Can cognitive rehabilitation improve attention deficits following stroke? - A Cochrane Review summary with commentary.

BACKGROUND: Disorders of attention are common following stroke, reducing quality of life and limiting rehabilitation. OBJECTIVE: To determine if cognitive rehabilitation can improve attention and functional outcomes in stroke survivors with attentional disorders. METHODS: A summary of the Cochrane Review update by Loetscher et al. 2019, with comments. RESULTS: Six studies with 223 participants were included: this was the same as the previous review (in 2013). Evidence quality was very low to moderate, and results suggest a beneficial impact on divided attention immediately after training, but no effect on any other outcome either immediately or at follow up timepoints. CONCLUSIONS: The low methodological quality and small number of studies means current evidence provides limited clinical guidance. Clearly more research is needed to inform care: researchers must improve the methodological quality of studies, plus fully consider and report the aspects of attention and function addressed in their work.