Improving Cognition, Participation, and Coping after Subarachnoid Hemorrhage: A pilot study of a new rehabilitation program

Objective. To determine the effectiveness of a rehabilitation program including physical exercise, in improving cognition, participation, and coping in patients with a subarachnoid hemorrhage (SAH). Secondary, it was aimed to identify the role of clinical characteristics in the effectiveness of the rehabilitation program. Methods. A longitudinal pilot intervention study was performed, with measurements before the start (T0), after three months (T1), and after six months (T2). Cognition was measured with the Montreal Cognitive Assessment, participation with the Impact on Participation and Autonomy questionnaire, and coping with the Utrecht Proactive Coping Competence Scale. Generalized Estimating Equation analyses were performed. Results. A total of 19 patients with SAH participated; 13 in the intervention group and 6 in the control group. For the intervention group, cognition improved between T0 and T2 and between T1 and T2. Participation declined between T0 and T1, but improved...Show moreObjective. To determine the effectiveness of a rehabilitation program including physical exercise, in improving cognition, participation, and coping in patients with a subarachnoid hemorrhage (SAH). Secondary, it was aimed to identify the role of clinical characteristics in the effectiveness of the rehabilitation program. Methods. A longitudinal pilot intervention study was performed, with measurements before the start (T0), after three months (T1), and after six months (T2). Cognition was measured with the Montreal Cognitive Assessment, participation with the Impact on Participation and Autonomy questionnaire, and coping with the Utrecht Proactive Coping Competence Scale. Generalized Estimating Equation analyses were performed. Results. A total of 19 patients with SAH participated; 13 in the intervention group and 6 in the control group. For the intervention group, cognition improved between T0 and T2 and between T1 and T2. Participation declined between T0 and T1, but improved between T1 and T2. Proactive coping declined between T0 and T2 and between T1 and T2. Cognition of the control group did not change, but participation improved between T0 and T1 and proactive coping declined between T0 and T1. There was no significant difference between the control and intervention groups in improvements in cognition between T0 and T1 (p = 0.090). However, there was a significant difference between the control and intervention groups in changes in participation between T0 and T1 (p = 0.001) and in changes in coping between T0 and T1 (p < 0.001). The location of SAH played a role in the differences in participation, but not in cognition and coping. For treatment type and time since SAH, no significant effects were found. Conclusion. There was no effect of the rehabilitation program on cognition. The control group had a better participation level after three months and the intervention group worsened. The intervention group had a stable coping style after three months, whereas the control group declined in the use of proactive coping. Only the characteristic location of the aneurysm played a role in the participation level after three months, but not in cognition or coping. The other characteristics did not play a role in the changes. This study indicates that some long-term complaints can improve after the rehabilitation program, but more research is needed.Show less

Leiden University Student Repository

Documents

In Collections

Improving Cognition, Participation, and Coping after Subarachnoid Hemorrhage: A pilot study of a new rehabilitation program