Date Presented 04/05/2025
Barriers to and facilitators of remote computerized cognitive remediation (CCR) for adults with traumatic brain injury (TBI) are prevalent, and adjustments for CCR are needed to enhance OT practices and improve patient outcomes.
Primary Author and Speaker: Maggie Helena Balslev Helena Balslev Bisgaard
Additional Authors and Speakers: Yousef Jouhargy
Contributing Authors: Gerald Voelbel
PURPOSE: Cognitive impairments are prevalent after traumatic brain injury (TBI) and impact everyday functions and participation. Research indicates computerized cognitive remediation (CCR) improves cognitive function and self-report quality of life in individuals with TBI. However remote delivery of CCR remains to be fully explored. This study explores the feasibility as well as the facilitators and barriers to delivering remote CCR’s for adults with TBI.
DESIGN: Mixed Methods Design was used. Participants were thirteen adults (average age= 44.62 ± 14.80), 61% male, with moderate to severe TBI occurring at least one year prior to enrollment.
METHOD: participants utilized the CCR program BrainHQ’s focusing on Auditory Process or People Skills exercises for 40 training sessions over 14 weeks of training. A self-report questionnaire about facilitators and barriers of the training was administered post-training.
RESULT: In this study, 53.8% of participants did not reach the expected number of completed BrainHQ levels within the timeframe. Participants who completed the program trended towards having a higher overall satisfaction (65.67 ± 5.086) with the CCR program compared to participants not completing (61.14 ± 6.230), t(11)=1.417, p=0.092. A significant facilitator identified was the extrinsic motivation derived from interacting with the research staff and feeling connected to adhering to the program. The primary barrier encountered was the challenge of integrating the program into participants’ weekly routines due to time constraints and the decontextualized nature of the remote CCR.
CONCLUSION: This study highlights the challenges and opportunities of remote CCR interventions for adults with TBI. To address the findings, adjustments in intervention frequency and duration are suggested. These insights contribute to ongoing efforts to optimize cognitive rehabilitation strategies for individuals with TBI, aiming to enhance their quality of life and functioning.
References
Voelbel, G. T., Lindsey, H. M., Mercuri, G., Bushnik, T., & Rath, J. (2021). The effects of neuroplasticity-based auditory information processing remediation in adults with chronic traumatic brain injury. NeuroRehabilitation, 49(2), 267–278. https://doi.org/10.3233/NRE-218025
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