Enhancing Neuroplasticity Post Stroke: The Role of Cognitive-Behavioral Training

Background: Stroke is a primary cause of adult disability and often causes cognitive impairment. Rehabilitation interventions aim to enhance patients' cognitive abilities, thereby addressing care needs, improving quality of life, and optimizing performance in compromised functions. Objective: To evaluate the impact of incorporating cognitive-behavioral training (CBT) into a selected exercise program on cortical reorganization and cognitive recovery in post-stroke patients. Methods: Thirty post-stroke patients of both sexes (27 male and 3 female) aged from 40 to 65 years were randomly divided into two groups: the study group (n = 15) received CBT combined with a selected exercise program including weight-bearing, balance, and aerobic exercises, while the control group (n = 15) underwent the selected exercise program only. All participants engaged in an 8-week intervention with three sessions per week. Cortical reorganization was measured using quantitative electroencephalography (QEEG) at electrode sites F3, F4, T5, and T6, and cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and RehaCom, focusing on memory, attention, concentration, logical reasoning, and reaction behavior. Assessments were carried out for all patients before and after the 8-week treatment program. Results: Improvements were assessed through three key measures: QEEG, the MoCA, and RehaCom. Post-intervention, the study group demonstrated a significantly higher (alpha + beta)/(delta + theta) ratio at F3, F4, T5, and T6 (p < 0.01), indicative of enhanced cortical reorganization. MoCA scores increased by 16.98% in the study group compared to 7.40% in the control group (p < 0.01). Additionally, RehaCom assessments revealed marked improvements in memory, attention, logical reasoning, and reaction behavior in the study group (p < 0.01). Conclusions: Integrating cognitive-behavioral training with a selected exercise program significantly enhances cortical reorganization and cognitive recovery in post-stroke patients. These findings suggest that adding CBT to rehabilitation protocols can effectively address deficits in memory and attention, ultimately improving functional outcomes.