Executive function improvement in response to meta-cognitive training in chronic mTBI / PTSD.
J Kay Waid-Ebbs, Pey-Shan Wen, Tyler Grimes and 4 others
PMID 37484602WHAT IT FOUND
Veterans with mild TBI and PTSD who received Goal Management Training plus a smartphone app for home practice showed significant improvements in executive function and life role participation.
This uncontrolled pilot suggests the combined approach aids transfer of skills to daily life.
Key findings
01Participants showed statistically significant improvement in the primary measure of executive function, the NIH EXAMINER Unstructured Task.
02Secondary measures indicated significant improvements in problem-solving speed and in the extent of and perceived limitations in life role participation.
03The satisfaction with life role participation subdomain did not show a statistically significant change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study design was a single cohort without a control group, so improvements cannot be definitively attributed to the treatment rather than natural recovery or placebo effects. The sample size was very small (n=14 completers, n=13 analysed for primary outcomes), limiting generalizability. There were significant dropouts (12 out of 29 enrolled) and missing data, particularly for the life role participation measures (n=9 analysed). No follow-up data was collected after the end of treatment, so it is unknown if the gains were sustained. Multiple secondary outcomes were reported without p-value corrections, increasing the risk of Type I errors.
Declared interests
The study was conducted within the Veterans Health Administration. No specific funding sources or commercial conflicts of interest were explicitly declared in the provided text.
The easy way to misread this
Do not assume this treatment is proven effective. This was a small, uncontrolled pilot study with high dropout rates and no comparison group. The improvements seen could be due to factors other than the intervention, such as natural recovery or the attention received during the study.