Cognitive remediation (CR) has been shown to improve cognitive abilities following a stroke. However, an updated quantitative literature review is needed to synthesize recent research and build understanding of factors that may optimize training parameters and treatment effects. Randomized controlled trials of CR were retrieved from seven electronic databases. Studies specific to adult stroke populations were included. Treatment effects were estimated using a random effects model, with immediate and longer-term follow-up outcomes, and moderator effects, examined for both overall and domain-specific functioning. Twenty-two studies were identified yielding 1098 patients (583 in CR groups). CR produced a small overall effect (g = 0.48, 95% CI 0.35–0.60, p < 0.01) compared with control conditions. This effect was moderated by recovery stage (p < 0.01), study quality (p = 0.04), and dose (p = 0.04), but not CR approach (p = 0.63). Significant small to medium (g = 0.25–0.75) post-intervention gains were evident within each individual outcome domain examined. A small overall effect (g = 0.27, 95% CI 0.04–0.51, p = 0.02) of CR persisted at follow-up (range 2–52 weeks). CR is effective and efficient at improving cognitive performance after stroke. The degree of efficacy varies across cognitive domains, and further high-quality research is required to enhance and sustain the immediate effects. Increased emphasis on early intervention approaches, brain-behavior relationships, and evaluation of activity and participation outcomes is also recommended.

中文翻译：

---

脑卒中后认知矫治的一般效果和特定领域的效果：系统文献综述和荟萃分析

认知矫治（CR）已被证明可以改善中风后的认知能力。但是，需要更新的定量文献综述来综合最近的研究并建立对可能优化训练参数和治疗效果的因素的理解。从七个电子数据库中检索了CR的随机对照试验。纳入了针对成人中风人群的研究。使用随机效应模型评估治疗效果，并评估其近期和长期随访结果以及慢化剂效应，并检查总体和特定领域的功能。进行了22项研究，确定了1098例患者（CR组583例）。CR产生了较小的总体影响（g  = 0.48，95％CI 0.35–0.60，p <0.01）与对照条件相比。通过恢复阶段（p  <0.01），研究质量（p  = 0.04）和剂量（p  = 0.04）减轻了这种影响，但未采用CR方法（p  = 0.63）。显著小到介质（克 内的每个单独的结果域审查= 0.25-0.75）后干预增益是很明显的。阿小整体作用（克 = 0.27，95％CI 0.04-0.51，p  CR的= 0.02）持续在随访（范围2-52周）。CR有效且有效改善中风后的认知能力。疗效程度因认知领域而异，需要进一步的高质量研究来增强和维持其即时效果。还建议增加对早期干预方法，脑-行为关系以及活动和参与结果的评估的重视。