A randomised control trial of the effects of home-based online attention training and working memory training on cognition and everyday function in a community stroke sample

Abstract

AbstractCognitive difficulties are common following stroke and can have widespread impacts on everyday functioning. Technological advances offer the possibility of individualised cognitive training for patients at home, potentially providing a low-cost, low-intensity adjunct to rehabilitation services. Using this approach, we have previously demonstrated post-training improvements in attention and everyday functioning in fronto-parietal stroke patients. Here we examine whether these benefits are observed more broadly in a community stroke sample. Patients were randomised to either 4 weeks of online adaptive attention training (SAT), working memory training (WMT) or waitlist (WL). Cognitive and everyday function measures were collected before and after intervention, and after 3months. During training, weekly measures of patients’ subjective functioning were collected. The training was well received and compliance good. No differences in standardised cognitive tests were observed for either intervention relative to controls. However, on patient reported outcomes, SAT participants showed greater levels of improvement in everyday functioning than WMT or WL participants. In line with our previous work, everyday functioning improvements were greatest for patients with spatial impairments and those who received SAT training. Whether attention training can be recommended for stroke survivors depends on whether cognitive test performance or everyday functioning is considered more relevant.