Cognitive remediation of attention deficits following acquired brain injury: A systematic review and meta-analysis

Virk, Sohaib; Williams, Tracey; Brunsdon, Ruth; Suh, Flora Minsun; Morrow, Angela M

doi:10.3233/nre-151225

Cited by 48 publications

(32 citation statements)

References 32 publications

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“…The mean effect estimates for CT and CS across the different populations suggest modest efficacy. For stroke, we found that meta-analyses of CT interventions targeting a specific cognitive domain, such as memory (das Nair et al, 2016) and attention (Loetscher & Lincoln, 2013;Virk et al, 2015) showed no significant effect, however, results were imprecise and based on a small number of primary trials. In contrast, there was evidence from a moderate-quality review including 22 primary trials covering a variety of cognitive remediation techniques (Rogers et al, 2018), to support the use of COTs to improve cognitive performance following stroke.…”

Section: Summary Of Main Resultsmentioning

confidence: 99%

“…Three reviews reported meta-analytical results for CT for stroke (das Nair et al, 2016;Loetscher & Lincoln, 2013;Virk et al, 2015). The mean effect estimate was 0.23 (-0.19 to 0.65).…”

Section: Cognitive Outcomesmentioning

confidence: 99%

“…The mean effect estimate was 0.23 (-0.19 to 0.65). The most recent review with a 'moderate confidence' AMSTAR rating (Virk et al, 2015) focused specifically on treatment of attentional deficits, showing no significant effect, Hedge's g 0.18 (-0.24 to 0.60). In contrast, a moderate quality review on mixed COTs for stroke revealed a small and significant effect on overall cognitive outcomes, Hedge's g 0.48…”

Section: Cognitive Outcomesmentioning

confidence: 99%

“…As has previously been recognized Tardif & Simard, 2011) the different types of COTs are sometimes used interchangeably in the literature and interventional elements belonging to the different categories can overlap within trials. In our overview, three meta-analyses (das Nair et al, 2016;Loetscher & Lincoln, 2013;Virk et al, 2015) were described as CR by review authors, but reclassified as CT in order to be consistent with definitions provided by Clare and Woods (2004). This definition of CR emphasizes an individualized approach based on collaborative goal-setting; however, other definitions have also been used, particularly in the field of stroke rehabilitation (Cicerone et al, 2000).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Cognition-oriented treatments for older adults: A systematic overview of systematic reviews

Gavelin¹,

Lampit²,

Hallock³

et al. 2019

Preprint

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Cognition-oriented treatments (COTs) -commonly categorized as cognitive training, cognitive rehabilitation and cognitive stimulation -are promising approaches for the prevention of cognitive and functional decline in older adults. We conducted a systematic overview of meta-analyses investigating the efficacy of COTs on cognitive and non-cognitive outcomes in older adults with or without cognitive impairment. Review quality was assessed by AMSTAR 2. We identified 51 eligible reviews, 46 of which were included in the quantitative synthesis. The confidence ratings were "moderate" for 9 (20%), "low" for 13 (28%) and "critically low" for 24 (52%) of the 46 reviews. While most reviews provided pooled effect estimates for objective cognition, non-cognitive outcomes of potential relevance were more sparsely reported. The mean effect estimate on cognition was small for cognitive training in healthy older adults (Hedge's g 0.32, range 0.13-0.64, 19 reviews), mild cognitive impairment (Hedge's g 0.40, range 0.32-0.60, five reviews), and dementia (Hedge's g 0.38, range 0.09-1.16, seven reviews), and small for cognitive stimulation in dementia (Hedge's g 0.36, range 0.26-0.44, five reviews). Meta-regression revealed that higher AMSTAR score was associated with larger effect estimates for cognitive outcomes. The available evidence supports the efficacy of COTs improving cognitive performance in older adults. The extent to which such effects are of clinical value remains unclear, due to the scarcity of high-quality evidence and heterogeneity in reported findings. An important avenue for future trials is to include relevant non-cognitive outcomes in a more consistent way and, for meta-analyses in the field, there is a need for better adherence to methodological standards. PROSPERO registration number: CRD42018084490.

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Section: Summary Of Main Resultsmentioning

confidence: 99%

“…Three reviews reported meta-analytical results for CT for stroke (das Nair et al, 2016;Loetscher & Lincoln, 2013;Virk et al, 2015). The mean effect estimate was 0.23 (-0.19 to 0.65).…”

Section: Cognitive Outcomesmentioning

confidence: 99%

Section: Cognitive Outcomesmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Cognition-oriented treatments for older adults: A systematic overview of systematic reviews

Gavelin¹,

Lampit²,

Hallock³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…6 These differing perspectives continue to co-exist in the literature. [7][8][9][10] Unfortunately, there is a dearth of empirical evidence to guide a clinician's decision-making as to when to provide challenging interventions, compensatory activities, and metacognitive strategies in TBI inpatient rehabilitation. The evidence that does exist is based on applications in alternative settings and with different levels of acuity.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Advanced Therapy in Traumatic Brain Injury Inpatient Rehabilitation: Effects on Outcomes During the First Year After Discharge

Timpson

Hade

Beaulieu

et al. 2019

Archives of Physical Medicine and Rehabilitation

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Objective: To use causal inference methods to determine if receipt of a greater proportion inpatient rehabilitation treatment focused on higher level functions, e.g. executive functions, ambulating over uneven surfaces (Advanced Therapy, AdvTx) results in better rehabilitation outcomes. Design: A cohort study using propensity score methods applied to the TBI-Practice-Based Evidence (TBI-PBE) database, a database consisting of multi-site, prospective, longitudinal observational data. Setting: Acute inpatient rehabilitation (IRF). Participants: Patients enrolled in the TBI-PBE study (n=1843), aged 14 years or older, who sustained a severe, moderate, or complicated mild TBI, receiving their first IRF admission to one of 9 sites in the US, and consented to follow-up 3 and 9 months post discharge from inpatient rehabilitation. Interventions: Not applicable. Main Outcome Measures: Participation Assessment with Recombined Tools-Objective-17, FIM TM Motor and Cognitive scores, Satisfaction with Life Scale, and Patient Health Questionnaire-9. Results: Controlling for measured potential confounders, increasing the percentage of AdvTx during inpatient TBI rehabilitation was found to be associated with better community participation, functional independence, life satisfaction, and decreased likelihood of depression during the year following discharge from inpatient rehabilitation. Participants who began

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Cognitive rehabilitation for attention deficits following stroke

Loetscher

Potter

Wong

et al. 2019

Cochrane Database of Systematic Reviews

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Cognitive remediation of attention deficits following acquired brain injury: A systematic review and meta-analysis

Abstract: Cognitive rehabilitation resulted in short-term improvements in divided attention following stroke, but not after TBI or CNS-impacting malignancy. Cognitive interventions did not significantly improve other attentional domains in participants with stroke, TBI or CNS-impacting malignancy.

Cited by 48 publications

References 32 publications

Cognition-oriented treatments for older adults: A systematic overview of systematic reviews

Cognition-oriented treatments for older adults: A systematic overview of systematic reviews

Advanced Therapy in Traumatic Brain Injury Inpatient Rehabilitation: Effects on Outcomes During the First Year After Discharge

Cognitive rehabilitation for attention deficits following stroke

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