Research Reports - Cognitive Training for Post-Acute Traumatic Brain Injury

Front Hum Neurosci. 2016 Oct 27;10:537. eCollection 2016.

Hallock H(1), Collins D(1), Lampit A(2), Deol K(3), Fleming J(4), Valenzuela

Objective: To quantitatively aggregate effects of cognitive training (CT) on
cognitive and functional outcome measures in patients with traumatic brain injury
(TBI) more than 12-months post-injury. Design: We systematically searched six
databases for non-randomized and randomized controlled trials of CT in TBI
patients at least 12-months post-injury reporting cognitive and/or functional
outcomes. Main Measures: Efficacy was measured as standardized mean difference
(Hedges' g) of post-training change. We investigated heterogeneity across studies
using subgroup analyses and meta-regressions. Results: Fourteen studies
encompassing 575 patients were included. The effect of CT on overall cognition
was small and statistically significant (g = 0.22, 95%CI 0.05 to 0.38; p = 0.01),
with low heterogeneity (I(2) = 11.71%) and no evidence of publication bias. A
moderate effect size was found for overall functional outcomes (g = 0.32, 95%CI
0.08 to 0.57, p = 0.01) with low heterogeneity (I(2) = 14.27%) and possible
publication bias. Statistically significant effects were also found only for
executive function (g = 0.20, 95%CI 0.02 to 0.39, p = 0.03) and verbal memory (g
= 0.32, 95%CI 0.14 to 0.50, p < 0.01). Conclusion: Despite limited studies in
this field, this meta-analysis indicates that CT is modestly effective in
improving cognitive and functional outcomes in patients with post-acute TBI and
should therefore play a more significant role in TBI rehabilitation. 

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