EFEK LATIHAN PERMAINAN UNTUK MENINGKATKAN FUNGSI KOGNITIF PADA STROKE KRONIS DENGAN GANGGUAN KOGNITIF RINGAN

Authors

  • Anne Marannu Program Studi Ilmu Kedokteran Fisik dan Rehabilitasi Fakultas Kedokteran Universitas Sam Ratulangi Manado
  • Lidwina Sima Sengkey KSM Ilmu Kedokteran Fisik dan Rehabilitasi RSUP Prof. Dr. R. D. Kandou Manado
  • Joudy Gessal KPS Ilmu Kedokteran Fisik dan Rehabilitasi RSUP Prof. Dr. R. D. Kandou Manado

Abstract

Abstract

Background : Cognitive impairment is one of long term complication of stroke. Stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. We assessed the effect of a 6 weeks intensive cognitive skills training through game on cognitive functions in adults with chronic stroke. Material and Methods: This was an experimental study with pre-test and post-test group design performed at the outpatient clinic in Department of Physical Medicine and Rehabilitation Kandou Hospital Manado. Twenty-two chronic stroke survivors (ie, 6 months since an index stroke) were participated in this study. Participants received a 6-weeks intensive cognitive skills training with sudoku game and memory card game where the training was held 3 times per week with total 18 meetings. The primary outcome measure was the MoCA-Ina score, angka span forwards test a cognitive test of memory, stroop test a cognitive test of selective attention , trail making test A and B a test for executive function. Results: Compared MoCA-Ina score before and after intervention were significantly improved (p<0,001) so does the angka span forwards test for memory, the stroop test for selective attention , trail making test A and B for executive function were significantly improved at the end of the 6-weeks intervention period (p<0,001). Conclusions: Cognitive skills training through game can significantly benefit cognitive functions in community-dwelling chronic stroke survivors who are mildly cognitively impaired, a population at high-risk for dementia. Thus, clinicians should consider prescribing cognitive training through game in the cognitive rehabilitation of chronic stroke survivors.

Key Words: Chronic stroke, Cognitive functions, Game, MCI.

 

Abstrak

Latar Belakang : Gangguan kognitif merupakan salah satu komplikasi jangka panjang dari stroke. Penderita stroke yang mampu bertahan hidup merupakan populasi target yang membutuhkan strategi intervensi untuk meningkatkan fungsi kognitif dan mencegah demensia. Kami menilai efek dari pelatihan keterampilan kognitif intensif selama 6 minggu melalui permainan terhadap fungsi kognitif pada orang dewasa dengan stroke kronik. Bahan dan Metode : Penelitian ini merupakan penelitian eksperimental dengan rancangan pre-test dan post-test group design yang dilakukan di Instalasi Rawat Jalan Departemen Rehabilitasi Medik Rumah Sakit Kandou Manado. Dua puluh dua penderita stroke kronik (yaitu, 6 bulan sejak stroke indeks) berpartisipasi dalam penelitian ini. Peserta mendapatkan pelatihan keterampilan kognitif intensif selama 6 minggu dengan permainan sudoku dan permainan kartu memori dimana pelatihan tersebut dilaksanakan sebanyak 3 kali dalam seminggu dengan total 18 kali pertemuan. Hasil pengukuran yang utama adalah skor MoCA-Ina, tes rentang angka maju untuk mengevaluasi kognitif memori, tes stroop untuk mengevaluasi kognitif perhatian selektif, trail making test A dan B untuk mengevaluasi fungsi eksekutif. Hasil : Dibandingkan skor MoCA-Ina sebelum dan sesudah intervensi meningkat secara signifikan (p <0,001) begitu juga dengan tes rentang angka maju untuk memori, tes stroop untuk perhatian selektif, trail making test A dan B untuk fungsi eksekutif meningkat secara signifikan pada akhir periode intervensi 6 minggu (p <0,001). Kesimpulan : Pelatihan keterampilan kognitif melalui permainan dapat secara signifikan memberi manfaat pada fungsi kognitif pada penderita stroke kronik yang tinggal di komunitas yang memiliki gangguan kognitif ringan yang merupakan populasi yang berisiko tinggi untuk demensia. Dengan demikian, klinisi harus mempertimbangkan untuk meresepkan pelatihan kognitif melalui permainan dalam rehabilitasi kognitif penderita stroke kronik.

Kata Kunci : Fungsi Kognitif , Gangguan Kognitif Ringan , Permainan, Stroke Kronik.

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Published

2020-10-26