The Effect of Executive Training Program on Cognitive Functions in Patients with Minor Stroke

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Hathaichanok Poonlert
Wimolrat Puwarawuttipanit
Kanaungnit Pongthavornkamol
Yongchai Nilanont

Abstract

          Purpose: To evaluate the effect of executive training program on cognitive functions in patients with minor stroke.


          Design: Experimental design.


          Method: Minor stroke subjects were stratified by age, and then simple random sampling into the experimental and control groups. Twenty-seven patients in the experimental group received standard nursing care and the executive training program with eight tasks while 29 patients in the control group received standard nursing care and diary recording. The duration of study was four weeks. The instruments for data collection included demographics record form, case record form, and Montreal Cognitive Assessment. Data were analyzed using descriptive statistics, chi-square test, Fisher exact test, t-test, and ANCOVA.


          Main findings: Compared to the control group, the experimental group had significantly higher levels of cognitive function (p < .05). Post-intervention, the experimental group had significantly higher levels of cognitive function than pre-intervention (p < .05). Level of cognitive function after receiving intervention in the experimental group was significantly higher than that before the intervention. However, the significant better cognitive function was also found in the control group.


          Conclusion and recommendations: The executive training program developed by the researchers could improve cognitive functions in patients with minor stroke. Nurses should implement the executive training program in their nursing practice for minor stroke patients to improve cognitive functions and reduce the cognitive decline that can occur after minor stroke.

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How to Cite
Poonlert, H. ., Puwarawuttipanit, W., Pongthavornkamol, K. ., & Nilanont, Y. (2020). The Effect of Executive Training Program on Cognitive Functions in Patients with Minor Stroke. Nursing Science Journal of Thailand, 38(3), 50–62. Retrieved from https://he02.tci-thaijo.org/index.php/ns/article/view/242348
Section
Research Papers

References

Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation. 2019;139(10):e56-528. doi: 10.1161/CIR.0000000000000659.

Donkor ES. Stroke in the 21st century: a snapshot of the burden, epidemiology, and quality of life. Stroke Res Treat. 2018;2018:3238165. doi: 10/1155/2018/3238165.

Yaghi S, Willey JZ, Khatri P. Minor ischemic stroke: triaging, disposition, and outcome. Neurol Clin Pract. 2016;6(2):157-163. doi: 10.1212/CPI.0000000000000234.

Kaveeta C. Acute stroke management [internet]. Bangkok: Faculty of Medicine Siriraj Hospital, Mahidol University; 2018 [cited 2020 May 15]. Available from: https://www.sirirajstrokecenter.org/wp-content/uploads/2018/03/Acute-stroke-fast-track-managment_stroke-curriculum.pdf.

Nicolas K, Levi C, Evans T-J, Michie PT, Magin PT, Quain D, et al. Cognition in the first year after a minor stroke, transient ischemic attack, or mimic event and the role of vascular risk factors. Front Neurol. 2020;11:216. doi: 10.3389/fneur.2020.00216.

Fiske A, Holmboe K. Neural substrates of early executive function development. Dev Rev. 2019;52:42-62. doi: 10.1016/j.dr.2019.100866.

Povroznik JM, Ozga JE, Haar CV, Engler-Chiurazzi EB. Executive (Dys) function after stroke: special considerations for behavioral pharmacology. Behav Pharmacol. 2018;29(7):638-53. doi: 10.1097/FBP.0000000000000432.

Wolf TJ, Rognstad MC. Changes in cognition following mild stroke. Neuropsychol Rehabil. 2013;23(2):256-66. doi: 10.1080/09602011.2012.748672.

Hamasaki A, Akazawa N, Yoshikawa T, Myoenzono K, Tagawa K, Maeda S. Age-related declines in executive function and cerebral oxygenation hemodynamics. Tohoku J Exp Med. 2018;245(4):245-50. doi: 10.1620/tjem.245.245.

Munketwit P. The rehabilitation of cognitive functions. In: Munketwit P, Rattanakorn P, Khemthong S, Sowlorm S, editors. The occupational therapy for cognitive dysfunction. 2nd ed. Chiang Mai: Darawan Printery; 2010. p.125-49. (in Thai).

McHutchison CA, Cvoro V, Makin S, Chappell FM, Shuler K, Wardlaw JM. Functional, cognitive and physical outcomes 3 years after minor lacunar or cortical ischaemic stroke. J Neurol Neurosurg Psychiatry. 2019;90(4):436-43. doi: 10.1136/jnnp-2018-319134.

Zucchella C, Capone A, Codella V, Vecchione C, Buccino G, Sandrini G, et al. Assessing and restoring cognitive functions early after stroke. Funct Neurol. 2014;29(4):255-62.

Khanthee R, Dhippayom JP, Munkhetvit P. Effects of cognitive training program on cognitive abilities in stroke patients. Journal of Associated Medical Sciences. 2016;49(3):298-306. (in Thai).

Pacharee K. Cognitive impairment. In: Pacharee K, editor. Stroke rehabilitation. Bangkok: Faculty of Medicine Siriraj Hospital Mahidol University; 2007. p.201-24. (in Thai).

Coleman ER, Moudgal R, Lang K, Hyacinth HI, Awosika OO, Kissela BM, et al. Early rehabilitation after stroke: a narrative review. Curr Atheroscler Rep. 2017;19(12):59. doi: 10.1007/s11883-017-0686-6.

Tong Y, Cheng Z, Rajah GB, Duan H, Cai L, Zhang N, et al. High intensity physical rehabilitation later than 24 h post stroke is beneficial in patients: a pilot randomized controlled trial (RCT) study in mild to moderate ischemic stroke. Front Neurol. 2019;10:113. doi: 10.3389/fneur.2019.00113.

Sukontapol C, Kemsen S, Chansirikarn S, Nakawiro D, Kuha O, Taemeeyapradit U. The effectiveness of a cognitive training program in people with mild cognitive impairment: a study in urban community. Asian J Psychiatr. 2018;35:18-23. doi: 10.1016/j.ajp.2018.04.028.

Hebb DO. The organisation of behaviour. New York: John Wiley & Sons; 1949. 378 p.

Li B, Zhu X, Hou J, Chen T, Wang P, Li J. Combined cognitive training vs. memory strategy training in healthy older adults. Front Psychol. 2016;7:834. doi: 10.3389/fpsyg.2016.00834.

Poulin V, Korner-Bitensky N, Bherer L, Lussier M, Dawson DR. Comparison of two cognitive interventions for adults experiencing executive dysfunction post-stroke: a pilot study. Disabil Rehabil. 2017;39(1):1-13. doi: 10.3109/09638288.2015.1123303.

Skidmore ER, Butters M, Whyte E, Grattan E, Shen J, Terhorst L. Guided training relative to direct skill training for individuals with cognitive impairments after stroke: a pilot randomized trial. Arch Phys Med Rehabil. 2017;98(4):673-80. doi: 10.1016/j.apmr.2016.10.004.

Adulwattanasiri P, Puwarawuttipanit W, Sanaehar J, Nilanont Y. The effectiveness of brain training program on attention and memory in acute ischemic stroke patients. Poster session presented at: Thailand Research Expo; 2012 Aug 24-28; Bangkok, Thailand. (in Thai).

Hemrungrojn S. Montreal Cognitive Assessment (MoCA): Thai Version [Internet]. Bangkok: Faculty of Medicine, Chulalongkorn University; 2007 [cited 2020 May 15]. Available from: http://www.cueid.org/content/view/2764/1/ (in Thai).

Hao Y, Yao L, Smith DM, Sorel E, Anderson AK, Schumacher EH, et al. Prefrontal-posterior coupling mediates transitions between emotional states and influences executive function. Sci Rep. 2019;9(1):8252. doi: 10.1038/s41598-019-44624-2.

Sivakumar L, Kate M, Jeerakathil T, Camicioli R, Buck B, Butcher K. Serial montreal cognitive assessments demonstrate reversible cognitive impairment in patients with acute transient ischemic attack and minor stroke. Stroke. 2014;45(6):1709-15. doi: 10.1161/STROKEAHA.114.004726.