Cognitive Rehabilitation for Executive Dysfunction in Adults With Stroke or Other Adult Non-progressive Acquired Brain Damage

Cochrane Database of Systematic Reviews

Chung, C. S., Pollock, A., et al. (2013).

Cochrane Database of Systematic Reviews, 4, Cd008391.

This meta-analysis investigates the effects of cognitive rehabilitation on executive function skills in adults with non-progressive acquired brain injuries (e.g., stroke, traumatic brain injury, encephalitis).

The Cochrane Collaboration; Scottish Government Health Directorate (United Kingdom)

Up to 2012

Randomized controlled trials

19

<div>Overall, there was no significant effect of cognitive rehabilitation for people with executive functioning deficits status-post acquired brain injury on primary and secondary outcomes. The specific findings were as follows:</div> <ul> <li><span style="color: #333333;">Within one study there was a statistically significant benefit of cognitive rehabilitation when compared to sensorimotor therapy for concept formation (MD=-0.43) and performance on activities of daily living (ADL; MD= -28.28).</span></li> <li><span style="color: #333333;">Four studies investigated the difference in outcomes between cognitive intervention and no treatment or placebo treatments. No significant differences were noted in concept formation, planning, flexibility, working memory, and ADLs.&nbsp;</span></li> <li><span style="color: #333333;">Eight studies investigated the difference in outcomes for experimental cognitive rehabilitation versus standard cognitive rehabilitation. No significant differences in global executive functioning, inhibition, concept formation, planning, flexibility, working memory, ADLs, quality of life, or vocational outcomes.&nbsp;</span></li> <li><span style="color: #333333;">There was no significant difference in outcomes between restorative and compensatory techniques.&nbsp;</span></li> <li><span style="color: #333333;">No included studies investigated the effect of cognitive rehabilitation on adverse events or death.&nbsp;</span></li> </ul> <div><span style="color: #333333;">Overall, there was insufficient high-quality evidence to either support the use of cognitive rehabilitation interventions to improve executive functioning. Further research is warranted.</span></div>