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.
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
- 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|
- Baycrest Lead