Posts Tagged cognitive rehabilitation

[Abstract] Exploiting Awareness for the Development of Collaborative Rehabilitation Systems

Abstract

Physical and cognitive rehabilitation is usually a challenging activity as people with any kind of deficit has to carry out tasks difficult due to their abilities damaged. Moreover, such difficulties become even harder while they have to work at home in an isolated manner. Therefore, the development of collaborative rehabilitation systems emerges as one of the best alternatives to mitigate such isolation and turn a difficult task into a challenging and stimulating one. As any other collaborative system, the need of being aware of other participants (their actions, locations, status, etc.) is paramount to achieve a proper collaborative experience. This awareness should be provided by using those feedback stimuli more appropriate according to the physical and cognitive abilities of the patients. This has led us to define an awareness interpretation for collaborative cognitive and physical systems. This has been defined by extending an existing proposal that has been already applied to the collaborative games field. Furthermore, in order to put this interpretation into practice, a case study based on an association image-writing rehabilitation pattern is presented illustrating how this cognitive rehabilitation task has been extended with collaborative features and enriched
with awareness information

Source: http://scholar.google.gr/scholar_url?url=http://downloads.hindawi.com/journals/misy/aip/4714328.pdf&hl=en&sa=X&scisig=AAGBfm3JVyov5uyNG4mj9U_e1I0YTQ_vvA&nossl=1&oi=scholaralrt

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[Abstract+References] Neuroplastic Changes Induced by Cognitive Rehabilitation in Traumatic Brain Injury: A Review 

Background. Cognitive deficits are among the most disabling consequences of traumatic brain injury (TBI), leading to long-term outcomes and interfering with the individual’s recovery. One of the most effective ways to reduce the impact of cognitive disturbance in everyday life is cognitive rehabilitation, which is based on the principles of brain neuroplasticity and restoration. Although there are many studies in the literature focusing on the effectiveness of cognitive interventions in reducing cognitive deficits following TBI, only a few of them focus on neural modifications induced by cognitive treatment. The use of neuroimaging or neurophysiological measures to evaluate brain changes induced by cognitive rehabilitation may have relevant clinical implications, since they could add individualized elements to cognitive assessment. Nevertheless, there are no review studies in the literature investigating neuroplastic changes induced by cognitive training in TBI individuals.

Objective. Due to lack of data, the goal of this article is to review what is currently known on the cerebral modifications following rehabilitation programs in chronic TBI.

Methods. Studies investigating both the functional and structural neural modifications induced by cognitive training in TBI subjects were identified from the results of database searches. Forty-five published articles were initially selected. Of these, 34 were excluded because they did not meet the inclusion criteria.

Results. Eleven studies were found that focused solely on the functional and neurophysiological changes induced by cognitive rehabilitation.

Conclusions. Outcomes showed that cerebral activation may be significantly modified by cognitive rehabilitation, in spite of the severity of the injury.

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Source: Neuroplastic Changes Induced by Cognitive Rehabilitation in Traumatic Brain Injury: A ReviewNeurorehabilitation and Neural Repair – Valentina Galetto, Katiuscia Sacco, 2017

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[ARTICLE] Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review – Full Text

Neurofeedback therapy (NFT) has been used within a number of populations however it has not been applied or thoroughly examined as a form of cognitive rehabilitation within a stroke population.

Objectives for this systematic review included:

  • i) identifying how NFT is utilized to treat cognitive deficits following stroke,
  • ii) examining the strength and quality of evidence to support the use of NFT as a form of cognitive rehabilitation therapy (CRT) and
  • iii) providing recommendations for future investigations.

Searches were conducted using OVID (Medline, Health Star, Embase + Embase Classic) and PubMed databases. Additional searches were completed using the Cochrane Reviews library database, Google Scholar, the University of Toronto online library catalogue, ClinicalTrials.gov website and select journals. Searches were completed Feb/March 2015 and updated in June/July/Aug 2015. Eight studies were eligible for inclusion in this review.

Studies were eligible for inclusion if they:

  • i) were specific to a stroke population,
  • ii) delivered CRT via a NFT protocol,
  • iii) included participants who were affected by a cognitive deficit(s) following stroke (i.e. memory loss, loss of executive function, speech impairment etc.).

NFT protocols were highly specific and varied within each study. The majority of studies identified improvements in participant cognitive deficits following the initiation of therapy. Reviewers assessed study quality using the Downs and Black Checklist for Measuring Study Quality tool; limited study quality and strength of evidence restricted generalizability of conclusions regarding the use of this therapy to the greater stroke population.

Progression in this field requires further inquiry to strengthen methodology quality and study design. Future investigations should aim to standardize NFT protocols in an effort to understand the dose-response relationship between NFT and improvements in functional outcome. Future investigations should also place a large emphasis on long-term participant follow-up.

Introduction

In 2011, stroke was identified as the third leading cause of death among Canadians (5.5%, 13 283 deaths), and considered to be the leading cause of neurological disability in Canadian adults [12]. Although stroke occurrence is most common in individuals aged 70 and older, stroke incidence for individuals over the age of 50 has increased by 24% and 13% in individuals over the age of 60, in the last decade [3]. Following a stroke, patients typically enter rehabilitation programs (i.e. physical therapy, occupational therapy, etc.) to address a multitude of physical, emotional and cognitive deficits [45]. Many rehabilitation interventions initiated following stroke primarily target functional motor impairments. In reviewing the literature, few investigations have been published that aim to target cognitive deficits, despite 40% of stroke survivors experiencing a decline in cognitive function (especially memory) following stroke [6].

The brain is a highly complex and organized organ therefore the extent of impairment and deficits that follow stroke are largely dependent on lesion severity and location [7]. Physiologically these impairments are a result of the loss of neuronal circuits and connections linked to the relevant sensory, motor, and cognitive functions [89]. Furthermore, it is thought that the neurological recovery that occurs following a stroke is a direct result of brain plasticity and it’s ability to repair and reorganize [10]. Some evidence exists for the initiation of reparative functions in the brain in as little as a few hours following a stroke [1112]. In respect to recovery trajectories following stroke, ninety-five percent of stroke patients reach their peak language recovery within 6 weeks of a stroke, and within 3 months for hemispatial neglect [1314]. Deficits that do not spontaneously resolve contribute to the large number of individuals requiring long term care following stroke (i.e. rehabilitative therapy) [1516]. Occupational and physical rehabilitation programs target functional and mobility issues however, in addition to these impairments patients experience a wide range of cognitive and neurological deficits. Individuals with impairments of this nature often require cognitive rehabilitation therapy (CRT).

CRT encompasses any intervention targeting the restoration, remediation and adaptation of cognitive functions including: attention, concentration, memory, comprehension, communication, reasoning, problem solving, planning, initiation, judgement, self-monitoring and awareness [17]. CRT can be offered in a variety of settings such as rehabilitation hospitals, community care facilities, private residences as well as the workplace [18]. Although cognitive therapy has been around since the early 19th century, the 1970’s marked the most recent biofeedback movement in CRT [18]. Traditionally used to treat muscular impairments (via electromyography (EMG) feedback) biofeedback has taken on a new form known as neurofeedback therapy (NFT). NFT targets the brain and cognitive functions through the use of electroencephalography (EEG), hence neurofeedback is sometimes referred to as EEG biofeedback [19]. In classical NFT, EEG and brainwave activity is provided as a visual or auditory cue to the user [6]. Using these cues the user can consciously adapt their brainwave activity to reach targeted training thresholds. NFT relies on operant conditioning to stimulate the neuroplastic abilities of the brain [2021]. Physiologically stimulating specific band frequencies over damaged areas stimulates cortical metabolism [19]. NFT is also used to counter excessive slow wave activity (i.e. theta waves and sometimes alpha waves) that typically follow stroke [21]. An alternative form of NFT known as nonlinear dynamical neurofeedback has also been used to restore homeostasis to the brain. This form of NFT requires no conscious effort from the participant to adapt their brainwaves in any particular direction (i.e. the participant maintains a passive role). Modalities like NeurOptimal® utilize Functional Targeting to provide the brain with “… information about itself which allows the brain to assemble it’s own, best organizing strategies moment by moment” [22]. In the context of this review, the studies included herein concern the use of classical NFT only.

To date, NFT has been used extensively to treat cognitive deficits associated with other neurological disorders and illnesses including: mild traumatic brain injury [23], ADD/ADHD [24], Epilepsy [25], Autism Spectrum Disorders [2627], Dyslexia [28], Fibromyalgia [29], Depression [30], and opiate additions [31]. Despite promising NFT outcomes within these populations, NFT has not been thoroughly evaluated for use in a stroke population. The aim of this systematic review was to thoroughly evaluate the available evidence pertinent to understanding the effectiveness of NFT as a form of CRT following stroke. To achieve this objective a number of research questions were established to guide this review:

  1. Among a stroke population, how is NFT utilized to treat cognitive deficits?
  2. Among identified NFT interventions targeting a stroke population, what is the quality and strength of evidence to support the use of NFT as a form of CRT following stroke?
  3. Based on the available NFT evidence for use in stroke populations, what recommendations can be made for future research?

 

The primary outcome of interest in this review was to identify if cognitive symptom complaints could be ameliorated following the initiation of NFT in a sub-acute and chronic post-stroke population. Secondary outcomes aimed to assess study quality, methodology and strength of support for use of NFT in this population.

Continue —> Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review

Fig 1. PRISMA flow diagram.

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[Abstract+References] A Serious Games Platform for Cognitive Rehabilitation with Preliminary Evaluation

Abstract

In recent years Serious Games have evolved substantially, solving problems in diverse areas. In particular, in Cognitive Rehabilitation, Serious Games assume a relevant role. Traditional cognitive therapies are often considered repetitive and discouraging for patients and Serious Games can be used to create more dynamic rehabilitation processes, holding patients’ attention throughout the process and motivating them during their road to recovery. This paper reviews Serious Games and user interfaces in rehabilitation area and details a Serious Games platform for Cognitive Rehabilitation that includes a set of features such as: natural and multimodal user interfaces and social features (competition, collaboration, and handicapping) which can contribute to augment the motivation of patients during the rehabilitation process. The web platform was tested with healthy subjects. Results of this preliminary evaluation show the motivation and the interest of the participants by playing the games.

Source: A Serious Games Platform for Cognitive Rehabilitation with Preliminary Evaluation | SpringerLink

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[ARTICLE] Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients – Full Text

Abstract

Background

Stroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patients’ capability to live independently. There is substancial evidence on post-stroke cognitive rehabilitation benefits, but its implementation is generally limited by the use of paper-and-pencil methods, insufficient personalization, and suboptimal intensity. Virtual reality tools have shown potential for improving cognitive rehabilitation by supporting carefully personalized, ecologically valid tasks through accessible technologies. Notwithstanding important progress in VR-based cognitive rehabilitation systems, specially with Activities of Daily Living (ADL’s) simulations, there is still a need of more clinical trials for its validation. In this work we present a one-month randomized controlled trial with 18 stroke in and outpatients from two rehabilitation units: 9 performing a VR-based intervention and 9 performing conventional rehabilitation.

Methods

The VR-based intervention involved a virtual simulation of a city – Reh@City – where memory, attention, visuo-spatial abilities and executive functions tasks are integrated in the performance of several daily routines. The intervention had levels of difficulty progression through a method of fading cues. There was a pre and post-intervention assessment in both groups with the Addenbrooke Cognitive Examination (primary outcome) and the Trail Making Test A and B, Picture Arrangement from WAIS III and Stroke Impact Scale 3.0 (secondary outcomes).

Results

A within groups analysis revealed significant improvements in global cognitive functioning, attention, memory, visuo-spatial abilities, executive functions, emotion and overall recovery in the VR group. The control group only improved in self-reported memory and social participation. A between groups analysis, showed significantly greater improvements in global cognitive functioning, attention and executive functions when comparing VR to conventional therapy.

Conclusions

Our results suggest that cognitive rehabilitation through the Reh@City, an ecologically valid VR system for the training of ADL’s, has more impact than conventional methods.

Trial registration

This trial was not registered because it is a small sample study that evaluates the clinical validity of a prototype virtual reality system.

Continue —> Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients | Journal of NeuroEngineering and Rehabilitation | Full Text

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[Abstract] Cognitive rehabilitation for memory deficits after stroke – The Cochrane Library

Abstract

Background

Memory problems are a common cognitive complaint following stroke and can potentially affect ability to complete functional activities. Cognitive rehabilitation programmes either attempt to retrain lost or poor memory functions, or teach patients strategies to cope with them.

Some studies have reported positive results of cognitive rehabilitation for memory problems, but the results obtained from previous systematic reviews have been less positive and they have reported inconclusive evidence. This is an update of a Cochrane review first published in 2000 and most recently updated in 2007.

Objectives

To determine whether participants who have received cognitive rehabilitation for memory problems following a stroke have better outcomes than those given no treatment or a placebo control.

The outcomes of interest were subjective and objective assessments of memory function, functional ability, mood, and quality of life. We considered the immediate and long-term outcomes of memory rehabilitation.

Search methods

We used a comprehensive electronic search strategy to identify controlled studies indexed in the Cochrane Stroke Group Trials Register (last searched 19 May 2016) and in the Cochrane Central Register of Controlled Trials (CENTRAL2016, Issue 5), MEDLINE (2005 to 7 March 2016), EMBASE 2005 to 7 March 2016), CINAHL (2005 to 5 February 2016), AMED (2005 to 7 March 2016), PsycINFO (2005 to 7 March 2016), and nine other databases and registries. Start dates for the electronic databases coincided with the last search for the previous review. We handsearched reference lists of primary studies meeting the inclusion criteria and review articles to identify further eligible studies.

Selection criteria

We selected randomised controlled trials in which cognitive rehabilitation for memory problems was compared to a control condition. We included studies where more than 75% of the participants had experienced a stroke, or if separate data were available from those with stroke in mixed aetiology studies. Two review authors independently selected trials for inclusion, which was then confirmed through group discussion.

Data collection and analysis

We assessed study risk of bias and extracted data. We contacted the investigators of primary studies for further information where required. We conducted data analysis and synthesis in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. We performed a ‘best evidence’ synthesis based on the risk of bias of the primary studies included. Where there were sufficient numbers of similar outcomes, we calculated and reported standardised mean differences (SMD) using meta-analysis.

Main results

We included 13 trials involving 514 participants. There was a significant effect of treatment on subjective reports of memory in the short term (standard mean difference (SMD) 0.36, 95% confidence interval (CI) 0.08 to 0.64, P = 0.01, moderate quality of evidence), but not the long term (SMD 0.31, 95% CI -0.02 to 0.64, P = 0.06, low quality of evidence). The SMD for the subjective reports of memory had small to moderate effect sizes.

The results do not show any significant effect of memory rehabilitation on performance in objective memory tests, mood, functional abilities, or quality of life.

No information was available on adverse events.

Authors’ conclusions

Participants who received cognitive rehabilitation for memory problems following a stroke reported benefits from the intervention on subjective measures of memory in the short term (i.e. the first assessment point after the intervention, which was a minimum of four weeks). This effect was not, however, observed in the longer term (i.e. the second assessment point after the intervention, which was a minimum of three months). There was, therefore, limited evidence to support or refute the effectiveness of memory rehabilitation. The evidence was limited due to the poor quality of reporting in many studies, lack of consistency in the choice of outcome measures, and small sample sizes. There is a need for more robust, well-designed, adequately powered, and better-reported trials of memory rehabilitation using common standardised outcome measures.

Plain language summary

Cognitive rehabilitation for memory deficits after stroke

Review question

We reviewed the evidence for the effectiveness of cognitive rehabilitation for memory problems in people with stroke.

Background

People often struggle with memory problems following stroke and this can lead to difficulties in everyday life. The degree and kind of memory problems, mood changes, and performance of everyday activities can vary widely depending on many factors, including the location of the stroke in the brain, severity, age, and the previous health of the person experiencing a stroke.

Memory rehabilitation, a part of cognitive rehabilitation, is a therapeutic activity that may play a role in the recovery of memory functions, or in enabling the individual to adapt to the problems. Memory rehabilitation is a standard part of rehabilitation in many settings. However, it is uncertain whether memory rehabilitation can improve people’s memory problems, or whether it has an effect on mood, performance in everyday activities, or quality of life.

Study characteristics

The evidence is current to May 2016. In this review, we included 13 studies with 514 participants. Seven trials were conducted with community participants, four with in-patients, and two with mixed community and in-patient samples. Participants received various types of memory retraining techniques, including training using computer programs and training in the use of memory aids, such as diaries or calendars. In three studies treatment was provided in groups and in 10 studies treatment was provided individually. Treatment lasted between two weeks and 10 weeks. In these studies, those who received the treatment were compared with a control group. The control group included those who did not receive cognitive rehabilitation or received another form of treatment. The control groups varied. Some studies had a control group wherein people received their usual care, whereas in others individuals in the control groups were placed on a waiting list to receive cognitive rehabilitation.

Key results

We found that people who received cognitive rehabilitation reported fewer memory problems in daily life immediately after treatment compared with the control groups. This represents a small to moderate effect of the intervention in comparison to the control group. However, there was no evidence that the benefits persisted in the long term. We found no evidence that cognitive rehabilitation improved people’s independence in activities of daily living, mood, or quality of life. There was no information about any harm caused to participants from taking part in cognitive rehabilitation.

Quality of the evidence

The quality of the evidence ranged from very low (effect on outcomes that relate to everyday activities) to moderate (effect on self-reported memory problems, memory tests, and mood measures). There were a number of flaws in these studies, such as having very few people in them, and these could have affected our findings.

Source: Cognitive rehabilitation for memory deficits after stroke – das Nair – 2016 – The Cochrane Library – Wiley Online Library

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[ARTICLE] Cognitive impairment and rehabilitation strategies after traumatic brain injury – Full Text

Abstract

Traumatic brain injury (TBI) is among the significant causes of morbidity and mortality in the present world. Around 1.6 million persons sustain TBI, whereas 200,000 die annually in India, thus highlighting the rising need for appropriate cognitive rehabilitation strategies. This literature review assesses the current knowledge of various cognitive rehabilitation training strategies. The entire spectrum of TBI severity; mild to severe, is associated with cognitive deficits of varying degree. Cognitive insufficiency is more prevalent and longer lasting in TBI persons than in the general population. A multidisciplinary approach with neuropsychiatric evaluation is warranted. Attention process training and tasks for attention deficits, compensatory strategies and errorless learning training for memory deficits, pragmatic language skills and social behavior guidance for cognitive-communication disorder, meta-cognitive strategy, and problem-solving training for executive disorder are the mainstay of therapy for cognitive deficits in persons with TBI. Cognitive impairments following TBI are common and vary widely. Different cognitive rehabilitation techniques and combinations in addition to pharmacotherapy are helpful in addressing various cognitive deficits.

   Introduction Top

Traumatic brain injury (TBI) is a steadily rising public health concern and one of the significant causes of morbidity and mortality in India.[1] Around 10 million people sustain TBI worldwide annually.[2] The recent global status report on road safety by the World Health Organization, 2013 has clearly highlighted the existing and growing enormity of this problem across the world and has emphasized on the outmost need for well-designed and evaluated programs in prevention, management, and rehabilitation. As India continues to progress to greater urbanization with rapid development in terms of motorization, incidence of TBIs will increase significantly. Data from an epidemiological study undertaken in Bengaluru have shown incidence, mortality, and case fatality rates of 150/100,000, 20/100,000 and 10%, respectively.[3] An estimated 2 million people sustain brain injuries with nearly a million requiring rehabilitation services at the national level.[3]

Persons, who survive TBI, end up with chronic disability.[1] It significantly impacts on an individual’s life, in terms of cognitive, behavioral, psychosocial and physical factors, and vocational issues.[4] Among them, cognitive disabilities are often the most disabling and distressing for the affected persons, family members, and the society. Cognitive deficits can significantly impair activities of daily living (ADL), employment, social relationships, recreation, and active participation in the community.

TBI is classified as mild, moderate, and severe depending on the level of consciousness, particularly duration of coma and posttraumatic amnesia (PTA).[4],[5] In moderate to severe TBI, cognition appears to be markedly impaired around 1-month postinjury [6] or shortly after resolution of PTA.[7],[8] Cognitive impairments persisting even after 3 months were found to be associated with higher frequency disability.[9] In moderate to severe TBI, cognitive recovery does not return to baseline even after 2 years of injury. In contrast, the cognitive recovery tends to be rapid in patients with mild TBI, returning almost to “normal baseline functioning” within 3 months.[10],[11]

Literature and studies have reported that effective cognitive rehabilitation interventions initiated post-TBI enhance the recovery process and minimize the functional disability. Hence, it is necessary to have a proper guideline for the cognitive rehabilitation of traumatic brain injured persons with multiple cognitive impairments. This article has been adapted from various literatures and outlines briefly the commonly encountered cognitive deficits following TBI. It also provides a summary of effective rehabilitation strategies for the cognitively impaired persons.

Continue —> Cognitive impairment and rehabilitation strategies after traumatic brain injury Barman A, Chatterjee A, Bhide R – Indian J Psychol Med

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[Abstract] Transcranial Electrical Stimulation in Post-Stroke Cognitive Rehabilitation: European Psychologist: Vol 21, No 1

Source: Transcranial Electrical Stimulation in Post-Stroke Cognitive Rehabilitation: Transcranial Electrical Stimulation in Post-Stroke Cognitive Rehabilitation: European Psychologist: Vol 21, No 1

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[WEB SITE] Computerized rehab aids those suffering from brain injuries | EurekAlert! Science News

(Boston) — For the first time, researchers have shown that computerized cognitive rehabilitation (a program to help brain-injured or otherwise cognitively impaired individuals to restore normal functioning) can improve attention and executive functioning in brain injury survivors including traumatic brain injury (TBI) and stroke.

The findings, which appear online in the Journal of Head Trauma Rehabilitation, may lead to improved treatment outcomes in patients with brain injury, especially for patients with limited mobility and means and those residing in rural areas.

Persistent cognitive problems are very common following brain injury, especially in executive functioning, attention and learning.

The research team conducted a systematic literature review of computerized treatment for attention and executive function in adults who suffered a brain injury. Studies published before or during April 2015 were evaluated for quality and methodology as no previous reviews had been completed. They found eight of 11 studies reported significant gains in cognitive function following treatment in TBI patients, with the three remaining studies reporting trends toward significance. Similarly, 10 of 12 mixed population studies observed significant improvements on measures of attention and executive function, with the remaining two studies reporting positive trends. Five studies reported significant improvements subsequent to treatment for stroke patients.

“The results of this systematic review provide encouraging evidence that computerized cognitive rehabilitation can improve attention and executive functioning in brain injury survivors,” explained corresponding author Yelena Bogdanova, PhD, assistant professor of psychiatry at Boston University School of Medicine and principal investigator at the VA Boston Healthcare System.

According to the researchers computerized treatment delivery can significantly reduce the wait time and cost of treatment, provide immediate access to treatment in any location, improve the quality of life of patients and reduce the burden of caregivers.

Bogdanova believes further studies are needed. “It is important to evaluate the efficacy of computerized cognitive training programs and to provide specific guidelines for computerized methods of rehabilitation in patients with brain injury, as it can reduce cost and increase accessibility of treatment to traditionally underserved populations,” she added.

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Funding for this study was provided by the Rehabilitation Research & Development Service of the Department of Veterans Affairs (VA) grants D6996W and I21RX001773-01 to YB, the National Institutes of Health and Boston University Clinical & Translational Science Institute grant UL1-RR025771 to YB, the VA Translation Research Center for TBI & Stress Disorders [YB], and the VA BHS Psychology Research Service [YB].

Contact:

Gina DiGravio,
617-638-8480
ginad@bu.edu

Source: Computerized rehab aids those suffering from brain injuries | EurekAlert! Science News

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[ARTICLE] The Effect of Occupation-based Cognitive Rehabilitation for Traumatic Brain Injury: A Meta-analysis of Randomized Controlled Trials

Abstract

Traumatic brain injury (TBI) is the leading cause of death and disability among people younger than 35 years in the United States. Cognitive difficulty is a common consequence of TBI. To address cognitive deficits of patients with TBI, various cognitive rehabilitation approaches have been used for the clinical setting. The purpose of this study was to investigate the overall effect of occupation-based cognitive rehabilitation on patients’ improvement in cognitive performance components, activity of daily living (ADL) performance, and values, beliefs and spirituality functions of patients with TBI.

The papers used in this study were retrieved from the Cochrane Database, EBSCO (CINAHL), PsycINFO, PubMed and Web of Science published between 1997 and 2014. The keywords for searching were cognitive, rehabilitation, occupation, memory, attention, problem-solving, executive function, ADL, values, beliefs, spirituality, randomized controlled trials and TBI. For the meta-analysis, we examined 60 effect sizes from nine studies that are related to the occupation-based cognitive rehabilitation on persons with TBI. In persons with TBI, overall mental functions, ADL, and values, beliefs and spirituality were significantly improved in the groups that received occupation-based cognitive rehabilitation compared with comparison groups (mean d = 0.19, p < .05).

Evidence from the present meta-analytic study suggests that occupation-based cognitive rehabilitation would be beneficial for individuals with TBI for improving daily functioning and positively be able to affect their psychosocial functions. Collecting many outcome measures in studies with relatively few participants and the final data are less reliable than the whole instrument itself. Future research should evaluate the effectiveness of specific occupation-based cognitive rehabilitations programmes in order to improve consistency among rehabilitation providers. Copyright © 2015 John Wiley & Sons, Ltd

via The Effect of Occupation-based Cognitive Rehabilitation for Traumatic Brain Injury: A Meta-analysis of Randomized Controlled Trials – Park – 2015 – Occupational Therapy International – Wiley Online Library.

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