Effects of combined intervention of computer-aided self-regulation learning (CA-SRL) and cognitive training on generalization ability and cognitive function in post-stroke patients with cognitive impairment: a randomized controlled trial

Abstract Emerging study suggests the application of self-regulation learning (SRL) for improving generality abilities in post-stroke patients. It is proposed that SRL could generate an added effect on computer-aided cognitive training (CACT). This study aimed to examine the efficacy of the combined intervention of computer-aided SRL (CA-SRL) training and CACT for generalization ability and cognitive function in patients with post-stroke cognitive impairment (PSCI). A total of 75 patients were randomly assigned into CA-SRL group, demonstration learning (DL) group and traditional learning (TL). Over three weeks, patients in these three groups underwent CA-SRL or DL training combining with cognitive training respectively. After intervention, all outcomes have significantly improved after intervention (P < 0.05). CA-SRL group showed better improvements in all trained tasks among groups, especially in "wash the dishes" and “change the bed”. The analysis of generalization ability found CA-SRL groups obtained the highest scores among groups in untrained tasks. Mean changes of MoCA in both CA-SRL and TL groups were significantly higher than the DL group (P < 0.001, P = 0.002) after adjusting education year and Lawton Instrumental ADL Scale. In general, the combination of CA-SRL and CACT is effective for PSCI patient and it has a better effect in promoting the skills generalization from cognitive gains than traditional training.