Background: The multi-tasking approach may be promising for cognitive rehabilitation in cardiac surgery patients due to a significant effect on attentional and executive functions. This study aimed to compare the neuropsychological changes in patients who have undergone two variants of multi-tasking training and a control group in the early postoperative period of coronary artery bypass grafting (CABG). Methods: One hundred and ten CABG patients were divided into three groups: cognitive training (CT) I (a postural balance task with mental arithmetic, verbal fluency, and divergent tasks) (n = 30), CT II (a simple visual–motor reaction with mental arithmetic, verbal fluency, and divergent tasks) (n = 40), and control (n = 40). Results: Two or more cognitive indicators improved in 93.3% of CT I patients, in 72.5% of CT II patients, and in 62.5% of control patients; CT I patients differed from CT II and control (p = 0.04 and p = 0.008, respectively). The improving short-term memory and attention was found more frequently in the CT I group as compared to control (56.7% vs. 15%; p = 0.0005). The cognitive improvement of all domains (psychomotor and executive functions, attention, and short-term memory) was also revealed in CT I patients more frequently than CT II (46.7% vs. 20%; p = 0.02) and control (46.7% vs. 5%; p = 0.0005). Conclusions: The CT I multi-tasking training was more effective at improving the cognitive performance in cardiac surgery patients as compared to CT II training and standard post-surgery management. The findings of this study will be helpful for future studies involving multi-tasking training.

Aim. To evaluate the effectiveness of dual-task computerized cognitive training (CCT) in the prevention of postoperative cognitive dysfunction in patients after on-pump coronary artery bypass grafting (CABG).Material and methods. This cohort prospective study included 68 patients (median age, 64 years [54; 69]) admitted for elective on-pump CABG. In addition to the standard preoperative examination, all patients underwent advanced neuropsychological and neurophysiological examination. Starting from 3-4 days of the postoperative period, all patients underwent dual-task CCT.Results. After 8-10 days, early postoperative cognitive dysfunction was observed in 37 (54,4%) patients from CCT group, while in patients without training in 69,3% of cases (n=79). The best results of cognitive functioning were achieved in neurodynamics and short-term memory. In addition, in patients who completed the training course, a postoperative increase in the frontooccipital gradient of theta rhythm was observed.Conclusion. Neuropsychological and neurophysiological assessment have demonstrated the limited effectiveness of a short-term dual task CCT using in the prevention of early postoperative cognitive dysfunction in patients after on-pump CABG. The dual task method can be an additional preventive intervention in the development of a personalized approach to cognitive rehabilitation therapy in cardiac surgery patients.

Aim. To assess the effects of cognitive rehabilitation with dual-task training that involves a cognitive task combined with postural and walking control, as well as electroencephalogram indices in patients in the early postoperative period after direct myocardial revascularization.Methods. The study enrolled 48 patients scheduled for coronary artery bypass graft surgery. Subjects in this prospective, randomized study were randomized using envelopes to a postoperative cognitive training group (n = 23) and non-training group (n = 25). The cognitive training was carried out daily, starting 3-4 days after the procedure and until the discharge order. Dual tasks training (a cognitive task combined with postural and walking control) lasted 15-20 minutes. All patients were submitted to an extended neurophysiological assessment (psychometric tests and electroencephalogram study) and stabilography 3-5 days before and 8-11 days after coronary artery bypass grafting.Results. The patients who underwent cognitive training experienced postoperative cognitive dysfunction (POCD) in 39% cases in the early postoperative period after intervention, while the non-training group - in 64%. The relative risk of developing POCD in the non-training group was 2.77 (95% CI: 0.86-8.91, Z = 1.704, p = 0.08). The patients in cognitive training exhibited better cognitive state compared to the preoperative state (Z = 2.58; p = 0.01) in the absence of statistically significant differences in the non-training group. Moreover, type-1 theta power values increased in the non-training group in comparison to the preoperative values, while the cognitive training group did not have a statistically significant difference in theta power.Conclusion. Positive effects of dual task rehabilitation on the neurophysiological parameters of patients undergoing direct myocardial revascularization were demonstrated. Positive effects include lower frequency of POCD, improved cognitive state and less pronounced cortical dysfunction. The dual task training had proved a suitable training method for this category of patients. Additional studies are required to test the possibility of increasing the duration and intensity of dual task training for stronger recovery effect and improved cognitive and walking performance of patients in the postoperative period after direct myocardial revascularization.

Background. Previously, it has been demonstrated that the use of the dual-task method (performance cognitive and motor tasks simultaneously) in cognitive rehabilitation provides sustainable improvements in cognitive and motor functions. However, the effectiveness of the dual-task method in cardiac surgery patients has not been studied enough yet. Aim. To evaluate the effectiveness of the training for recovering cognitive function using a computer program of dual tasks in the early postoperative period of on-pump coronary artery bypass surgery (CABG). Material and methods. Sixty-two patients aged 64 [60; 69] years were examined before surgery and divided into two groups: with postoperative cognitive training (n=29) and without cognitive rehabilitation (n=33). The extended neuropsychological testing was performed 23 days before and 89 days after CABG to assess the psychomotor and executive functions (neurodynamic), attention and short-term memory, as well as the serum concentrations of markers of brain damage: neuron-specific enolase and S100 protein were measured. Results. The data of preoperative extended neuropsychological testing did not demonstrate between-group differences. At 810 days after CABG, 20% decrease of the cognitive indicators was detected in patients of both groups. In the group with cognitive training, the number of patients with impaired memory, attention and neurodynamics was significantly lower than in the group without training. Also, in patients who underwent cognitive rehabilitation, there was no increase in the concentrations of neuron-specific enolase and calcium-binding protein S100 compared to preoperative values, in contrast to patients without rehabilitation. Conclusion. The use of dual tasks computer program demonstrated a decrease in the severity of cognitive impairment after surgery.

Background: The use of virtual reality (VR) has great potential for medical research and practice, which can help expand rehabilitation activities. This study aimed to evaluate the acceptability and feasibility of the original protocol VR multitasking cognitive training (CT) in both a healthy group and cardiac surgery patients. Methods: A specialized hardware and software complex was developed and tested on both a group of 25 practically healthy individuals, mean age 22.9 years (SD 2.57), and 25 cardiac surgery patients, mean age 62.2 years (SD 7.35). The participants were instructed to complete one session of multitasking CT within the VR complex. Psychometric testing and EEG studies were conducted. Results: All participants were highly accepting of the intended future use, attitude, and pleasure of the training. The healthy subjects demonstrated a statistically significant improvement in attention and spatial skills after VR (p ˂ 0.05). The EEG data revealed a significant increase in alpha power compared to pre-experiment levels (p ˂ 0.0001). The theta/alpha ratio significantly decreased after the VR multitasking CT as compared to the baseline (p ˂ 0.0001). Conclusions: The data obtained indicate that the original training protocol for multitasking CT using VR is acceptable and easy to use for both healthy individuals and cardiac surgery patients.

Aim. To compare the incidence of postoperative cognitive dysfunction and neuropsychological changes in the early postoperative period of coronary artery bypass grafting (CABG) in patients who underwent two versions of multitask cognitive training, which involved various cognitive and motor tasks, as well as in a control group.Material and methods. The study included 100 patients after elective CABG. All patients were randomly divided into three following groups: cognitive training (CT) 1 (postural balance combined with mental arithmetic, verbal fluency, and unusual object use tasks) (n=30), CT 2 (simple visual-motor response combined with task on mental arithmetic, verbal fluency and unusual object use) (n=35) and without training (standard postoperative therapy) (n=35). All patients underwent extensive neuropsychological testing before CABG. Reexamination with assessment of postoperative cognitive dysfunction (POCD) was carried out on days 2-3 and upon completion of 5-7 days of training or on days 11-12 after CABG.Results. The presence of POCD on days 2-3 was found in 100% of patients in the study groups. On days 11-12 of CABG, POCD persisted in 17 people (56,7%) from the CT 1 group, in 24 (68,6%) from the CT 2 group, and in 28 (80%) patients in the control group. Significant differences were obtained in the POCD prevalence in the CT 1 and control groups (odds ratio =3,06; 95% confidence interval: 1,02-9,18, p=0,04), but not CT 2 and control groups (odds ratio =1,83; 95% confidence interval: 0,64-5,47, p=0,28).Conclusion. Multitask training using a combination of postural balance and mental arithmetic tasks, verbal fluency, and unusual object use had a greater effect in reducing the POCD incidence in patients after CABG compared with standard postoperative care. The results of this study may be used to develop cognitive rehabilitation programs in cardiology and cardiac surgery.