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Cognitive training perspectives show no significant far transfer effects in acute stroke rehabilitation trialCan changing how stroke patients think about space help their mood and movement?

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Key Takeaway
Note: Adding perspective-based cognitive training showed no significant far transfer benefits in acute stroke rehabilitation.

A randomized clinical trial enrolled 128 patients with acute stroke to compare conventional rehabilitation alone (control) against conventional rehabilitation supplemented with either allocentric perspective cognitive training or egocentric perspective cognitive training. The primary outcome was far transfer effects on emotional state and psychomotor functions, with secondary measures including cognitive function (Addenbrooke Cognitive Evaluation-III), depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7 scale), and psychomotor function (Finger Tapping Test).

After the 2-week intervention period, no statistically significant differences were found between groups for anxiety (F(2, 111)=0.056, p=0.945, η=0.058), depression (F(2, 109)=0.831, p=0.160, η=0.074), psychomotor function in the dominant hand (F(2, 111)=0.059, p=0.943, η=0.001), or psychomotor function in the non-dominant hand (F(2, 108)=1.375, p=0.257, η=0.290). Absolute numbers for these outcomes were not reported.

Safety and tolerability data were not reported. The trial had several limitations including a non-blind design and very short follow-up period of only 2 weeks, which limits assessment of longer-term effects. While the RCT design allows for causal inference, the lack of significant findings for any measured outcomes suggests that adding these specific cognitive training perspectives to conventional rehabilitation may not provide additional benefit for the far transfer outcomes studied in acute stroke patients over this timeframe.

When someone has a stroke, the road to recovery involves not just physical therapy, but also managing the emotional toll and regaining fine motor skills. Researchers wondered if adding a specific type of mental exercise—training patients to think about space from different perspectives—to standard rehab could give patients a meaningful boost in these areas.

They tested this idea in 128 people recovering from an acute stroke. One group received only conventional rehabilitation. Two other groups received the same conventional rehab plus extra cognitive training focused on either an 'allocentric' (object-centered) or 'egocentric' (self-centered) perspective. After the two-week program, the researchers looked for 'far transfer' effects—improvements in mood, anxiety, and psychomotor function (like finger tapping speed) that might carry over from the mental training.

The key finding was that neither type of added perspective training led to significantly better outcomes than conventional rehab alone. Measures of depression, anxiety, and psychomotor function in both hands showed no meaningful differences between the groups. It's important to note this was a single study with a short follow-up period, and the trial was not 'blinded,' meaning patients and therapists knew which treatment was being given, which can sometimes influence results. The study did not report on safety issues or whether anyone dropped out.

What this means for you:
Adding perspective-based cognitive training to stroke rehab didn't improve mood or movement more than standard care in this study.

Study Details

Study typeRct
Sample sizen = 128
EvidenceLevel 2
Follow-up0.5 mo
PublishedApr 2026
View Original Abstract ↓
OBJECTIVE: This study aimed to evaluate the role of egocentric and allocentric perspectives in facilitating far transfer (improvement of emotional state and psychomotor functions) following cognitive training in stroke patients. METHODS: In a three-arm, non-blind, randomized clinical trial, 128 patients with acute stroke were randomly allocated to one of the following groups: 1) control, 2) allocentric perspective, or 3) egocentric perspective groups. Each group received a 2-week intervention, with the experimental groups completing an additional 10 sessions. Cognitive function was measured by the Addenbrooke Cognitive Evaluation-III, depression by the Patient Health Questionnaire-9, anxiety by the Generalized Anxiety Disorder-7 scale, and psychomotor function by the Finger Tapping Test. RESULTS: Cognitive training tasks based on allocentric and egocentric perspectives, when combined with conventional rehabilitation, did not yield a statistically significant far transfer effect compared to conventional rehabilitation alone. No significant differences between-groups were observed for changes in anxiety (F(2, 111) = .056, p = .945, η = .058), depression (F(2, 109) = 0.831, p = .160, η = .074), or dominant (F(2, 111) = 0.059, p = .943, η = .001) and non-dominant (F(2, 108) = 1.375, p = .257, η = .290) psychomotor functions. CONCLUSION: The incorporation of an allocentric and egocentric perspective based cognitive training tasks in conventional rehabilitation do not provide significantly better improvements in emotional state and psychomotor functions. The ISRCTN clinical trial registry (https://doi.org/10.1186/ISRCTN14922230).
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