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The impact of multimodal cognitive rehabilitation on executive functions in older adults with traumatic brain injury - 21/07/21

Doi : 10.1016/j.rehab.2021.101559 
Eduardo Cisneros, MA 1, 2, , Véronique Beauséjour, BSc 1, 2, Elaine de Guise, PhD 1, 2, 3, Sylvie Belleville, PhD 2, 4, Michelle McKerral, PhD 1, 2,
1 Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)-IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada 
2 Department of Psychology, Université de Montréal, Montreal, QC, Canada 
3 Research Institute of the Montreal University Hospital Centre, Montreal, QC, Canada 
4 Research Centre of the Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada 

Corresponding authors: Eduardo Cisneros and Michelle McKerral, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)-IURDPM, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 6363, Hudson Rd, Montreal, QC, Canada H3S 1M9; Tel.: 514-343-6503.Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR)-IURDPMCIUSSS du Centre-Sud-de-l'Île-de-Montréal6363, Hudson RdMontrealQCH3S 1M9Canada
Sous presse. Manuscrit accepté. Disponible en ligne depuis le Wednesday 21 July 2021

Highlights

There is a gap in research on cognitive rehabilitation after traumatic brain injury (TBI) during aging.
Cognitive rehabilitation can improve executive functions in older adults with TBI.
Gains in resumption of daily activities can also be seen with such an intervention.
Access to cognitive rehabilitation for older people with TBI must be increased.

Le texte complet de cet article est disponible en PDF.

Abstract

Objectives

This study evaluated the impact of a 12-week, 24-session multimodal group cognitive rehabilitation intervention, the Cognitive Enrichment Program (CEP), on executive functioning and resumption of daily activities after traumatic brain injury (TBI) in older individuals as compared with an active control group that received individual holistic rehabilitation as usual care.

Methods

In total, 37 patients with a TBI and age 57 to 90 years were assigned to experimental (n = 23) and control (n = 14) groups in a semi-randomized, controlled, before–after intervention trial with follow-up at 6 months, with blinded outcome measurement. The CEP's executive function module included planning, problem solving, and goal management training as well as strategies focusing on self-awareness. Efficacy was evaluated by neuropsychological tests (Six Elements Task-Adapted [SET-A], D-KEFS Sorting test and Stroop four-color version); generalization was measured by self-reporting questionnaires about daily functioning (Dysexecutive Functioning Questionnaire, forsaken daily activities).

Results

ANCOVA results showed significant group-by-time interactions; the experimental group showed a statistically significant improvement on Tackling the 6 subtasks and Avoiding rule-breaking measures of the SET-A, with medium effect sizes. The generalization measure, the Dysexecutive Functioning Questionnaire, showed a significant reduction in experimental patient–significant other difference on the Executive cognition subscale. The number of forsaken daily activities was reduced in the experimental versus control group, which was not significant immediately after the CEP but was significant 6 months later.

Conclusions

Our study shows that older adults with TBI can improve their executive functioning, with a positive impact on everyday activities, after receiving multimodal cognitive training with the CEP. ClinicalTrials.gov Identifier: NCT04590911.

Le texte complet de cet article est disponible en PDF.

Key words : traumatic brain injury, aging, cognitive rehabilitation, executive functions, self-awareness


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© 2021  Publié par Elsevier Masson SAS.
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