КардиоСоматика (Dec 2021)
Possibilities of neurocognitive rehabilitation using the dual tasks method in patients in the early postoperative period of coronary bypass surgery
Abstract
Background. Previously, it has been demonstrated that the use of the dual-task method (performance cognitive and motor tasks simultaneously) in cognitive rehabilitation provides sustainable improvements in cognitive and motor functions. However, the effectiveness of the dual-task method in cardiac surgery patients has not been studied enough yet. Aim. To evaluate the effectiveness of the training for recovering cognitive function using a computer program of dual tasks in the early postoperative period of on-pump coronary artery bypass surgery (CABG). Material and methods. Sixty-two patients aged 64 [60; 69] years were examined before surgery and divided into two groups: with postoperative cognitive training (n=29) and without cognitive rehabilitation (n=33). The extended neuropsychological testing was performed 23 days before and 89 days after CABG to assess the psychomotor and executive functions (neurodynamic), attention and short-term memory, as well as the serum concentrations of markers of brain damage: neuron-specific enolase and S100 protein were measured. Results. The data of preoperative extended neuropsychological testing did not demonstrate between-group differences. At 810 days after CABG, 20% decrease of the cognitive indicators was detected in patients of both groups. In the group with cognitive training, the number of patients with impaired memory, attention and neurodynamics was significantly lower than in the group without training. Also, in patients who underwent cognitive rehabilitation, there was no increase in the concentrations of neuron-specific enolase and calcium-binding protein S100 compared to preoperative values, in contrast to patients without rehabilitation. Conclusion. The use of dual tasks computer program demonstrated a decrease in the severity of cognitive impairment after surgery.
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