Enhancing poststroke cognitive recovery with Mindlenses, a combined prism adaptation and serious game device: a randomized controlled trial

Background: Cognitive impairment is highly prevalent after stroke, and effective long-term rehabilitation strategies remain limited. Mindlenses Professional is a medical device that combines prism adaptation, delivered through wearable prismatic glasses, with tablet-based digital cognitive training using serious games. Objective: To evaluate the efficacy of Mindlenses Professional, compared with standard paper-and-pencil cognitive rehabilitation, on multiple cognitive outcomes in participants with stroke over a 6-month follow-up. Methods: In this randomized controlled clinical trial, 60 participants with stroke underwent 10 rehabilitation sessions over 2 weeks. Neuropsychological assessments were performed at baseline (T0), immediately after treatment (T1), and at 3- and 6-month follow-ups (T2–T3). Composite scores were computed for visual perception, hemineglect, language, memory, and executive functions. Longitudinal changes were analyzed using linear and generalized linear mixed-effects models, with group, lesion side, and time as fixed factors. Results: Compared with standard rehabilitation (control group), the use of Mindlenses Professional induced greater and sustained improvements in hemineglect and language. The experimental group showed significant advantages for hemineglect at 3 months and for language at all posttreatment time points. In the memory domain, significant gains emerged from 3 months onward and further increased at 6 months. Executive functions improved in both groups, with a differential temporal pattern influenced by lesion side and a marked long-term advantage in participants with right-hemisphere stroke treated with Mindlenses. Visuoperceptual performance remained stable in the experimental group, whereas it declined over time in the control group. Conclusion: These findings support the integration of prism adaptation and digital cognitive training as a safe, feasible, and promising approach for long-term poststroke cognitive rehabilitation. Clinical trial registration: NCT07322614; retrospectively registered on January 7, 2026.