Retooling cognitive rehabilitation for patients with traumatic brain injury

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Our col­league Kate Sul­li­van, who led a superb Sharp­Brains Vir­tu­al Sum­mit work­shop on How to Set Up a Brain Fit­ness Cen­ter to Enhance Cog­ni­tive Retrain­ing and Reha­bil­i­ta­tion, based on her expe­ri­ence at Wal­ter Reed Nation­al Mil­i­tary Med­ical Cen­ter, just alert­ed us of a new study pre­pared by her team: Out­comes from a Pilot Study using Com­put­er-Based Reha­bil­i­ta­tive Tools in a Mil­i­tary Pop­u­la­tion (Stud­ies in Health Tech­nol­o­gy and Informatics).

  • Abstract: Nov­el ther­a­peu­tic approach­es and out­come data are need­ed for cog­ni­tive reha­bil­i­ta­tion for patients with a trau­mat­ic brain injury; com­put­er-based pro­grams may play a crit­i­cal role in fill­ing exist­ing knowl­edge gaps. Brain-fit­ness com­put­er pro­grams can com­ple­ment exist­ing ther­a­pies, max­i­mize neu­ro­plas­tic­i­ty, pro­vide treat­ment beyond the clin­ic, and deliv­er objec­tive effi­ca­cy data. How­ev­er, these approach­es have not been exten­sive­ly stud­ied in the mil­i­tary and trau­mat­ic brain injury pop­u­la­tion. Wal­ter Reed Nation­al Mil­i­tary Med­ical Cen­ter estab­lished its Brain Fit­ness Cen­ter (BFC) in 2008 as an adjunct to tra­di­tion­al cog­ni­tive ther­a­pies for wound­ed war­riors. The BFC offers com­mer­cial­ly avail­able “brain-train­ing” prod­ucts for mil­i­tary Ser­vice Mem­bers to use in a sup­port­ive, struc­tured envi­ron­ment. Over 250 Ser­vice Mem­bers have uti­lized this ther­a­peu­tic inter­ven­tion. Each patient receives sub­jec­tive assess­ments pre and post BFC par­tic­i­pa­tion includ­ing the Mayo-Port­land Adapt­abil­i­ty Inventory‑4 (MPAI‑4), the Neu­robe­hav­ioral Symp­tom Inven­to­ry (NBSI), and the Sat­is­fac­tion with Life Scale (SWLS). A review of the first 29 BFC par­tic­i­pants, who fin­ished ini­tial and repeat mea­sures, was com­plet­ed to deter­mine the effec­tive­ness of the BFC pro­gram. Two of the three ques­tion­naires of self-report­ed symp­tom change com­plet­ed before and after par­tic­i­pa­tion in the BFC revealed a sta­tis­ti­cal­ly sig­nif­i­cant reduc­tion in symp­tom sever­i­ty based on MPAI and NBSI total scores (p < .05). There were no sig­nif­i­cant dif­fer­ences in the SWLS score. Despite the typ­i­cal lim­i­ta­tions of a ret­ro­spec­tive chart review, such as vari­a­tion in treat­ment pro­ce­dures, pre­lim­i­nary results reveal a trend towards improved self-report­ed cog­ni­tive and func­tion­al symptoms.

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Pic: cour­tesy of Kate Sulivan