Changes in cognitive functional performance and basic activities of daily living in patients with traumatic brain injury after two methods of cognitive retraining

Abstract

Introduction

Evidence supports a bottom-up approach to address specific cognitive deficits to assist in addressing functional cognitive deficits in patients with traumatic brain injury (TBI). There is however little evidence supporting the use of online mobile applications (apps) for this purpose. The aim of this research was to describe the outcomes for cognitive functional performance and self-care functioning after cognitive retraining using a mobile application (app) versus task-oriented intervention for patients with acute mild and moderate traumatic brain injury (TBIs).

Methods

A quantitative, quasi experimental, longitudinal research design was used for determining within-group and between-groups changes for cognitive functional performance and self-care functioning in two sample groups with mild to moderate TBI. Intervention using a mobile app (n=7) or task-oriented activities (n=15) was evaluated at three assessment intervals: on recruitment into the study (Assessment 1), on completion of inpatient hospital intervention (Assessment 2) and after four weeks of home programme intervention and fortnightly outpatient intervention (Assessment 3).

Results

Results for both groups showed a statistically significant change for cognitive functional performance assessed on the Bay Area Functional Performance Evaluation (BaFPE) while the task-oriented cognitive training group also achieved a statistically significant change in self-care scores during the first inpatient assessment period.  Only the mobile app group had statistically significant improvement during the home programme in the second assessment period.

Conclusion

Cognitive retraining using a mobile app or task-oriented activities result in positive change in a therapist directed inpatient programme but a structured, graded, online mobile app was more effective in supporting significant improvement in cognitive functional performance when used with an outpatient home programme.