Rehabilitation of executive function deficits following acquired brain injury : a randomised controlled trial using Goal Management Training and Implementation Intentions to improve prospective memory

摘要

Introduction: Deficits in executive function (e.g. planning, problem-solving, prospective memory) following brain injury are associated with significant negative social and occupational outcomes. Prospective memory (PM) is particularly susceptible to the effects of brain injury, as it relies on controlled attentional resources to establish and recall intentions. Implementation intentions (II) have been shown to improve performance on prospective memory tasks across a variety of durations, by circumventing controlled attention and establishing strong cue-action associations using imagery and declarative statements. Aims: To determine the efficacy of a theory-based training intervention for prospective memory deficits following acquired brain injury. Methods: A single-blind, randomised trial was used to assess the efficacy of implementation intentions as compared to a control intervention for individuals with acquired brain injury. A within-between repeated measures designs was used. Participants were assessed using an ecologically valid measure of executive function. Results: No significant differences in interaction effects were found according to treatment allocation. Use of baseline performance, estimated premorbid intelligence, depression, fluid intelligence and processing speed as covariates did not result in significant changes to the effectiveness of interventions. Discussion: The lack of treatment effect may be attributable to several factors, including the interaction of severity of impairments, length of training, and complexity of the outcome measure. The appropriateness of group designs when assessing neuropsychological rehabilitation is also discussed.