Abstract
Neurofeedback
therapy (NFT) has been used within a number of populations however it
has not been applied or thoroughly examined as a form of cognitive
rehabilitation within a stroke population. Objectives for this
systematic review included: i) identifying how NFT is utilized to treat
cognitive deficits following stroke, ii) examining the strength and
quality of evidence to support the use of NFT as a form of cognitive
rehabilitation therapy (CRT) and iii) providing recommendations for
future investigations. Searches were conducted using OVID (Medline,
Health Star, Embase + Embase Classic) and PubMed databases. Additional
searches were completed using the Cochrane Reviews library database,
Google Scholar, the University of Toronto online library catalogue,
ClinicalTrials.gov website and select journals. Searches were completed
Feb/March 2015 and updated in June/July/Aug 2015. Eight studies were
eligible for inclusion in this review. Studies were eligible for
inclusion if they: i) were specific to a stroke population, ii)
delivered CRT via a NFT protocol, iii) included participants who were
affected by a cognitive deficit(s) following stroke (i.e. memory loss,
loss of executive function, speech impairment etc.). NFT protocols were
highly specific and varied within each study. The majority of studies
identified improvements in participant cognitive deficits following the
initiation of therapy. Reviewers assessed study quality using the Downs
and Black
Checklist for Measuring Study Quality tool; limited
study quality and strength of evidence restricted generalizability of
conclusions regarding the use of this therapy to the greater stroke
population. Progression in this field requires further inquiry to
strengthen methodology quality and study design. Future investigations
should aim to standardize NFT protocols in an effort to understand the
dose-response relationship between NFT and improvements in functional
outcome. Future investigations should also place a large emphasis on
long-term participant follow-up.
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