Comprehensive Rehabilitation Training Decreases Cognitive Impairment, Anxiety, and Depression in Poststroke Patients: A Randomized, Controlled Study

Abstract

Background: To explore the effect of comprehensive rehabilitation training (CRT) on cognitive impairment, anxiety, and depression in poststroke patients.

Methods: 168 poststroke patients were consecutively recruited in this randomized controlled study. Patients were randomly assigned to CRT group (CRT plus conventional treatment) and control group (conventional treatment) as 1:1 ratio. The specific interventions of CRT included patient and family member education, cognitive training, rehabilitation training, and regular check.

Results: Both montreal cognitive assessment score change (Month12 [M12]-baseline; P = .001) and minimum mental state examination score change (M12-baseline) were higher in CRT group than that in control group (P = .004), and the percentage of cognitive impairment by montreal cognitive assessment score ≤26 was lower (P = .003) in CRT group compared to control group at month 12. Anxiety assessments were performed by hospital anxiety and depression scale (HADS) and Zung self-rating anxiety scale (SAS). The HADS anxiety score change (M12-baseline; P = .002) and the SAS score change (M12-baseline; P = .006) were decreased in CRT group compared to control group. Lower occurrence rate of anxiety assessed by SAS was observed in CRT group compared to control group (P = .033). Depression assessments were performed by HADS and Zung self-rating depression scale (SDS). HADS depression score change (M12-baseline; P < .001) and the SDS score change (M12-baseline; P = .002) were reduced in CRT group compared to control group. Decreased occurrence rate of depression assessed by SDS was found in CRT group compared to control group (P = .022).

Conclusions: CRT contributes to the recovery of cognitive impairment, and decreases anxiety and depression in poststroke patients.

Keywords: CRT; anxiety; cognitive impairment; depression; poststroke patients.