Rehabilitation with intensive attention training early after acquired brain injury promotes better long-term status on health-related quality of life, daily activities, work ability and return to work.
Gabriela Markovic, Aniko Bartfai, Marie-Louise Schult and 1 others
PMID 38214119WHAT IT FOUND
Patients starting intensive attention training within 4 months of brain injury had better long-term quality of life, work ability, and return-to-work rates than those starting later.
The specific type of training made little difference overall, though early process-based training showed minor advantages.
Key findings
01Participants who began attention training in the subacute phase (less than 4 months post-injury) reported significantly higher health-related quality of life, better work ability, and higher rates of return to work compared to those who started in the post-acute phase (4-12 months).
02There were no significant differences in outcomes between the two attention training methods (process-based vs. activity-based) when analyzed independently, although the process-based method showed minor advantages in the subacute group.
03The subacute group reported fewer occupational gaps (activities they wanted to do but could not) and higher self-rated work ability compared to the post-acute group.
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 excluded patients with aphasia, severe neglect, or significant psychiatric comorbidities, so results may not apply to the broader brain injury population. Outcomes were based on self-reported data collected via telephone, which can be subject to recall bias or interpretation differences. The study was a follow-up of an RCT but analyzed cohorts based on timing and type, which introduces potential confounding variables not fully controlled for. The sample size was relatively small (100 participants), and the groups were split further into subgroups, reducing statistical power for detecting small differences between training types. The follow-up period was 2 years, which may not capture long-term durability of effects beyond that timeframe.
Declared interests
The authors declared no conflicts of interest. The study was funded by several Swedish foundations and research councils, including the Promobilia Foundation and the Swedish Research Council.
The easy way to misread this
Do not conclude that one specific attention training method is superior for all patients. The study found that the timing of the intervention (starting within 4 months) had a much stronger effect on outcomes than whether the training was process-based or activity-based. Delaying intensive attention training to the post-acute phase (4-12 months) resulted in significantly worse long-term functional outcomes.