ABSTRACT

A systematic review and meta-analysis based on randomized controlled trials (RCTs) from the last 10 years was conducted to identify the effect of computer-based training compared to routine methods on post-stroke cognitive rehabilitation and to provide recommendations for future research. A literature search was performed in the Cochrane Library, EMBASE, PubMed, EBSCO (CINAHL), and Web of Science that focused on studies comparing the effects of computerized cognitive training and routine methods in stroke survivors. After extraction of the study characteristics and methodological quality evaluation, a meta-analysis was conducted using the standard model based on the level of the overall cognitive domain. Ten out of 201 studies were included in the systematic review, with a total of 600 stroke survivors. The average age of the participants ranged from 42.1 to 66 years old, 305 participants used the computer-based training method, and males accounted for approximately 58.5%. All studies compared the baseline characteristics of participants at the onset of their studies, and no significant difference was shown. Six studies that reported the results for the overall cognitive domain were further analyzed by meta-analysis. The outcome of the meta-analysis showed that the effect size was 0.61 with a 95% confidence interval [−0.18, 0.35], and the P value (P = 0.54) indicated no significant difference between the control group and the computer-based cognitive training group. The results of the meta-analysis, based on a limited number of studies, did not show significant superiority of computer-based cognitive training compared to the traditional method in post-stroke patients. More high-quality studies focusing on different illness phases and various types of intervention software should be conducted to improve the meta-analysis and to explore the influence of computer-based cognitive training by subgroup analysis.

摘要

一项基于过去 10 年随机对照试验 (RCT) 的系统评价和荟萃分析旨在确定计算机训练与常规方法相比对卒中后认知康复的影响，并为未来的研究提供建议。在 Cochrane Library、EMBASE、PubMed、EBSCO (CINAHL) 和 Web of Science 中进行了文献检索，重点是比较计算机化认知训练和常规方法对中风幸存者的影响的研究。在提取研究特征和方法学质量评估后，使用基于整体认知领域水平的标准模型进行荟萃分析。系统评价纳入了 201 项研究中的 10 项，共有 600 名中风幸存者。参与者的平均年龄为42.1至66岁，305名参与者使用基于计算机的培训方法，男性约占58.5%。所有研究都比较了参与者在研究开始时的基线特征，没有显示出显着差异。通过荟萃分析进一步分析了报告整体认知领域结果的六项研究。荟萃分析的结果显示，效应量为 0.61，置信区间为 95% [-0.18, 0.35]，而 通过荟萃分析进一步分析了报告整体认知领域结果的六项研究。荟萃分析的结果显示，效应量为 0.61，置信区间为 95% [-0.18, 0.35]，而 通过荟萃分析进一步分析了报告整体认知领域结果的六项研究。荟萃分析的结果显示，效应量为 0.61，置信区间为 95% [-0.18, 0.35]，而P值（P  =0.54）表示对照组与计算机认知训练组之间无显着差异。荟萃分析的结果基于有限数量的研究，与中风后患者的传统方法相比，基于计算机的认知训练并未显示出显着优势。应开展更多针对不同疾病阶段和各类干预软件的高质量研究，以改进荟萃分析，并通过亚组分析探索基于计算机的认知训练的影响。