Abstract
INTRODUCTION: This study explored the feasibility and the preliminary efficacy of adaptive tablet-based cognitive training (CT) and paper-and-pencil CT approaches for mitigating multidomain post-stroke cognitive and noncognitive deficits. METHODS: In this two-arm pilot randomized controlled trial, participants were randomly assigned to the NeuroAIreh@b (NAIr; adaptive tablet-based CT inspired by activities of daily living) and the Task Generator (TG; adaptive paper-and-pencil CT). A non-randomized passive control group was recruited for comparative purposes. Interventions comprised 12 bi-weekly 30-minute sessions. Primary outcomes explored training effects on several cognitive (e.g., global cognition, episodic memory), and noncognitive domains (e.g., quality of life, functional abilities). RESULTS: A total of 20 participants were randomized (NAIr: n = 10; TG = 10). Within-group analysis revealed that the NAIr group presented significant improvements in more cognitive domains than the TG, and reported less functional disability, increased quality of life and greater motivation for rehabilitation at post-intervention. At follow-up, the NAIr group further improved in several cognitive domains and reported greater quality of life, while TG only improved in global cognition. Between-group analysis exhibited a pattern of superior performance in the adaptive CT groups over passive controls. CONCLUSIONS: Findings suggest that adaptive CT interventions are feasible to implement and lead to cognitive and noncognitive improvements in community-dwelling stroke survivors. However, while both training approaches yield different short and medium/long-term benefits, the NAIr - a more ecologically valid method - was the only to promote generalization of training effects to functionality and quality of life at post-intervention and three-month follow-up, respectively. TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov, number NCT05929287. Registered July 3rd, 2023 (cf. https://classic.clinicaltrials.gov/ct2/show/NCT05929287).