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.