A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients.
Ana Lúcia Faria, Maria Salomé Pinho, Sergi Bermúdez I Badia
PMID 32546251WHAT IT FOUND
Virtual reality cognitive training improved general cognition more than paper-and-pencil tasks in chronic stroke patients.
However, the VR group also used their affected arm for motor tasks, so the benefit may come from combined motor-cognitive training rather than VR alone.
Key findings
01The VR group (Reh@City v2.0) showed significant improvement in general cognitive functioning (MoCA) compared to baseline, while the paper-and-pencil group (TG) did not.
02The VR intervention required using the paretic arm to solve tasks, whereas the paper-and-pencil intervention allowed use of the healthy arm, introducing a motor component difference.
03Most participants in the VR group were lost at follow-up, limiting the certainty of long-term comparisons between the two interventions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was not blinded, as the same clinicians performed assessments and interventions. High dropout rate in the VR group at follow-up limits long-term comparison. The VR intervention included motor training with the paretic arm, while the paper-and-pencil group used the healthy arm, confounding the source of cognitive improvement. Sample size was small (32 participants), and the study duration was only one month. Potential learning effects on cognitive tests were not fully controlled, as only the MoCA had parallel versions.
Declared interests
The study was funded by the European Commission, Interreg (MACBIOIDI), Fundação para a Ciência e a Tecnologia, and Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação. No commercial conflicts of interest were declared by the authors.
The easy way to misread this
Do not attribute the cognitive improvements solely to the virtual reality environment. The VR group used their affected arm to interact with tasks, unlike the paper-and-pencil group who used their healthy arm, meaning the benefit may stem from combined motor and cognitive training rather than the technology itself.