title: Computerised cognitive training in acquired brain injury: A systematic review of outcomes using the International Classification of Functioning (ICF).
abstract: Computerised cognitive training (CCT) is an increasingly popular intervention for people experiencing cognitive symptoms. This systematic review evaluated the evidence for CCT in adults with acquired brain injury (ABI), focusing on how outcome measures used reflect efficacy across components of the International Classification of Functioning, Disability and Health. Database searches were conducted of studies investigating CCT to treat cognitive symptoms in adult ABI. Scientific quality was rated using the PEDro-P and RoBiNT Scales. Ninety-six studies met the criteria. Most studies examined outcomes using measures of mental functions (93/96, 97%); fewer studies included measures of activities/participation (41/96, 43%) or body structures (8/96, 8%). Only 14 studies (15%) provided Level 1 evidence (randomised controlled trials with a PEDro-P score ≥ 6/10), with these studies suggesting strong evidence for CCT improving processing speed in multiple sclerosis (MS) and moderate evidence for improving memory in MS and brain tumour populations. There is a large body of research examining the efficacy of CCT, but relatively few Level 1 studies and evidence is largely limited to body function outcomes. The routine use of outcome measures of activities/participation would provide more meaningful evidence for the efficacy of CCT. The use of body structure outcome measures (e.g., neuroimaging) is a newly emerging area, with potential to increase understanding of mechanisms of action for CCT.
authors.affiliation: a John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern, University of Sydney , St Leonards , NSW , Australia.|b Brain Injury Rehabilitation Unit , Liverpool Hospital , Sydney , Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Sigmundsdottir
authors.affiliation: a John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern, University of Sydney , St Leonards , NSW , Australia.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Longley
authors.affiliation: a John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern, University of Sydney , St Leonards , NSW , Australia.
authors.forename: Robyn L
authors.initials: RL
authors.lastname: Tate
mesh_terms: D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation*; D001932:Brain Neoplasms / Q000523:psychology / Q000534:rehabilitation*; D004660:Encephalitis / Q000534:rehabilitation; D004827:Epilepsy / Q000534:rehabilitation; D006801:Humans; D009103:Multiple Sclerosis / Q000523:psychology / Q000534:rehabilitation*; D000066530:Neurological Rehabilitation; D020521:Stroke; D000071939:Stroke Rehabilitation; D013813:Therapy, Computer-Assisted; D016896:Treatment Outcome
keywords: Acquired brain injury; ICF; cognitive rehabilitation; computerised cognitive training; systematic review