Cognitive Strategy Training

Physical activity can improve health and lower risk for heart disease, stroke, type 2 diabetes, depression, and some cancers, (CDC, 2014). Even though physical activity can reduce recurrent stroke, stroke survivors are not engaging in physical activity at optimal levels to protect against recurrent stroke. In their research, Boysen & Krarup, pg. 148, (2013) found that “following a stroke, sequelae such as hemiparesis and ataxia may limit the trainability of stroke patients and lead to decreasing levels of physical activity and physical performance.” Historically, motivation to exercise has also been cited in the literature as a deterrent and a facilitator to exercise among the stroke survivor population (Damush, Plue, Bakas, Schmid & Williams, 2007). According to a study conducted by researchers Mohan, Wolfe, Rudd, Heuschmann, Kolominsky-Rabas, & Grieve, (2011) patients who survive an initial stroke are at a significantly increased risk for future strokes compared with the general population; a systematic review and meta-analysis showed that the cumulative risk of stroke recurrence was 3.1% at 30 days, 11.1% at 1 year, 26.4% at 5 years and 39.2% at 10 years. Furthermore, recurrent strokes are more likely to be disabling or fatal compared with the first stroke (Mohan, Crichton, Grieve, Rudd , Wolfe, & Heuschmann,

The goal was to investigate the three different cognitive training areas: memory, reasoning and speed. The authors started with a baseline of participants of an average of “73.6 years old, had 13.5 years of schooling and 26% were African American.” After five years, they found that training effects with OTDI did not influence the subjects observed in the study and after the preliminary study they did a study on subjects with no diagnosis of dementia and no ADL limitations (bathing, dressing, and personal hygiene). After eliminating three of the 2,082 they worked with 2,799. The ODLT was measured by cognition and the response to verbal prompts every day and whether it led to better performance in the older

cognitive functional independence in stroke patients. Practitioners made treatment plans to check the patients’ response to treatment approach by adapting and grading the activities in order to verify their recovery process. The test result significantly correlate with ADL performance; it was predicted that the level of injury severity and injury location in stroke patients determine the cognition complication. The augment of the research shows the importance of visual perspective and spatial relations on ADL performance. Therefore, any obstacles to it impede ADL performance in the sense that stroke patients find it difficult to distinguish the relationship between an object and a person. For example, patients may not know if either leg is

Researches indicated that stroke patients categorized difficulties in memory, orientation, language and arithmetic as some of the most common cognitive impairments after stroke (Nys et al., 2007, Tatemichi et al., 2005, Hochstenbach, 1998, Rasquin et al., 2005). Thus, neuropsychological assessment and consequently treatment are extremely important to be conducted after stroke. The current paper will discuss both of them further. Finally, the paper reviews the effectiveness of neuropsychological assessment and treatment of stroke.

A number of studies have been conducted to study the effects of stroke on different memory systems and what can be done to improve or reverse memory damage. A study conducted in 2004 by Brooks, Rose, Potter, Jayawarden and Morling established that one area of memory impacted by stroke is prospective memory. Prospective memory is the ability to remember to do certain tasks in the future such as turning off a kitchen appliance or keeping an appointment (Brooks et al., 2004, p.391). Brooks

We recommend improvement of currently available stroke centers by increasing the number of trained personnel, upscaling of available facilities and establishing dedicated stroke care and rehabilitation centers where health personnel can cater to the needs of stroke survivors at individual level with great effect. We can utilize mass media not only to create awareness among common people regarding stroke but also provide better understanding of the risk factors leading to stroke. We also recommend developing support groups and stroke helplines for entertaining queries of stroke survivors on regular

A stroke is one of the most serious diseases which threatens public health worldwide. A prevalence of a stroke increases with age, but it is not a natural part of the aging process. According to Australian Institute of Health and Welfare (AIHW) (2013), more than 375,000 Australians had suffered by stroke in 2009 and 70% of them were more than aged 65. Furthermore, more than a third of Australians among them had a disability from the stroke (AIHW 2013). A stroke often leaves people with paralysis, balance problem, cognitive problem, speech impairment and loss of memory depends on which part of the brain is affected.

Subjects recruited for this study consisted of individuals aged 60 to 85, with 10 or more years of education or more. Those diagnosed with Alzheimer’s disease (AD) and mild cognitive impairment (MCI) were recruited to the study at the Memory Clinic of the Jewish General Hospital (JGH) in Montréal, and normal community elderly volunteers were recruited through advertising. Subjects received standardized clinical, mental status, neuropsychological, and cognitive evaluation. Depression was excluded via the Yesavage Geriatric Depression Scale (Geriatric Depression scale > 15) [37]. None had evidence of cerebral infarct on CT, and all subjects scored less than 4 on the Hachinski ischemic scale [38]. No individuals had evidence of significant heart disease, alcoholism, or drug use and all showed normal routine blood work.

Rehabilitation training is effective to minimize long-term effects in memory functions, but similar to standardized testing therapies often possess limitations. In many cases we are unaware if the patient continues to use what he or she learned throughout training after the rehabilitation treatment ended. One limitation is that the recovery period does not end with the rehabilitation training. Up until now, little research exists about the long term recovery of patients with acquired brain damage. Results of an observation show that after 2-5 years post-traumatic-brain-injury patients report functional gains after rehabilitative therapy, but still report cognitive, behavioral, and emotional impairments (Olver et al. 1996). Although, patients show improvement in cognitive and emotional functions up to 10 years port-traumatic-brain-injury (Sbordone et al. 1995). Yet, researchers found that patients who had a stroke overall improved in cognitive functions, but patients with damage to the right side and higher consciousness at admission revealed higher improvements (Hochstenbach et al. 2003). This shows that rehabilitation does not end with the training sessions.

interventions, which includes the cognitive training that is combined practicing ADL skills (Korner-Bitensky et al., 2011). Most popular training of cognition during ADL or instrumental ADL tasks was also conducted in Australian studies. However, when the definition was further defined to indicate cognition-specific interventions, it does not relate to cognition. Regarding cognitive interventions, the practitioners scarcely used words such as ‘memory’ and ‘orientation’ to describe the practices. Thus, it shows the reason why practitioners hardly use computed-remediation, verbal or picture instruction as their intervention. Despite the fact that this reveals the cognitive ideas that clinicians are focusing on, there was no trace of the therapeutic

Furthermore, there were a lot of studies that did not meet the matrix criteria because of the sample size and/or did not fall under level I-III criteria. However, a number of studies were just commentaries that provide valuable information on early post-stroke cognitive intervention and constant report of lasting functional outcome. Another article “National survey of Canadian occupational therapists' assessment and treatment of cognitive impairment post-stroke” by Korner-Bitensky et al was not used in the matrix. The research was based on different management of cognitive impairment that arises after stroke and the

Moreover; another very beneficial approach for stroke patients receiving occupational therapy is the cognitive retrainig after the stroke. “Cognitive and/or perceptual deficits that prohibit them from safely taking meds, driving, and completing other higher-order ADLs. Cognitive and perceptual sequelae after stroke may include impairments in memory, attention, initiation, problemsolving, reasoning.” (Ma H & Trombly, 2002). Most likely stroke patients tend to have

Occupational therapists working with the stroke population use activity analysis and observation skills to identify and analyze the functional impairments that result in activity limitations (McHugh Pendleton & Schultz-Krohn, 2011). Established and effective OT interventions, such as repetitive task training (RTP) and constraint-induced movement therapy (CIMT), are used to address functional impairments in the stroke population (Nilsen, Gillen, Arbesman, & Lieberman, 2015; Wolf et al., 2006). According to the National Board for Certification in Occupational Therapy (2012), 60.7% of registered OTs provide rehabilitation services to individuals who had been diagnosed with a Cerebral Vascular Accident (CVA). A systematic review (Nilsen et al., 2015) found that the responsibilities of an occupational therapist include administering a variety of assessments to create an occupational profile when treating an individual following a stroke. One example of an OT assessment that measures participation, one’s involvement in a life situation (WHO, 2001), is the Canadian Occupational Performance Measure (COPM), which asks the client to identify up to five occupations he or she would like improve performance for, and rate his or her perceived performance and satisfaction of these occupations (Law et al., 2014). Performance skills and client factors are often evaluated with Fugl-Meyer Assessment and the Action Research Arm Test to further assess functionality of the upper extremity with respect to neuromusculoskeletal functions, sensory functions, and motor skills (Fugl-Meyer, Jaasko, Leyman, Olsson, & Steglind, 1975; Lyle, 1981; Nilsen et al.,

Provides an overview of stroke rehabilitation covering patient management in the acute, subacute, and chronic phases of poststroke treatment. Cognitive, behavioral, and functional assessment in the subacute poststroke phase is discussed, neuropsychiatric problems occurring during this phase are identified, and cognitive deficits and perceptual deficits encountered during occupational therapy are described. Speech, recreational, and music therapy and social support services are also considered.

Besides this, studies 35 have also reported effectiveness of a 1-year cognitive training (CT) by comparing the cognitive performance of 16 patients with AD treated with CT and cholinesterase inhibitors (ChEIs) (experimental group) with the performance of 16 patients treated with a non-specific cognitive treatment and ChEIs (control group). It was a single-blind randomized controlled trial. The patients in the experimental group received pharmacological treatment and repeated cycles of CT for 1 year, whereas the control group received pharmacological treatment and repeated cycles of non-specific cognitive exercises. The patients in the two groups were administered a variety of neuropsychological tests measuring several cognitive functions (i.e.