Stroke: attention deficit: the role of cognitive rehabilitation is unclear

Clinical bottom line (level 1a)

  1. Patients with attention deficit following a stroke who received cognitive rehabilitation compared with standard therapy had small improvements in sustained attention and alertness, but no clear improvement in functional independence.
Lincoln et al: Cochrane Library 2000; 3 : -
Expires November 2003

The study

Systematic review of all controlled trials of
  • Patients: attention deficit following stroke
  • Intervention: cognitive rehabilitation compared with standard therapy
  • Outcome: improvement in attention, functional improvement

    Articles found in all languages using Cochrane Stroke Group Trials Register, Medline, EMBASE, CINAHL and CLIN PSYCH databases, to December 1998 (search terms: detailed in text ) and checking reference lists from relevant articles and hand-searching around 20 relevant journals. Investigators were contracted where necessary for further details of studies.

    Selection criteria: by 2 independent reviewers
    Appraisal criteria: by 2 reviewers - based on randomisation, blinding, sample size, loss to follow-up
    Articles excluded if:
    • studies with mixed aetiology groups, unless more than 75% were stroke patients or stroke data could be separated out


    2 trials involving 56 patients

    The evidence

    • Small improvements in alertness and sustained attention were noted in the cognitive rehabilitation group compared with control.
    • Only one study reported the effect on activities of daily living - no significant effect on functional independence was found.

    Comments

    1. Neither study was blinded.

    Citation

    1. Lincoln NB, Majid MJ, Weyman N: cognitive rehabilitation for attention deficits following stroke. Cochrane Library 2000; 3 : -
    Search Terms: stroke in Cochrane Library
    Contributor: Chris Ball, November 2001
    Reviewer:

    Clinical Question.
    Patient attention deficit following stroke
    Intervention or Exposure cognitive rehabilitation
    Comparison standard therapy
    Outcome functional improvement, increased attention
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