Advances in the application of web-based cognitive stimulation in improving cognitive function in patients with cognitive impairment after stroke
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Abstract
Stroke is a leading cause of long-term disability worldwide, with post-stroke cognitive impairment (PSCI) affecting over 70% of survivors and significantly diminishing their independence and quality of life. In Indonesia, the prevalence of PSCI exceeds 60%, the highest in Southeast Asia, creating a critical demand for effective and accessible rehabilitation strategies. This review addresses the effectiveness of web-based cognitive stimulation applications in enhancing cognitive recovery, specifically during the first three months post-stroke, which is identified as the "golden period" for recovery due to heightened cortical plasticity. In this review, we systematically searched and analyzed articles published in English from the date of inception up to December 31st, 2025, using PubMed, Science Direct, Google Scholar, Cochrane Central Library, and SpringerLink. Relevant search terms included “POST-STROKE COGNITIVE IMPAIRMENT” AND (“COGNITIVE REHABILIATION” OR “COGNITIVE STIMULATION” OR “WEB-BASED COGNITIVE TRAINING”). The rationale for this review stems from the need to overcome barriers in traditional rehabilitation, such as high clinician workload and limited accessibility, by utilizing technology-based interventions that facilitate telerehabilitation. Major studies and paradigms reviewed include the Montreal Cognitive Assessment (MoCA-Ina) for sensitive screening, as well as specific training tasks such as the Stroop Effect and Go/No-Go paradigms. Key findings from some researchers demonstrate significant improvements in MoCA-Ina scores following computerized training, while some meta-analyses suggest that Go/No-Go tasks are highly effective in improving inhibitory control. The review concludes that web-based applications offer a practical and effective solution for individualized, repetitive cognitive training that can be accessed without specialized software installation. Furthermore, these digital tools support continuity of care after hospital discharge. To maximize clinical impact, future research must focus on integrating these prototype applications into standardized clinical practice and establishing a clearer consensus on the diagnostic timing of post-stroke dementia.
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