A home programme for patients with cognitive dysfunction: a pilot study

To evaluate the effectiveness of a 12-week individualized home programme of rehabilitation for patients with cognitive impairment.

Six patients with cognitive dysfunction, after haemorrhagic stroke, participated in this study. A programme was carried out in the home environment that consisted of four mixed training programmes: cognitive remediation therapy, story retelling, cognitive enhancing games and aerobic exercise. The patients performed the home programme for 2 hours a day, 7 days a week, for 12 weeks. The main outcomes were measured using the MMSE, Neurobehavioural Cognitive Status Examination (NCSE), domain-specific computerized neuropsychological test for attention, memory and executive function, the Lowenstein Occupational Therapist Cognitive Assessment (LOTCA), the Modified Barthel Index (MBI) and the Seoul-Instrumental Activity of Daily Living (S-IADL).

After completion of a 12-week home programme, the patients' S-IADL scores improved significantly (p < 0.05). The patients' MMSE and NCSE scores improved marginally, with mean score changes of 4.2 (p = 0.058), 4.7 (p = 0.078) and 6.8 (p = 0.068) points, respectively. However, the patients' domain-specific cognitive test and LOTCA scores did not significantly change.

The results of this study showed that an individualized home programme improved IADL performance in patients with cognitive dysfunction and may have a beneficial effect on cognition, as assessed by general cognitive measures.