The Effectiveness of Cognitive Flexibility Training Program on Cognitive Functions and Activities of Daily Living in Patients with Ischemic Stroke

Abstract

Objective: To evaluate the effectiveness of a cognitive flexibility training program on cognitive functions and activities of daily living (ADLs) in patients with ischemic stroke. Methods: A single blind randomized controlled trial study was conducted in a stroke unit of a tertiary hospital in a Bangkok setting. The sample size was 80 participants of both genders, aged 18 – 80 years. The sample size was stratified by age. Randomization was generated by a computer program dividing 40 participants into the experiment and 40 into the control group. Eleven participants dropped out during data collection. Therefore, 34 participants in the experimental group received cognitive flexibility training four days a week for 30-40 minutes per day over a period of 4 weeks in addition to usual care. There were 35 participants in the control group who received diary recording and usual care. The study used various instruments for data collection, including a Thai version of the Montreal Cognitive Assessment and Barthel’s Index of Activities of Daily Living. Data were analyzed by multivariate analysis of covariance (MANCOVA). Results: The experimental group had higher cognitive functions and abilities in performing activities of daily living than the control group with statistical significance (p < .05). Conclusion: The study suggested that the program can be used to increase both cognitive functions and activities of daily living. Nurses and healthcare staff should apply this program in patients with acute ischemic stroke for nervous system recovery.