Competition Enhances the Effectiveness and Motivation of Attention Rehabilitation After Stroke. A Randomized Controlled Trial

Attention deficits are among the most common cognitive impairments observed after experiencing stroke. However, a very limited number of studies have investigated the effectiveness of interventions that specifically focus on the rehabilitation of attention deficits among subjects with impaired atten...

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Main Authors: María Dolores Navarro, Roberto Llorens, Adrián Borrego, Mariano Alcañiz, Enrique Noé, Joan Ferri
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-09-01
Series:Frontiers in Human Neuroscience
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fnhum.2020.575403/full
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author María Dolores Navarro
Roberto Llorens
Roberto Llorens
Adrián Borrego
Mariano Alcañiz
Enrique Noé
Joan Ferri
author_facet María Dolores Navarro
Roberto Llorens
Roberto Llorens
Adrián Borrego
Mariano Alcañiz
Enrique Noé
Joan Ferri
author_sort María Dolores Navarro
collection DOAJ
description Attention deficits are among the most common cognitive impairments observed after experiencing stroke. However, a very limited number of studies have investigated the effectiveness of interventions that specifically focus on the rehabilitation of attention deficits among subjects with impaired attention. Although several interventions have included the use of computerized programs to provide dynamic stimuli, real-time performance feedback, and motivating tasks, existing studies have not exploited the potential benefits of multi-user interactions. Group-based and competitive interventions have been reported to be more enjoyable and motivating, depending on individual traits, and may potentially be more demanding, which may increase their effectiveness. This study investigated the effectiveness and motivating abilities of an intervention specifically designed to address attention deficits. This intervention combined paper-and-pencil tasks and interactive, computerized, multi-touch exercises, which were administered, either non-competitively or competitively, to a group of 43 individuals with chronic stroke. The mediating effects of competitiveness were evaluated for both intervention effectiveness and motivation. Participants were randomly sorted into two groups and underwent 20 one-hour group-based sessions, during which they either worked individually or competed with peers, according to their group allocation. Participants were assessed before and after the intervention, using the Conners' Continuous Performance Test, the d2 Test of Attention, the Color Trail Test, the Digit Span Test, and the Spatial Span Test. The competitiveness and subjective experiences of the participants after the intervention were investigated with the Revised Competitiveness Index and the Intrinsic Motivation Inventory, respectively. The results showed that participants who competed demonstrated significantly greater improvements in all cognitive abilities, except for divided attention, and reported greater enjoyment than their non-competitive peers. Both groups reported comparable levels of perceived competence, pressure, and usefulness. Interestingly, the competitiveness of the participants did not alter either the effectiveness or the subjective experience of the intervention. These findings suggest that competition might enhance the effectiveness and enjoyment of rehabilitation interventions designed to address attention deficits in individuals post-stroke, regardless of their level of competitiveness and without having a negative effect on their perceived pressure and competence.
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spelling doaj.art-3ad08532cad040f5b62d70c9c13a416c2022-12-22T01:31:06ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612020-09-011410.3389/fnhum.2020.575403575403Competition Enhances the Effectiveness and Motivation of Attention Rehabilitation After Stroke. A Randomized Controlled TrialMaría Dolores Navarro0Roberto Llorens1Roberto Llorens2Adrián Borrego3Mariano Alcañiz4Enrique Noé5Joan Ferri6NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Vithas, València, SpainNEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Vithas, València, SpainNeurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, València, SpainNeurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, València, SpainNeurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, València, SpainNEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Vithas, València, SpainNEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Vithas, València, SpainAttention deficits are among the most common cognitive impairments observed after experiencing stroke. However, a very limited number of studies have investigated the effectiveness of interventions that specifically focus on the rehabilitation of attention deficits among subjects with impaired attention. Although several interventions have included the use of computerized programs to provide dynamic stimuli, real-time performance feedback, and motivating tasks, existing studies have not exploited the potential benefits of multi-user interactions. Group-based and competitive interventions have been reported to be more enjoyable and motivating, depending on individual traits, and may potentially be more demanding, which may increase their effectiveness. This study investigated the effectiveness and motivating abilities of an intervention specifically designed to address attention deficits. This intervention combined paper-and-pencil tasks and interactive, computerized, multi-touch exercises, which were administered, either non-competitively or competitively, to a group of 43 individuals with chronic stroke. The mediating effects of competitiveness were evaluated for both intervention effectiveness and motivation. Participants were randomly sorted into two groups and underwent 20 one-hour group-based sessions, during which they either worked individually or competed with peers, according to their group allocation. Participants were assessed before and after the intervention, using the Conners' Continuous Performance Test, the d2 Test of Attention, the Color Trail Test, the Digit Span Test, and the Spatial Span Test. The competitiveness and subjective experiences of the participants after the intervention were investigated with the Revised Competitiveness Index and the Intrinsic Motivation Inventory, respectively. The results showed that participants who competed demonstrated significantly greater improvements in all cognitive abilities, except for divided attention, and reported greater enjoyment than their non-competitive peers. Both groups reported comparable levels of perceived competence, pressure, and usefulness. Interestingly, the competitiveness of the participants did not alter either the effectiveness or the subjective experience of the intervention. These findings suggest that competition might enhance the effectiveness and enjoyment of rehabilitation interventions designed to address attention deficits in individuals post-stroke, regardless of their level of competitiveness and without having a negative effect on their perceived pressure and competence.https://www.frontiersin.org/article/10.3389/fnhum.2020.575403/fullattentioncompetitionmotivationcompetitivenessstrokecognitive rehabilitation
spellingShingle María Dolores Navarro
Roberto Llorens
Roberto Llorens
Adrián Borrego
Mariano Alcañiz
Enrique Noé
Joan Ferri
Competition Enhances the Effectiveness and Motivation of Attention Rehabilitation After Stroke. A Randomized Controlled Trial
Frontiers in Human Neuroscience
attention
competition
motivation
competitiveness
stroke
cognitive rehabilitation
title Competition Enhances the Effectiveness and Motivation of Attention Rehabilitation After Stroke. A Randomized Controlled Trial
title_full Competition Enhances the Effectiveness and Motivation of Attention Rehabilitation After Stroke. A Randomized Controlled Trial
title_fullStr Competition Enhances the Effectiveness and Motivation of Attention Rehabilitation After Stroke. A Randomized Controlled Trial
title_full_unstemmed Competition Enhances the Effectiveness and Motivation of Attention Rehabilitation After Stroke. A Randomized Controlled Trial
title_short Competition Enhances the Effectiveness and Motivation of Attention Rehabilitation After Stroke. A Randomized Controlled Trial
title_sort competition enhances the effectiveness and motivation of attention rehabilitation after stroke a randomized controlled trial
topic attention
competition
motivation
competitiveness
stroke
cognitive rehabilitation
url https://www.frontiersin.org/article/10.3389/fnhum.2020.575403/full
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