WHAT IS COGNITIVE REHABILITATION? - PSYCHOLOGY - 2025

The cognitive rehabilitation refers to a series of mental exercises performed on an ongoing basis and under the organization, planning and supervision of a professional (neuropsychologists, psychologists, occupational therapists…), specialized in this area will influence 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, what a physical rehabilitation for a part of the body that is injured.

Cognitive rehabilitation is integrated within non-pharmacological therapies, that is, an intervention without chemistry, theoretically supported, focused and replicable, potentially capable of obtaining relevant benefits. (Olazarán and Clare, 2007).

It has been shown after several research studies, that changes in brain activation are significant after the performance of an 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. Firstly the patient, secondly the family and thirdly a team of professionals who work from a multidisciplinary perspective.

Who is cognitive rehabilitation for?

Cognitive rehabilitation is relevant in different neuropsychological, neurological and psychiatric pathologies such as head injuries (TBI), cerebrovascular accidents (CVA), brain tumors, dementias, multiple sclerosis, schizophrenia…

The cognitive processes on which to intervene are: language, memory, attention, praxis, gnosis, and executive functions. In addition to the importance of intervening in problems of anosognosia, lack of awareness of deficits, and always bearing in mind that treatment must be aimed at an intervention that integrates the three spheres of the "bio-psycho-social" person, which are to 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 to investigate with surviving soldiers of the First World War, which left its mark on some veterans in the form of brain damage.

From this moment on, Propperleur began to investigate and contrast that the performance of certain cognitive training activities in people who had suffered brain damage improved the performance of these soldiers in psychometric tests.

From Poppelreuter's studies, importance began to be given to this type of techniques, which could be carried out to improve the recovery process in brain damage or, as we will see below, slow down a neurodegenerative process.

Is cognitive rehabilitation and cognitive stimulation the same?

Several authors make the differentiation between these two terms explicit. At a conceptual level, rehabilitation would refer to a recovery of function, and on the other hand, stimulation would be more aimed at maintaining or exercising said function.

A clear example of the differentiated use of these two terms is seen in the treatment of neurodegenerative diseases (as it would be in the case of dementia among others), where according to the experts it is more appropriate to refer to cognitive stimulation.

As it is a degenerative process, function is not recovered, but the objective would be focused on slowing down the degenerative process of the disease and minimizing the effects that will be reflected in the cognitive functions of the person.

The importance of brain plasticity when we talk about cognitive rehabilitation

We cannot delve into the term cognitive rehabilitation without first explaining what brain plasticity is and the importance it will have to carry out a cognitive rehabilitation treatment.

Brain plasticity is a characteristic of our brain by which, after organic damage, our brain is capable of regenerating and reorganizing 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, that is, the brain will 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 capacity, although to a lesser extent over the years. However, brain plasticity is still present in people with older ages.

What are the objectives of cognitive rehabilitation?

In the first place, we must take into account our expectations, variables and prognostic factors, since there will be many causes that will condition cognitive rehabilitation.

Some of these factors refer to age, the clinical picture, the interval between injury and rehabilitation, the presence of a disorder associated with brain damage and personal motivation, among other factors.

The main objectives that arise are: reduce the cognitive deficits that occur after brain injury, promote integration in the different areas of the person's life, maximize the degree of autonomy and independence of the person, train in strategies such as error-free learning, visualization, spaced retrieval, etc.

All these objectives in order to increase the quality of life of both the patient and their families and caregivers.

Examples of different cognitive rehabilitation techniques

Use of "pencil and paper" cards, which is known as traditional cognitive rehabilitation, where the person performs exercises through writing, reading, cancellation… depending on the cognitive ability that you want to work on.

Another modality of cognitive rehabilitation would be through specific and adapted material, where the professional selects work sheets, everyday objects or any ecological tool that can be used to carry out the exercises that are proposed in the cognitive rehabilitation session.

Currently, cognitive stimulation by computer (ECO) is also carried out using new technologies, computers, mobile applications…

The latter provide some advantages compared to traditional stimulation since it is possible to work with stimuli that are more attractive and motivating for the patient and at a professional level, the precision of some variables such as exposure or reaction time as well as registration can be more easily controlled. of the quantitative level.

References

1. Wilson, BA: Recent Developments in Neuropsychological Rehabilitation, 2006.
2. Bach –and- Rita, P.: Theoretical basis for brain plasticity after a TBI (University of Wisconsin- Madison, Madison, USA 2003).
3. The Effectiveness of Rehabilitation for Cognitive Deficits Written by Peter W. Halligan, Derick T. Wade (2005).
4. http://exclusive.multibriefs.com/content/
5. http://www.sciencedaily.com/releases/2015/07/150708131446.htm.