Remote cognitive rehabilitation in patients post-cerebrovascular accident: an experience report.

Background: Aiming to contribute to the reduction of cognitive impairment, as well as to improve the quality of life of patients affected by stroke, it was proposed to carry out a cognitive rehabilitation focused on attentional aspects (sustained, alternate, selective and divided attention). Due to the new Coronavirus pandemic and the need for social isolation, the rehabilitation was adapted to the remote model.

Methods: The rehabilitation was designed and carried out with six patients, coming from a public neurology outpatient service, who had suffered a stroke within a period of up to one year before the start of rehabilitation. Fifteen sessions of cognitive rehabilitation were carried out, lasting approximately 50 minutes, once a week, for four months. In all functions, the four types of attention were worked on. In addition, there were also unassisted activities performed by the patients after each session.

Results: The protocol was carried out by Psychology and Medicine students, who elaborated and adapted all activities to be performed by video call. The adaptations were made based on the knowledge and effectiveness of face-to-face rehabilitation for this population. Patients and family members collaborated in the activities, but the emergency adaptation to the remote model also had limitations, such as the withdrawal of some patients due to difficulty access or unstable internet connection. However, there were also positive results, such as the possibility of participation by people from other cities and people with mobility difficulties. This experience allowed students to develop skills in interacting with patients, as well as strategies to deal with the challenges of remote care. Thus, it was not necessary to interrupt the students´ education, moreover, the skills developed are important for the e-health context, which is an increasingly present demand in today's world.

Conclusion: Remote cognitive rehabilitation is a possibility for patients who have suffered cognitive impairment due to stroke. Despite the difficulties arising from the pandemic, it was an important experience, with significant value for academic training, which stimulated the skills needed to care for patients, in addition to creativity and adaptation in the face of adversity.