Early Motor-Cognitive Integrative Training on Cognitive and Motor Performance in Patients With Aneurysmal Subarachnoid Hemorrhage

Early motor-cognitive integrative training (e-MCIT) is an approach where motor and cognitive training are conducted simultaneously (illustrated in Table 1). The intervention consists of 30-minute sessions, conducted 4-5 times per week, until discharging from the hospital. Both motor and cognitive training have five stages each, and their progression is independent, meaning that during training, a participant might be in the fourth stage of motor training and the second stage of cognitive training. According to hospital's policy, occupational therapy and speech therapy will be provided in schedule if needed.

It progresses through various stages, including raising the head of the bed, sitting up, standing, transferring to a wheelchair, marching in place, and walking. Additionally, the training includes general rehabilitation activities such as range of motion exercises, bed exercises, strengthening exercise, balance training and motor facilitation. To regulate appropriate training, range of motion exercises begin with passive range of motion (PROM) exercises and progress to assisted-active range of motion (AAROM) and active range of motion (AROM) exercises gradually according to the participant's ability to follow instructions. These exercises include all upper and lower extremities. Bed exercises consist of mat exercises, which focus on the lower extremities and core muscles, and bed mobility training.