Article

This series of articles for rehabilitation in practice aims to cover a knowledge
element of the rehabilitation medicine curriculum. Nevertheless they are intended
to be of interest to a multidisciplinary audience. The competency addressed in
this article is cognitive rehabilitation. Background: There is a paucity of
literature on the rationale, design, and content of successful cognitive
rehabilitation programmes. In the current paper, we describe in detail a
cognitive rehabilitation programme that has previously proven effective in a
randomized controlled trial in patients with primary brain tumours. The
programme's content may be of practical interest to those working with
populations of cognitively impaired patients. Programme: The programme consists
of six weekly, individual, 2-hour sessions plus homework, and incorporates both
strategy training and attention retraining. The elements were taken from two of
the few programmes that are evidence-based. It's design consists of
psycho-education, teaching of strategies to compensate for problems in attention,
memory and executive functioning in daily life. The retraining was based on the
assumption that a target process can be improved by frequently practising
exercises. It is focused on attention as intact attention may also be necessary
for adequate functioning of other cognitive domains. The hierarchically organized
exercises, embedded in a game-like computer program, were tailored to the needs
of the individual patient. Evaluation: Mean total training time was estimated to
be 35 hours in seven weeks. Adherence to the programme was high. The majority of
the participants found the programme to be (very) useful. However, older
participants found the programme more burdensome than younger patients.
Discussion: Splitting up and spreading out sessions may increase the feasibility
and usefulness of the programme for older participants. Further suggestions for
improvements and future studies on this programme are also provided.

Langue : ANGLAIS