Abstract
Cognitive rehabilitation training is a promising technique for remediating the cognitive deficits associated with brain injury. Extant research is dominated by computer-based interventions with varied results. Results from clinician-delivered cognitive rehabilitation are notably lacking in the literature. The current study examined the cognitive outcomes following ThinkRx, a clinician-delivered cognitive rehabilitation training program for soldiers recovering from traumatic brain injury and acquired brain injury. In a retrospective chart review, we examined cognitive outcomes of 11 cases who had completed an average of 80 h of ThinkRx cognitive rehabilitation training delivered by clinicians and supplemented with digital training exercises. Outcome measures included scores from six cognitive skill batteries on the Woodcock Johnson – III Tests of Cognitive Abilities. Participants achieved gains in all cognitive skills tested and achieved statistically significant changes in long-term memory, processing speed, auditory processing, and fluid reasoning with very large effect sizes. Clinically significant changes in multiple cognitive skills were also noted across cases. Results of the study suggest that ThinkRx clinician-delivered cognitive training supplemented with digital exercises may be a viable method for targeting the cognitive deficits associated with brain injury.
Highlights
Between 2000 and 2016, the US Department of Defense reported nearly 360,000 cases of traumatic brain injury (TBI) among military members (Defense and Veteran’s Brain Injury Center [DVBIC], 2017)
After Bonferroni correction for multiple comparisons and adjusting the alpha to p < 0.007, results remained statistically significant for general intellectual ability, t(9) = 7.8, p < 0.001, and for four of the six individual cognitive skills: long-term memory, t(9) = 4.2, p = 0.002; auditory processing, t(9) = 3.5, p = 0.007; fluid reasoning, t(9) = 6.9, p < 0.001; and processing speed, t(9) = 4.1, p = 0.003
The largest improvements were seen in General Intellectual Ability (GIA), long-term memory, working memory, and auditory processing, followed by fluid reasoning and processing speed
Summary
Between 2000 and 2016, the US Department of Defense reported nearly 360,000 cases of traumatic brain injury (TBI) among military members (Defense and Veteran’s Brain Injury Center [DVBIC], 2017). TBIs can range from mild concussions to severe amnesia causing a majority of patients to suffer functional deficits in thinking, sensation, language, and emotion regardless of the cause of the injury (Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury [DCOE] and Defense and Veterans’ Brain Injury Center, 2009). Memory is the most frequently impaired cognitive skill in patients with brain injury, and evidence suggests that attention skills are at the root of such memory. Much research on TBI is primarily targeted to civilians, but the cognitive impairments experienced as a result of TBI do not appear to differ among combat and non-combat related TBI survivors, nor between blast-related and other etiologies of brain trauma (Belanger et al, 2009)
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