Cognitive rehabilitation refers to a wide range of evidence-based interventions[1][2][3][4] designed to improve cognitive functioning in brain-injured or otherwise cognitively impaired individuals to restore normal functioning, or to compensate for cognitive deficits.[5] It entails an individualized program of specific skills training and practice plus metacognitive strategies. Metacognitive strategies include helping the patient increase self-awareness regarding problem-solving skills by learning how to monitor the effectiveness of these skills and self-correct when necessary.
Cognitive rehabilitation therapy (offered by a trained therapist) is a subset of Cognitive Rehabilitation (community-based rehabilitation, often in traumatic brain injury; provided by rehabilitation professionals) and has been shown to be effective for individuals who had a stroke in the left or right hemisphere.[6] or brain trauma.[7] A computer-assisted type of cognitive rehabilitation therapy called cognitive remediation therapy has been used to treat schizophrenia, ADHD, and major depressive disorder.[8][9][10][11][12]
It may also be recommended for traumatic brain injury, the primary population for which it was developed in the university medical and rehabilitation communities,[15][16][17][18] such as that sustained by U.S. Representative Gabby Giffords, according to Dr. Gregory J. O'Shanick of the Brain Injury Association of America.[19] Her new doctor has confirmed that it will be part of her rehabilitation.[20]
Cognitive rehabilitation may be part of a comprehensive community services program and integrated into residential services, such as supported living, supported employment, family support, professional education, home health (as personal assistance),[21][22] recreation, or education programs in the community.
Cognitive rehabilitation for spatial neglect following stroke
The current body of evidence is uncertain on the efficacy of cognitive rehabilitation for reducing the disabling effects of neglect and increasing independence remains unproven.[23] However, there is limited evidence that cognitive rehabilitation may have an immediate beneficial effect on tests of neglect.[23] Overall, no rehabilitation approach can be supported by evidence for spatial neglect.
^Cicerone, Keith D.; Dahlberg, Cynthia; Kalmar, Kathleen; Langenbahn, Donna M.; Malec, James F.; Bergquist, Thomas F.; Felicetti, Thomas; Giacino, Joseph T.; Harley, J.Preston (December 2000). "Evidence-based cognitive rehabilitation: Recommendations for clinical practice". Archives of Physical Medicine and Rehabilitation. 81 (12): 1596–1615. doi:10.1053/apmr.2000.19240. ISSN0003-9993. PMID11128897.
^Cicerone, Keith D.; Dahlberg, Cynthia; Malec, James F.; Langenbahn, Donna M.; Felicetti, Thomas; Kneipp, Sally; Ellmo, Wendy; Kalmar, Kathleen; Giacino, Joseph T. (August 2005). "Evidence-Based Cognitive Rehabilitation: Updated Review of the Literature From 1998 Through 2002". Archives of Physical Medicine and Rehabilitation. 86 (8): 1681–1692. doi:10.1016/j.apmr.2005.03.024. ISSN0003-9993. PMID16084827.
^Cicerone, Keith D.; Langenbahn, Donna M.; Braden, Cynthia; Malec, James F.; Kalmar, Kathleen; Fraas, Michael; Felicetti, Thomas; Laatsch, Linda; Harley, J. Preston (April 2011). "Evidence-Based Cognitive Rehabilitation: Updated Review of the Literature From 2003 Through 2008". Archives of Physical Medicine and Rehabilitation. 92 (4): 519–530. doi:10.1016/j.apmr.2010.11.015. ISSN0003-9993. PMID21440699.
^Cicerone, Keith D.; Goldin, Yelena; Ganci, Keith; Rosenbaum, Amy; Wethe, Jennifer V.; Langenbahn, Donna M.; Malec, James F.; Bergquist, Thomas F.; Kingsley, Kristine (March 2019). "Evidence-Based Cognitive Rehabilitation: Systematic Review of the Literature From 2009 Through 2014". Archives of Physical Medicine and Rehabilitation. 100 (8): 1515–1533. doi:10.1016/j.apmr.2019.02.011. hdl:1805/18829. ISSN0003-9993. PMID30926291. S2CID88480565.
^Cite error: The named reference cr2002 was invoked but never defined (see the help page).
^Soderback I.; Ekholm J. (1992). "January–March). Medical and social factors affecting behavior patterns in patients with acquired brain damage: a study of patients living at home three years after incident". Disability and Rehabilitation. 14 (1): 30–35. doi:10.3109/09638289209166424. PMID1586757.
^Elgamal S, McKinnon MC, Ramakrishnan K, Joffe RT, MacQueen G (Sep 2007). "Successful computer-assisted cognitive remediation therapy in patients with unipolar depression: a proof of principle study". Psychol. Med. 37 (9): 1229–38. doi:10.1017/S0033291707001110. PMID17610766. S2CID19958026.
^Wykes T (Aug 2007). "Cognitive remediation therapy (CRT) for young early onset patients with schizophrenia: an exploratory randomized controlled trial". Schizophr. Res. 94 (1–3): 221–30. doi:10.1016/j.schres.2007.03.030. PMID17524620. S2CID46117743.
^O'Connell RG, Bellgrove MA, Dockree PM, Robertson IH (Dec 2006). "Cognitive remediation in ADHD: effects of periodic non-contingent alerts on sustained attention to response". Neuropsychol Rehabil. 16 (6): 653–65. doi:10.1080/09602010500200250. PMID17127571. S2CID38725935.
^Zencius A.; Wesolowski M.; Burke W.H. (1990). "January–March). A comparison of four memory strategies with traumatically brain-injured clients". Brain Injury. 4 (1): 33–38. doi:10.3109/02699059009026146. PMID2297598.
^Burke W.H.; Zencius A.H.; Weslowski M.D.; Doubleday F. (1991). "Improving executive function disorders in brain-injured clients". Brain Injury. 5 (3): 241–252. doi:10.3109/02699059109008095. PMID1933075.
^Ben-Yishay, Diller L (1993). "Cognitive remediation in traumatic brain injury: Update and issues". Archives of Physical Medicine and Rehabilitation. 74 (2): 204–213. PMID8431107.
^Crowley J.; Miles J. (1991). "Cognitive remediation in pediatric head injury: A case study". Journal of Pediatric Psychology. 16 (5): 611–627. doi:10.1093/jpepsy/16.5.611. PMID1744809.
^Gordon W.; Hibbard M.; Kreutzer J. (1989). "Cognitive remediation: Issues in research and practice". Journal of Head Trauma Rehabilitation. 4 (3): 76–84. doi:10.1097/00001199-198909000-00011.
^Kreutzer, J. & Wehman, P. (1991). Cognitive Rehabilitation for Persons with Traumatic Brain Injury: A Functional Approach. Baltimore, MD: Paul H. Brookes.
^Thomas M. Burton (2011-01-10). "Brain at Risk Despite Quick Aid". The Wall Street Journal. Retrieved 2011-01-21. "The rapid treatment she received needs to be matched by a seamless course of rehabilitation such as cognitive rehabilitation," Dr. O'Shanick said.
^Watson, S. (1991). PAS and head injury. In: J. Weissman, J. Kennedy, & S.Litvak, Personal Perspectives on Personal Assistance Services. (pp. 72-75). Oakland, CA: Rehabilitation Research and Training Center on Public Policy and Independent Living, World Institute on Disability.
^Ulciny, G. & Jones, M. (1985). Enhancing the attendant management skills of persons with disabilities. American Rehabilitation, 18-20.