Effectiveness of a Serious Game for Cognitive Training in Chronic Stroke Survivors with Mild-to-Moderate Cognitive Impairment: A Pilot Randomized Controlled Trial

Abstract

Previous cognitive training games for stroke survivors required the close supervision of therapists. We aim to demonstrate the preliminary therapeutic effectiveness of Neuro-World, serious mobile games for cognitive training, in chronic stroke survivors with mild-to-moderate cognitive impairment without therapist supervision. For that, we conducted a randomized, controlled clinical trial at a single long-term care rehabilitation center with 50 stroke survivors in the chronic stage with mild-to-moderate cognitive impairment. Participants were randomized to standard medical care (n = 25) or standard medical care plus administration of Neuro-World (n = 25) over 12 weeks. A two-way mixed model ANOVA and Tukey’s post hoc tests identified significant differences in outcomes between the experimental and the control groups at post-intervention but not at baseline. Within the experimental group, there were statistically significant improvements in all the outcomes except for the language category of the Mini-Mental State Examination and Digit Forward Span. The improvements were clinically significant for the total Mini-Mental State Examination, Digit Forward Span, and Digit Backward Span. Within the control group, there were no improvements in any of the outcomes. The practice of Neuro-World led to significant improvements in cognitive function and marginal mitigation of depressive symptoms in chronic stroke survivors with mild-to-moderate cognitive impairment.