EFNS guidelines on cognitive rehabilitation: report of an EFNS task force

作者：Members of the Task Force on Cognitive Rehabilitation, Stefano F. Cappa, Thomas Benke, Stéphanie Clarke, B. Rossi, B. Stemmer, Caroline van Heugten · 发表于：European Journal of Neurology · 年份：2005 · DOI：10.1111/j.1468-1331.2005.01330.x · 被引用次数：304 · 研究领域：Spatial Neglect and Hemispheric Dysfunction、Neurobiology of Language and Bilingualism、Stroke Rehabilitation and Recovery

Disorders of language, spatial perception, attention, memory, calculation and praxis are a frequent consequence of acquired brain damage [in particular, stroke and traumatic brain injury (TBI)] and a major determinant of disability. The rehabilitation of aphasia and, more recently, of other cognitive disorders is an important area of neurological rehabilitation. We report here a review of the available evidence about effectiveness of cognitive rehabilitation. Given the limited number and generally low quality of randomized clinical trials (RCTs) in this area of therapeutic intervention, the Task Force considered, besides the available Cochrane reviews, evidence of lower classes which was critically analysed until a consensus was reached. In particular, we considered evidence from small group or single cases studies including an appropriate statistical evaluation of effect sizes. The general conclusion is that there is evidence to award a grade A, B or C recommendation to some forms of cognitive rehabilitation in patients with neuropsychological deficits in the post-acute stage after a focal brain lesion (stroke, TBI). These include aphasia therapy, rehabilitation of unilateral spatial neglect (ULN), attentional training in the post-acute stage after TBI, the use of electronic memory aids in memory disorders, and the treatment of apraxia with compensatory strategies. There is clearly a need for adequately designed studies in this area, which should take into account specific p...