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One of the most common complications in stroke patients is cognitive impairment. Cognitive impairment affects a large part of the life of stroke patients. However, the relationship between cognitive impairment and fear of falling in stroke patients has not been investigated in any study yet. Various treatment approaches have been developed to improve cognitive function. While some of these approaches focus on improving cognitive function, others aim to reach the maximum functional level with various compensation methods taught to the patient in the current cognitive situation. As a result of cognitive interventions, stroke patients' participation in daily life, adherence to treatment and quality of life increase. The aim of this study is to investigate the effects of cognitive interventions on motor performance, balance and fear of falling. This study will contribute to the literature by investigating these effects of cognitive rehabilitation.
Participants will be randomized into two groups as control and experimental groups. The control group will receive traditional rehabilitation intervention, while the experimental group will receive additional cognitive intervention to traditional rehabilitation. Two groups will be evaluated before and after the study. Participants' motor performance, balance and fear of falling will be determined by evaluation criteria.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Group | Active Comparator | Traditional exercises: stretching exercises, strengthening exercises, balance exercises, walking exercises and fine motor skill exercises. |
|
| Cognitive Rehabilitation Group | Experimental | Cognitive rehabilitation; memory, executive function, attention, concentration and calculation exercises. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cognitive Rehabilitation | Other | Language, memory, attention and executive function exercises are performed for the participants' deficient cognitive functions. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Montreal Cognitive Assessment | Developed to evaluate mild cognitive impairments, Montreal Cognitive Assessment assesses different cognitive abilities including executive functions, visuospatial skills, memory, language, attention concentration, abstract thinking, calculation and orientation. It takes about 10 minutes to administer and the highest total score that can be obtained from the test is 30. Accordingly, scores of 21 and above are considered normal. | a day before the study start |
| Montreal Cognitive Assessment | Developed to evaluate mild cognitive impairments, Montreal Cognitive Assessment assesses different cognitive abilities including executive functions, visuospatial skills, memory, language, attention concentration, abstract thinking, calculation and orientation. It takes about 10 minutes to administer and the highest total score that can be obtained from the test is 30. Accordingly, scores of 21 and above are considered normal. | through study completion, an average of 2 months |
| Fugl-Meyer Assessment | The Fugl-Meyer Assessment is used to evaluate any loss or abnormality in physiological, anatomical structure or function in motor function. | a day before the study start |
| Fugl-Meyer Assessment | The Fugl-Meyer Assessment is used to evaluate any loss or abnormality in physiological, anatomical structure or function in motor function. | through study completion, an average of 2 months |
| Tinetti Balance & Gait Test | Tinetti Balance and Gait Scale is used to evaluate patients' balance and gait. | a day before the study start |
| Tinetti Balance & Gait Test |
| Measure | Description | Time Frame |
|---|---|---|
| The Timed Up & Go (TUG) Test | TUG is a practical clinical assessment tool developed to measure the physical mobility and motor performance of elderly individuals. TUG measures the time for the person to stand up from the chair, walk 3 meters, and return to the chair and sit. | a day before the study start |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ömer Faruk Akan | Contact | +90 (531) 495 51 38 | omerfaruk.akan@ogr.iuc.edu.tr | |
| Rüstem Mustafaoğlu, PhD | Contact | +90 (555) 417 85 35 | rustem.mustafaoglu@istanbul.edu.tr |
| Name | Affiliation | Role |
|---|---|---|
| Rüstem Mustafaoğlu | IstanbulUniversity-Cerrahpasa | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20824849 | Background | Hoffmann T, Bennett S, Koh CL, McKenna KT. Occupational therapy for cognitive impairment in stroke patients. Cochrane Database Syst Rev. 2010 Sep 8;2010(9):CD006430. doi: 10.1002/14651858.CD006430.pub2. | |
| 20813995 | Background | Miller EL, Murray L, Richards L, Zorowitz RD, Bakas T, Clark P, Billinger SA; American Heart Association Council on Cardiovascular Nursing and the Stroke Council. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke. 2010 Oct;41(10):2402-48. doi: 10.1161/STR.0b013e3181e7512b. Epub 2010 Sep 2. No abstract available. |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| D003072 | Cognition Disorders |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D000091942 | Cognitive Training |
| ID | Term |
|---|---|
| D000066530 | Neurological Rehabilitation |
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
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Participants will be randomly divided into intervention and control groups. Both groups will be treated for 6 weeks. Each participant will be treated for a total of thirty hours, one hour a day, five days a week.
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| Conventional Therapy | Other | Strengthening, walking, balance and coordination exercises are performed according to the needs of the participants. |
|
Tinetti Balance and Gait Scale is used to evaluate patients' balance and gait. |
| through study completion, an average of 2 months |
| Falls Efficacy Scale International (FES-I) | FES-I is a self-report questionnaire that provides information on the level of anxiety about falls for 16 activities of daily living. | a day before the study start |
| Falls Efficacy Scale International (FES-I) | FES-I is a self-report questionnaire that provides information on the level of anxiety about falls for 16 activities of daily living. | through study completion, an average of 2 months |
| The Timed Up & Go (TUG) Test |
TUG is a practical clinical assessment tool developed to measure the physical mobility and motor performance of elderly individuals. TUG measures the time for the person to stand up from the chair, walk 3 meters, and return to the chair and sit. |
| through study completion, an average of 2 months |
| 10 meter walking test | 10-meter walking test is a practical clinical assessment tool developed to measure walking capacity and motor performance of elderly individuals. The 10-meter walking test is performed by measuring the time it takes for a person to walk at normal walking speed between two markers that are 10 meters apart. | a day before the study start |
| 10 meter walking test | 10-meter walking test is a practical clinical assessment tool developed to measure walking capacity and motor performance of elderly individuals. The 10-meter walking test is performed by measuring the time it takes for a person to walk at normal walking speed between two markers that are 10 meters apart. | through study completion, an average of 2 months |
| 32992171 | Background | Niemeijer M, Svaerke KW, Christensen HK. The Effects of Computer Based Cognitive Rehabilitation in Stroke Patients with Working Memory Impairment: A Systematic Review. J Stroke Cerebrovasc Dis. 2020 Dec;29(12):105265. doi: 10.1016/j.jstrokecerebrovasdis.2020.105265. Epub 2020 Sep 11. |
| 29471428 | Background | Liu TW, Ng GYF, Chung RCK, Ng SSM. Cognitive behavioural therapy for fear of falling and balance among older people: a systematic review and meta-analysis. Age Ageing. 2018 Jul 1;47(4):520-527. doi: 10.1093/ageing/afy010. |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D005791 |
| Patient Care |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |