 and amyloid plaque deposition in hippocampus of TgAPP/PS1 mice. The number of synapses and the length and thickness of postsynaptic densities (PSD) in the hippocampal CA1 region of TgAPP/PS1 mice were significantly increased after exercise. Concomitantly, TgAPP/PS1 displayed obstacles in synaptic plasticity as evidenced by significant decreases in the levels of synaptic structural plasticity-related proteins SYN, PSD95, MAP2 and NCAM, as well as ionic glutamate neuroreceptor subunit proteins GluN2B and GluA1. Interestingly, exercise alleviated these synaptic plasticity disorder in TgAPP/PS1 mice. Thus, this study demonstrates that 12-week treadmill exercise reduces Aß levels in the hippocampus and mitigates cognitive decline in TgAPP/PS1 mice, which may be mediated by improvements in synaptic structural plasticity and excitatory neurotransmission.


Subject(s)
Memory Disorders/metabolism , Memory Disorders/physiopathology , Memory Disorders/rehabilitation , Neuronal Plasticity/physiology , Physical Conditioning, Animal/physiology , Receptors, AMPA/metabolism , Receptors, N-Methyl-D-Aspartate/metabolism , Animals , Disease Models, Animal , Mice , Mice, Inbred C57BL , Mice, Transgenic , Random Allocation , Spatial Learning/physiology , Spatial Memory/physiology
9.
Behav Brain Res ; 407: 113237, 2021 06 11.
Article in English | MEDLINE | ID: mdl-33798820

ABSTRACT

Hypoxia-ischemia (HI) is a consequence of a lack of oxygen and glucose support to the developing brain, which causes several neurodevelopmental impairments. Environmental enrichment (EE) is considered an option to recover the alterations observed in rodents exposed to HI. The aim of this study was to investigate the impact of early EE on memory, hippocampal volume and brain-derived neurotrophic factor (Bbnf) and glucocorticoid receptor (Nr3c1) gene expression of mice exposed to HI. At P10, pups underwent right carotid artery permanent occlusion followed by 35 min of 8% O2 hypoxic environment. Starting at P11, animals were reared in EE or in standard cage (HI-SC or SHAM-SC) conditions until behavioral testing (P45). SHAM pups did not undergo carotid ligation and hypoxic exposure. Memory performance was assessed in the Y-maze, Novel object recognition, and Barnes maze. Animals were then sacrificed for analysis of hippocampal volume and Bdnf and Nr3c1 gene expression. We observed that animals exposed to HI performed worse in all three tests compared to SHAM animals. Furthermore, HI animals exposed to EE did not differ from SHAM animals in all tasks. Moreover, HI decreased hippocampal volume, while animals reared in early EE were not different compared to SHAM animals. Animals exposed to HI also showed upregulated hippocampal Bdnf expression compared to SHAM animals. We conclude that early EE from P11 to P45 proved to be effective in recovering memory impairments and hippocampal volume loss elicited by HI. Nevertheless, Bdnf expression was not associated with the improvements in memory performance observed in animals exposed to EE after a hypoxic-ischemic event.


Subject(s)
Brain-Derived Neurotrophic Factor/metabolism , Environment , Hippocampus , Hypoxia-Ischemia, Brain/complications , Memory Disorders/etiology , Memory Disorders/rehabilitation , Animals , Animals, Newborn , Disease Models, Animal , Hippocampus/metabolism , Hippocampus/pathology , Hippocampus/physiopathology , Hypoxia-Ischemia, Brain/metabolism , Hypoxia-Ischemia, Brain/pathology , Hypoxia-Ischemia, Brain/physiopathology , Male , Memory Disorders/physiopathology , Mice , Mice, Inbred BALB C
10.
J Alzheimers Dis ; 79(4): 1631-1646, 2021.
Article in English | MEDLINE | ID: mdl-33459713

ABSTRACT

BACKGROUND: Although episodic memory impairment is one of the hallmarks of Alzheimer's disease (AD), the relative decline in the components of episodic memory (What, Where, and When) and the effects of cognitive training on each of them are still unknown. OBJECTIVE: We aimed to independently assess the impairment in each component of episodic memory in early to moderate AD and address whether it can be enhanced through active, spatiotemporal episodic training. METHODS: A non-verbal scene-based episodic memory task was developed to assess the ability to remember What, Where, and When information. Experiment 1 tested whether this task can differentiate AD subjects (N = 16) from healthy controls (N = 16). In Experiment 2, 13 AD subjects underwent 16 training sessions, followed by a re-administration of the scene-based memory task. Experiment 3 tested 42 healthy older adults and 51 younger adults on the same task to investigate the effects of normal aging. RESULTS: Of the three components, When memory had the highest predictive power in distinguishing AD from normal aging. Following training of AD subjects, only Where memory improved. Only What memory revealed a significant decline in healthy subjects from 65-85 years of age. CONCLUSION: These findings shed new light on the importance of the temporal component of episodic memory as a behavioral marker of AD. The selective improvement of spatial but not temporal memory through training further demonstrates the fragility of temporal memory even in early AD. Neuroscientific research is needed to distinguish whether the Where component was enhanced by improvements in hippocampal spatial representation or by other compensatory mechanisms.


Subject(s)
Alzheimer Disease/diagnosis , Alzheimer Disease/rehabilitation , Memory, Episodic , Neurological Rehabilitation/methods , Neuropsychological Tests , Adult , Aged , Aged, 80 and over , Female , Healthy Aging , Humans , Male , Memory Disorders/diagnosis , Memory Disorders/etiology , Memory Disorders/rehabilitation , Middle Aged , Republic of Korea
11.
Int J Dev Neurosci ; 81(1): 60-70, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33135304

ABSTRACT

Neonatal hypoxia-ischemia (HI) can lead to cognitive impairments and motor dysfunction. Acrobatic exercises (AE) were proposing as therapeutic option to manage HI motor deficits, however, the cognitive effects after this treatment are still poorly understood. Therefore, we evaluated the effects of AE protocol on memory impairments and brain plasticity markers after Rice-Vannucci HI rodent model. Wistar rats on the 7th postnatal day (PND) were submitted to HI model and after weaning (PND22) were trained for 5 weeks with AE protocol, then subsequently submitted to cognitive tests. Our results showed recovery in novel object recognition (NOR) memory, but not, spatial Morris Water Maze (WM) memory after AE treatment in HI rats. BDNF and synaptophysin neuroplasticity markers indicate plastic alterations in the hippocampus and striatum, with maintenance of synaptophysin despite the reduction of total volume tissue, besides, hippocampal HI-induced ipsilateral BDNF increased, and striatum contralateral BDNF decreased were noted. Nevertheless, the exercise promoted functional recovery and seems to be a promising strategy for HI treatment, however, future studies identifying neuroplastic pathway for this improvement are needed.


Subject(s)
Hypoxia-Ischemia, Brain/psychology , Hypoxia-Ischemia, Brain/rehabilitation , Memory Disorders/psychology , Memory Disorders/rehabilitation , Physical Conditioning, Animal/psychology , Recognition, Psychology , Animals , Animals, Newborn , Atrophy , Brain-Derived Neurotrophic Factor/metabolism , Hippocampus/anatomy & histology , Maze Learning , Motor Skills , Neostriatum/anatomy & histology , Psychomotor Performance , Rats , Rats, Wistar , Recovery of Function , Spatial Memory , Synaptophysin/metabolism
12.
Behav Brain Res ; 400: 113048, 2021 02 26.
Article in English | MEDLINE | ID: mdl-33279639

ABSTRACT

Physical exercise has been associated with improved cognition and may even reduce memory deficits after brain injuries. The aims of this work were to: 1) assess whether voluntary physical exercise can reduce the deficits associated with traumatic brain injury (TBI) in two different components of episodic-like memory based on object recognition, temporal order memory ("when"), and object location memory ("where"); and 2) determine whether changes in levels of brain-derived neurotrophic factor (BDNF) in the hippocampus and prefrontal cortex, as well as alterations in hippocampal cytokines, insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF), may influence the effects exercise has on either or both tasks. The rats were distributed into a sham group, a TBI group that remained sedentary (TBI-sed), and a TBI group that had access to a running wheel for a 25-day period from post-injury day 11 (TBI-exe). The rats were sacrificed after the "where" memory task, at post-injury day 37. Physical exercise restored the "when" and "where" memories, which had been impaired by the TBI, and increased the concentration of BDNF in the hippocampus, but not the prefrontal cortex. Neither TBI nor exercise were found to significantly affect hippocampal cytokines, IGF-1 or VEGF at this time post-injury. BDNF levels showed significant positive correlations with exercise, and with "when" (but not "where") memory. These results indicate that post-injury physical exercise restores "when" and "where" object recognition memory tasks after TBI, and that increased BDNF seems to be involved in this effect, particularly with regard to "when" memory.


Subject(s)
Brain Injuries, Traumatic , Brain-Derived Neurotrophic Factor/metabolism , Hippocampus , Memory Disorders , Memory, Episodic , Physical Conditioning, Animal/physiology , Recognition, Psychology/physiology , Spatial Memory/physiology , Animals , Brain Injuries, Traumatic/complications , Brain Injuries, Traumatic/physiopathology , Brain Injuries, Traumatic/rehabilitation , Cytokines/metabolism , Disease Models, Animal , Exercise Therapy , Hippocampus/immunology , Hippocampus/metabolism , Male , Memory Disorders/etiology , Memory Disorders/physiopathology , Memory Disorders/rehabilitation , Rats, Sprague-Dawley
13.
J Alzheimers Dis ; 78(4): 1689-1706, 2020.
Article in English | MEDLINE | ID: mdl-33185602

ABSTRACT

BACKGROUND: Non-pharmacological therapies for persons with dementia (PWD) are needed. OBJECTIVE: To develop and test the Paired Preventing Loss of Independence through Exercise (PLIÉ) program, an integrative group movement program for PWD and care partners (CPs). METHODS: Participants were randomized to immediate or delayed start to Paired PLIÉ in community-based classes (1 hour, 2 days/week, 12 weeks, 3 home visits). Co-primary outcomes included standard measures of cognition, physical function,and quality of life (PWD) and caregiver burden (CPs) assessed by blinded assessors, analyzed using linear mixed models to calculate effect sizes for outcome changes during Paired PLIÉ, controlling for randomization group. Anonymous satisfaction surveys included satisfaction ratings and thematic analysis of open-ended responses. RESULTS: Thirty dyads enrolled, 24 (80%) completed. PWD (mean age 80; 55% female) experienced significant improvement in self-rated quality of life (Effect Size+0.23; p = 0.016) when participating in Paired PLIÉ, while CPs experienced a non-significant increase in burden (-0.23, p = 0.079). Changes in physical and cognitive function in PWD were not significant. All CPs returning the satisfaction survey (n = 20) reported being moderately-to-highly satisfied with the program. Thematic analyses identified physical (e.g., sit-to-stand, more energy), emotional (enjoyment), and social benefits (peer-to-peer interaction) for PWD and CPs; challenges were primarily related to getting to the in-person classes. CONCLUSION: Paired PLIÉ is a promising integrative group movement program that warrants further study. It is feasible and may improve self-rated quality of life in PWD. Although CPs may experience increased burden due to logistical challenges, most reported high satisfaction and physical, emotional, and social benefits.


Subject(s)
Caregivers , Dementia/rehabilitation , Exercise Therapy/methods , Memory Disorders/rehabilitation , Adult , Aged , Aged, 80 and over , Dementia/physiopathology , Female , Functional Status , Humans , Male , Memory Disorders/physiopathology , Middle Aged
14.
Neuropsychology ; 34(8): 874-880, 2020 Nov.
Article in English | MEDLINE | ID: mdl-33030916

ABSTRACT

Objective: Accumulating evidence suggests that retrieval practice (testing during learning) enhances memory in clinical populations. However, no study to date has examined the efficacy of retrieval practice in stroke survivors, despite the negative impact of poststroke memory difficulties. We investigated whether retrieval practice enhances memory for names in stroke survivors and healthy controls. Method: Using a within- and between-subjects design, 20 stroke survivors and 20 healthy controls completed an experimental paradigm that required them to learn 18 name-face pairs divided across 3 learning conditions (spaced restudy, retrieval practice, massed study). A mixed analysis of variance compared participants' name recall across conditions after 30 min and 7 days. Results: There was a main effect of learning condition (p < .001, ηp² = .67) and a significant Time × Condition interaction (p < .001, ηp² = .25). Post hoc comparisons revealed that retrieval practice was the superior learning condition in both groups after 30 min. After 7 days, there was no significant difference between the retrieval practice and spaced restudy conditions in stroke survivors (p = .08, d = 0.41), although retrieval practice remained superior to massed study (p = .001, d = 0.88). Conclusions: Retrieval practice is a promising memory technique that significantly enhanced stroke survivors' memory for names. Given similar performance in the retrieval practice and spaced restudy conditions after 7 days, stroke survivors may benefit from multiple presentations of information during learning, rather than 1 prolonged exposure. Future studies should investigate whether additional retrieval opportunities might prolong the beneficial effect of testing during learning. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Memory , Mental Recall , Practice, Psychological , Stroke Rehabilitation/methods , Stroke/psychology , Affect , Aged , Aged, 80 and over , Cognition , Female , Humans , Male , Memory Disorders/etiology , Memory Disorders/psychology , Memory Disorders/rehabilitation , Middle Aged , Neuropsychological Tests , Recognition, Psychology , Survivors , Treatment Outcome
15.
J Stroke Cerebrovasc Dis ; 29(12): 105265, 2020 Dec.
Article in English | MEDLINE | ID: mdl-32992171

ABSTRACT

OBJECTIVES: To evaluate benefits and harms for computer based cognitive rehabilitation (CBCR) on working memory impairment after stroke. METHODS: PRISMA guidelines were followed. Four electronic databases were systematically searched: Embase, Pubmed/Medline, PsycInfo and Cochrane Library. Authors of relevant studies were contacted to detect unpublished data or articles not found by searching databases. SELECTION CRITERIA: Studies were eligible for inclusion in the systematic review if they 1) investigated the effects of CBCR on working memory after acquired brain injury in a patient sample which consisted of at least 50% stroke-patients, 2) it was possible to isolate the effects of CBCR-training by comparison to passive or active control groups, and 3) if the outcome assessment included a quantitative working memory outcome measure either isolated or as part of a general outcome measure. Included studies were further eligible for the meta-analysis if 1) they were conducted as a randomized controlled trial, 2) they included only stroke patients, and 3) the effects of CBCR on working memory could be isolated. RESULTS: Literature is limited and reported effects of CBCR on working memory after stroke are very heterogeneous. A meta-analysis was not performed as all studies used different measures of working memory. An additional analysis was performed in order to cautiously estimate the difference between the control interventions (whether passive or active) and CBCR interventions. The analysis revealed no meaningful differences in increase of working memory measures between control conditions and intervention conditions. However, this additional analysis should be interpreted with caution as it does not take the heterogeneity of outcome measures or the differences in sample sizes between studies into account. No harms were observed. CONCLUSION: There is insufficient evidence to conclude if CBCR is beneficial for patients with working memory deficits after stroke. SYSTEMATIC REVIEW NUMBER: This systematic review is registered in Prospero with registration ID: CRD42018087437.


Subject(s)
Cognition , Memory Disorders/rehabilitation , Memory, Short-Term , Stroke Rehabilitation , Stroke/therapy , Therapy, Computer-Assisted , Adult , Executive Function , Female , Humans , Male , Memory Disorders/diagnosis , Memory Disorders/psychology , Middle Aged , Stroke/diagnosis , Stroke/psychology , Treatment Outcome
16.
Clin Rehabil ; 34(6): 754-763, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32475261

ABSTRACT

OBJECTIVE: The aim of this study is to determine the effectiveness of an extended cognitive rehabilitation program in group's sessions in multiple sclerosis. DESIGN: Double-blind multicenter randomized trial. PARTICIPANTS: People with multiple sclerosis of 18 to 60 years, Expanded Disability Status Scale ⩽6.0, mild to moderate cognitive impairment. INTERVENTIONS: They were randomized into cognitive rehabilitation program (ProCog-SEP) or in a placebo program. ProCog-SEP comprises 13 group's sessions over 6 months and includes psychoeducational advices and cognitive exercises. Placebo program included non-cognitive exercises. No strategy and no cognitive advice were provided. MAIN MEASURES: The primary endpoint was the percentage of verbal memory learning measured by the Selective Reminding Test. A comprehensive neuropsychological assessment is carried out before and after interventions by a neuropsychologist blinded to intervention. Effectiveness of the ProCog-SEP versus Placebo has been verified using linear regression models. RESULTS: In total, 128 participants were randomized and 110 were included in the study after planning session in groups; 101 completed this trial (77.2% females); mean age: 46.1 years (±9.6); disease duration: 11.8 years (±7.5). ProCog-SEP was more effective in increasing in learning index (9.21 (95% confidence interval (CI): 1.43, 16.99); p = 0.02) and in working memory on manipulation (0.63 (95% CI: 0.17, 1.09); p = 0.01), and updating capacities (-1.1 (95% CI: -2.13, -0.06); p = 0.04). No difference was observed for other neuropsychological outcomes. Regarding quality of life outcomes, no change was observed between the two groups. CONCLUSION: These findings suggest that ProCog-SEP could improve verbal learning abilities and working memory in people with multiple sclerosis. These improvements were observed with 13 group sessions over 6 months.


Subject(s)
Cognitive Behavioral Therapy , Memory Disorders/rehabilitation , Memory, Episodic , Multiple Sclerosis/psychology , Multiple Sclerosis/rehabilitation , Adult , Double-Blind Method , Female , Humans , Male , Memory Disorders/diagnosis , Memory Disorders/etiology , Middle Aged , Neuropsychological Tests , Quality of Life
17.
Rev Med Suisse ; 16(692): 894-897, 2020 May 06.
Article in French | MEDLINE | ID: mdl-32374532

ABSTRACT

Deficits of episodic memory and subjective memory complaints are common in adults with acquired brain injury. These impairments are likely to have a negative impact on daily activities and vocational integration. Neuropsychological assessments examine their degree of severity, the nature of the impaired processes and the presence of other, associated cognitive or affective symptoms. Cognitive rehabilitation mainly aims at reducing the impact of persisting memory difficulties on everyday life using compensation strategies. Cognitive rehabilitation studies have improved their quality in the last decade, as indicated by the increased number of randomized controlled trials and demonstrated the efficacy of some therapeutic interventions on various variables.


Les troubles de la mémoire épisodique et la plainte mnésique sont fréquents après une atteinte cérébrale acquise chez l'adulte. Ces déficits peuvent se répercuter sur les activités de la vie quotidienne et l'insertion professionnelle. L'évaluation neuropsychologique examine le degré de sévérité, la nature des processus perturbés et la présence d'autres symptômes cognitifs ou affectifs associés. Les prises en charge cognitives visent principalement à diminuer l'impact des difficultés mnésiques séquellaires en vie quotidienne par l'utilisation de stratégies de compensation. Les études de réhabilitation cognitive, dont la qualité a augmenté cette dernière décennie avec un nombre croissant d'essais contrôlés randomisés, ont montré l'efficacité de certaines interventions sur différentes variables.


Subject(s)
Brain Injuries/diagnosis , Brain Injuries/rehabilitation , Cognition , Memory Disorders/diagnosis , Memory Disorders/rehabilitation , Memory, Episodic , Brain Injuries/psychology , Humans , Memory Disorders/psychology , Neuropsychological Tests , Randomized Controlled Trials as Topic
18.
Clin Interv Aging ; 15: 519-536, 2020.
Article in English | MEDLINE | ID: mdl-32368019

ABSTRACT

INTRODUCTION: This study replicated and extended the findings from the author's previous pilot study to further explore how a spaced retrieval (SR) memory training program might be effectively applied to help persons with Alzheimer's disease (AD)  improve both short- and long-term recall of recent episodic events. METHODS: A quasi-experimental within-subject group study was conducted with 15 participants with a diagnosis of AD. RESULTS: Compared to a control condition, all participants were able to spontaneously recall significantly more specific details about trained events, and their recall was significantly enhanced when they were provided with cues. Although the findings indicated that people with AD were able to encode information during training, recall gains diminished by the end of the maintenance period. DISCUSSION: This study provides evidence that individuals with mild to moderate AD can learn and recall new episodic information through SR training. These findings support the use of SR as an intervention tool to help individuals maintain their functioning in episodic recent memory. However, more research into maintaining the long-term recall of recent episodic events is warranted.


Subject(s)
Alzheimer Disease/rehabilitation , Memory Disorders/rehabilitation , Memory, Episodic , Mental Recall , Aged , Alzheimer Disease/psychology , Female , Humans , Male , Memory Disorders/etiology , Neuropsychological Tests , Pilot Projects
19.
Disabil Rehabil Assist Technol ; 15(7): 810-824, 2020 10.
Article in English | MEDLINE | ID: mdl-32407217

ABSTRACT

Purpose: A systematic review was performed evaluating the effectiveness of Information and Communication Technology-based Assistive Technology (ICT-based-AT) to compensate for impaired cognition in everyday life activities.Materials and methods: The study was registered in PROSPERO, registration number CRD42018114913. Six databases were searched (years 2008-2019).Inclusion criteria: Randomized controlled trials (RCTs) or cohort studies; people with impaired cognition due to non-degenerative diseases; and evaluation of ICT-based-ATs' effectiveness regarding activity and participation, including prospective memory, execution of tasks and satisfaction with task execution. Each study's level of evidence and quality were assessed using "JBI Levels of Evidence" and the "JBI Meta-Analysis of Statistics Assessment and Review Instrument", respectively.Results: About 3,153 publications were located, of which 12 were included. The levels of evidence were: 1.c (RCT) (n = 7), 1.d (pseudo-RCT) (n = 1) and 3.e (observational study without control group) (n = 4). Three studies had high quality (2 RCT/1 cohort), eight acceptable (5 RCT/3 cohort) and one low (RCT) quality.Conclusions: Smartphones, personal digital assistants (PDAs), etc. with e.g. calendars and reminder alarms can improve prospective memory, especially for people with ABI. Furthermore, PDAs and similar products with prompts can improve execution of tasks for people with cognitive impairment due to different diagnoses. Products should be tailored to the users' needs and the users trained in product use. Further studies concerning children, older people and people with intellectual and developmental disability are required; as well as studies on cost-effectiveness and the effectiveness of related services.Implications for rehabilitationIn order to support activity and participation in everyday life for people with prospective memory problems, especially people with acquired brain injury, they should be offered information and communication technology-based products, such smart phones, mobile phones, personal digital assistants or similar mainstream products equipped with reminding software.People with cognitive impairment having difficulties executing tasks independently should be offered PDAs and mobile telephones and similar products with prompting software, e.g. audio-verbal, picture and video-based task-sequencing prompts.The ICT-based products should be individually tailored, and the person should be trained in using the selected product.


Subject(s)
Activities of Daily Living , Cognitive Dysfunction/rehabilitation , Computers, Handheld , Memory Disorders/rehabilitation , Self-Help Devices , Humans
20.
Behav Brain Res ; 390: 112667, 2020 07 15.
Article in English | MEDLINE | ID: mdl-32439346

ABSTRACT

Healthy aging is accompanied by a steady cognitive decline with clear losses in memory. Animal studies have consistently demonstrated that simply modifying an animal's living environment (known as environmental enrichment) can have a positive influence on age-related cognitive decline in the hippocampus. Previously, we showed that playing immersive 3D video games can improve hippocampal-based memory in young healthy adults, suggesting that the exploration of the large open worlds of modern-day video games may act as proxy for environmental enrichment in humans. Here, we replicated our previous video game study in healthy older adults, showing that playing video games for four weeks can improve hippocampal-based memory in a population that is already experiencing age-related decline in memory. Furthermore, we showed that the improvements last for up to four weeks past the intervention, highlighting the potential of video games as intervention for age-related cognitive decline.


Subject(s)
Aging/physiology , Cognitive Dysfunction/rehabilitation , Cognitive Remediation , Environment , Hippocampus/physiology , Memory Disorders/rehabilitation , Psychomotor Performance/physiology , Video Games , Aged , Aged, 80 and over , Cognitive Remediation/instrumentation , Cognitive Remediation/methods , Female , Humans , Male , Middle Aged , Outcome Assessment, Health Care
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