Bhanu Sharma1,2, Jennifer C Tomaszczyk2, Deirdre Dawson1,2,3,4, Gary R Turner5, Brenda Colella2, Robin E A Green1,2. 1. a Rehabilitation Sciences Institute (Formerly Graduate Department of Rehabilitation Science) , University of Toronto , Toronto , Ontario , Canada. 2. b Toronto Rehabilitation Institute , University Health Network , Toronto , Ontario , Canada. 3. c Rotman Research Institute, Baycrest , Toronto , Ontario , Canada. 4. d Department of Occupational Science & Occupational Therapy , University of Toronto , Toronto , Ontario , Canada. 5. e Department of Psychology , York University , Toronto , Ontario , Canada.
Abstract
PURPOSE: Cognitive environmental enrichment (C-EE) offers promise for offsetting neural decline that is observed in chronic moderate-severe traumatic brain injury (TBI). Brain games are a delivery modality for C-EE that can be self-administered over the Internet without therapist oversight. To date, only one study has examined the feasibility of self-administered brain games in TBI, and the study focused predominantly on mild TBI. Therefore, the primary purpose of the current study was to examine the feasibility of self-administered brain games in moderate-severe TBI. A secondary and related purpose was to examine the feasibility of remote monitoring of any C-EE-induced adverse symptoms with a self-administered evaluation tool. METHOD: Ten patients with moderate-severe TBI were asked to complete 12 weeks (60 min/day, five days/week) of online brain games with bi-weekly self-evaluation, intended to measure any adverse consequences of cognitive training (e.g., fatigue, eye strain). RESULTS: There was modest weekly adherence (42.6% ± 4.4%, averaged across patients and weeks) and 70% patient retention; of the seven retained patients, six completed the self-evaluation questionnaire at least once/week for each week of the study. CONCLUSIONS: Even patients with moderate-severe TBI can complete a demanding, online C-EE intervention and a self-administered symptom evaluation tool with limited therapist oversight, though at daily rate closer to 30 than 60 min per day. Further self-administered C-EE research is underway in our lab, with more extensive environmental support. Implications for Rehabilitation Online brain games (which may serve as a rehabilitation paradigm that can help offset the neurodegeneration observed in chronic TBI) can be feasibly self-administered by moderate-to-severe TBI patients. Brain games are a promising therapy modality, as they can be accessed by all moderate-to-severe TBI patients irrespective of geographic location, clinic and/or therapist availability, or impairments that limit mobility and access to rehabilitation services. Future efficacy trials that examine the effect of brain games for offsetting neurodegeneration in moderate-to-severe TBI patients are warranted.
PURPOSE: Cognitive environmental enrichment (C-EE) offers promise for offsetting neural decline that is observed in chronic moderate-severe traumatic brain injury (TBI). Brain games are a delivery modality for C-EE that can be self-administered over the Internet without therapist oversight. To date, only one study has examined the feasibility of self-administered brain games in TBI, and the study focused predominantly on mild TBI. Therefore, the primary purpose of the current study was to examine the feasibility of self-administered brain games in moderate-severe TBI. A secondary and related purpose was to examine the feasibility of remote monitoring of any C-EE-induced adverse symptoms with a self-administered evaluation tool. METHOD: Ten patients with moderate-severe TBI were asked to complete 12 weeks (60 min/day, five days/week) of online brain games with bi-weekly self-evaluation, intended to measure any adverse consequences of cognitive training (e.g., fatigue, eye strain). RESULTS: There was modest weekly adherence (42.6% ± 4.4%, averaged across patients and weeks) and 70% patient retention; of the seven retained patients, six completed the self-evaluation questionnaire at least once/week for each week of the study. CONCLUSIONS: Even patients with moderate-severe TBI can complete a demanding, online C-EE intervention and a self-administered symptom evaluation tool with limited therapist oversight, though at daily rate closer to 30 than 60 min per day. Further self-administered C-EE research is underway in our lab, with more extensive environmental support. Implications for Rehabilitation Online brain games (which may serve as a rehabilitation paradigm that can help offset the neurodegeneration observed in chronic TBI) can be feasibly self-administered by moderate-to-severe TBIpatients. Brain games are a promising therapy modality, as they can be accessed by all moderate-to-severe TBIpatients irrespective of geographic location, clinic and/or therapist availability, or impairments that limit mobility and access to rehabilitation services. Future efficacy trials that examine the effect of brain games for offsetting neurodegeneration in moderate-to-severe TBIpatients are warranted.
Authors: Anne-Fleur Domensino; Jolanda C M van Haastregt; Ieke Winkens; Coen A M van Bennekom; Caroline M van Heugten Journal: PLoS One Date: 2020-06-22 Impact factor: 3.240
Authors: Asaf Gilboa; Robin Green; Zorry Belchev; Mary Ellene Boulos; Julia Rybkina; Kadeen Johns; Eliyas Jeffay; Brenda Colella; Jason Ozubko; Michael Johnathan Charles Bray; Nicholas Di Genova; Adina Levi; Alana Changoor; Thomas Worthington Journal: BMJ Open Date: 2021-02-11 Impact factor: 2.692
Authors: Melissa Miao; Rachael Rietdijk; Melissa Brunner; Deborah Debono; Leanne Togher; Emma Power Journal: J Med Internet Res Date: 2022-07-26 Impact factor: 7.076
Authors: Henry W Mahncke; Joseph DeGutis; Harvey Levin; Mary R Newsome; Morris D Bell; Chad Grills; Louis M French; Katherine W Sullivan; Sarah-Jane Kim; Annika Rose; Catherine Stasio; Michael M Merzenich Journal: Brain Date: 2021-08-17 Impact factor: 15.255