JMIR Publications

ABSTRACT

Background:

Stroke often triggers post-stroke cognitive impairment (PSCI) within six months, impairing memory, attention, and executive function while exacerbating physical disabilities and mortality. Computerized cognitive training (CCT) is a promising treatment approach. Compared to traditional methods, CCT provides cost-effective, easily accessible, personalized and repetitive rehabilitation training. Therefore, we performed a systematic review of the efficacy of CCT to improve cognitive function in patients with PSCI and supplemented the findings with a meta-analysis.

Objective:

To evaluate the efficacy of CCT in comparison to usual care or routine rehabilitation for patients with PSCI, with the aim of providing clinicians and therapists with more effective and convenient therapeutic options.

Methods:

The systematic search was conducted across multiple databases, including PubMed, Web of Science, Embase, Cochrane Library, and Scopus, covering publications from 2010 to June 2024, with a focus on English-language articles. The primary outcome measured was cognitive function, assessed through standardized cognitive function scales, while secondary outcomes included daily living activities and motor function of the patients. The risk of bias was evaluated using the Cochrane Risk of Bias tool, and the quality of evidence was determined according to the GRADE framework.

Results:

A total of nineteen trials were included in the meta-analysis (n = 880 participants). The findings provided moderate to high-quality evidence indicating that CCT significantly enhances general cognitive function (15 trials, standardized mean difference [SMD]= 0.46, 95% CI = 0.21 to 0.71; P <.001, I2 = 60%), attention (11 trials, SMD = -0.41, 95% CI = -0.62 to -0.20; P <.001, I2 = 15%), executive function (6 trials, SMD = 0.39, 95% CI = 0.12 to 0.67; P =.005, I2 = 0%), and quality of life of PSCI patients (9 trials, SMD = 0.34, 95% CI = 0.15 to 0.53; P <.001, I2 = 6%). However, low to very low quality evidence indicated that CCT has limited improvement in memory, language function, and motor function in PSCI patients.

Conclusions:

CCT can significantly enhance general cognitive function, attention, executive function, and quality of life in PSCI patients. Clinical Trial: PROSPERO, CRD42024573594.