Computer-based cognitive flexibility training after stroke

Stroke survivors often suffer from cognitive impairments and other complaints that reduce their quality of life even long after their stroke occurred. Brain training is currently widely used in an attempt to improve cognitive functioning. However, the conclusion of our systematic review is that the evidence for the effectiveness of computer-based training in improving executive functioning after acquired brain injury is inconclusive. Several studies have reported transfer effects, but most studies suffered from methodological limitations, such as lack of appropriate control conditions. We, therefore, evaluated whether a high potential computer-based cognitive training could contribute to cognitive recovery after stroke compared to mock training and waiting list control conditions.
Adults who had suffered a stroke were assigned to either an intervention group, active control group (i.e., mock training), or waiting list control group. Objective cognitive functioning, subjective cognitive functioning, and quality of life were assessed before the training, immediately after training, and 4 weeks after training completion.
All groups improved on several transfer tasks and two subjective measures. These improvements remained stable 4 weeks after training completion. However, the intervention group did not improve more than the two control groups. This suggests that improvement was due to training-unspecific effects.
We conclude that the high potential computer-based cognitive flexibility training did not result in larger recovery of executive functioning after stroke than when no training or a mock training was given. Moreover, we suggest that previous positive findings of studies without proper control conditions should be interpreted with caution.