Cognitive rehabilitation is extremely beneficial for victims of brain injury or stroke, according to researchers.
The suggestion is based on a meta-analysis that suggests that treatment may work best when tailored to age, injury, symptoms, and time since injury.
Researchers at the University of South Alabama and the University of North Carolina at Charlotte analysed say that the findings, published in the journal Neuropsychology, may help establish evidence-based treatment guidelines.
For their study, the researchers analysed and updated the data found in systematic reviews, published in 2000 and 2005, of several hundred studies of cognitive rehabilitation.
The data was taken from those studies whose samples and methods were most amenable to rigorous statistical techniques.
The researchers documented the extent to which various treatments improve the language, attention, memory and other cognitive problems that appear after acquired brain injury.
The meta-analysis examined 97 articles, comprising 115 studied treatment samples and 45 control samples. The samples collectively included 2,014 individuals who underwent cognitive rehabilitation after brain injury, and 870 individuals in a variety of control conditions.
Following the initial reviews, the researchers came to the conclusion that there was enough evidence to generally support the use of a variety of rehabilitative treatments.
With a view to formulating specific treatment guidelines, the new analysis documented the extent to which treatment type and timing, origin of the injury, recovery level, and participant age affected the odds of success.
The researchers said that it would be better to start treating patients as early as possible, instead of waiting for a more complete neurological recovery.
They further said that even older patients, aged 55 or above, might benefit from cognitive rehabilitation, especially if the brain injury resulted from a stroke.
According to them, clinicians should focus their efforts on direct cognitive skills training in specific cognitive domains, such as attention or visuospatial processing, because more holistic, non-targeted interventions appear to be less effective.
The research team observed that language training soon after the event helped older people after stroke with aphasia, problems producing and/or comprehending language. However, language training was still effective, just not as much, when it started more than a year after the stroke.
They revealed that attention training helped people with acquired brain injury, and seemed to work best with younger patients less than a year after injury. It was the most specific treatment, improving nothing but attention.
Visuospatial training helped stroke patients with visuospatial neglect, the inability to respond or orient to something shown on the side opposite to the site of the injury. Visuospatial training also tended to improve performance in other cognitive domains.
Memory treatment, however, did not produce clear results, said the researchers.
They even said that comprehensive treatments, attempted to treat cognitive problems holistically, also failed to show any promising results.
The study also revealed that patients treated less than a year after injury did better than those treated more than a year later, and that older patients tended to improve more after stroke than younger patients improved after traumatic brain injury (TBI).
However, because strokes are more common in old age and TBI is more common in youth, the researchers admitted that further research was needed to disentangle the roles of age and injury type.