Working memory training for patients with acquired brain injury: effects in daily life

Institution: Habilitering & Halsa, Stockholm, Sweden

Title: Working memory training for patients with acquired brain injury: effects in daily life

Researcher(s): Johansson, B., & Tornmalm, M.

Program: Cogmed QM

Published: Scandinavian Journal of Occupational Therapy

Overview: Individuals with acquired brain injury struggle with working memory deficits that are commonly experienced as difficulties with multi-tasking, forgetfulness and distractibility. The aim of this Cogmed training study was to examine whether working memory training, coaching, peer support and education would impact the perceived daily functioning of patients with acquired brain injury.

A sample of 18 adults, mean age 47.5 years, with acquired brain injury (TBI, tumor, and stroke) trained with Cogmed QM in groups of 4 to 6 people for 30 -45 minutes a day, 3 times a week for 7 to 8 weeks. In addition to training, participants also exchanged experiences of working memory deficits for 30 minutes on each training day as well as, learned about the function of working memory in everyday life for 30 minutes on each training day. Researchers collected self-report ratings of cognitive failures (CFQ; Cognitive Failures Questionnaire) and self-report ratings of occupational performance (COPM; Canadian Occupational Performance Measure) pre-, post- and 6 months after training. Participants also kept records of their progress and problems with working memory training in a diary and reported subjective changes in daily functioning in an interview at 6 month follow-up.

Results: Following training, all participants improved on the trained working memory tasks. Participants with the lowest baseline training performance showed the greatest improvement during training. Patients self-reported reduced cognitive failures on the CFQ at post-training that were maintained at 6 month follow-up as well as, significant improvements in occupational performance and satisfaction with job performance. Qualitative content analysis of interview data revealed that patients generally had an increased understanding of how working memory deficits impaired their daily life and had increased confidence in their ability to remember where they were and how to return.

Summary and Implications: Although this study included a small sample size and lacked a control group, acquired brain injury patients successfully completed training with Cogmed QM and reported improved occupational performance and decreased cognitive failures. Patient’s also described feeling positively about group training and being afforded the opportunity to commune with others struggling with acquired brain injury. Participant revealed that adaptive training more than 3 times per week would not have been feasible, implying that different training schedules for Cogmed should be evaluated in the future. Despite the intense and difficult nature of Cogmed QM, all participants in this study reported that they would recommend the program to others in the same situation.