Effectiveness of computer-based training on post-stroke cognitive rehabilitation: A systematic review and meta-analysis

A systematic review and meta-analysis based on randomized controlled trials (RCTs) from the last 10 years was conducted to identify the effect of computer-based training compared to routine methods on post-stroke cognitive rehabilitation and to provide recommendations for future research. A literature search was performed in the Cochrane Library, EMBASE, PubMed, EBSCO (CINAHL), and Web of Science that focused on studies comparing the effects of computerized cognitive training and routine methods in stroke survivors. After extraction of the study characteristics and methodological quality evaluation, a meta-analysis was conducted using the standard model based on the level of the overall cognitive domain. Ten out of 201 studies were included in the systematic review, with a total of 600 stroke survivors. The average age of the participants ranged from 42.1 to 66 years old, 305 participants used the computer-based training method, and males accounted for approximately 58.5%. All studies compared the baseline characteristics of participants at the onset of their studies, and no significant difference was shown. Six studies that reported the results for the overall cognitive domain were further analyzed by meta-analysis. The outcome of the meta-analysis showed that the effect size was 0.61 with a 95% confidence interval [−0.18, 0.35], and the P value (P = 0.54) indicated no significant difference between the control group and the computer-based cognitive training group. The results of the meta-analysis, based on a limited number of studies, did not show significant superiority of computer-based cognitive training compared to the traditional method in post-stroke patients. More high-quality studies focusing on different illness phases and various types of intervention software should be conducted to improve the meta-analysis and to explore the influence of computer-based cognitive training by subgroup analysis.