Cognitive telerehabilitation in neurological patients: systematic review and meta-analysis

Luisa Cacciante, Camilla Della Pietà, Sebastian Rutkowski, Błażej Cieślik, Joanna Szczepańska-Gieracha, Michela Agostini, Pawel Kiper, Luisa Cacciante, Camilla Della Pietà, Sebastian Rutkowski, Błażej Cieślik, Joanna Szczepańska-Gieracha, Michela Agostini, Pawel Kiper

Abstract

Telerehabilitation (TR) seems to be an encouraging solution for the delivery of cognitive treatments in patients with neurological disorders. This study was aimed to analyze and synthesize the evidence on the efficacy of cognitive TR interventions in patients with neurological diseases, compared with conventional face-to-face rehabilitation. From a total of 4485 records, 9 studies met the inclusion criteria for qualitative analysis. At the end of the process, 7 studies remained for quantitative analysis. By comparing TR with face-to-face treatments for cognitive impairments, we assessed improvements in global cognitive domain (Mini Mental State Exam) (MD = -0.86; 95% CI -2.43, 0.72, I2 = 0%), in learning and memory domains (SMD = 0.26, 95% CI -0.22, 0.74, I2 = 24%), in verbal fluency (SMD = 0.08, 95% CI -0.47, 0.62, I2 = 0%), and in executive functions (i.e., problem-solving, central processing speed and working memory) (SMD = 0.38, 95% CI 0.06, 0.71, I2 = 0%). In all the included studies, improvement in the performance of the TR groups was comparable to that achieved through face-to-face intervention. Significant differences between those two modalities of providing treatments were observed for working memory and total executive function comparison, in favor of TR. The results of this study can sustain the efficacy of TR and its application for the treatment of neurological patients, especially when treated for executive function impairments.

Keywords: Cognition disorders; Cognitive impairments; Cognitive treatment; Telerehabilitation.

Conflict of interest statement

The authors declare no competing interests.

© 2021. The Author(s).

Figures

Figure 1
Figure 1
Flow diagram of the studies
Figure 2
Figure 2
Risk of bias summary
Figure 3
Figure 3
Comparison 1. Cognitive domain, global (Mini Mental State Exam): telerehabilitation vs. conventional face-to-face treatment. SD: standard deviation; 95% CI: 95% confidence interval
Figure 4
Figure 4
Comparison 2. Learning and memory (improvement in learning and memory abilities): telerehabilitation vs. conventional face-to-face treatment. SD: standard deviation; 95% CI: 95% confidence interval
Figure 5
Figure 5
Comparison 3. Language (fluency): telerehabilitation vs. conventional face-to-face treatment. SD: standard deviation; 95% CI: 95% confidence interval
Figure 6
Figure 6
Comparison 4. Executive functions (executive functions): telerehabilitation vs. conventional face-to-face treatment. SD: standard deviation; 95% CI: 95% confidence interval

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Source: PubMed

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