Effect of computer-based cognitive rehabilitation (CBCR) for people with stroke: A systematic review and meta-analysis

Abstract

Objective: We conducted a systematic review and meta-analysis to identify the effect of computer-based cognitive rehabilitation (CBCR) on improving cognitive functions in patients with stroke. Methods: Researchers performed a literature search using computerized databases such as the Cochrane Database, EBSCO (CINAHL), PsycINFO, PubMed and Web of Science. The following keywords were used: stroke, computer-based, cognitive rehabilitation, and others. The methodological quality was evaluated. Statistical heterogeneity and standardized mean difference were used to compute the overall effect size and that of subgroups. Also publication bias of the selected studies was analysed. Results: Twelve studies met the inclusion criteria including a total of 461 stroke survivors. Among studies, six RCT studies were rated as high methodological quality. Overall effect size was medium 0.54, and the 95 % confidence interval was 0.33-0.74. The effect sizes of acute and chronic phase of stroke were both 0.54. They can be interpreted as medium effect size and were statistically significant. The statistical heterogeneity and publication bias were not significant. Conclusion: The present study provides evidence that CBCR is effective on improving cognitive function after stroke. We recommend conducting meta-analysis on subgroups of CBCR programs in further studies. © 2013 - IOS Press and the authors. All rights reserved.