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Rehabilitation of Executive Functions in Patients with Chronic Acquired Brain Injury with Goal Management Training, External Cuing, and Emotional Regulation: A Randomized Controlled Trial

Published online by Cambridge University Press:  26 January 2016

Sveinung Tornås ,
Marianne Løvstad ,
Anne-Kristin Solbakk ,
Jonathan Evans ,
Tor Endestad ,
Per Kristian Hol ,
Anne-Kristine Schanke  and
Jan Stubberud
Sveinung Tornås*
Affiliation:
Sunnaas Rehabilitation Hospital, Norway
Marianne Løvstad
Affiliation:
Sunnaas Rehabilitation Hospital, Norway Department of Psychology, University of Oslo, Norway
Anne-Kristin Solbakk
Affiliation:
Department of Neurosurgery, Division of Surgery and Clinical Neuroscience, Oslo University Hospital – Rikshospitalet, Norway Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway
Jonathan Evans
Affiliation:
Department of Mental Health and Wellbeing, Institute of Health & Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, Scotland, United Kingdom
Tor Endestad
Affiliation:
Department of Psychology, University of Oslo, Norway
Per Kristian Hol
Affiliation:
The Intervention Center, Oslo University Hospital – Rikshospitalet, Norway Institute of Clinical Medicine, University of Oslo, Norway
Anne-Kristine Schanke
Affiliation:
Sunnaas Rehabilitation Hospital, Norway Department of Psychology, University of Oslo, Norway
Jan Stubberud
Affiliation:
Sunnaas Rehabilitation Hospital, Norway
*
Correspondence and reprint requests to: Sveinung Tornås, Sunnaas Rehabilitation Hospital, Bjørnemyrveien, 1450 Nesoddtangen, Norway. E-mail: sveinung.tornaas@sunnaas.no
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Abstract

Executive dysfunction is a common consequence of acquired brain injury (ABI), causing significant disability in daily life. This randomized controlled trial investigated the efficacy of Goal Management TrainingTM (GMT) in improving executive functioning in patients with chronic ABI. Seventy patients with a verified ABI and executive dysfunction were randomly allocated to GMT (n=33) or a psycho-educative active control condition, Brain Health Workshop (BHW) (n=37). In addition, all participants received external cueing by text messages. Neuropsychological tests and self-reported questionnaires of executive functioning were administered pre-intervention, immediately after intervention, and at 6 months follow-up. Assessors were blinded to group allocation. Questionnaire measures indicated significant improvement of everyday executive functioning in the GMT group, with effects lasting at least 6 months post-treatment. Both groups improved on the majority of the applied neuropsychological tests. However, improved performance on tests demanding executive attention was most prominent in the GMT group. The results indicate that GMT combined with external cueing is an effective metacognitive strategy training method, ameliorating executive dysfunction in daily life for patients with chronic ABI. The strongest effects were seen on self-report measures of executive functions 6 months post-treatment, suggesting that strategies learned in GMT were applied and consolidated in everyday life after the end of training. Furthermore, these findings show that executive dysfunction can be improved years after the ABI. (JINS, 2016, 22, 436–452)

Keywords

Cognitive rehabilitationGoal managementExecutive functioningBrain injuryEvidence basedRandomized controlled trail
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 22 , Issue 4 , April 2016 , pp. 436 - 452
Copyright
Copyright © The International Neuropsychological Society 2016 

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