TeleCognitive Training In Adults With Traumatic Brain Injury

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TeleCognitive Training In Adults With Traumatic Brain Injury Asha Vas, Molly Keebler, Kay Moolenijzer, Sandi Chapman Center for BrainHealth, University of Texas at Dallas BACKGROUND TBI is a chronic health condition. Long-term monitoring, including assessment and training, are critical to sustain and optimize function and prevent later emerging deficits or decline in cognitive capacities (Corrigan & Hammond, 2013). Several factors such as geography, disability, resources, and travel costs hinder the current model of coming back to rehabilitation centers. Therefore, tele-rehab may offer a viable solution to achieve later-stage follow-up with clinicians (Brennan et al., 2010). AIMS and HYPOTHESES Overall goal: To examine feasibility of online delivery of a proven reasoning training labeled Strategic Memory Advanced Reasoning Training (SMART) in adults with TBI Aim 1: To examine effects of SMART on higher-order reasoning in adults with TBI Hypothesis 1: Adults with TBI will show significant gains in higher-order reasoning (trained domain) at post-SMART as compared to pre-SMART. Aim 2: To explore generalizable benefits of SMART to untrained cognitive domains Hypothesis 2: The effects of SMART will generalize to untrained abilities including mental flexibility, innovation, and memory Aim 3: To determine benefits of SMART on daily-life functionality Hypothesis 3: The effects of SMART will be evident on improved participation in daily life tasks and psychological resilience. METHODS Design- Pre-post feasibility study Participants: N=10, (7 men, 3 women) including seven civilians, and three veterans Training: Ten-twelve sessions (1 hr. each) over 4-6 weeks on Skype audio-video interactive platform. Measures: EF-Abstraction, WM, inhibition, switching, memory Questionnaires- participation in daily life activities, depressive symptoms, and resilience Pre- and post-training assessments-in person. Analysis: ANOVA to compare pre- versus post-SMART cognitive and psychological functioning Demographic and Clinical Characteristics Mean (SD) Range Age 42.9 (11.37) 22-65 Edu 17.4 (1.9) 14-20 GOSe 6.2 (1.14) 4-8 SES 49.5(6.93) 39.2-59.5 IQpre 115.7 (7.66) 103-125 IQcurrent 114 (11.55) 96-134 Note- GOSe- Glasgow Outcome Scale Extended, SES- Socio economic status, IQ- Intelligence Quotient. DISCUSSION and SIGNIFICANCE for REHABILITATION The current proposal extends emerging approaches to leverage a telehealth platform of two-way audio- video interaction to maximize access to cognitive rehabilitation in adults with TBI. Telehealth top-down training programs such as SMART are feasible and beneficial in training higher-order reasoning abilities, even in chronic stages of recovery. Furthermore, improved reasoning abilities could generalize to associated executive functions, psychological health, resilience, and daily function. Online delivery of cognitive training could have significant economic & health policy implications. More research is needed to examine and validate TeleCognitive training as standard TBI care. RESULTS Significant gains: Memory (p<.01), depressive symptoms (p<.01), resilience (p<.05), and participation in daily life activities (p<.05). Positive trends: executive functions REFERENCES 1. Brennan, D., Tindall, L., Theodoros, D., Brown, J., Campbell, M., Christiana, D., et al. (2010). A blueprint for telerehabilitation guidelines. International Journal of Telerehabilitation, 2(2), 31. 2. Corrigan, J. D., & Hammond, F. M. (2013). Traumatic brain injury as a chronic health condition. Archives of Physical Medicine and Rehabilitation, 94(6), 1199-1201. Asha.Vas@utdallas.edu. Supported by the Friends of Brain Health Research Award and the Dee Wyly BrainHealth Research fund.