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INTRODUCTION: Patients with post-COVID-19 syndrome may present cognitive and emotional symptomatology. This study aims to analyse the results of an outpatient neuropsychological intervention program for post-COVID-19 syndrome. METHOD: In June 2020 Institut Guttmann started an outpatient post-COVID-19 neurorehabilitation program, including respiratory therapy, physiotherapy, and neuropsychological rehabilitation. Before and after the program, the cognitive-emotional state of all participants is assessed. Six months after treatment, a follow-up assessment is administered (which includes a collection of information on various aspects of daily life). RESULTS: The sample analysed consisted of 123 patients (mean age: 51 years, SD: 12.41). Seventy-four per cent (n=91) had cognitive impairment and underwent cognitive treatment (experimental group); the remaining 26% (n=32) constituted the control group. After the intervention, the experimental group improved in working memory, verbal memory (learning, recall and recognition), verbal fluency and anxious-depressive symptomatology. The control group showed changes in immediate memory, verbal memory (learning and recognition) and depressive symptomatology, although the effect size in the latter two was smaller than in the experimental group. Six months after treatment, 44.9% of the patients were unable to perform their pre-COVID-19 work activity, and 81.2% reported difficulties in their activities of daily living. CONCLUSIONS: Neuropsychological rehabilitation is an effective tool to treat the cognitive-emotional deficits present in post-COVID-19 syndrome. However, months after the end of treatment, not all patients recover their pre-COVID-19 functional level.
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BACKGROUND AND PURPOSE: Aerobic exercise is as important for individuals with traumatic brain injury (TBI) as for the general population; however, the approach to aerobic training may require some adaptation. The objective of the trial program was to examine the feasibility of introducing aerobic physical exercise programs into the subacute phase of multidisciplinary rehabilitation from moderate to severe TBI, which includes computerized cognitive training. CASE DESCRIPTION: Five individuals undergoing inpatient rehabilitation with moderate or severe TBIs who also have concomitant physical injuries. All of these individuals were in the subacute phase of recovery from TBIs. INTERVENTION: An 8-week progressive aerobic physical exercise program. Participants were monitored to ensure that they could both adhere to and tolerate the exercise program. In addition to the physical exercise, individuals were undergoing their standard rehabilitation procedures that included cognitive training. Neuropsychological testing was performed to gain an understanding of each individual's cognitive function. OUTCOMES: Participants adhered to both aerobic exercise and cognitive training. Poor correlations were noted between heart rate reserve and ratings of perceived effort. Two minor adverse events were reported. DISCUSSION: Despite concomitant physical injuries and cognitive impairments, progressive aerobic exercise programs seem feasible and well tolerated in subacute rehabilitation from moderate to severe TBI. Findings highlight the difficulty in measuring exercise intensity in this population.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A235).
Assuntos
Lesões Encefálicas Traumáticas/reabilitação , Disfunção Cognitiva/reabilitação , Remediação Cognitiva/métodos , Terapia por Exercício/métodos , Reabilitação Neurológica/métodos , Avaliação de Processos e Resultados em Cuidados de Saúde/métodos , Adulto , Lesões Encefálicas Traumáticas/complicações , Disfunção Cognitiva/etiologia , Terapia Combinada , Exercício Físico , Estudos de Viabilidade , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Adulto JovemRESUMO
Cognitive dysfunction has been widely studied in multiple sclerosis (MS), however decision-making has been less investigated. The current study examined the decision-making processes of patients with multiple sclerosis (MS) using a computerized version of the Iowa Gambling Task (IGT). This task was applied to 18 patients with clinically diagnosed MS and 18 healthy control subjects matched for age, sex, and years of education. The results showed that IGT scores differ significantly between patients with MS and the healthy control subjects: the patients with MS made significantly less advantageous decisions than the controls in the IGT. Possible causes of impaired decision-making in multiple sclerosis are discussed.