Cognitive problems after stroke Computer-aided cognitive therapy with RehaCom

2. If people had a stroke, then they could find it
difficult to concentrate or remember certain
things.
They may also find it difficult to work out how to
do something or know how to respond to what’s
going on around.
This is what people mean when they talk about
cognitive problems or cognitive impairment.
cognitive problems?
 take an active role in
recovery by practicing
with RehaCom
 you may see
improvements within
a few weeks or
months

4. Problems with Attention & Concentration
When you concentrate on something, your brain has to
process a lot of information coming in from the world
around you. A stroke can affect your brain’s ability to do
this.
you may not be able to:
• stay focused on a single task
• filter out what’s going on around you
• to move from one task to another very easily
• do more than one thing at once
• process things very quickly

5. RehaCom provides a comprehensive range of clinical
proven Attention trainings
Alertness
= ability to temporarily increase and sustain the intensity of attention
Vigilance
= ability to maintain focus and level of attention to a condition of rare stimuli frequency
Sustained attention
= ability to maintain focus and level of attention during high frequency of stimuli
Focused attention
= being able to actively focus on one thing without being distracted by other stimuli
Selective attention
= focusing on a specific stimulus while ignoring other competing or distracting stimuli
Divided attention
= ability to respond simultaneously to multiple tasks or multiple task demands
Alternating attention
= ability to rapidly shift focus back and forth between tasks

6. Memory problems
People often struggle with memory problems following stroke
and this can lead to difficulties in everyday life.
We store all kinds of information in our memory. We also
remember things in different ways, and for different lengths of
time.
It becomes difficult for stroke patients to make new memories,
whereas they can be very good about remembering things in the
past.
They have difficulties with their prospective memory too, the
ability to remember to carry out intended actions in the future,
like remembering to take medication in the evening.
Memory vs Attention
• most memory problems are
actually caused by problems
with attention
• if you’re unable to focus on
what you’re being told, you’re
not going to be able to
remember it later
• improve your attention at first

7. Memory trainings with RehaCom
reinforce learning strategies and
compensation techniques
 verbal, figural, topological, physiognomic, naming,
working memory
 close to everyday life
 rich in variety
 complexity adapts automatically to the actual
performance

8. Problems with planning and problem-solving
(executive function)
Many higher order, complex thinking processes happen without
us being aware of them, known as automatic processes.
Together, many of these automatic processes are known as
executive function.
Executive function includes all the things that allow us to
organise, make decisions and solve problems. It also involves the
way we monitor what’s going on around us and adjust what we
think and do in response to it.
It has been estimated that around 75%
of people will have executive function
difficulties after a stroke.
signs for executive functioning
disorders:
• not being able to manage time well
• difficulty meeting goals
• difficulty determining the amount of
time necessary to complete a task
• difficulty organizing and planning
• trouble switching focus and shifting
between activities
• difficulty prioritizing work or
responsibilities

9. Executive Function Trainings
with RehaCom
Therapists are provided with close to everyday
life templates in order to provide and practice
compensatory strategies. The trainings use a variety of
stimuli such as playing cards, shops, money and complex
situations.
 identify and consider solution-relevant information
 develop precise approaches to the solution
 plan and analyze the approach to the solution in parts
 recognize mistakes and steps that are not effective
 correct errors and develop alternative approaches to the
solution

10. Problems noticing things on one side
(visuospatial neglect)
Visuospatial neglect is a common attentional
disorder resulting from unilateral hemisphere
damage, most commonly from a stroke.
Patients with neglect pay no attention to the
space on the opposite side to their injury.
Many patients recover spontaneously, but in
approximately 40% of patients symptoms
persist.
signs of visuo-spatial neglect, you may:
• miss things that are placed on your affected side
• ignore people or bump into things
• not eat food on one side of your plate
• not read one side of a book or page
• have problems finding your way around because
you may not notice doors

11. Visuospatial neglect trainings with RehaCom
Visual scanning therapy is widely used in rehabilitating patients with
neglect. It mainly involves encouraging them to explore neglected side of
space, often with the help of visual cues.
RehaCom provides three sophisticated training procedures:
 Exploration
 Exploration2
 Saccadic Training
The trainings enable the therapist to implement visual exploration and visual
scanning training inclusive optokinetic stimulation.

12. Problems with Visual field loss
Visual impairment is a common finding after
stroke and can have negative implications on
quality of life and activities of daily living. About
20% of stroke survivors experience visual field loss.
With a visual field loss you are unable to see a
section of your field of vision, usually because the
vision areas of your brain have been damaged by
the stroke. The eyes themselves work normally,
but the brain can't process the images from one
area of vision.
most common type of vision loss:
 Homonymous hemianopia is the loss
of one half of the visual field in each
eye. You may feel like you are unable
to see out of one eye, but in fact, both
your eyes are affected. When reading,
words and sentences disappear when
in the missing visual field. People may
appear to have only half a face.
other types:
 loss of a quarter of the visual field =
quadrantanopia
 loss of central vision
 random areas of visual loss (scotomas).

13. Visual Field Training with RehaCom
There is a substantial amount of evidence that patients can
be supported to compensate and adapt to visual field loss
following stroke using a range of strategies and methods.
RehaCom provides:
 systematic adaptive exploration exercises
 searching missing numbers, identifying shapes, searching and
counting objects
 re-establishing assigned perceptual functions by intense light stimuli
 the use of a large screen or projector is recommended
 head should be fixed in order to reduce head movement

14. More information for US customers at:
https://www.pearsonassessments.com/RehaCom
e-mail: rehacominfo@pearson.com