***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To evaluate a paging system design ed to improve independence in people with memory problems and executive deficits . METHODS After a successful pilot study , a r and omised control trial was conducted involving a crossover design with 143 people aged between 8 and 83 years . All had one or more of the following : memory , planning , attention , or organisation problems . Most had sustained a traumatic head injury or a stroke although a few had developmental learning difficulties or other conditions . The crossover design ensured that some people received a pager after a 2 week baseline whereas others were required to wait for 7 weeks after the baseline before receiving the pager . Participants were assessed at three time periods — namely , at baseline , 7 weeks , and at 14 weeks postbaseline . RESULTS More than 80 % of those who completed the 16 week trial were significantly more successful in carrying out everyday activities ( such as self care , self medication , and keeping appointments ) when using the pager in comparison with the baseline period . For most of these , significant improvement was maintained when they were monitored 7 weeks after returning the pager . CONCLUSIONS This particular paging system significantly reduces everyday failures of memory and planning in people with brain injury Deficits in attention and executive control are some of the most common , debilitating and persistent consequences of brain injuries . Underst and ing neural mechanisms that support clinical ly significant improvements , when they do occur , may help advance treatment development . Intervening via rehabilitation provides an opportunity to probe such mechanisms . Our objective was to identify neural mechanisms that underlie improvements in attention and executive control with rehabilitation training . We tested the hypothesis that intensive training enhances modulatory control of neural processing of perceptual information in patients with acquired brain injuries . Patients ( n=12 ) participated either in st and ardized training design ed to target goal -directed attention regulation , or a comparison condition ( brief education ) . Training result ed in significant improvements on behavioural measures of attention and executive control . Functional magnetic resonance imaging methods adapted for testing the effects of intervention for patients with varied injury pathology were used to index modulatory control of neural processing . Pattern classification was utilized to decode individual functional magnetic resonance imaging data acquired during a visual selective attention task . Results showed that modulation of neural processing in extrastriate cortex was significantly enhanced by attention regulation training .  Neural changes in prefrontal cortex , a c and i date mediator for attention regulation , appeared to depend on individual baseline state . These behavioural and neural effects did not occur with the comparison condition . These results suggest that enhanced modulatory control over visual processing and a rebalancing of prefrontal functioning may underlie improvements in attention and executive control Aim : To examine the effects of working memory ( WM ) training in adult patients with stroke . Methods : A r and omized pilot study with a treatment group and a passive control group ; 18 participants ( 12 males ) in a vocational age group ( mean age 54 years ) were r and omized to either the treatment or the control condition . The intervention consisted of computerized training on various WM tasks for five weeks . A neuropsychological test battery and self-rating on cognitive functioning in daily life ( the CFQ ) were administered both before and after the treatment . Results : Statistically significant training effects were found on the non-trainedtests for WM and attention , i.e. , tests that measure related cognitive functions but are not identical to tasks in the training programme ( Span board p < 0.05 ; PASAT p < 0.001 ; Ruff 2&7 p < 0.005 ) . There was a significant decrease in symptoms of cognitive problems as measured by the CFQ ( p < 0.005 ) . Conclusion : More than one year after a stroke , systematic WM training can significantly improve WM and attention Objective : Study short- and long-term transfer effects of a computerized working memory ( WM ) training programme for patients suffering from working memory deficits after acquired brain injury . Research design : A controlled experimental study with a cross-over design . Methods : A consecutive sample of 21 subjects . Mean age 43.2 years , time since injury/illness onset 37 months ( median ) . The subjects were r and omly selected into two groups where one group served as controls . All subjects trained daily for 5 weeks in a computer WM task program . They were followed-up at 4 and 20 weeks after the training . Results : A significant improvement in the trained WM tasks , significant improvements in neuropsychological WM-test results at 4 and 20 weeks after training compared to baseline . Improvement in the subjects ’ rated occupational performance and satisfaction with performance in pre-defined occupational problems . Rated quality -of-life did not change . However , rated overall health increased 20 weeks after training . Conclusions : Structured and intense computerized WM training improves subjects ’ cognitive functioning as measured by neuropsychological WM-dem and ing tests , rated occupational performance , satisfaction with performance and rated overall health . The training probably has an impact on the rehabilitation outcome , returning to work , as well as on daily activities for individuals with verified WM impairments The aim of the study was to compare the fidelity of manualised group memory rehabilitation programmes for participants with neurological disabilities . A sample of 11 neurological patients with memory problems , enrolled in a r and omised controlled trial comparing compensation , restitution and self-help treatments  , were observed during group sessions . Time-sampling was used to record the activity of the participants and the content of the discussion at one minute intervals . There was a significant difference between groups in the amount of time the group leader and participants spent talking ( p < .001 ) . Participants in the compensation and restitution groups spent significantly more time in memory rehabilitation discussion than participants in the self-help group ( p < .001 ) . There was also a significant difference between the amount of time spent discussing internal and external memory aids in the compensation and restitution groups ( p < .001 ) . These results support the fidelity of the interventions provided . This study also highlights the usefulness of time-sampling as a method to record the content and activity in rehabilitation groups Cognitive impairment is a frequent complication of stroke . The aim of this study was to evaluate the effectiveness of cognitive training performed early after stroke . Ninety-two patients were r and omly assigned to either the study group ( SG ) or the  control  group ( CG ) . Cognitive rehabilitation consisted of 16 individual one-hour sessions in which patients performed therapist- guided computer exercises . The patients in the CG performed a sham intervention . After four weeks all the patients were re-evaluated . In the SG , significant improvements ( p<0.05 ) were detected in all neuropsychological measures at the post-training evaluation , while the CG showed mild ( not statistically significant ) improvements on cognitive tests . Between-group analysis revealed statistically significant differences in the domains of memory and visual attention .  Cognitive training performed early after stroke seems to be a viable option for improving cognitive outcome in stroke survivors . Further studies should assess whether this may favor their reintegration into everyday life BACKGROUND AND PURPOSE To be useful for clinical research , an outcome measure must be feasible to administer and have sound psychometric attributes , including reliability , validity , and sensitivity to change . This study characterizes the psychometric properties of the Stroke Impact Scale ( SIS ) Version 2.0 . METHODS Version 2.0 of the SIS is a self-report measure that includes 64 items and assesses 8 domains ( strength , h and function , ADL/IADL , mobility , communication , emotion , memory and thinking , and participation ) . Subjects with mild and moderate strokes completed the SIS at 1 month ( n=91 ) , at 3 months ( n=80 ) , and at 6 months after stroke ( n=69 ) . Twenty-five subjects had a replicate administration of the SIS 1 week after the 3-month or 6-month test . We evaluated internal consistency and test-retest reliability . The validity of the SIS domains was examined by comparing the SIS to existing stroke measures and by comparing differences in SIS scores across Rankin scale levels . The mixed model procedure was used to evaluate responsiveness of the SIS domain scores to change . RESULTS Each of the 8 domains met or approached the st and ard of 0.9 alpha-coefficient for comparing the same patients across time . The intraclass correlation coefficients for test-retest reliability of SIS domains ranged from 0.70 to 0.92 , except for the emotion domain ( 0.57 ) . When the domains were compared with established outcome measures , the correlations were moderate to strong ( 0.44 to 0.84 ) . The participation domain was most strongly associated with SF-36 social role function . SIS domain scores discriminated across 4 Rankin levels . SIS domains are responsive to change due to ongoing recovery . Responsiveness to change is affected by stroke severity and time since stroke . CONCLUSIONS This new , stroke-specific outcome measure is reliable , valid , and sensitive to change . We are optimistic about the utility of measure . More studies are required to evaluate the SIS in larger and more heterogeneous population s and to evaluate the feasibility and validity of proxy responses for the most severely impaired patients Background Stroke is one of the most common causes of cognitive impairment . Up to 75 % of stroke survivors may be considered to have cognitive impairment , which severely limit individual autonomy for successful reintegration into family , work and social life . The clinical efficacy of acupuncture with Baihui ( DU20 ) and Shenting ( DU24 ) in stroke and post-stroke cognitive impairment has been previously demonstrated . Computer-assisted cognitive training is part of conventional cognitive rehabilitation and has also shown to be effective in improvement of cognitive function of affected patients . However , the cognitive impairment after stroke is so complexity that one single treatment can not resolve effectively . Besides , the effects of acupuncture and RehaCom cognitive training have not been systematic ally compared , nor has the possibility of a synergistic effect of combination of the two therapeutic modalities been evaluated . Our primary aim of this trial is to evaluate the synergistic effect of acupuncture and RehaCom cognitive training  on cognitive dysfunction after stroke . Method / Design A r and omized controlled trial of 2 × 2 factorial design will be conducted in the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine . A total of 240 patients with cognitive dysfunction after stroke who meet the eligibility criteria will be recruited and r and omized into RehaCom training group , acupuncture group , a combination of both or control group in a 1:1:1:1 ratio . All patients will receive conventional treatment . The interventions will last for 12 weeks ( 30 min per day , Monday to Friday every week ) . Evaluations will be conducted by blinded assessors at baseline and again at 4 , 8 and 12 weeks . Outcome measurements include mini – mental state examination ( MMSE ) , Montreal cognitive assessment s ( MoCA ) , functional independence measure scale ( FIM ) and adverse events . Discussion The results of this trial are expected to clarify the synergistic effect of acupuncture and RehaCom cognitive training on cognitive dysfunction after stroke . Furthermore , to confirm whether combined or alone of acupuncture and RehaCom cognitive training , is more effective than conventional treatment in the management of post-stroke cognitive dysfunction . Trial registration Chinese Clinical Trial Registry : ChiCTR-TRC-13003704 . Registration date : 4 September , 2013 BACKGROUND Rehabilitation of impaired cognitive functions begins to be considered a st and ard component of medical care after acquired brain injury . Indeed , many evidence s support the effectiveness of the two major categories of techniques , i.e. the traditional and computer-assisted ones , which are widely used in cognitive rehabilitative treatment . OBJECTIVE Aim of this study is to evaluate the effects of pc - cognitive training in brain injury patients . METHODS We studied 35 subjects ( r and omly divided into two groups ) , affected by traumatic or vascular brain injury , having attended from January 2010 to December 2012 the Laboratory of Robotic and Cognitive Rehabilitation of IRCCS Neurolesi of Messina . Cognitive impairment was investigated through psychometric battery , administered before ( T0 ) and two months ( T1 ) after the cognitive pc-training , which was performed only by the experimental group , in addition to conventional treatment . Statistical analysis was performed using Wilcoxon test with a p < 0.01 . RESULTS At time T0 , all patients showed language deficits and cognitive alterations in visual attention and memory abilities . After the rehabilitation program we noted a global improvement in both the groups . However , at T1 , the experimental group showed a greater cognitive improvement than the control group , with significant differences in nearly all the neuropsychological tests performed . CONCLUSIONS Our data suggest that cognitive pc-training may be a promising methodology to optimize the rehabilitation outcomes following brain injury Memory problems are common in patients with a range of neurological conditions , but there have been few attempts to provide and evaluate the usefulness of memory training for groups of neurological out patients . We used a waitlist-controlled trial design to assess the effectiveness of a newly created , 6-session intervention , which involved training in the use of compensatory strategies as well as education regarding memory function , neurological damage , sleep and lifestyle factors that have an impact on memory . Fifty-six patients with neurological conditions ( e.g. , stroke , epilepsy ) and memory complaints completed the training and assessment s. Outcomes were evaluated in terms of reported strategy use as well as objective and subjective measures of antero grade and prospect i ve memory . Training result ed in significant improvements on number of strategies used , scores on the Rey Auditory Verbal Learning Test ( total learning and delayed recall ) and self-report on the Comprehensive Assessment of Prospect i ve Memory . Improvements were stable at 3-month follow-up . Better individual outcomes were related to lower baseline memory scores , fewer symptoms of depression and greater self-awareness of memory function . Overall the study provides encouraging results to indicate that patients with neurological conditions such as stroke and epilepsy can show improvements in memory after a relatively short group-based intervention Background and Purpose — Impaired attention contributes to poor stroke outcomes . Attention process training ( APT ) reduces attention deficits after traumatic brain injury . There was no evidence for effectiveness of APT in stroke 
    Output:
    
The results do not show any significant effect of memory rehabilitation on performance in objective memory tests , mood , functional abilities , or quality of life .
AUTHORS ' CONCLUSIONS Participants who received cognitive rehabilitation for memory problems following a stroke reported benefits from the intervention on subjective measures of memory in the short term ( i.e. the first assessment point after the intervention , which was a minimum of four weeks ) .
This effect was not , however , observed in the longer term ( i.e. the second assessment point after the intervention , which was a minimum of three months ) .
There was , therefore , limited evidence to support or refute the effectiveness of memory rehabilitation .