OTSLPSystematic ReviewThe Journal of head trauma rehabilitation2016

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

Yelena Bogdanova, Megan K Yee, Vivian T Ho and 1 others

PMID 26709580

WHAT IT FOUND

Computerized attention and executive training after acquired brain injury was often reported to improve test scores, but no standard program, control, or dose emerged, so it does not tell therapists which treatment to use.

Key findings

01Computerized attention or working memory training produced significant improvements on tests of attention, memory, or executive function compared with control groups in several included studies.

02Only one working memory program, Cogmed QM, was tested in 5 studies; most programs were unique to the study.

03Twenty-six of the 28 studies had fewer than 50 participants, and 11 studies did not use a control group.

STILL TO COME

How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs

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What it does not show

Twenty-six of the 28 studies had fewer than 50 participants, and some had as few as 1 to 4 participants. Eleven studies did not use a control group, and only 17 studies directly compared treatment with a control outcome. Only 5 studies using control groups adequately described randomization, and only 4 studies reported masked investigators or study personnel. No studies reported intent-to-treat analysis, and no study reported adherence to protocol rate. Most studies did not specify injury severity, and only 4 studies completed long-term follow-up. No standardized computerized training protocol was used, and most programs were unique to each study.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not conclude that any computerized cognitive rehabilitation program is proven to improve attention or executive function after acquired brain injury. The review included many small studies, many without controls, and no standardized protocol, so it cannot tell which program, dose, or supervision level works.

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