A meta-analytic review examining the validity of executive functioning tests to predict functional outcomes in individuals with a traumatic brain injury

Abstract

Objectives Deficits in executive functioning are a common consequence of Traumatic Brain Injury (TBI) and the severity of TBI is known to predict functional outcomes. In this review, the authors examine the ability of three commonly used tests of executive functioning [The Trail Making Test (TMT-B), The Wisconsin Card Sorting Test (WCST), and Verbal Fluency (VF)] to predict domains of function. Methods Seven hundred and twenty articles were identified and twenty-four met inclusion criteria (original articles published in English examining an adult TBI population). Data were subject to a study quality analysis and then meta-analyzed to assess whether tests of executive functioning (TMT-B, WCST, and VF) can predict functional, employment, and driving outcomes following a TBI. Results The TMT-B (r = 0.29; 95% CI 0.17–0.41) and the WCST (r = 0.20; 95% CI 0.02–0.37) were significantly associated with functional outcomes. The TMT-B was also associated with a person’s ability to return to driving (r = 0.3890; 95% CI 0.2678–0.5103). No test of executive functioning was associated with employment outcomes following a TBI. Conclusion These findings are important to guide rehabilitation strategies and future planning. This review has also highlighted the scarcity of research on specific outcomes.