Small overall effect means these were complete failures.
The fact they had to do a meta-analysis means that more wasted time occurred because our fucking failures of stroke associations have not set up a publicly available database of updated stroke research and stroke protocols.
General and Domain-Specific Effectiveness of Cognitive Remediation after Stroke: Systematic Literature Review and Meta-Analysis
Review
First Online: 13 July 2018
Abstract
Cognitive
remediation (CR) has been shown to improve cognitive abilities
following a stroke. However, an updated quantitative literature review
is needed to synthesize recent research and build understanding of
factors that may optimize training parameters and treatment effects.
Randomized controlled trials of CR were retrieved from seven electronic
databases. Studies specific to adult stroke populations were included.
Treatment effects were estimated using a random effects model, with
immediate and longer-term follow-up outcomes, and moderator effects,
examined for both overall and domain-specific functioning. Twenty-two
studies were identified yielding 1098 patients (583 in CR groups). CR
produced a small overall effect (g = 0.48, 95% CI 0.35–0.60, p < 0.01) compared with control conditions. This effect was moderated by recovery stage (p < 0.01), study quality (p = 0.04), and dose (p = 0.04), but not CR approach (p = 0.63). Significant small to medium (g = 0.25–0.75) post-intervention gains were evident within each individual outcome domain examined. A small overall effect (g = 0.27, 95% CI 0.04–0.51, p = 0.02) of CR persisted at follow-up (range 2–52 weeks). CR is effective and
efficient at improving cognitive performance after stroke. The degree
of efficacy varies across cognitive domains, and further high-quality
research is required to enhance and sustain the immediate effects.
Increased emphasis on early intervention approaches, brain-behavior
relationships, and evaluation of activity and participation outcomes is
also recommended.
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