Cognitive recovery in acute stroke: Measurement and facilitation of change

Strokes can affect any part of the brain and therefore have a wide range of potential outcomes including an array of cognitive deficits such as memory problems, neglect, problem solving difficulties and decision making errors. From a biological perspective, recovery from stroke can be categorized into two time phases, acute (up until 3 months) and chronic (3+ months), with most changes occurring in the actue phase. In the motor and speech areas, it is recognised that early intervention during the acute phase leads to the best long-term outcomes. The research into recovery of cognitive function is less well developed than in the motor and speech areas, however, there is a literature that explores the prevalence of cognitive impairments and recovery in the chronic phase. Such research is based upon patients with stroke’ performance on batteries of standardised neuropsychological tests. This literature consistently demonstrates only small improvements over time. Training programs aimed at directly facilitating the recovery process, as opposed to developing compensatory behaviours to circumvent the effects of the impairment, have been implemented during the chronic phase. Many of these programs are based upon cognitive theories and employ commonly used cognitive psychology paradigms. These training programs have resulted in substantial improvements in the impaired functions. However, there are no studies that attempt to track changes in behaviour during the acute phase of stroke despite this being consistently demonstrated as a crucial period of recovery. The intent of the current research is to address this gap in the literature by exploring behaviour change in patients with stroke who are in hospital in the early stages of recovery from their first stroke.