Efficacy of Prospective Memory Rehabilitation Plus Metacognitive Skills Training for Adults With Traumatic Brain Injury: A Randomized Controlled Trial

Author:

Fleming Jennifer1ORCID,Ownsworth Tamara2ORCID,Doig Emmah13,Hogan Christy2,Hamilton Caitlin1,Swan Sarah1ORCID,Griffin Janelle4,Kendall Melissa5,Shum David6

Affiliation:

1. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia

2. School of Applied Psychology, and The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia

3. Surgical Treatment and Rehabilitation Service (STARS) Education and Resource Alliance, The University of Queensland and Metro North Health, Brisbane, QLD, Australia

4. Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, QLD, Australia

5. Acquired Brain Injury Outreach Service, Metro South Health, Queensland, Australia and The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia

6. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong

Abstract

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/ ACTRN12615000996561

Funder

National Health and Medical Research Council

Publisher

SAGE Publications

Subject

General Medicine

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