Background

Evidence-based cognitive rehabilitation programs for brain tumor patients are not widely available, despite the high need. We aimed to evaluate the effects of a tablet-based cognitive rehabilitation program on cognitive performance, cognitive complaints, fatigue, and psychological distress in primary brain tumor patients following neurosurgery. Also, attrition, adherence and patient satisfaction with the program were evaluated.

Methods

Adults with presumed low-grade glioma and meningioma were recruited before surgery. Three months thereafter, participants were allocated to the intervention group or waiting-list control group using minimization. The 10-week eHealth app ReMind, based on the effective face-to-face intervention, consisted of psychoeducation, strategy-training and attention retraining. Performance-based cognitive outcomes and patient-reported outcomes were assessed before surgery and 3, 6 and 12 months thereafter. Mean scores, percentages of cognitively impaired individuals and reliable change indices (RCIs) were compared between groups.

Results

Sixty-two out of 183 eligible patients were randomized. Of the people who declined, 56% reported that participation would to be too burdensome. All participants found a tablet-app suitable for delivery of cognitive rehabilitation and 90% rated the program as “good” or “excellent”. Performance-based cognitive outcomes and patient-reported outcomes did not significantly differ in group means over time nor RCIs between the intervention (final n = 20) and control group (final n = 25).

Conclusions

Recruitment at this early stage was difficult, resulting in limited statistical power. No significant effects were demonstrated, while adherence and satisfaction with the eHealth program were good. In clinical practice, ReMind may be helpful, if timing would be adapted to patients’ needs.

中文翻译：

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脑肿瘤患者的电子健康认知康复：随机对照试验的结果

背景

尽管需求量很大，但针对脑肿瘤患者的循证认知康复计划并未广泛应用。我们旨在评估基于平板电脑的认知康复计划对神经外科手术后原发性脑肿瘤患者的认知表现、认知主诉、疲劳和心理困扰的影响。此外，还评估了减员、依从性和患者对该计划的满意度。

方法

在手术前招募了推测为低级别胶质瘤和脑膜瘤的成年人。三个月后，参与者被分配到干预组或使用最小化的等待名单对照组。为期 10 周的 eHealth 应用程序ReMind基于有效的面对面干预，包括心理教育、策略培训和注意力再培训。在手术前和术后 3、6 和 12 个月评估基于表现的认知结果和患者报告的结果。比较了各组之间的平均分数、认知障碍个体的百分比和可靠变化指数 (RCI)。

结果

183 名符合条件的患者中有 62 名被随机分配。在拒绝的人中，有 56% 的人表示参与会过于繁重。所有参与者都发现了一款​​适合提供认知康复的平板电脑应用程序，90% 的参与者将该计划评为“好”或“优秀”。基于表现的认知结果和患者报告的结果在干预组（最终n  = 20）和对照组（最终n  = 25）之间的组均值和 RCI 上没有显着差异。

结论

在这个早期阶段招募很困难，导致统计能力有限。没有显示出显着效果，而对电子健康计划的依从性和满意度都很好。在临床实践中，如果时间可以适应患者的需要， ReMind可能会有所帮助。