Objective: To explore the feasibility of a computerized cognitive skill-building program for
individuals with acute traumatic brain injury (TBI). Design: Case study. Setting: Inpatient TBI rehabilitation unit at an urban medical facility. Patient: 20-year-old woman with severe TBI, 65 days post-injury. Patient was out of PTA during
study. Interventions: Individual computerized skill-building with InSightTM, a software program previously
shown to improve cognitive functioning in adults with cognitive impairments. The program
is designed to improve processing speed, attention, memory, and accuracy through a
graduated series of five structured exercises presented on a laptop computer. Fourteen
40–45 minute training sessions were scheduled around patient's rehabilitation program
over a 3-week period. Outcomes were assessed before and after treatment. Main Outcome Measures: (1) Automated Neuropsychological Assessment Metrics (ANAM-4), a validated computerized
neuropsychological battery that tests processing speed, working memory, attention,
encoding, spatial processing, and accuracy. (2) User Experience Survey and brief interview
assessing overall experience and impressions of training program. Results: Patient was able to use the computer with assistance, comprehend instructions, and
progress through the program. She reported a positive experience on self-report survey
and interview. Gains resulting from intervention in the current study cannot be distinguished
from those due to other rehabilitation and spontaneous recovery. However, patient
showed improvements in speed on tests of simple reaction time and delayed memory,
as well as improved accuracy across all domains tested. Challenges encountered in
recruitment, consenting, and study logistics were used to refine procedures for use
in an upcoming pilot project of InSightTM on an inpatient unit. Conclusions: Computerized cognitive skill-building program is usable by a subset of individuals
with TBI during acute inpatient rehabilitation. Recommendations for increasing the
feasibility of this intervention on an inpatient unit are discussed.
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Disclosure: None declared.
© 2009 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.