Beneficial effects of early attention process training after acquired brain injury: A randomized controlled trial

Abstract Introduction. Older adults with mild cognitive impairment (MCI) are at increased risk of developing dementia even if they do not meet the criteria for dementia. Executive control of working memory, which is implicated in divided attention, is often impaired in this population, and such impairment is a strong predictor of dementia. Slowing the development of dementia by enhancing cognitive and brain plasticity represents a current and future challenge for clinicians and researchers. Cognitive rehabilitation allows patients to compensate for cognitive deficits with the ultimate goal of reducing the impact of such deficits on everyday life. We aim to examine the effectiveness and generalization of an attention and working memory training program (Attention Process Training or APT-II) in improving cognitive and everyday functioning in patients with MCI by means of a single-blind, randomized controlled trial.Methods. Twenty-two MCI patients will be randomly assigned to either a "Cognitive Training with APT-II" group or a "Standard Care" group. Initially, patients will be administered a battery of standardized neuropsychological tests to ensure that they meet MCI criteria. The intervention will consist of a cognitive training program (APT-II) and will last 8 weeks (two sessions per week). One of the strengths of APT-II training is that it emphasizes the transfer of cognitive gains from training sessions to everyday life. To evaluate the treatment's effectiveness in improving cognitive and daily life functioning, cognitive and functional outcomes will be assessed just before, immediately after, 3 months after, and 6 months after the intervention program. A divided attention memory task performed in virtual reality will also be administered to evaluate the effects of APT-II training on the management of attentional resources in a relatively ecological situation. Perspective. If our results indicate an improvement in the cognitive and daily life performance of older adults with MCI, this non-invasive, low-cost technique may deserve increased consideration as a therapeutic intervention to delay or reverse cognitive decline an diminish the risk of developing dementia in this population.Trial registration. ClinicalTrials.gov, ID: NCT04606953, Registered on 28 October 2020.

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Evaluating the CARE4Carer Blended Care Intervention for Partners of Patients With Acquired Brain Injury: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.9108 ◽

2017 ◽

Author(s):

Vincent CM Cox ◽

Vera PM Schepers ◽

Marjolijn Ketelaar ◽

Caroline M van Heugten ◽

Johanna MA Visser-Meily

Keyword(s):

Randomized Controlled Trial ◽

Brain Injury ◽

Outcome Measures ◽

Controlled Trial ◽

Acquired Brain Injury ◽

Secondary Outcome ◽

Face To Face ◽

Randomized Controlled ◽

Care Intervention ◽

Blended Care

BACKGROUND Support programs for partners of patients with acquired brain injury are necessary since these partners experience several unfavorable consequences of caregiving, such as a high burden, emotional distress, and poor quality of life. Evidence-based support strategies that can be included in these support programs are psychoeducation, skill building, problem solving, and improving feelings of mastery. A promising approach would seem to be to combine web-based support with face-to-face consultations, creating a blended care intervention. OBJECTIVE This paper outlines the protocol of a randomized controlled trial to evaluate the CARE4Carer blended care intervention for partners of patients with acquired brain injury. METHODS A multicenter two-arm randomized controlled trial will be conducted. A total of 120 partners of patients with acquired brain injury will be recruited from five rehabilitation centers in the Netherlands. The blended care intervention consists of a nine-session web-based support program and two face-to-face consultations with a social worker. Themes that will be addressed are: giving partners insight into their own situation, including possible pitfalls and strengths, learning how to cope with the situation, getting a grip on thoughts and feelings, finding a better balance in the care for the patient with acquired brain injury, thinking about other possible care options, taking care of oneself, and communication. The intervention lasts 20 weeks and the control group will receive usual care. The outcome measures will be assessed at baseline and at 24- and 40-week follow-up. The primary outcome is caregiver mastery. Secondary outcome measures are strain, burden, family functioning, emotional functioning, coping, quality of life, participation, and social network. RESULTS The effect of the intervention on the primary and secondary outcome measures will be determined. Additional a process evaluation will be conducted. CONCLUSIONS The findings of this study will be used to improve the care for partners of patients with acquired brain injury. Barriers and facilitators that emerge from the process evaluation will be used in the nationwide implementation of the intervention. CLINICALTRIAL Dutch Trial Register NTR6197; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6197 (Archived by WebCite at http://www.webcitation.org/6xHBAxx0y)

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