Is computer-assisted training effective in improving rehabilitative outcomes after brain injury? A case-control hospital-based study

Luca, Rosaria De; Calabrò, Rocco Salvatore; Gervasi, Giuseppe; Salvo, Simona De; Bonanno, Lilla; Corallo, Francesco; Cola, Maria Cristina De; Bramantı, Placido

doi:10.1016/j.dhjo.2014.04.003

Cited by 53 publications

(72 citation statements)

References 20 publications

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“…With the same outcome measures as used in the current study, two studies did report transfer effects of training to executive functioning, verbal memory [38], and to attention [34]. Compared with our study, their participants were more severely impaired, suggesting that training programs may be more effective for these patients.…”

Section: Discussionmentioning

confidence: 55%

Brain training improves recovery after stroke but waiting list improves equally: A multicenter randomized controlled trial of a computer-based cognitive flexibility training

et al. 2017

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BackgroundBrain training is currently widely used in an attempt to improve cognitive functioning. Computer-based training can be performed at home and could therefore be an effective add-on to available rehabilitation programs aimed at improving cognitive functioning. Several studies have reported cognitive improvements after computer training, but most lacked proper active and passive control conditions.ObjectiveOur aim was to investigate whether computer-based cognitive flexibility training improves executive functioning after stroke. We also conducted within-group analyses similar to those used in previous studies, to assess inferences about transfer effects when comparisons to proper control groups are missing.MethodsWe conducted a randomized controlled, double blind trial. Adults (30–80 years old) who had suffered a stroke within the last 5 years were assigned to either an intervention group (n = 38), active control group (i.e., mock training; n = 35), or waiting list control group (n = 24). The intervention and mock training consisted of 58 half-hour sessions within a 12-week period. Cognitive functioning was assessed using several paper-and-pencil and computerized neuropsychological tasks before the training, immediately after training, and 4 weeks after training completion.Results and conclusionsBoth training groups improved on training tasks, and all groups improved on several transfer tasks (three executive functioning tasks, attention, reasoning, and psychomotor speed). Improvements remained 4 weeks after training completion. However, the amount of improvement in executive and general cognitive functioning in the intervention group was similar to that of both control groups (active control and waiting list). Therefore, this improvement was likely due to training-unspecific effects. Our results stress the importance to include both active and passive control conditions in the study design and analyses. Results from studies without proper control conditions should be interpreted with care.

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Section: Discussionmentioning

confidence: 55%

Brain training improves recovery after stroke but waiting list improves equally: A multicenter randomized controlled trial of a computer-based cognitive flexibility training

et al. 2017

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“…23,25,27,28,31,32,35,36,37,38,46 One intervention program, Cogmed QM, was evaluated by 2 class I studies, 1 class Ia study, and a class III study. Cogmed QM, a working memory training program, incorporates visual and verbal/auditory tasks, adjusting difficulty level according to individual performances.…”

Section: Resultsmentioning

confidence: 99%

Computerized Cognitive Rehabilitation of Attention and Executive Function in Acquired Brain Injury: A Systematic Review

Bogdanova

Yee

et al. 2016

Journal of Head Trauma Rehabilitation

138

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Objective Comprehensive review of the use of computerized treatment as a rehabilitation tool for attention and executive function in adults (aged 18 years or older) who suffered an acquired brain injury. Design Systematic review of empirical research. Main Measures Two reviewers independently assessed articles using the methodological quality criteria of Cicerone et al. Data extracted included sample size, diagnosis, intervention information, treatment schedule, assessment methods, and outcome measures. Results A literature review (PubMed, EMBASE, Ovid, Cochrane, PsychINFO, CINAHL) generated a total of 4931 publications. Twenty-eight studies using computerized cognitive interventions targeting attention and executive functions were included in this review. In 23 studies, significant improvements in attention and executive function subsequent to training were reported; in the remaining 5, promising trends were observed. Conclusions Preliminary evidence suggests improvements in cognitive function following computerized rehabilitation for acquired brain injury populations including traumatic brain injury and stroke. Further studies are needed to address methodological issues (eg, small sample size, inadequate control groups) and to inform development of guidelines and standardized protocols.

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“…However, current practice statements regarding effectiveness of computer program interventions for TBI draw upon one randomised controlled trial (RCT) conducted in 1994 as evidence [90], and the associated computer software is no longer available for scrutiny [123]. Recent research further supports the notion that computer programs for cognitive training may lead to better outcomes for people with cognitive-communicative difficulties after TBI -when used in conjunction with other methods [42,73]. Indeed, Fraas and colleagues (2008) noted positive patient-reported outcomes following an electronic journal-writing intervention, including improved communication, a new awareness of writing ability, personal fulfilment, and empowerment [49].…”

Section: Augmentative and Alternative Communication (Aac) Technologiesmentioning

confidence: 99%

“…The use of computer programs in cognitive-communicative rehabilitation for people with TBI appeared in eight of the included papers (see Table 2), consisting of three systematic reviews [38,91,96], three group comparison trials [42,43,90], and two case series studies [49,73]. Authors of systematic reviews recommend that computer programs be considered and used in conjunction with clinician-guided treatment [38,91,96].…”

Section: Computer Program Interventionsmentioning

confidence: 99%

Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI)

et al. 2017

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distinct from motor speech impairments or primary language impairments (e.g. aphasia), in that the impairments arise from the diffuse axonal injuries which occur in frontal and prefrontal areas of the brain [6]. These impairments can be defined as any aspect of communication that result from underlying deficits in cognition [4,5,7].Communication difficulties after a TBI can affect how a person hears, listens, understands, speaks, reads, writes, and how they engage in conversation and social communication [5]. The underlying deficits of cognition that affect these communicative functions can include slowed information processing; impaired working memory and attention; disorientation and disorganisation; executive function problems including rigidity, poor conceptualization, planning, and problem solving; and poor self-control or selfregulation of cognition or behaviour [4,5]. As a result of these changes in cognitivecommunicative processes, people with TBI have been described as 'overtalkative, inefficient, tangential or drifting from topic to topic, or lacking in language output. ' [4] (p.354). These cognitive-communication impairments can restrict a person's ability to communicate, live independently, return to work or education, participate in society, and build or maintain relationships after their TBI [8].The International Cognitive (INCOG) guidelines for the management of a person's cognitive rehabilitation following TBI highlight that assessment of cognitive-communication skills should incorporate performance in everyday social activities [4]. Adolescents and young adults, the group most at risk of TBI, use digital and online communication MANUSCRIPT ACCEPTED -BRAIN INJURY: 02 FEBRUARY 2017 4 technologies from a young age [9] and, following TBI, involvement in social, academic, and societal situations may be reduced with difficulties using technology and social media [5]. As a result, people with cognitive-communication impairments resulting from a TBI face challenges in accessing information independently and engaging effectively in social networks [8]. However, little is known about how people with cognitive-communication impairments after TBI use and experience digital communication and the internet.Furthermore, clinical guidelines for the assessment of cognitive-communication skills following a TBI do not provide guidance on the use of social media, or of assistive technologies (AT) to support cognitive-communication rehabilitation [4,5].In order to review the existing literature on technology it is essential to consider which types of technology appear in relation to TBI and cognitive-communication. In this study, we considered three major categories of technology: (i) Assistive Technology (AT), being 'any item, piece of equipment, or product, whether it is acquired commercially, includes technology such as email, the internet, and mobile phones [13] which enable users to access, store, transmit, and manipulate information [14]. The multiple purposes of the different types of technology selected ...

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Is computer-assisted training effective in improving rehabilitative outcomes after brain injury? A case-control hospital-based study

Cited by 53 publications

References 20 publications

Brain training improves recovery after stroke but waiting list improves equally: A multicenter randomized controlled trial of a computer-based cognitive flexibility training

Brain training improves recovery after stroke but waiting list improves equally: A multicenter randomized controlled trial of a computer-based cognitive flexibility training

Computerized Cognitive Rehabilitation of Attention and Executive Function in Acquired Brain Injury: A Systematic Review

Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI)

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