Computerised cognitive training in acquired brain injury: A systematic review of outcomes using the International Classification of Functioning (ICF)

Sigmundsdottir, Linda; Longley, Wendy A.; Tate, Robyn

doi:10.1080/09602011.2016.1140657

Cited by 49 publications

(52 citation statements)

References 130 publications

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“…While participants in the CCT group described some increase in goal attainment, performance did not improve beyond WC at any timepoint. These results do not support the generalization of training to real-word benefit; a finding consistent with recent commentary (6,8). Within the context of equivocal memory rehabilitation outcomes to date (10), this study meaningfully contributes to the extant body of literature through confirmation of real-world improvement following group intervention training the use of compensatory memory strategies and highlights the potential utility of MSG in clinical practice.…”

Section: Discussionsupporting

confidence: 39%

“…In addition, the format of delivery differs. CCT training tasks are generally completed individually, with associated well-recognized advantages of low cost, wide availability and potential for at personalized use at home (8). MSG intervention is facilitated by a trained clinician and is delivered face-to-face in a group format, due, in part, to increased recognition of the multifaceted nature of memory dysfunction and limited economic resources (9).…”

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confidence: 99%

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Comparing memory group training and computerized cognitive training for improving memory function following stroke: A phase II randomized controlled trial

Withiel¹,

Wong²,

Ponsford³

et al. 2019

J Rehabil Med

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Memory problems are commonly reported following stroke but receiving help for these difficulties remains a high unmet need among survivors. Two different approaches to memory rehabilitation are available: memory skills group training and computerised cognitive training; however, it is unclear which approach is more effective. This study compared these two approaches in 65 stroke survivors who all reported memory difficulties. We found that participants who received memory group training were more likely to achieve their memory improvement goals than those who received computerised cognitive training. It was concluded that memory skills group training may be a more effective approach to improve memory function in daily life following stroke, but more research is required. Objectives: Memory deficits are common after stroke, yet remain a high unmet need within the community. The aim of this phase II randomized controlled trial was to determine whether group compensatory or computerized cognitive training approaches were effective in rehabilitating memory following stroke. Methods: A parallel, 3-group, single-blind, randomized controlled trial was used to compare the effectiveness of a compensatory memory skills group with restorative computerized training on functional goal attainment. Secondary outcomes explored change in neuropsychological measures of memory, subjective ratings of prospective and everyday memory failures and ratings of internal and external strategy use. Results: A total of 65 community dwelling survivors of stroke were randomized (24: memory group, 22: computerized cognitive training, and 19: wait-list control). Participants allocated to the memory group reported significantly greater attainment of memory goals and internal strategy use at 6-week follow-up relative to participants in computerized training and wait-list control conditions. However, groups did not differ significantly on any subjective or objective secondary outcomes. Conclusion: Preliminary evidence shows that memory skills groups, but not computerized training, may facilitate achievement of functional memory goals for community dwelling survivors of stroke. These findings require further replication, given the modest sample size, subjective nature of the outcomes and the absence of objective eligibility for inclusion.

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Section: Discussionsupporting

confidence: 39%

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confidence: 99%

Comparing memory group training and computerized cognitive training for improving memory function following stroke: A phase II randomized controlled trial

Withiel¹,

Wong²,

Ponsford³

et al. 2019

J Rehabil Med

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“…Recently, reviews have examined technology-based rehabilitation, both for cognitive deficits (Bogdanova et al, 2016 ; Sigmundsdottir et al, 2016 ) and language deficits (Lee and Cherney, 2016 ; Zheng et al, 2016 ) and have found preliminary evidence for the effectiveness of this method of rehabilitation. Importantly, the reviews highlight the need for more research due to vast differences in methodological designs, thereby, limiting the breadth of conclusions that can be drawn about the efficacy of such approaches.…”

Section: Introductionmentioning

confidence: 99%

Technology-Based Rehabilitation to Improve Communication after Acquired Brain Injury

Roches

Kıran

2017

Front. Neurosci.

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The utilization of technology has allowed for several advances in aphasia rehabilitation for individuals with acquired brain injury. Thirty-one previous studies that provide technology-based language or language and cognitive rehabilitation are examined in terms of the domains addressed, the types of treatments that were provided, details about the methods and the results, including which types of outcomes are reported. From this, we address questions about how different aspects of the delivery of treatment can influence rehabilitation outcomes, such as whether the treatment was standardized or tailored, whether the participants were prescribed homework or not, and whether intensity was varied. Results differed by these aspects of treatment delivery but ultimately the studies demonstrated consistent improvement on various outcome measures. With these aspects of technology-based treatment in mind, the ultimate goal of personalized rehabilitation is discussed.

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“…Another review 30 that focused specifically on computerised cognitive training (CCT) in ABI and on outcomes classified within the framework of the International Classification of Functioning, Disability and Health (ICF) 31 included 96 primary studies that evaluated CCT. The authors noted that only 15% of these studies represented 'level 1′ evidence (i.e.…”

Section: Literature Reviewsmentioning

confidence: 99%

A group memory rehabilitation programme for people with traumatic brain injuries: the ReMemBrIn RCT

Nair

Bradshaw

Carpenter

et al. 2019

Health Technol Assess

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Background People with traumatic brain injuries (TBIs) commonly report memory impairments. These are persistent, debilitating and reduce quality of life, but patients do not routinely receive memory rehabilitation after discharge from hospital. Objective To assess the clinical effectiveness and cost-effectiveness of a group memory rehabilitation programme for people with TBI. Design Multicentre, pragmatic, cluster randomised controlled trial. Qualitative and health economic evaluations were also undertaken. Setting Community settings in nine sites in England. Participants Participants were aged 18–69 years, had undergone a TBI > 3 months prior to recruitment, reported memory problems, were able to travel to a site to attend group sessions, could communicate in English and gave informed consent. Randomisation and blinding Clusters of four to six participants were randomised to the memory rehabilitation arm or the usual-care arm on a 1 : 1 ratio. Randomisation was based on a computer-generated pseudo-random code using random permuted blocks of randomly varying size, stratified by study site. Participants and therapists were aware of the treatment allocation whereas outcome assessors were blinded. Interventions In the memory rehabilitation arm 10 weekly sessions of a manualised memory rehabilitation programme were provided in addition to usual care. Participants were taught restitution strategies to retrain impaired memory functions and compensation strategies to enable them to cope with memory problems. The usual-care arm received usual care only. Main outcome measures Outcomes were assessed at 6 and 12 months after randomisation. Primary outcome: patient-completed Everyday Memory Questionnaire – patient version (EMQ-p) at 6 months’ follow-up. Secondary outcomes: Rivermead Behavioural Memory Test – third edition (RBMT-3), General Health Questionnaire 30-item version, European Brain Injury Questionnaire, Everyday Memory Questionnaire – relative version and individual goal attainment. Costs (based on a UK NHS and Personal Social Services perspective) were collected using a service use questionnaire, with the EuroQol-5 Dimensions, five-level version, used to derive quality-adjusted life-years (QALYs). A Markov model was developed to explore cost-effectiveness at 5 and 10 years, with a 3.5% discount applied. Results We randomised 328 participants (memory rehabilitation, n = 171; usual care, n = 157), with 129 in the memory rehabilitation arm and 122 in the usual-care arm included in the primary analysis. We found no clinically important difference on the EMQ-p between the two arms at 6 months’ follow-up (adjusted difference in mean scores –2.1, 95% confidence interval –6.7 to 2.5; p = 0.37). For secondary outcomes, differences favouring the memory rehabilitation arm were observed at 6 months’ follow-up for the RBMT-3 and goal attainment, but remained only for goal attainment at 12 months’ follow-up. There were no differences between arms in mood or quality of life. The qualitative results suggested positive experiences of participating in the trial and of attending the groups. Participants reported that memory rehabilitation was not routinely accessible in usual care. The primary health economics outcome at 12 months found memory rehabilitation to be £26.89 cheaper than usual care but less effective, with an incremental QALY loss of 0.007. Differences in costs and effects were not statistically significant and non-parametric bootstrapping demonstrated considerable uncertainty in these findings. No safety concerns were raised and no deaths were reported. Limitations As a pragmatic trial, we had broad inclusion criteria and, therefore, there was considerable heterogeneity within the sample. The study was not powered to perform further subgroup analyses. Participants and therapists could not be blinded to treatment allocation. Conclusions The group memory rehabilitation delivered in this trial is very unlikely to lead to clinical benefits or to be a cost-effective treatment for people with TBI in the community. Future studies should examine the selection of participants who may benefit most from memory rehabilitation. Trial registration Current Controlled Trials ISRCTN65792154. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 16. See the NIHR Journals Library website for further project information.

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Computerised cognitive training in acquired brain injury: A systematic review of outcomes using the International Classification of Functioning (ICF)

Cited by 49 publications

References 130 publications

Comparing memory group training and computerized cognitive training for improving memory function following stroke: A phase II randomized controlled trial

Comparing memory group training and computerized cognitive training for improving memory function following stroke: A phase II randomized controlled trial

Technology-Based Rehabilitation to Improve Communication after Acquired Brain Injury

A group memory rehabilitation programme for people with traumatic brain injuries: the ReMemBrIn RCT

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