Findings from an Asian post‐stroke cognitive impairment intervention programme
Bibliographic record
Abstract
Abstract Background Singapore sees more than 7,000 ischemic stroke cases yearly, with majority having physical and cognitive sequelae. Previous reports demonstrate that Post‐stroke cognitive impairment (PSCI) occurs in 37.3% of stroke patients at the National Neuroscience Institute (NNI, Singapore) within 6 months post‐stroke. The severity of rising PSCI rates prompted the implementation of the NNI Stroke Memory Rehabilitation Programme (SMaRT) for ischaemic stroke patients with mild physical impairments. This study aims to evaluate the outcomes of the SMaRT programme on PSCI and post‐stroke coping over a 6‐month period. Method The SMaRT programme is a 8‐week group‐based post‐stroke cognitive rehabilitation programme focusing on healthy living habits, memory models, memory strategies and emotion regulation strategies. Patients with clinically diagnosed ischaemic strokes, mild functional and cognitive issues (modified Rankin Scale score≤3 and Mini Mental‐State Examination score≥20) were recruited from April 2018 to September 2020. Assessments were administered at baseline, 8 weeks and 6 months post‐SMaRT, measuring global cognition (Montreal Cognitive Assessment, Visual Cognitive Assessment Tool), visuospatial function/attention (Trail Making Test‐A), emotional coping (Geriatric Depression Scale‐15), daily functioning (Nottingham Extended Activities of Daily Living (NEADL)), subjective quality of life (Dementia Quality of Life (DemQOL)). Paired samples t‐tests compared scores between the three timepoints, adjusting for type I errors with Bonferroni correction. Result 137 subjects (N males=90 (65.7.%); mean age=63.49 years, SD=9.38, mean years of education=9.50, SD=3.79) underwent SMaRT. Comparing week‐8 to baseline, there was significant improvement in global cognition (MoCA, VCAT: p<.001), emotional coping (GDS, p<.001), daily functions (NEADL, p<.001), subjective quality of life (DemQOL: p=.008). Significant improvement was also observed comparing month‐6 to baseline scores in global cognition (MoCA, VCAT: p<.001), emotional coping (GDS, p<.001), daily functions (NEADL, p<.001), subjective quality of life (DemQOL: p<.001). In both analyses, decreasing trends in TMT‐A (seconds) were observed and approached significance. Conclusion The SMaRT programme is effective in mitigating post‐stroke cognitive impairment, particularly in global cognition. Additionally, SMaRT improved mood, daily functioning and subjective quality of life, suggesting its ability to instill positivity and confidence in stroke patients. These suggest a group‐based structured cognitive rehabilitation programme is likely to benefit stroke patients and reduces incidence of PSCI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".