Annals of Rehabilitation Medicine

"Cognitive dysfunction"

Original Articles

Brain disorders

Artificial Intelligence-Guided Mobile Telerehabilitation for Individuals With Cognitive Impairment: A Feasibility Study: Suebeen Kim, Doo Young Kim, Si-Woon Park, Namo Jeon, Taeksoo Jeong, Min-Soo Kang, Sangwook Park; Ann Rehabil Med 2025;49(6):371-380. Published online December 31, 2025; DOI: https://doi.org/10.5535/arm.250060

Objective
To test the feasibility and usability of an artificial intelligence (AI)-guided mobile cognitive telerehabilitation program for patients with stroke or older adults with mild cognitive impairment (MCI).
Methods
Thirteen participants with cognitive impairment (Mini-Mental State Examination [MMSE] score≤26; nine with stroke and four with MCI) were enrolled in the study. Each participant was provided with an AI-guided mobile cognitive rehabilitation program (Zenicog®). Participants were instructed to complete 24 sessions within 6 weeks, and those with sufficient adherence (≥70%, 17 sessions) were included in the analysis. Cognitive assessments included the MMSE, digit span, and Trail Making Tests A & B. The usability questionnaire investigated equitable use and flexibility in use, simple and intuitive use, perceptible information, tolerance for error, low physical effort, size and space for use, overall product quality, overall satisfaction.
Results
Eleven participants completed the study, and 10 participants met adherence criteria. The MMSE score increased significantly from 24.00 [21.00, 25.75] at baseline to 27.50 [26.00, 28.75] after intervention. The overall product quality (Likert scale: 1–5) score was 4.00±0.87. The lowest score in the usability questionnaire was for tolerance for error. Female participants and participants with <12 years’ education gave lower scores for tolerance for error and equitable/ flexibility in use, respectively.
Conclusion
The AI-guided mobile cognitive telerehabilitation program is feasible and potentially beneficial for improving cognitive function in patients with stroke or older adults with MCI. Individuals who are less familiar with electronic devices require special consideration to improve their usability.

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AI-driven telerehabilitation for older adults with mild cognitive impairment: a randomized controlled trial
Minsong Kim, Doo Young Kim, Taeksoo Jeong, Si-Woon Park
Frontiers in Neurology.2026;[Epub] CrossRef

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Physical therapy

Potential Effects of Computer-Based Cognitive Training on Postural Stability and Locomotion in Parkinson’s Disease Patients: A Randomized Controlled Trial: Engy BadrEldin S. Moustafa, Moshera H. Darwish, Mohammed S. El-Tamawy, Mohamed Mohamed Mazen, Nehad A. Abo-Zaid, Heba A. Khalifa; Ann Rehabil Med 2025;49(4):196-207. Published online August 27, 2025; DOI: https://doi.org/10.5535/arm.250067

Objective
To examine the short-term and long-term effects of computer-based cognitive training on postural stability, locomotion, and cognitive performance in Parkinson’s disease (PD) patients.
Methods
Sixty-eight PD participated in this randomized-controlled trial, were randomly allocated into two groups; control group (GA) received a designed physiotherapy program for 60 minutes, and an experimental group (GB) got 30 minutes physiotherapy program as GA, along with 30 minutes of computerized cognitive training. Treatment sessions were three times/week for eight weeks. Primary outcomes were balance and spatiotemporal gait parameters; cognition was a secondary outcome. Primary and secondary measures were examined at baseline, immediately post-treatment, and three months post-treatment.
Results
From baseline to post-treatment, GB showed greater reductions in postural sway compared to GA. The mean differences in stability indices were 1.461±1.240, 0.982±1.185, and 1.006±0.982 in GB, vs. 0.581±1.503, 0.426±1.459, and 0.374±1.072 in GA. For gait parameters (gait velocity, stride length, and cadence), GB demonstrated larger improvements, with mean differences of -0.361±0.245, -0.242±0.158, and -11.606±12.628, compared to -0.155±0.254, -0.191±0.248, and -4.516±10.773 in GA. PD-Cognitive Rating Scale improved more substantially in GB (-16.091±6.978) than in GA (-1.129±4.552). These gains in postural stability, gait, and cognition were statistically significant (p<0.001) and sustained at the 3-month follow-up.
Conclusion
Computerized cognitive training as an add-on in the rehabilitation of PD is efficient in improving postural stability and locomotion, as well as the cognitive performance. The consistency of these findings for 3 months is an imperative point in the clinical course of PD patients.

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Efficacy of Adding Lower Extremity Weights on Balance and Gait Disturbances in Children with Ataxic Cerebral Palsy: A Randomized Controlled Trial
Nehad A Abo-zaid, Heba A Khalifa, Tamer M Shousha, Mohamed Y Abdelsamee, Walaa E Heneidy
NeuroRehabilitation.2026;[Epub] CrossRef

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Post-stroke Aphasia as a Prognostic Factor for Cognitive and Functional Changes in Patients With Stroke: Ischemic Versus Hemorrhagic: Kyung Cheon Seo, Joo Young Ko, Tae Uk Kim, Seong Jae Lee, Jung Keun Hyun, Seo Young Kim; Ann Rehabil Med 2020;44(3):171-180. Published online June 30, 2020; DOI: https://doi.org/10.5535/arm.19096

Abstract
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Objective
To investigate the comprehensive outcomes in aphasic patients, including their cognitive and functional status after ischemic or hemorrhagic stroke. It also aimed to clarify whether aphasia is a prognostic factor for cognitive and functional improvements in stroke patients.
Methods
Sixty-seven ischemic or hemorrhagic stroke patients in the subacute stage who had been diagnosed with aphasia using the Korean version of Frenchay Aphasia Screening Test (K-FAST) were included in the study. Forty-six stroke patients without aphasia were used as controls. All patients were examined with the Korean version of the Western Aphasia Battery (K-WAB). Cognitive and functional assessments of the patients including the Korean version of Mini-Mental State Examination (K-MMSE), and the Korean version of Modified Barthel Index (K-MBI) were performed during admission and 4 weeks after the initial assessments.
Results
The initial and follow-up total K-MMSE and K-MBI scores were significantly lower in aphasic patients than in non-aphasic controls. The K-WAB scores highly correlated with the total K-MMSE scores at the follow-up stage in all aphasic stroke patients. The K-WAB scores moderately correlated with the follow-up scores of the K-MBI in ischemic stroke patients but not in hemorrhagic stroke patients.
Conclusion
Aphasia influences the cognitive and functional status of stroke patients and has a greater impact on cognitive improvement. Aphasia severity can be one of the prognostic factors for cognitive status in aphasic patients with stroke.

Citations

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Possibilities of functional outcome prediction in patients with acute ischemic stroke, who did not receive reperfusion therapy
A. M. Tynterova, N. N. Shusharina, M. S. Khoimov, A. N. Nikishova, G. G. Osadchii
Russian neurological journal.2025; 30(1): 16. CrossRef
Factors influencing the choice of rehabilitation measures for a disabled person with consequences of acute stroke
Olga I. Khokhlova, Elena M. Vasilchenko, Yana A. Denisova
Medical and Social Expert Evaluation and Rehabilitation.2025; 28(1): 39. CrossRef
The effectiveness of drug therapy in the rehabilitation of patients with post-stroke aphasia
S.V. Kotov, E.V. Isakova, M.M. Shcherbakova, V.A. Zenina
S.S. Korsakov Journal of Neurology and Psychiatry.2024; 124(11): 132. CrossRef
The Effect of Rehabilitation without Specific Cognitive Rehabilitation on the Improvement of Cognitive Functions in Stroke Patients: Evaluation with Risk Factors
İlker Fatih SARI, Evren ER, İlker İLHANLI, Fazıl KULAKLI, Nurçe ÇİLESİZOĞLU YAVUZ
Medical Records.2023; 5(2): 277. CrossRef
A Novel Telerehabilitation Approach for Cognitive-Language Therapy in Chronic Stroke Subjects With Aphasia: Neurocognitive Intervention Through Neurorehabilitation Exercises and Assessments
Francesco Infarinato, Paola Romano, Francesco Adinolfi, Marco Franceschini, Roberta Ginocchi, Michela Goffredo, Marco Ottaviani, Marianna Valente, Sanaz Pournajaf
IEEE Robotics & Automation Magazine.2023; 30(1): 84. CrossRef
Comparing the brain–behaviour relationship in acute and chronic stroke aphasia
Natalie Busby, Argye E Hillis, Lisa Bunker, Chis Rorden, Roger Newman-Norlund, Leo Bonilha, Erin Meier, Emily Goldberg, Gregory Hickok, Grigori Yourganov, Julius Fridriksson
Brain Communications.2023;[Epub] CrossRef
A Comparative Analysis of Functional Status and Mobility in Stroke Patients with and without Aphasia
Zbigniew Guzek, Wioletta Dziubek, Małgorzata Stefańska, Joanna Kowalska
Journal of Clinical Medicine.2022; 11(12): 3478. CrossRef
Cross-validation of predictive models for functional recovery after post-stroke rehabilitation
Silvia Campagnini, Piergiuseppe Liuzzi, Andrea Mannini, Benedetta Basagni, Claudio Macchi, Maria Chiara Carrozza, Francesca Cecchi
Journal of NeuroEngineering and Rehabilitation.2022;[Epub] CrossRef
Current view on post‐stroke dementia
Jakub Droś, Aleksandra Klimkowicz‐Mrowiec
Psychogeriatrics.2021; 21(3): 407. CrossRef
Cognitive and psychoemotional impairment dynamics in patients with hemorrhagic hemispheric stroke at the early rehabilitation stage
Svitlana Medvedkova, Anastasiia Dronova
Ukrains'kyi Visnyk Psykhonevrolohii.2021; (Volume 29,): 27. CrossRef

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Correlation Between Montreal Cognitive Assessment and Functional Outcome in Subacute Stroke Patients With Cognitive Dysfunction: Kil-Byung Lim, Jiyong Kim, Hong-Jae Lee, JeeHyun Yoo, Eun-Cheol You, Joongmo Kang; Ann Rehabil Med 2018;42(1):26-34. Published online February 28, 2018; DOI: https://doi.org/10.5535/arm.2018.42.1.26

Abstract
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Objective

To investigate the correlation between the Montreal Cognitive Assessment (MoCA) and functional outcome among subacute stroke patients with cognitive dysfunction.

Methods

Records of 61 inpatients were reviewed. Patients were divided into two groups based on their initial MoCA score. MoCA score of 11 was set as the differentiating criterion. We compared the improvements in Modified Barthel Index (MBI) from initial assessment to discharge between the two groups.

Results

There were no significant differences between the two groups in relation to age, duration from onset to admission, hospitalization period, or years of education. In a comparison of the results of Mini-Mental Status Examinations (MMSE) administered at admission and again at discharge, there was significantly more improvement in MMSE scores in the group with low MoCA scores than in the group with high MoCA scores. However, the group with high MoCA scores also showed high MBI scores at discharge and exhibited greater MBI improvement.

Conclusion

Higher initial MoCA scores (which reflect preservation of executive function) indicate better functional outcome in the subacute stroke phase.

Citations

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Effects of NeuroReAlign therapy on cognition in patients with stroke: A randomized controlled trial
Anas R. Alashram
Applied Neuropsychology: Adult.2026; : 1. CrossRef
Anodal Transcranial Direct Current Stimulation as an Adjunct to Physiotherapy in Lacunar Stroke
Ayesha Juhi, Shreya Sharma, Dinesh Bhatia, Suman Dhaka, Rajesh Kumar, Deepak Kumar, Pritam Choudhary , Pradosh Kumar Sarangi, Himel Mondal
Cureus.2026;[Epub] CrossRef
Vitamin D Supplement Intake is Associated with Better Cognition in Persons with Sleep Disturbance and Mild Cognitive Impairment
Sirui Zhou, Paul Sudeshna, Lynn Marie Trotti, Donald Bliwise, Victoria Pak
Sleep Medicine.2026; : 108960. CrossRef
Effects of an Eye-Tracking Digital Serious Game on Cognitive Function in Mild Cognitive Impairment: Pilot Intervention Study
Sang-Woo Lee, Jun-Su Kim, Seung-Jae Kim, Seungho Choun, Jeong-Heon Song
JMIR Formative Research.2026; 10: e88924. CrossRef
Evaluation and significance of cognitive dysfunction after cerebrovascular disease with convalescent rehabilitation. Assessment based on FIM, MMSE and HDS-R
Katsuo Usuda, Takahiko Uesaka, Takeshi Okubo, Takashi Shimada, Chieko Shimada, Haruhide Ito, Norihito Douko, Takuya Aoki, Mio Mizukami, Asami Onojima, Kenshiro Ikemoto, Kengo Kitagawa, Mayumi Takada, Naoaki Itamoto, Osami Shimada
Balneo and PRM Research Journal.2025; 16(Vol 16 No.): 783. CrossRef
Incidence and Factors Associated With Cognitive Impairment 90 Days After First Ever Ischemic Stroke
Małgorzata Dec‐Ćwiek, Paweł Wrona, Tomasz Homa, Joanna Słowik, Aleksandra Bodzioch, Agnieszka Słowik
International Journal of Geriatric Psychiatry.2025;[Epub] CrossRef
Cognitive feature evaluation for disease progression in dementia and its precursors using feature selection
Fadi Thabtah, David Peebles
Health and Technology.2025; 15(6): 1075. CrossRef
Association of Cognitive Impairment After Hemorrhagic Stroke With Psychiatric Outcomes and Functional Status
Saami Zakaria, Hamza Ahmed, Kara R. Melmed, Benjamin Brush, Aaron Lord, Lindsey Gurin, Jennifer Frontera, Koto Ishida, Jose Torres, Cen Zhang, Leah Dickstein, Ethan Kahn, Ting Zhou, Ariane Lewis
The Journal of Neuropsychiatry and Clinical Neurosciences.2025;[Epub] CrossRef
Implementing strategy training in Taiwan: perspectives of individuals with Acquired brain injury
Valeria Chiu, Beth E. Fields, Yen-Nung Lin, Jiunn-Horng Kang, Der-Sheng Han, Yi-Hsuan Wu, Yu Su, Elizabeth R. Skidmore, Feng-Hang Chang
Disability and Rehabilitation.2024; 46(6): 1121. CrossRef
Incidence and predictors of post-stroke cognitive impairment among patients admitted with first stroke at tertiary hospitals in Dodoma, Tanzania: A prospective cohort study
Baraka Alphonce, John Meda, Azan Nyundo, Kamal Sharma
PLOS ONE.2024; 19(4): e0287952. CrossRef
Environmental Enrichment and Health Outcomes Among Low-Grade Glioma Brain Tumor Survivors
Karl Cristie F. Figuracion, Christine Mac Donald, David Hunt, Tresa McGranahan, Frances M. Lewis, Jason Rockhill, Myron Goldberg, Lia M. Halasz, Hilaire J. Thompson
Journal of Neuroscience Nursing.2024; 56(6): 229. CrossRef
Impaired Cognition and Stroke Rehabilitation Outcomes: Are They Related?
Eric F. Tanlaka, Torri Trojand
Open Journal of Therapy and Rehabilitation.2024; 12(02): 101. CrossRef
Análisis del estado cognitivo y su relación con la dependencia en las actividades de la vida diaria: un estudio transversal en pacientes con accidente cerebrovascular
Víctor Sánchez Silverio, Vanesa Abuín Porras, Isabel Rodríguez Costa
Revista Científica de la Sociedad Española de Enfermería Neurológica.2022; 56: 4. CrossRef
Analysis of cognitive status and its relationship with activities of daily living dependency: A cross-sectional study in stroke patients
Víctor Sanchez Silverio, Vanesa Abuín Porras, Isabel Rodríguez Costa
Revista Científica de la Sociedad de Enfermería Neurológica (English ed.).2022; 56: 4. CrossRef
Personalized Neurophysiological and Neuropsychological Assessment of Patients with Left and Right Hemispheric Damage in Acute Ischemic Stroke
Anastasia Tynterova, Svetlana Perepelitsa, Arкady Golubev
Brain Sciences.2022; 12(5): 554. CrossRef
The Prognostic Value of Domain-Specific Cognitive Abilities Assessed by Chinese Version of Oxford Cognitive Screen on Determining ADLs Recovery in Patients with Post-Stroke Cognitive Impairment
Miaoran Lin, Jinxin Ren, Jingsong Wu, Jia Huang, Jing Tao, Lidian Chen, Zhizhen Liu, Peng-Yue Zhang
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
Persisting cognitive impairment predicts functional dependence at 1 year after stroke and transient ischemic attack: a longitudinal, cohort study
Xiaoling Liao, Lijun Zuo, Yanhong Dong, Yuesong Pan, Hongyi Yan, Xia Meng, Hao Li, Xingquan Zhao, Yilong Wang, Jiong Shi, Yongjun Wang
BMC Geriatrics.2022;[Epub] CrossRef
Effects of a Tai Chi-Based Stroke Rehabilitation Program on Symptom Clusters, Physical and Cognitive Functions, and Quality of Life: A Randomized Feasibility Study
Rhayun Song, Moonkyoung Park, Taejeong Jang, Jiwon Oh, Min Kyun Sohn
International Journal of Environmental Research and Public Health.2021; 18(10): 5453. CrossRef
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The efficacy of computerized cognitive rehabilitation in improving attention and executive functions in acquired brain injury patients, in acute and postacute phase
Ha Seong KIM, Kil-Byung LIM, Jeehyun YOO, Yong Wook KIM, Sang Wan LEE, Sungsik SON, Changgyu KIM, Jiyong KIM
European Journal of Physical and Rehabilitation Medicine.2021;[Epub] CrossRef
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Jennapher Lingo VanGilder, Cielita Lopez-Lennon, Serene S. Paul, Leland E. Dibble, Kevin Duff, Sydney Y. Schaefer
Frontiers in Rehabilitation Sciences.2021;[Epub] CrossRef
Multiple relationships between cognition-motor impairment and activity-based clinical outcome measures in 218 hemiplegic stroke patients1
Seon Ah Jeong, Chanhee Park, Seung Jun Oh, Joshua (Sung) H. You
NeuroRehabilitation.2021; 49(4): 553. CrossRef
Association Between Early Cognitive Impairment and Midterm Functional Outcomes Among Chinese Acute Ischemic Stroke Patients: A Longitudinal Study
Juan Li, Jing Wang, Bei Wu, Hanzhang Xu, Xiongfeng Wu, Lanshu Zhou, Benqiang Deng
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Richa Sharma, Dania Mallick, Rafael H. Llinas, Elisabeth B. Marsh
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Jin Bong Choi, Kang Jun Cho, Joon Chul Kim, Chung Ho Kim, Yong-An Chung, Hyeonseok S. Jeong, Yong Soo Shim, Jun Sung Koh
Clinical Psychopharmacology and Neuroscience.2019; 17(3): 432. CrossRef
Cognitive Impairment in Patients with Coronary Artery Disease; Comparison of Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE)
Seyed Shahin Eftekhari, Seyed Amir Hejazi, Ehsan Sharifipour, Seyed Fakhreddin Hejazi, Mohsen Talebizadeh, Hossein Mostafavi, Sadegh Yoosefee
Journal of Advances in Medical and Biomedical Research.2018; 26(119): 12. CrossRef

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Assessment of Post-Stroke Cognitive Dysfunction Using 3-Dimensional Virtual Reality Program.: Kim, Deog Young , Joo, So Young , Park, Chang Il , Park, Tae Hun , Park, Ki Deok , Jung, Kang Jae , Lee, Jang Han; J Korean Acad Rehabil Med 2009;33(1):12-20.

Abstract
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Objective
To test the feasibility of newly developed 3- dimensional virtual reality (VR) program for assessing the post-stroke cognitive dysfunction. Method: Thirty five post-stroke patients and twenty normal healthy subjects were recruited in this study, and post-stroke patients were classified into three groups according to the severity of cognitive dysfunction. We developed three dimensional virtual reality program to assess the cognitive function with virtual subway environment from taking a subway to arriving at one's destination. The total score, number of success and cue were obtained during completing virtual tasks. We investigated the test-retest reliability, and the parameters of the 3-dimensional VR program were compared with Korean Mini-mental status examination. Results: All parameters of the VR program were significantly correlated with MMSE score (p＜0.01), and showed the significant difference between patient subgroups and control group (p＜0.05). The test-retest reliability of the VR program was significantly high (p＜0.01). Conclusion: Three dimensional virtual reality program may be helpful to assess the cognitive function in patients with stroke. (J Korean Acad Rehab Med 2009; 33: 12-20)

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Effects of Amantadine Therapy on Seizure Development in the Patients with Brain Injury and Stroke.: Park, Jae Heung , Sohn, Hyun Joo , Ko, Hyun Yoon , Park, In Sun; J Korean Acad Rehabil Med 2004;28(2):117-121.

Abstract
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Objective
The objective of this study was to evaluate incidence and risk factors of seizure development during amantadine therapy for the patients with brain injury and stroke. Method: Thirty subjects (15 subjects with traumatic brain injuries and 15 subjects with strokes) who received a 4-week trial of amantadine from 100 mg/day to 400 mg/day were included. Control group, 40 patients (20 subjects with traumatic brain injuries and 20 subjects with strokes), did not take any brain stimulant. There were no differences in number, age, lesion area, and cognitive levels between two groups. Incidence of seizure in two groups was evaluated. Results: Seizure occurred in 9 subjects in therapy group (30%) and in 1 subject in control group (2.5%). There was higher incidence of seizure in the group treated with amantadine than in the control group. In therapy group, most of the seizures occurred in high dose of 400 mg/day.Conclusion: Amantadine in high dose appeared to be associated with higher incidence of seizure. This study suggested that administration of amantadine in high dose in management of brain injury and stroke should be accompanied with careful monitoring of seizure. (J Korean Acad Rehab Med 2004; 28: 117-121)

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Evoked Potential Findings in Chronic Renal Failure Patients with Retarded Cognitive Function.: Choi, In Sung , Lee, So Young , Kim, Jae Hyung , Lee, Sam Gyu , Rowe, Sung Man; J Korean Acad Rehabil Med 2001;25(6):1001-1006.

Abstract
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Objective: The purpose of this study is to evaluate the relationship between cognitive function and findings of evoked potential study in chronic renal failure patients.

Method: Thirty chronic renal failure patients with cognitive dysfunction were recruited, whose mini-mental state examination (MMSE) scores were less than 24 points. According to the underlying diseases of chronic renal failure, we categorized thirty patients into diabetic group (11 patients) and non-diabetic group (19 patients), and the control-group was composed of 15 normal volunteers. Somatosensory evoked potential (SEP) on stimulating median and posterior tibial nerves, and cortical and spinal conduction time of the motor pathways were valuated.

Results: In tibial nerve SEP, N22-P38 interpeak latencies (IPL) were 18.1⁑4.2 msec in the patient group and 15.7⁑1.9 msec in the control group, respectively. In MEP, cortico-lumbar central motor conduction times (CMCT) were 19.5⁑2.7 and 16.5⁑3.0 msec, respectively. CMCT were prolonged in patients than controls (p＜0.05). There was significant correlation between serum creatinine concentration and N22-P38 IPL (r=0.64, p＜0.05), but, there were no correlations between the underlying diseases of chronic renal failure, duration of disease, MMSE score and cortico-lumbar CMCT, N22-P38 IPL (p＞0.05).

Conclusion: Evoked potentials will be helpful in evaluating the patients with cognitive dysfunction in chronic renal failure.