RehaCom

HASOMED cooperation S

RehaCom a évolué depuis son lancement il y a 25 ans. Il a été développé par des thérapeutes pour des thérapeutes. Les origines de RehaCom remontent à l'année 1986 quand le professeur Hans Regel (Neuropsychologie) fut le premier à entamer des recherches dans le domaine de l'attention. Depuis, de nombreuses études et résultats de recherches couvrant différents domaines ont prouvé l'efficacité de RehaCom.

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Stroke/ Memory impairments, Germany

A Randomized Double-Blind Controlled Study Investigating the Efficacy
of a Working Memory Training During Stroke Rehabilitation

Kim Merle Richter, MSc, Claudia Mödden, MSc, Paul Eling, PhD, Helmut Hildebrandt, Prof. Published online before print April 2, 2014

OBJECTIVES: Memory training in combination with practice in semantic structuring and word fluency has been shown to improve memory performance. This study investigated the efficacy of a working memory training combined with exercises in semantic structuring and word fluency and examined whether training effects generalize to other cognitive tasks.

METHODS: In this double-blind randomized control study, 36 patients with memory impairments following brain damage were allocated to either the experimental or the active control condition, with both groups receiving 9 hours of therapy. The experimental group received a computer-based working memory training and exercises in word fluency and semantic structuring. The control group received the standard memory therapy provided in the rehabilitation center. Patients were tested on a neuropsychological test battery before and after therapy, resulting in composite scores for working memory; immediate, delayed, and prospective memory; word fluency; and attention.

RESULTS: The experimental group improved significantly in working memory and word fluency. The training effects also generalized to prospective memory tasks. No specific effect on episodic memory could be demonstrated.

CONCLUSIONS: Combined treatment of working memory training with exercises in semantic structuring is an effective method for cognitive rehabilitation of organic memory impairment.

 

Stroke/ Visual field, Germany

A Randomized Controlled Trial Comparing 2 Interventions for Visual Field Loss WithLogo NeurorehabilitationNeural Repair
Standard Occupational Therapy During Inpatient Stroke Rehabilitation

Claudia Mödden, Marion Behrens, Iris Damke, Norbert Eilers, Andreas Kastrup and Helmut Hildebrandt
in Neurorehabil and Neural Repair, DOI: 10.1177/1545968311425927, published on 2 December 2011

OBJECTIVES: Compensatory and restorative treatments have been developed to improve visual field defects after stroke. However, no controlled trials have compared these interventions with standard occupational therapy (OT).

METHODS: A total of 45 stroke participants with visual field defect admitted for inpatient rehabilitation were randomized to restorative computerized training (RT) using computer-based stimulation of border areas of their visual field defects or to a computer-based compensatory therapy (CT) teaching a visual search strategy. OT, in which different compensation strategies were used to train for activities of daily living, served as standard treatment for the active control group. Each treatment group received 15 single sessions of 30 minutes distributed over 3 weeks. The primary outcome measures were visual field expansion for RT, visual search performance for CT, and reading performance for both treatments. Visual conjunction search, alertness, and the Barthel Index were secondary outcomes.

RESULTS: Compared with OT, CT resulted in a better visual search performance, and RT did not result in a larger expansion of the visual field. Intragroup pre–post comparisons demonstrated that CT improved all defined outcome parameters and RT several, whereas OT only improved one.

CONCLUSIONS: CT improved functional deficits after visual field loss compared with standard OT and may be the intervention of choice during inpatient rehabilitation. A larger trial that includes lesion location in the analysisis recommended.

 

Stroke, South Korea

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

Yu-Jin Cha and Hee Kim in NeuroRehabilitation 32 (2013) 359–368 DOI:10.3233/NRE-130856

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, computerbased, 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 % confi dence 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 signifi cant.

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.

JournalOfNeurologicalScience A total of 150 patients with RR MS and an Expanded Disability Status Scale (EDSS) score of ≤ 4 were examined. Information processing, working memory and attention were assessed by the Paced Auditory Serial Addition Test (PASAT) and executive functions by the Wisconsin Card Sorting Test (WCST). Twenty patients who scored below certain cut-off measures in both tests were included in this double-blind controlled study. Patients were casually assigned to a study group (SG) or a control group (CG) and underwent neuropsychological evaluation at baseline and after 3 months. Patients in the SG received intensive computerassisted cognitive rehabilitation of attention, information processing and executive functions for 3 months; the CG did not receive any rehabilitation.

 

Traumatic brain injury, Cuba

Clinical Impact of RehaCom Software for Cognitive Rehabiltation of Patients withJuly-2013-MEDICC-REVIEW-Cover-small
Acquiered Brain Injury

Elízabeth Fernández, María Luisa Bringas, Sonia Salazar, Daymí Rodríguez, María Eugenia García and
Maydané Torres in MEDICC Review, October 2012, Vol 14, No 4

We describe the clinical impact of the RehaCom computerized cognitive training program instituted in the International Neurological Restoration Center for rehabilitation of brain injury patients. Fifty patients admitted from 2008 through 2010 were trained over 60 sessions. Attention and memory functions were assessed with a pre- and posttreatment design, using the Mini-Mental State Examination, Wechsler Memory Scale and Trail Making Test (Parts A and B). Negative effects were assessed, including mental fatigue, headache and eye irritation. The program’s clinical usefulness was confi rmed, with 100% of patients showing improved performance in trained functions..

 

Multiple sclerosis, Italy

Efficacy and specificity of intensive cognitive rehabilitation of attention andJournalOfNeurologicalScience
executive functions in multiple sclerosis

Mattioli Flavia, Chiara Stampatori , Deborah Zanotti , Giovanni Parrinello and Ruggero Capra in
Journal of the Neurological Sciences 288 (2010) 101–105

OBJECTIVE: To evaluate the efficacy of a computer-based intensive training program of attention, information processing and executive functions in patients with clinically-stable relapsing–remitting (RR) multiple sclerosis (MS) and low levels of disability.

DESIGN, PATIENTS AND INTERVENTIONS: A total of 150 patients with RR MS and an Expanded Disability Status Scale (EDSS) score of ≤ 4 were examined. Information processing, working memory and attention were assessed by the Paced Auditory Serial Addition Test (PASAT) and executive functions by the Wisconsin Card Sorting Test (WCST). Twenty patients who scored below certain cut-off measures in both tests were included in this double-blind controlled study. Patients were casually assigned to a study group (SG) or a control group (CG) and underwent neuropsychological evaluation at baseline and after 3 months. Patients in the SG received intensive computerassisted cognitive rehabilitation of attention, information processing and executive functions for 3 months; the CG did not receive any rehabilitation.

SETTING: Ambulatory patients were sent by the MS referral center. Outcome measures: Improvement in neuropsychological test and scale scores.

RESULTS: After rehabilitation, only the SG significantly improved in tests of attention, information processing and executive functions (PASAT 3 p=0.023, PASAT 2 p=0.004, WCSTte p=0.037), as well as in depression scores (MADRS p=0.01). Neuropsychological improvement was unrelated to depression improvement in regression analysis.

CONCLUSIONS: Intensive neuropsychological rehabilitation of attention, information processing and executive functions is effective in patients with RR MS and low levels of disability, and also leads to improvement in depression.

 

ADHD, Germany

Evaluation of a computer-based neuropsychological training in children withLogo Neurorehabilitation
Attention-Defi cit Hyperactivity Disorder (ADHD)

Frauke Amonn, Jan Fröhlich, Dieter Breuer, Tobias Banaschewski and Manfred Doepfner in Neuro
Rehabilitation 32 (2013) 555–562 DOI:10.3233/NRE-130877

BACKGROUND: We report the effects of a computer-based neuropsychological training in children with Attention-Deficit Hyperactivity Disorder (ADHD). We hypothesized that a specific training focusing on attentional Dysfunction would result in an improvement of inattention, observable in test performance, behavior and performance during experimental school lessons and in parent and teacher ratings of the related core symptom.

METHOD: We chose a within-subject-control-design with a 4 week baseline period and subsequent 12 to 15 weekly training sessions. 30 children (6 to 13 years old) with a diagnosis of ADHD (ICD 10: F 90.0) and no other co morbidities participated in the study.

RESULTS: The training revealed significant improvement in training parameters of the neuropsychological training and in the symptoms of inattention and deportment as rated during experimental school lessons. However, generalization of training effects as measured by parent and teacher ratings was not detected.

CONCLUSIONS: We conclude that neuropsychological training could be helpful as one adjunct module in the complex treatment of ADHD but to prove clinical value, similar training programs must focus more strongly on individually existing neuropsychological defi cits. Training programs should be more intensive and should eventually be combined with home based training access.

 

Schizophrénie, France

Impact de la remédiation cognitive dans la schizophrénie sur les stratégies de résolution de problèmes et l’autonomie sociale : Utilisation du logiciel RehaCom®

A. COCHET ; M. SAOUD ; S. GABRIELE ; V. BROALLIER ; C. EL ASMAR ; J. DALERY ; T. d’AMATO.
CH « Le Vinatier », 95 boulevard Pinel, 69 677 BRON cedex, France.

Résumé: Malgré des avancées récentes, l’impact des stratégies thérapeutiques médicamenteuses sur l’amélioration de l’autonomie sociale et des capacités de résolution de problèmes interpersonnels des patients schizophrènes reste limité, avec des conséquences en terme de réinsertion socioprofessionnelle. En effet, indépendamment des symptômes positifs, négatifs et/ou de désorganisation, le déficit fonctionnel des patients schizophrènes dépend principalement de déficits cognitifs variés. Nos objectifs étaient de déterminer l’impact d’une stratégie de remédiation des déficits cognitifs sur les capacités de résolution de problèmes interpersonnels, l’autonomie sociale et les symptômes des patients schizophrènes. Trente patients schizophrènes ont participé à un programme constitué de 14 séances d’entraînement de 4 fonctions cognitives (attention/concentration, mémoire topologique, raisonnement logique, fonctions exécutives) au moyen du logiciel REHACOM®. Les capacités d’attention soutenue, mémoire et fonctions exécutives (ainsi que les capacités de résolution de problèmes interpersonnels et l’autonomie sociale et enfin les symptômes étaient évalués au début et à la fin des 14 séances de remédiation. Les fonctions cognitives, les capacités de résolution de problèmes interpersonnels, l’autonomie sociale et les symptômes ont été significativement améliorées à l’issue des séances de remédiation. Nos résultats confirment l’intérêt thérapeutique d’une remédiation cognitive chez 30 patients schizophrènes stabilisés sur les plans cliniques, thérapeutiques et fonctionnels. La question du maintien à long terme de ces améliorations devra faire l’objet d’une évaluation extérieure.

 

Schizophrénie, A randomized, controlled trial, France

A randomized, controlled trial of computer-assisted cognitive remediation for schizophrenia  (France)

Thierry d'Amato,Remy Bation, Alain Cochet, Isabelle Jalenques, Fabienne Galland, Elisabeth Giraud-Baro, Michele Pacaud-Troncin,
Françoise Augier-Astolfi, Pierre-Michel Llorca, Mohamed Saoud, Jérôme Brunelin,

Available online 19 November 2010

Abstract: Objective: There is considerable interest in cognitive remediation for schizophrenia. Our study aimed to evaluate, in a large sample of patients with schizophrenia, the interest of a computer-assisted cognitive remediation program on cognitive performances of patients as well as in clinical and functional outcome.

Method: Seventy-seven patients with remitted schizophrenia were randomly assigned to 14 2-hours individual sessions of computer-assisted cognitive remediation (n=39) or a control condition (n=38). Remediation was performed using RehaCom ® software. Four procedures were chosen to train four cognitive functions involved in different stages of the information processing: attention/concentration, working memory, logic, and executive functions. Primary outcomes were remediation exercise metrics, neuropsychological composites (episodic memory, working memory, attention, executive functioning, and processing speed), clinical and community functioning measures.

Results: Cognitive performances concerning Attention/vigilance, verbal working memory and verbal learning memory and reasoning/problem solving improved significantly in the remediation condition when no difference was reported in the control condition between the 2 assessments. However, there were no significant benefits of cognitive remediation on non-verbal working memory and learning and speed of processing or functional outcome measures.

Conclusions: Cognitive remediation for people with schizophrenia was effective in improving performance, but the benefits of training did not generalize to functional outcome measures. Long term follow-up studies are needed to confirm the maintenance of such improvements.

© 2010 Elsevier B.V. All rights reserved.

 

TDA, France

Une théarapie émergente du trouble déficitaire de l’attention : La remédiation cognitive assistée par ordinateur (France)

Brigitte Forgeot et al.

Article disponible en ligne à l'adresse:

http://www.cairn.info/revue-perspectives-psy-2011-1-page-69.htm

Résumé: Les troubles déficitaires de l‘attention (TDA) peuvent être considérés comme des retards cognitifs affectant les processus d‘attention ainsi que des fonctions connexes telles que les fonctions exécutives et de la mémoire de travail. La remédiation cognitive informatisée des fonctions attentionnelles dont la déficience a été détectée par l‘évaluation neuropsychologique améliore les TDA. L‘article offre un bref aperçu de la littérature récente et une vignette clinique pour soutenir l‘utilité des méthodes de réhabilitation cognitive dans le traitement des TDA.