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The present literature regarding patients with breast cancer after chemotherapy treatment indicates increased occurrence of cognitive deficits, particularly in executive function. To explore these deficits, the researchers used an online, computer-based intervention program aimed to improve impaired cognition. The population of this study was a group of female breast cancer survivors who had previously received chemotherapy treatment with or without hormonal therapy. The participants were randomly assigned to the intervention group or the control group. The implemented intervention was a home-based cognitive training computer program accessible through an online subscription to the Lumos Lab, Inc. The intervention group completed the cognitive training computer program, whereas the control group received no treatment. Both the intervention and the control group received pre- and posttests assessing cognition, primarily in the area of executive function.

The components of the computer program were selected to promote improvement in executive function. The program’s exercises provided games that focused on memory, spatial sequencing, route planning, and problem solving. Weekly treatments included five exercises per session, for a total of 48 sessions over a duration of 12 weeks. The difficulty level of the sessions was regulated by the computer program and adapted according to each participant’s progress. The study found that participants who received the intervention showed significant improvements in executive function, cognitive flexibility, and letter fluency (language), ranging from moderate to large effect sizes.

The results of the study indicate immediate improvement in executive function after the cognitive training computer program. However, the limitations of this study include the small sample size and the lack of practical assessments of executive function. Additionally, long-term effects of the treatment could not be determined because of the lack of follow-up assessments.

Therefore, an online computer-based cognitive training program may not be beneficial as a sole intervention for breast cancer survivors with impaired cognition. Nevertheless, such training could be used as an adjunctive home program in congruence with occupational therapy.


A product of the American Occupational Therapy Association's Evidence-based Literature Review Project.


Copyright © 2016 American Occupational Therapy Association. All Rights Reserved. Reproduced here with permission.

Publisher's Statement

Originally published as: Williams, K., Mousley, M., Blank, K., Flores, J., & Li, K. (2016). Critically Appraised Paper for “Cognitive training for improving executive function in chemotherapy-treated breast cancer survivors” Clinical Breast Cancer, 13(4), 153-164. Bethesda, MD: American Occupational Therapy Association, Evidence-Based Practice Project.