Cognitive stimulation therapy in the rehabilitation of patients after coronary artery bypass grafting: a pilot study

BACKGROUND: Recent research is increasingly focusing on the development of novel cognitive stimulation approaches that can be applied in the early post–cardiac surgery period. The wider use of these approaches may be facilitated by evaluating their effectiveness and testing them in clinical settings.

AIM: This study aimed to investigate changes in the cognitive status of patients after coronary artery bypass grafting (CABG) with cardiopulmonary bypass under a dual-task cognitive stimulation program, as well as to assess the feasibility of using this program in the early postoperative period.

METHODS: The study included 25 patients: a training group (n = 9) who underwent 5 to 7 sessions of the cognitive stimulation program and a non-training group (n = 16) who received standard postoperative care. The inclusion criteria were elective CABG with cardiopulmonary bypass and an age range of 45–75 years. Patients had to provide informed consent. Patients with dementia, depression, acute cerebrovascular accidents, or a history of traumatic brain injury were excluded. The cognitive stimulation program was administered daily from post–CABG day 3 until discharge and consisted of two tasks performed simultaneously: a complex visual-motor task and a verbal one. All patients underwent two extended neuropsychological assessments, including assessments of neurodynamics, memory, and attention: 2 or 3 days before CABG, and on post–CABG day 11 or 12. Postoperative cognitive dysfunction was assessed using the 20–20 criterion defined as a 20% decline in at least 20% of the tests administered during the extended neuropsychological assessment.

RESULTS: On day 11–12 after surgery, postoperative cognitive dysfunction was reported in 44.4% of patients in the training group and 75% of patients in the non-training group (p = 0.06). Patients who underwent the cognitive stimulation program made fewer errors on the complex sensorimotor reaction test (p = 0.04) and were more likely to recall more words and figures. They also showed better results in attention span (p = 0.04) compared with the non-training group. Additionally, the training group showed lower rates of a 20% decline in attention (p = 0.04) and short-term visual memory scores (p = 0.02).

CONCLUSION: Patients who underwent the cognitive stimulation in the early post–CABG period demonstrated lower rates of cognitive decline in attention and short-term memory. These findings could be used to develop and implement cognitive stimulation methods in clinical practice.