Article

Acquired brain injury (ABI) can impair executive function, impeding
planning and attainment of intentions. Research shows promise for some
goal-management rehabilitation interventions. However, evidence that alerts
assist monitoring and completion of day-to-day intentions is limited. OBJECTIVE:
To examine the efficacy of brief goal-directed rehabilitation paired with
periodic SMS text messages designed to enhance executive monitoring of intentions
(assisted intention monitoring [AIM]). METHODS: A randomized, double-blind,
controlled trial was conducted. Following a baseline phase, 74 people with ABI
and executive problems were randomized to receive AIM or control (information and
games) for 3 weeks (phase 1) before crossing over to either AIM or no
intervention (phase 2). The primary outcome was change in composite score of
proportion of daily intentions achieved. A total of 59 people (71% male; 46%
traumatic brain injury) completed all study phases. RESULTS: Per protocol
crossover analysis found a significant benefit of AIM for all intentions [ F(1,
56) = 4.28; P = .04; f = 0.28; 3.7% mean difference; 95% CI = 0.1%-7.4%] and all
intentions excluding a proxy prospective memory task [ F(1, 55) = 4.79; P = .033;
f = 0.28, medium effect size; 3% mean difference; 95% CI = 0.3%-5.6%] in the
absence of significant changes on tests of executive functioning.
Intention-to-treat analyses, comparing AIM against control at the end of phase 1
revealed no statistically significant differences in the attainment of intentions. CONCLUSION: Combining brief executive rehabilitation with alerts may
be effective for some in improving achievement of daily intentions, but further
evaluation of clinical effectiveness and mechanisms is required.

Langue : ANGLAIS