The Cognitive rehabilitation Refers to a series of mental exercises that performed on a continuous basis and under the organization, planning and supervision of a professional (neuropsychologists, psychologists, occupational therapists...), specialized in this area, will influence the recovery or improvement of a Person who has suffered brain damage.
Expressed in metaphorical terms, we could make the simile that cognitive rehabilitation would be like a"mental gymnastics"for the brain, which Physical rehabilitation for a body part that is injured.
Cognitive rehabilitation is integrated into non-pharmacological therapies, that is, an intervention without chemistry, theoretically sustained, Focused and replicable system potentially capable of gaining relevant benefits. (Olazarán and Clare, 2007).
It has been demonstrated after several research studies that changes in brain activation are significant after performing a Effective cognitive rehabilitation.
It should not be forgotten that rehabilitation must be done through teamwork, bearing in mind at all times the existence of three figures who Are essential in a rehabilitation treatment. In the first place the patient, secondly the family and thirdly a team of Professionals working from a multidisciplinary perspective.
Who is cognitive rehabilitation aimed at?
Cognitive rehabilitation becomes relevant in different neuropsychological, neurological and psychiatric pathologies such as, for example, Trauma Cranioencephalic disorders (TBI), Stroke (LCA), Brain tumors , Dementia , multiple sclerosis , schizophrenia ...
The cognitive processes that are going to be intervened are: language, memory, attention, praxis, gnosis and executive functions. In addition to the importance of intervening in Anosognosia , Lack of awareness of the deficits, and always taking into account that the treatment Must be directed to an intervention that integrates the three spheres of the"bio-psycho-social"person, which will always be interrelated.
What were the first approaches to cognitive rehabilitation?
It was in Germany at the beginning of the last century, when a psychologist and neurologist named Walther Poppelreuter, began researching with surviving soldiers Of the First World War, which left its mark on some ex-combatants in the form of brain damage.
From this moment, Propperleur began to investigate and contrast that the realization of certain activities of cognitive training in people who Had suffered brain damage, improved performance in the psychometric tests of these soldiers.
Poppelreuter studies began to give importance to these types of techniques, which could be carried out to improve the Recovery in a brain damage or as we will see below, slow down a neurodegenerative process.
Is it the same cognitive rehabilitation and cognitive stimulation?
Several authors make explicit the differentiation between these two terms. At the conceptual level, rehabilitation would refer to a recovery of the Function, and on the other hand the stimulation would be more directed to a maintenance or exercise of said function.
A clear example of the differential use of these two terms is seen in the treatment of neurodegenerative diseases (as in the case of Dementia among others), where according to experts it is more appropriate to refer to a Cognitive stimulation .
As it is a degenerative process, it is not It recovers the function, but that the objective would be focused to slow the process of degeneration of the disease and to minimize the effects that are going to Reflect in the Cognitive functions of the person.
The importance of brain plasticity when we talk about cognitive rehabilitation
We can not delve into the term cognitive rehabilitation without first explaining what the brain plasticity is and the importance it will have for Carry out a cognitive rehabilitation treatment.
The brain plasticity Is a feature of our brain By which, after organic damage, our brain is able to regenerate and reorganize itself Even after several months after the damage suffered.
The brain is more plastic depending on the age of the person, there is an inverse correlation with brain maturity, ie, the brain is going to be More plastic at younger ages.
It should be noted that in recent studies related to brain plasticity, it has been shown that our brain continues to maintain this ability Although in a smaller proportion with the passage of the years. However, brain plasticity is still present in people with more advanced ages.
What are the objectives of cognitive rehabilitation?
First, we must take into account our expectations, variables and forecasting factors, since there will be many causes that go to Conditioning cognitive rehabilitation.
Some of these factors refer to the age, the clinical picture, the interval between the injury and the rehabilitation, the presence of some Disorder associated with brain damage and personal motivation, among other factors.
The main objectives are: to reduce the cognitive deficits that occur after the brain injury, to favor an integration in the Different areas of the person's life, maximizing the degree of autonomy and independence of the person, training in strategies such as learning without Error, the display , Spaced recovery, etc.
All these objectives in order to increase the quality of life of the patient as well as their relatives and caregivers.
Examples of Different Cognitive Rehabilitation Techniques
Use of"pencil and paper"sheets, what is known as traditional cognitive rehabilitation, where the person performs exercises through writing, Reading, canceling... depending on the cognitive ability you want to work.
Another modality of cognitive rehabilitation would be through specific and adapted material, where the professional selects worksheets, objects Everyday or any ecological tool that can serve to carry out the exercises that arise in the session of cognitive rehabilitation.
Currently, computer-based cognitive stimulation (ECO) is also being used using new technologies, computers, mobile applications...
The latter provide some advantages over traditional stimulation, since it is possible to work with more attractive and motivating stimuli to The patient and at a professional level, the accuracy of some variables such as the exposure or reaction time can be more easily controlled Such as the registration of quantitative level.
References
- Wilson, B.A.: Recent Developments in Neuropsychological Rehabilitation, 2006.
- Bach -y- Rita, P.: Theoretical basis for brain plasticity after TBI (University of Wisconsin-Madison, Madison, USA 2003).
- The Effectiveness of Rehabilitation for Cognitive Deficits Written by Peter W. Halligan, Derick T. Wade (2005).