Neuropsychological Memory Rehabilitation After Stroke and Techniques

Cognitive rehabilitation, also called rehabilitation of higher brain functions, is a therapeutic method aimed at improve or compensate neurocognitive deficits produced by processes that affect normal brain function. It is the set of interventions designed to increase the functional capacity of the individual in their daily life.

In this PsychologyOnline article we will talk about the Neuropsychological Rehabilitation of Memory After Stroke and Techniques.

Basically three approaches are used, often complementary:

• Try reduce disturbances cognitive and behavioral.
• Teach to handlethose alterations.
• Modify the environment so that it is less demanding.

Various neurological diseases or psychological conditions can cause difficulties in the capacities of attention, memory, language, reasoning, organization, etc. Through cognitive rehabilitation therapy, it is sought either restore or compensate for those functions through learning other skills

Restoration

Is about

Substitution

The use of alternative skills promoting a functional reorganization from intact brain systems and structures. That is, exercises are carried out aimed at strengthening healthy brain connections so that they replace the function performed by the connections that have been damaged. This is based on the fact that the brain's organization of functions is somewhat redundant (neural systems in parallel). For example, there are several motor systems that are complementary so that if one fails, others can at least partially replace its function.

Compensation

Minimization of the impact of cognitive alterations to achieve greater functional autonomy. It is the use of alternative strategies or external aids to replace impaired cognitive functions.

Between the general strategies compensatory strategies or memory aids are found to intervene in memory difficulties external (SMA), from which it is sought to reduce the impact of the patient's cognitive deficits in life daily. The use of these tools in memory rehabilitation has been considered the most important approach to functional rehabilitation of this cognitive function, since it really helps to compensate for the deficit after alterations in memory. The different procedures that can be used to work with memory problems refer to:

External aid

Agendas, alarms, calendars, plans, diaries, labels... in many cases they avoid the problems that affect daily operation. There are those aids aimed at adaptation of the environment, those that facilitate the patient access to previously stored information and those aids that facilitate the storage or consultation of the information (agendas).

Mnemonic strategies

That favor the association and organization of the elements, and the deeper processing of the information. They may be:

• Verbal or visual: It is important to study the injured area well, especially those localized strokes, since the hemisphere right has more involvement in the processing of visual images and the left predominates in the processing verbal; in such a way that those strategies that activate the hemisphere not damaged by the CVA will be used.
• Surface or deep processing: There is ample evidence that indicates that the most effective strategies are those that favor the organization of the material.

Utilization of preserved memory systems

To try to make up for, in part, the consequences of memory deficits from the patients. The spaced recovery technique (RE) is part of a set of techniques designed for learning knowledge specific from the implicit memory preserved, in order to favor the autonomy of the patient in life activities daily.

Another technique that helps patients remember their past (retrograde memory) is the Reminiscence Therapy: Reminiscence Therapy helps to remember, in a natural way, past experiences to stimulate the ability to self-recognition and maintenance of identity.

The general structure of this cognitive stimulation technique generally requires two steps:

• First, the patient is taught a material (photograph or story of an event) linked to his own experience or to the events of her generation.
• From this material, the patient will evoke a series of associated memories and will make personal comments.

It is intended to enhance the autobiographical episodic memory (personal memories) and memory semantics (containing knowledge about relevant historical data), as well as recalling the personal events and historical facts with as much clarity as possible, experiencing the emotions linked to those memories.

This therapy can be done in individual sessions but frequently includes group meetings, at least once a week, with patients who are approximately the same age (due to generational experiences Similar). Among the materials that are usually used in reminiscence sessions, we can find the following:

• Memories box: In it, personal objects of a patient or materials that are common to a group of patients of the same generation are collected. Photographs, music, clothing, documentation, etc. can be included.
• Autobiographical book or Book of Memory: It is usually used with the help of the therapist and, usually, also of a family member who knows the life of the patient very closely.
• Sociohistorical and / or cultural data: It consists of collecting information on the most important historical, social and cultural events of the generation of patients to, after that, read this information one by one in different sessions and cause comments on their experiences of such event.

It should produce the following positive aspects:

• Help maintain and reinforce self-esteem, highlighting elements and positive aspects of memories.
• Highlight the experience and accumulated wisdom, offering opportunities for expression and sharing with others.
• Avoid the stereotype that the patient is an old man or a sick person, facilitating the maintenance of the sense of personal identity.
• The time spent on reminiscence should be turned into a positive and stimulating experience.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

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