Managing Dysexecutive Syndrome (DS): CIHR 2011-2014


Phase N/A Results N/A

Trial Description

Successful community participation following acquired brain injury (ABI) continues to be an elusive goal for patients, clinicians and researchers. Our pilot work shows that community dwelling survivors of ABI can significantly improve performance on self-identified real- world performance problems and that they can transfer this learning to improve goals not trained in the treatment sessions. We will compare two types of rehabilitation intervention using a randomized controlled trial. We will also interview survivors, their significant others and clinicians regarding their experiences with each intervention to help us discover what works best.

Detailed Description

Executive dysfunction is endemic after severe acquired brain injuries (ABIs) and is highly associated with long-lasting psychosocial distress, problems in a multiplicity of everyday activities and overall reduced quality of life. There is increasing evidence to suggest that a novel behavioral intervention is a treatment of choice for executive dysfunction. However few studies have addressed ecological relevance: failing to take into account the significant impact of the complex settings of real life on executive function. More data are desperately needed in this area given the devastating consequences of ABI. We propose to investigate the benefits of two community- based interventions.



  • Real-world strategy approach Behavioral
    Other Names: Adapted CO-OP approach
    Intervention Desc: The experimental protocol is a form of meta-cognitive strategy training (Cognitive Orientation to daily Occupational Performance).
  • Meta-cognitive strategy training Behavioral
    Intervention Desc: One hour, 2 x / week for up to 15 sessions.
    ARM 1: Kind: Experimental
    Label: Meta-cognitive strategy training
    Description: In-home, contextually relevant strategy training.
  • Conventional rehabilitation. Behavioral
    Intervention Desc: 1 hour / 2x / week for up to 15 sessions
    ARM 1: Kind: Experimental
    Label: Conventional rehabilitation
    Description: In-home work on problems in daily living.
  • Novel rehabilitation approach Behavioral
    Intervention Desc: 1 hr, 2x/week for up to 15 sessions
    ARM 1: Kind: Experimental
    Label: Novel rehabilitation approach

Trial Design

  • Allocation: Randomized
  • Masking: Double Blind (Subject, Caregiver, Outcomes Assessor)
  • Purpose: Treatment
  • Endpoint: Efficacy Study
  • Intervention: Single Group Assignment


Type Measure Time Frame Safety Issue
Primary Change in performance on COPM pre, post, 3 month follow-up No
Secondary DEX, MET pre, post, 3 month follow-up No
Secondary DEX, IADL profile pre, post, 3 month follow-up No