Poster 27: Feasibility of a Computerized Cognitive Skill-building Program in an Inpatient Traumatic Brain Injury Rehabilitation Setting

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.