TY - JOUR
T1 - Efficacy of Prospective Memory Rehabilitation Plus Metacognitive Skills Training for Adults With Traumatic Brain Injury
T2 - A Randomized Controlled Trial
AU - Fleming, Jennifer
AU - Ownsworth, Tamara
AU - Doig, Emmah
AU - Hogan, Christy
AU - Hamilton, Caitlin
AU - Swan, Sarah
AU - Griffin, Janelle
AU - Kendall, Melissa
AU - Shum, David
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the National Health and Medical Research Council of Australia, Project Grant APP1083064.
Publisher Copyright:
© The Author(s) 2022.
PY - 2022/8
Y1 - 2022/8
N2 - Background: Prospective memory (PM) failure can limit independence and productivity following traumatic brain injury (TBI). Compensatory strategy use may ameliorate the effect of PM impairment on daily life but requires sufficient self-awareness. Metacognitive skills training (MST) can facilitate self-awareness and strategy use and may improve the efficacy of PM rehabilitation. Objective: To evaluate the effectiveness of compensatory strategy training (COMP) with an MST component (COMP-MST) for reducing everyday PM failure and improving psychosocial integration in adults with moderate–severe TBI, compared to COMP alone and a control condition. Secondary aims were to evaluate the effect of training on psychometric PM test scores, strategy use, self-awareness, and level of care. Methods: Assessor and participant-blinded randomized controlled trial with 52 participants (77% male, mean age = 39.0. SD = 13.6) allocated to 3 groups: COMP-MST, COMP, and waitlist control. Interventions were delivered over 6 weekly sessions. Measures were collected pre- and post-intervention and 3-month follow-up. Data were analyzed using unstructured linear mixed-effects modeling for repeated measures and planned contrasts between time-points for each group. Results: The models showed no significant differences between the groups on primary or secondary outcome measures. Significant pre–post intervention improvements were found for significant other’s ratings of everyday PM failure for both intervention groups but not the control group, with medium to large effect sizes. Clinically relevant improvements on primary outcomes were found for participants across all 3 groups. Conclusions: This study found no significant benefits of combining MST with COMP for improving everyday PM and psychosocial integration. Clinical Trial Registration: Australian and New Zealand Clinical Trials Registry https://www.anzctr.org.au/
AB - Background: Prospective memory (PM) failure can limit independence and productivity following traumatic brain injury (TBI). Compensatory strategy use may ameliorate the effect of PM impairment on daily life but requires sufficient self-awareness. Metacognitive skills training (MST) can facilitate self-awareness and strategy use and may improve the efficacy of PM rehabilitation. Objective: To evaluate the effectiveness of compensatory strategy training (COMP) with an MST component (COMP-MST) for reducing everyday PM failure and improving psychosocial integration in adults with moderate–severe TBI, compared to COMP alone and a control condition. Secondary aims were to evaluate the effect of training on psychometric PM test scores, strategy use, self-awareness, and level of care. Methods: Assessor and participant-blinded randomized controlled trial with 52 participants (77% male, mean age = 39.0. SD = 13.6) allocated to 3 groups: COMP-MST, COMP, and waitlist control. Interventions were delivered over 6 weekly sessions. Measures were collected pre- and post-intervention and 3-month follow-up. Data were analyzed using unstructured linear mixed-effects modeling for repeated measures and planned contrasts between time-points for each group. Results: The models showed no significant differences between the groups on primary or secondary outcome measures. Significant pre–post intervention improvements were found for significant other’s ratings of everyday PM failure for both intervention groups but not the control group, with medium to large effect sizes. Clinically relevant improvements on primary outcomes were found for participants across all 3 groups. Conclusions: This study found no significant benefits of combining MST with COMP for improving everyday PM and psychosocial integration. Clinical Trial Registration: Australian and New Zealand Clinical Trials Registry https://www.anzctr.org.au/
KW - awareness
KW - brain injury
KW - occupational therapy
KW - prospective memory
KW - randomized controlled trial
KW - rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=85135008244&partnerID=8YFLogxK
U2 - 10.1177/15459683221110886
DO - 10.1177/15459683221110886
M3 - Journal article
C2 - 35880650
AN - SCOPUS:85135008244
SN - 1545-9683
VL - 36
SP - 487
EP - 499
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
IS - 8
ER -