A home programme for patients with cognitive dysfunction: a pilot study

Abstract

Objective: To evaluate the effectiveness of a 12-week individualized home programme of rehabilitation for patients with cognitive impairment.

Methods: Six patients with cognitive dysfunction, after haemorrhagic stroke, participated in this study. A programme was carried out in the home environment that consisted of four mixed training programmes: cognitive remediation therapy, story retelling, cognitive enhancing games and aerobic exercise. The patients performed the home programme for 2 hours a day, 7 days a week, for 12 weeks. The main outcomes were measured using the MMSE, Neurobehavioural Cognitive Status Examination (NCSE), domain-specific computerized neuropsychological test for attention, memory and executive function, the Lowenstein Occupational Therapist Cognitive Assessment (LOTCA), the Modified Barthel Index (MBI) and the Seoul-Instrumental Activity of Daily Living (S-IADL).

Results: After completion of a 12-week home programme, the patients' S-IADL scores improved significantly (p < 0.05). The patients' MMSE and NCSE scores improved marginally, with mean score changes of 4.2 (p = 0.058), 4.7 (p = 0.078) and 6.8 (p = 0.068) points, respectively. However, the patients' domain-specific cognitive test and LOTCA scores did not significantly change.

Conclusion: The results of this study showed that an individualized home programme improved IADL performance in patients with cognitive dysfunction and may have a beneficial effect on cognition, as assessed by general cognitive measures.