New cognitive training intervention for stroke survivors shows promising results
The NeuroAIreh@b programme may help reduce inequalities in access to personalised cognitive training by increasing the intensity and frequency of support for stroke survivors.
A research team co-led by the University of Coimbra (UC) has successfully created and tested a new cognitive training intervention, using information and communication technologies (ICT), for stroke survivors. Results from this pilot study suggest that the NeuroAIreh@b programme (NAIr) may help reduce inequalities in access to personalised cognitive training by increasing the intensity and frequency of support for stroke survivors.
Developed by researchers from the Centre for Research in Neuropsychology and Cognitive-Behavioural Intervention (CINEICC, FPCEUC), the NOVA Laboratory for Computer Science and Informatics (NOVA LINCS), and the NeuroRehabLab at the University of Madeira, NAIr is a tablet-based cognitive training platform that incorporates tasks inspired by activities of daily living, such as going shopping or preparing meals.
CINEICC and NOVA LINCS researcher Joana Câmara, first author of the study, explains: “The programme is personalised according to each survivor’s neuropsychological profile, based on a comprehensive neuropsychological assessment (NPA) that defines the cognitive training requirements. As participants complete the sessions, the cognitive training difficulty is adjusted based on their performance through artificial intelligence (AI) algorithms, in a truly interactive experience with cues, auditory and visual feedback, and errorless learning to support task performance, as well as gamification elements, such as badges and points, to boost motivation and engagement.”
The study recruited 30 participants with chronic cognitive deficits post-stroke, including difficulties in attention and concentration, verbal episodic memory, and executive functions. Participants were divided into three groups: 10 received NAIr (NeuroAIreh@b), the adaptive tablet-based cognitive training; 10 followed the already tested paper-and-pencil cognitive training; and 10 did not participate in any intervention. Only the NAIr group demonstrated significant improvements in the quality of life and autonomy in daily activities of stroke survivors, while those with no intervention experienced significant cognitive decline.
All participants underwent NPAs before the programme, after completion, and three months later, assessing global cognition, processing speed, verbal episodic memory, as well as non-cognitive domains such as anxiety, depression, quality of life, and functionality.
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Joana Câmara highlights that “beyond the visible post-stroke impairments, there are ‘invisible’ cognitive and emotional deficits that have received less attention. Stroke survivors, even in the chronic phase, can benefit from these cognitive training programmes, which may also help prevent pathological cognitive decline, as they face a higher risk of developing vascular dementia.”
At the national level, cognitive training and rehabilitation programmes are still scarce within the Portuguese National Health Service, making NeuroAIreh@b particularly valuable. It can be delivered both in person and remotely, with monitoring modules allowing neuropsychologists to supervise performance while participants train at home.
The next step involves expanding the programme to other healthcare institutions in Portugal to increase the sample of community-dwelling stroke survivors and verify whether the encouraging preliminary results are confirmed.
The study also involved Manuela Vilar (FPCEUC/CINEICC), neuropsychologist Sofia Aguiar (Hospital Central do Funchal), and researchers from the University of Madeira, including Teresa Paulino, Sergi Bermúdez i Badia, Ana Lúcia Faria, and Eduardo Fermé.
The results are published in Comparing adaptive tablet-based cognitive training and paper-and-pencil cognitive training: a pilot randomized controlled trial with community-dwelling stroke survivors, in the International Journal of Clinical and Health Psychology (DOI: 10.1016/j.ijchp.2025.100627).