با همکاری مشترک دانشگاه پیام نور و انجمن عصب روان‌شناسی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی عمومی، واحد تبریز، دانشگاه آزاد اسلامی، تبریز، ایران

2 استادیار، روانشناسی، واحد تبریز، دانشگاه آزاد اسلامی، تبریز، ایران.

3 استاد نورولوژی، مرکز تحقیقات علوم اعصاب، پژوهشکده سالمندی، دانشگاه علوم پزشکی تبریز، تبریز، ایران

4 دانشیار علوم اعصاب شناختی، دانشگاه تبریز، تبریز، ایران

چکیده

مقدمه:امروزه سکته مغزی از شایع­ترین بیماری­ های نورولوژیک ناتوان کننده در جهان است.بروز عوارض شناختی یکی از مشکلات شایع در افراد مبتلا به سکته مغزی است.از این رو این مطالعه با هدف بررسی تاثیر توانبخشی شناختی رایانه ­محور بر عملکرد حافظه فعال بیماران مبتلا به سکته مغزی انجام گرفت.روش: مطالعه حاضر یک پژوهش نیمه­ تجربی با طرح پیش آزمون – پس­ آزمون با گروه کنترل است. در این پژوهش30 بیمار 30 تا 65 ساله مبتلا به سکته مغزی  که ملاک­ های ورود به پژوهش را داشتند،به صورت تصادفی به گروه­ های آزمایش و کنترل تقسیم شدند.افراد گروه آزمایش، با استفاده از نرم­افزار توانبخشی شناختی Captain’s Log،21 جلسه آموزش دیدند و افراد گروه کنترل در آن دوره هیچ­ گونه مداخله­ ای دریافت نکردند.در این پژوهش آزمون حافظه فعال وکسلر(مقیاس حافظه عددی)و آزمون حافظه کاری فضایی کمبریج در پیش­ آزمون و پس­آزمون به­ کار رفت.یافته­ ها:نتایج تحلیل انکوا حاکی از آن است که تفاوت معناداری بین میانگین نمرات حافظه فعال گروه آزمایش و گروه کنترل در پس­آزمون وجود دارد.نتیجه ­گیری:یافته­ ها نشان داد که توانبخشی شناختی رایانه­ محور،حافظه فعال مبتلایان به سکته مغزی را بهبود می­ بخشد و می­توان از آن به عنوان روش موثر و مفیدی برای بهبود عملکرد حافظه این­ گونه بیماران سود جست.

کلیدواژه‌ها

عنوان مقاله [English]

Effectiveness of Computer- based Cognitive Rehabilitation Intervention on Working Memory of Patients with Stroke in Tabriz

نویسندگان [English]

  • Elham Ghorbanian 1
  • marziye alivandi vafa 2
  • mahdi farhoudi 3
  • mohammad ali nazari 4

1 Ph.D. Student of General Psychology, Tabriz Branch, Islamic Azad University, Tabriz, Iran.

2 Assistant Professor of Psychology, Tabriz Branch, Islamic Azad University, Tabriz, Iran.

3 Professor of Neurosciences, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran

4 Associate Professor of Cognitive Neuroscience, University of Tabriz, Tabriz, Iran.

چکیده [English]

Aim: Nowadays stroke is one of the most common disabling neurological diseases in the world. Cognitive complications are common problems in people with stroke. So the aim of this study was to evaluate the effect of computer-based cognitive rehabilitation on working memory function in the patients with stroke. Method: The present study is a quasi- experimental investigation using a pretest- posttest design and a control group. 30 stroke patients aged 30-65 who had the inclusion criteria, were randomly assigned to experimental and control groups. Experimental group trained for 21 sessions with Captain’s Log Cognitive Rehabilitation Software and control group did not receive any intervention. Wechsler working Memory Test (Number Memory Scale) and Cambridge Spatial Working Memory Test was applied at pretest and posttest. Findings: The results of ANCOVA analysis indicated that a significant difference between the means of working memory in experimental and control groups. Conclusion: Our findings indicated that computer-based cognitive rehabilitation improved working memory in people with stroke and it can be used as an effective and helpful method to improve memory performance of these patients.
 

کلیدواژه‌ها [English]

  • stroke
  • cognitive rehabilitation
  • Working memory
Abedi,   M.R.,  Rabiei,  M., &   Sadeghi,   A. (2010). Guidance  on  the  implementation and scoring   of the Wechsler IV  Intelligence  Scale  of  Children.  Isfahan: Neveshte.
Alipoor,  A., & Mohammadighareghoozloo,  R. (2018). The Effectiveness of Computer-Assisted Cognitive Remediation on Executive Functions and Cognitive Abilities of Students With Diabetes. Neuropsychology, 4(15): 55-74.
Åkerlund,  E., Esbjörnsson,  E., Sunnerhagen,  KS., & Björkdahl,  A. 2013. Can computerized working memory training improve impaired working memory, cognition and psychological health? Brain Injury, 27(13-14):1649-1657.
Alipour, A., & Agah-Haris, M. (2007). Reliability and validity of the Edinburgh handedness questionnaire in Iran. Journal of Psychologlical Sciences, 6(22): 117-33.
Arjmandnia, A., Sharifi, A., & Rostami, R. (2014). The effectiveness of computerized cognitive training on the performance of visual-spatial working memory of students with mathematical problems. Journal of Learning Disabilities, 3(4): 6-24.
 Azarpazhooh, M., Etemadi, M., Donnan, G., Mokhber, N., Majdi, M., Ghayour-mobarhan, M., Ghandehary, K., Farzadfard, M., Kiani, R., & Panahandeh, M. (2010). Excessive incidence of stroke in Iran: evidence from the Mashhad stroke incidence study (MSIS), a population-based study of stroke. International Journal of Stroke, 41(1):3-10
Baddeley, A. (2003). Working Memory: Looking Back and Looking Forward. Neuroscience Nature Reviews,4(10):829-839
Borhani-Haghighi, A., Safari, R., Heydari, ST., Soleimani, F., Sharifian, M., Kashkuli, SY., Khayatghuchani, MN., Azadi, M., Shariat, A., & Safari, A. (2013). Hospital mortality associated with stroke in southern Iran. Iranian journal of medical sciences, 38(4):314-320
Bour, A., Rasquin, S., Boreas, A., Limburg, M., & Verhey, F. (2010). How predictive is the MMSE for cognitive performance after stroke? Journal of neurology, 257(4):630-637.
Cho,  HY., Kim,  KT., & Jung,  JH. (2015). Effects of computer assisted cognitive rehabilitation on brain wave, memory and attention of stroke patients: a randomized control trial. Journal of physical therapy science, 27(4):1029-1032
Claesson, L., Lindén, T., Skoog, I., & Blomstrand, C. (2005). Cognitive impairment after stroke- Impact  on  activities  of  daily  living  and  costs  of  care  for  elderly  people. Cerebrovascular Diseases, 19(2):102-9.
Connor,  B., & Shaw,  C. (2014). Case study series using brain training games to treat attention & memory following brain injury paper presented at the 10th Intl conf. Disability. Virtual Reality & Associated Technologies, Gothenburg, Sweden. 
Delbari, A., Salman, R.R., Tabatabaei, S.S., Rahgozar, M., & Lokk, J. (2011). Stroke epidemiology and one-month fatality among an urban population in Iran. Int J Stroke, 6(3): 195-200
Douiri,  A.,  Rudd,  A.G., &  Wolfe,  C.D. (2013). Prevalence  of  Poststroke  Cognitive  Impairment. Stroke, 44(1):138-145.
Ebrahimi- Fakhar,  H.R.,  Moshiri,  E., & Zand,  S. (2008).  An investigation  on  quality  of  emergency  care  of head injury patients in emergency ward, vali-easr  hospital arak.  journal  of  Arak university  of  medical  sciences,10(4):1– 12.
Eckroth-Bucher, M., & Siberski, J. (2009).  Preservingcognition  through  an  integrated  cognitive stimulation  and  training  program.  Journal  of  Alzheimer's  Disease,     24(3): 234–245.
Elliott,  M., & Parente,  F. (2014).  Efficacy  of  memory rehabilitation  therapy:  a  meta-analysis  of  TBI and  stroke  cognitive  rehabilitation  literature. Brain Injury, 28(12):1610–1616.
Emsaki, G., Molavi, H.,  Chitsaz, A., Movahed Abtahi, M., & Asgari, K. (2011). Psychometric Properties of the   Montreal Cognitive Assessment (MoCA) in Parkinson's Disease Patients in Isfahan. Journal of Isfahan Medical School, 29(158): 1391-1399.
Gutiérrez- Pérez,  C.,  Sävborg,  M.,  Påhlman, U.,  Cederfeldt,  M.,  Knopp,  E.,  Nordlund,  A.,  Åstrand,  R., Wallin, A,. Fröjd, K., & Wijk, H. (2011).  High frequency of cognitive dysfunction before stroke among older people. International journal of geriatric psychiatry, 26(6):622-629.
Hellgren, L., Samuelsson, K., Lundqvist, A., & Borsbo, B. (2015). Computerized Training of working memory for patients with Acquired Brain Injury. Open journal of Therapy and Rehabilitation, 3:46-55
Johansson, B., & Tornmalm, M. (2012). Working memory training for patients with acquired brain injury:effects  in  daily  life. Scandinavian  Journal  of Occupational Therapy,19(2):176-83.
Kesler, S. R., Lacayo, N. J. & Jo, B. (2011). A pilot study of an online cognitive rehabilitation program for executive function skills in children with cancer-related brain injury, Stanford University; 25(1): 101-12
Klingberg, T. (2010). Training and Plasticity of working memory. Trends in cognitive sciences, 14(7): 317-324
 Lundqvist,  A., Grundstörm,  K., Samuelsson,  K., & Rönnberg,  J. (2010). Computerized training of working memory in a group of patients suffering from acquired brain injury. Brain Injury, 24(10):1173-1183
Luria,  A.  R.  (1963).  Restoration  of function  after brain injury. New York: Macmillan.
Mitchell, A.J, Kemp, S., Benito-Leon, J., &   Reuber, M. (2010). The influence of cognitive impairment on health-related quality of life in neurological disease. Acta Neuropsychiatrica, 22:2–13.
Montez,  D.F., Calabro,  F.J., & Luna,  B. (2017). The expression of established cognitive brain states stabilizes with working memory development. Human Biology and Medicine Neuroscience, 6:1-26
Najarzadegan,  M., Nejati,  V., &  Amiri,  N. (2015). Effect of Cognitive Rehabilitation of working Memory in Reducing Behavioral Symptoms (Attention Deficit and Impulsivity) of Children with Attention Deficit and Hyperactivity Disorder. Neuropsychology, 1(1): 45-52 
Nasredddine,  Z.S., Phillips,  N.A., Bedirian,  V., Charbonneau,  S., Whitehead,  V., Collin,  I., & Chertkow,  H. (2005). The Montreal Cognititive Assessment, MOCA: a brief screening tool for mild cognitive impairment . journal of the American Geriatrics Society, 53(4): 695-699
 O'Connell, R.G., Bellgrove, M.A. & Robertson, I.H. (2007). Avenues for the neuro-remediation of ADHD: Lessons from clinical neurosciences. In M.A. Bellgrove, M. Fitzgerald, (Eds.),Handbook of ADHD(pp. 29-38). Chichester, UK: Wiley.
Oldfield,  R.C. (1971). The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychology, 9(1): 97-113.
Olesen,  P.J., Westerberg,  H., & Klingberg,  T. (2004).  Increased prefrontal and parietal activity after training of working memory. Nature neuroscience, 7(1): 75-88
Pantone, L. (2017). Have Stroke Neurologists Entered the Arena of Stroke-Related Cognitive Dysfunctions? Not yet, but They shoud. Journal of Amerrican Heart Assosiation, 48:1441-1442.
Pedram-Razi, S., Bassam-Pour, S., Faghihzadeh, S., & Alefbaei, A. (2017). Effect of Multi-Sensory Stimulation on Memory Status in Patients with Acute Phase of Ischemic Stroke. JHC, 18 (4) :280-291.
Pendlebury, S.T., & Rothwell, P.M.(2009). Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis. The Lancet Neurology,8(11):1006-1018.
Powell T. (2017). The brain injury workbook :Exercises for cognitive rehabilitation.2 nd Edition. Routledge.
Robbins, T.W., James, M., Owen, AM., Sahakian, B.J., Lawrence, A.D., McInnes, L., & Rabbit, P.M. (1998). A study of performance on tests from the CANTAB battery sensitive to frontal lobe dysfunction in a large sample of normal volunteers: Implications for theories of executive functioning and cognitive aging. Journal of the International Neuropsychological Society, 4(5): 474-490
Robinson, R.G. (2006). The clinical neuropsychiatry of stroke: Cognitive, behavioral and emotional disorders following vascular brain injury: Cambridge University Press.
Sohlberg, M. M., & Mateer, C.  A. (2001). Cognitive Rehabilitation:An Integrative Neuropsychological Approach. The Guilford Press. 
Stathopoulou,  S., &  Lubar  J.F. (2004). EEG changes in traumatic brain injured patients after cognitive rehabilitation.  Journal of Neurotherapy, 8 (2): 21- 51.
Stuifbergen, A. K., Becker, H., Perez, F., Morison, J.,  Kullberg,  V.,  &  Todd,  A.  (2012).  A  randomized controlled  trial  of  a  cognitive  rehabilitation intervention for persons with multiple sclerosis. Clin Rehabil, 26(10): 882–93.
Takeuchi,  H.,  Sekiguchi,  A.,  Taki, Y., Yokoyama,  S., Yomogida,  Y., Komuro,  N., & Kawashima,  R. (2010).  Training of working memory impacts structural connectivity. Journal of Neuroscience, 30(9): 3297-3303
Tinius,  T.P., &  Tinius,  K.A. (2000).  Changes  after  EEG biofeedback  and  cognitive  retraining  in adults with mild traumatic brain injury  and attention  deficit  hyperactivity  disorder. Journal of Neurotherapy, 4: 27-44.
Toby, B.C., Randolph, S.M., & Ronald, M.L. (2013). stroke, cognitive deficits and rehabilitation: still an incomplete picture. international journal of stroke, 8:38-45
van de Ven, R.M., Murre, J.M., Veltman, D.J & Schmand, B.A. (2016). Computer-Based Cognitive Training for Executive Functions after Stroke: A Systematic Review. Frontiers in human neuroscience, 10:1-28
van Rijsbergen, M.W., Mark, R.E., de Kort, P.L., & Sitskoorn, M.M. (2014). Subjective cognitive complaints after stroke: a systematic review. Journal of Stroke and Cerebrovascular Diseases, 23(3):408-420.
Weist, D., Wong, E.H, Minero, L.P., & Pumaccahua, T.T. (2014).  Utilizing  Computerized  Cognitive Training  to  Improve  Working  Memory  and Encoding:  Piloting  a  School-Based Intervention. Journal of Education, 135 (2):154-167.
 Westerberg, H., Jacobaeus, H., Hirvikoski, T., Clevberger, P., Östensson, M.L., Bartfai, A., & Klingberg, T. (2007). Computerized working memory training after stroke–a pilot study. Brain Injury, 21(1):21-29.