National Rehabilitation Hospital

Rehabilitation of Awareness of Deficits in Patients with Traumatic Brain Injury Applying a User-friendly Computerised Intervention Approach

Principal Researchers: Mary FitzGerald, Dr. Simone Carton, Dr. Paul Dockree (TCD), & Dr. Jacinta Morgan.

Objective : Awareness of errors is an important prerequisite in rehabilitation.  Few studies have investigated rehabilitation of error awareness following acquired brain injury.  Pilot research has shown that receiving feedback about errors during a computerised task of sustained attention improves performance in patients who have sustained a traumatic brain injury.  In this study, a computer-based intervention training programme aimed at improving error awareness was developed. 

Participants and Methods:  20 patients who sustained a Traumatic or Acquired Brain Injury and had low error awareness level were enrolled in the study.  Matched random groups design was used to test the effects of audio-visual feedback on error awareness.  One group (n=10) received audio-visual feedback on errors and a second group (n=10) did not receive feedback on error.  The task involved responding or withholding a response to specific images on a computer screen.  Training was undertaken in 8 sessions over 4 weeks. 

Results: Analysis of pre and post intervention measures indicated that error awareness improved for all participants, and that the improvement was greater for the feedback group.  An unexpected finding was that during recruitment more than 80 candidates with serious and recently diagnosed ABI were excluded because they had high levels of error awareness.

Conclusions : This intervention provides an engaging task suitable for use amongst a broad age span that can be delivered in the home, community or clinical setting.  Its potential use for assessing as well as rehabilitating error awareness shall be explored further.

Acknowledgements: The authors would like to thank the patients of the National Rehabilitation Hospital.  This work was supported by grants from the Health Research Board, National Rehabilitation Hospital Trust, UCD Seed Fund, and National Disability Authority.

Final Report presented to the NRH Ethics Committee –  May 2010