前瞻性记忆康复加元认知技能训练对成人外伤性脑损伤的疗效:一项随机对照试验。

IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY
Neurorehabilitation and Neural Repair Pub Date : 2022-08-01 Epub Date: 2022-07-26 DOI:10.1177/15459683221110886
Jennifer Fleming, Tamara Ownsworth, Emmah Doig, Christy Hogan, Caitlin Hamilton, Sarah Swan, Janelle Griffin, Melissa Kendall, David Shum
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引用次数: 1

摘要

背景:前瞻记忆(PM)失败会限制外伤性脑损伤(TBI)后的独立性和生产力。使用代偿策略可以改善PM损伤对日常生活的影响,但需要足够的自我意识。元认知技能训练(MST)可以促进自我意识和策略的使用,并可能提高PM康复的疗效。目的:评估补偿策略训练(COMP)与MST成分(COMP-MST)在减少成人中重度TBI患者日常PM失败和改善心理社会融合方面的有效性,与单独的COMP和对照组相比。次要目的是评估训练对心理测量PM测试分数、策略使用、自我意识和护理水平的影响。方法:52例受试者(男性77%,平均年龄39.0岁)采用评估者和参与者双盲随机对照试验。SD = 13.6),分为3组:COMP- mst组、COMP组和等候名单组。干预措施每周进行6次。在干预前后和3个月的随访中收集测量数据。使用非结构化线性混合效应模型分析数据,以重复测量和每组时间点之间的计划对比。结果:模型显示各组在主要或次要结局指标上无显著差异。在干预前和干预后,两个干预组的重要他人对日常PM失败的评分都有显著的改善,但对照组没有,具有中到大的效应量。所有三组参与者的主要结局均有临床相关改善。结论:本研究发现MST联合COMP在改善日常PM和社会心理融合方面没有显著的益处。临床试验注册:澳大利亚和新西兰临床试验注册中心https://www.anzctr.org.au/ ACTRN12615000996561。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of Prospective Memory Rehabilitation Plus Metacognitive Skills Training for Adults With Traumatic Brain Injury: A Randomized Controlled Trial.

Background: Prospective memory (PM) failure can limit independence and productivity following traumatic brain injury (TBI). Compensatory strategy use may ameliorate the effect of PM impairment on daily life but requires sufficient self-awareness. Metacognitive skills training (MST) can facilitate self-awareness and strategy use and may improve the efficacy of PM rehabilitation.

Objective: To evaluate the effectiveness of compensatory strategy training (COMP) with an MST component (COMP-MST) for reducing everyday PM failure and improving psychosocial integration in adults with moderate-severe TBI, compared to COMP alone and a control condition. Secondary aims were to evaluate the effect of training on psychometric PM test scores, strategy use, self-awareness, and level of care.

Methods: Assessor and participant-blinded randomized controlled trial with 52 participants (77% male, mean age = 39.0. SD = 13.6) allocated to 3 groups: COMP-MST, COMP, and waitlist control. Interventions were delivered over 6 weekly sessions. Measures were collected pre- and post-intervention and 3-month follow-up. Data were analyzed using unstructured linear mixed-effects modeling for repeated measures and planned contrasts between time-points for each group.

Results: The models showed no significant differences between the groups on primary or secondary outcome measures. Significant pre-post intervention improvements were found for significant other's ratings of everyday PM failure for both intervention groups but not the control group, with medium to large effect sizes. Clinically relevant improvements on primary outcomes were found for participants across all 3 groups.

Conclusions: This study found no significant benefits of combining MST with COMP for improving everyday PM and psychosocial integration.

Clinical trial registration: Australian and New Zealand Clinical Trials Registry https://www.anzctr.org.au/ ACTRN12615000996561.

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来源期刊
CiteScore
8.30
自引率
4.80%
发文量
52
审稿时长
6-12 weeks
期刊介绍: Neurorehabilitation & Neural Repair (NNR) offers innovative and reliable reports relevant to functional recovery from neural injury and long term neurologic care. The journal''s unique focus is evidence-based basic and clinical practice and research. NNR deals with the management and fundamental mechanisms of functional recovery from conditions such as stroke, multiple sclerosis, Alzheimer''s disease, brain and spinal cord injuries, and peripheral nerve injuries.
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