RESUMEN
People with brain injuries must often deal with cognitive problems, including social problem solving. The present study evaluated the effectiveness of a 20-session, online, interactive, skill-training programme on the solving of problems using analogies. It was hypothesized that the programme could help people with brain injuries learn better problem-solving skills through systematic, theoretically driven learning strategies. Fifteen Hong Kong-Chinese with brain injuries participated in this pilot study. They were randomly assigned to an online programme, a computer-assisted programme or a therapist-administered programme. The three programmes had a similar structure and contents, including basic components problem solving, reflective sessions and functional problem solving. Outcome measures included the Category Test of Halstead-Reitan Test Battery, and a daily problem-solving performance and self-efficacy checklist. The results showed that the subjects of the three programmes generally demonstrated higher post-training self-efficacy and basic problem-solving skills. The group using the online programme, however, showed better and quicker improvements in problem-solving performance, and demonstrated a general trend towards making fewer errors in complex problem-solving tasks. In conclusion, people with brain injuries can use the successful problem-solving experiences obtained in the training programmes with different delivery modes to solve daily living problems that are similar in nature. However, the generalizability of the effects of the programme is still to be determined.
Asunto(s)
Lesiones Encefálicas/rehabilitación , Trastornos del Conocimiento/terapia , Instrucción por Computador , Sistemas en Línea , Solución de Problemas , Aprendizaje Basado en Problemas/métodos , Adolescente , Adulto , Lesiones Encefálicas/complicaciones , Trastornos del Conocimiento/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Resultado del TratamientoRESUMEN
OBJECTIVE: The present study was designed to perform theory-driven empirical work that might contribute to a better understanding of computer-assisted training effects adopting theoretically different memory retraining strategies for people who had amnesia as a result of a brain injury. RESEARCH DESIGN: A pre-test and post-test control group quasi-experimental design was adopted to test the differences in effectiveness of four different computer-assisted memory training strategies, which were hypothesized to improve different memory skills of persons with brain injury. METHOD AND PROCEDURES: Twenty-six persons with brain injury were randomly assigned to four age- and gender-matched memory training groups (self-paced, feedback, personalized, visual presentation) and they were trained using the related computer software, evaluated by the Rivermead Behavioural Memory Test (RBMT), self-efficacy scale and built-up computer performance records. MAIN OUTCOMES AND RESULTS: All the four memory training methods showed positive among the persons with brain injury as compared with a control group, although there was no statistically significant difference among the four training methods. However, clinical improvement was found in all four methods and the Feedback group showed significant improvement in self efficacy, in comparison with the other groups. CONCLUSION: This attempt to develop and evaluate different computer applications for memory retraining was made and the effectiveness of applying customized computer technology in memory rehabilitation was critically evaluated. Results of the present study showed that the unique customized therapeutic characteristics of computer-assisted memory retraining (e.g. self-paced practice, performance feedback, salient visual presentation and personalized training contents) are positive attributes of memory skill retraining outcomes.
Asunto(s)
Amnesia/rehabilitación , Lesiones Encefálicas/rehabilitación , Instrucción por Computador/métodos , Adolescente , Adulto , Amnesia/psicología , Lesiones Encefálicas/psicología , Retroalimentación , Femenino , Humanos , Masculino , Memoria , Recuerdo Mental , Persona de Mediana Edad , Pruebas Psicológicas , AutoimagenRESUMEN
Traumatic brain injury (TBI) is one of the main causes of long-term disability, and its rehabilitation is a challenge to the healthcare team. Tele-rehabilitation, through using advancements in networking and tailor-made software, has been developed and applied to the cognitive rehabilitation of persons with brain injury in the present study. Tele-cognitive rehabilitation uses customized online computer software as a treatment mode. The online treatment software is operated on an interactive tele-communication platform--for example, video conferencing with screen sharing. Through implementing the tele-cognitive rehabilitation activities, therapists can help clients to practise and thus improve their cognitive skills through using the treatment software successfully. Moreover, hypermedia programming techniques allow the therapist to adjust the software to meet the client's treatment needs, so that the treatment is appropriate to his/her functional levels and living environment. Also the software can customize immediate visual, auditory and personalized feedback to motivate the client and training can be set at the right pace for the client's needs. The present study aimed to evaluate the effectiveness and perceived efficacy of the newly developed customized tele-cognitive rehabilitation programme for three subjects with traumatic brain injury through using single-case and qualitative research design. The cognitive factors investigated in this pilot study were, respectively, Chinese word recognition, prospective memory and semantic memory. The subjects had undergone a recruitment process with stipulated screening criteria. A single case experimental design (ABA reversal/withdrawal design) consisted of a no-intervention baseline phase (A), an intervention phase (B) and a no-intervention withdrawal phase (A). There were six sessions in each phase, making a total of 18 sessions. Tele-cognitive rehabilitation software was tailor-made according to each subject's cognitive functional needs. To monitor the change in cognitive functions, variables were tapped by tailor-made assessment and qualitative questionnaires through interviews, and they were then used to explore subjects' opinions of the programme and to test the treatment efficacy of the tele-cognitive rehabilitation programme. Finally, the relationships among the three phases were analysed through visual analysis and trend line analysis by means of the split-middle method. The three persons with brain injury showed improving trends and levels of specific cognitive performance during the treatment phase. Qualitative findings were analysed and confirmed the efficacy of the treatment module. The tele-cognitive rehabilitation approach was well received by subjects. The authors suggest that further replication studies of this kind should be conducted in the future and that more subjects should be recruited to improve the generalizability of the results.