The efficacy of prospective memory rehabilitation plus metacognitive skills training for adults with traumatic brain injury: study protocol for a randomized controlled trialReport as inadecuate

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, 18:3

First Online: 05 January 2017Received: 14 September 2016Accepted: 15 December 2016DOI: 10.1186-s13063-016-1758-6

Cite this article as: Fleming, J., Ownsworth, T., Doig, E. et al. Trials 2017 18: 3. doi:10.1186-s13063-016-1758-6


BackgroundImpairment of prospective memory PM is common following traumatic brain injury TBI and negatively impacts on independent living. Compensatory approaches to PM rehabilitation have been found to minimize the impact of PM impairment in adults with TBI; however, poor self-awareness after TBI poses a major barrier to the generalization of compensatory strategies in daily life. Metacognitive skills training MST is a cognitive rehabilitation approach that aims to facilitate the development of self-awareness in adults with TBI. This paper describes the protocol of a study that aims to evaluate the efficacy of a MST approach to compensatory PM rehabilitation for improving everyday PM performance and psychosocial outcomes after TBI.

Methods-designThis randomized controlled trial has three treatment groups: compensatory training plus metacognitive skills training COMP-MST, compensatory training only COMP, and waitlist control. Participants in the COMP-MST and COMP groups will complete a 6-week intervention consisting of six 2-h weekly training sessions. Each 1.5-h session will involve compensatory strategy training and 0.5 h will incorporate either MST COMP-MST group or filler activity as an active control COMP group. Participants in the waitlist group receive care as usual for 6 weeks, followed by the COMP-MST intervention. Based on the sample size estimate, 90 participants with moderate to severe TBI will be randomized into the three groups using a stratified sampling approach. The primary outcomes include measures of PM performance in everyday life and level of psychosocial reintegration. Secondary outcomes include measures of PM function on psychometric testing, strategy use, self-awareness, and level of support needs following TBI. Blinded assessments will be conducted pre and post intervention, and at 3-month and 6-month follow-ups.

DiscussionThis study seeks to determine the efficacy of COMP-MST for improving and maintaining everyday PM performance and level of psychosocial integration in adults with moderate to severe TBI. The findings will advance theoretical understanding of the role of self-awareness in compensatory PM rehabilitation and skills generalization. COMP-MST has the potential to reduce the cost of rehabilitation and lifestyle support following TBI because the intervention could enhance generalization success and lifelong application of PM compensatory strategies.

Trial registrationNew Zealand Clinical Trials Registry, ACTRN12615000996561. Registered on 23 September 2015; retrospectively registered 2 months after commencement.

KeywordsBrain injury Prospective memory Self-awareness Rehabilitation Randomized controlled trial AbbreviationsAQAwareness Questionnaire

BAPMBrief Assessment of Prospective Memory

CAMPROMPTCambridge Prospective Memory Test

CANSCare and Needs Scale

COMPCompensatory approaches to prospective memory rehabilitation

COMP-MSTCompensatory approaches to prospective memory rehabilitation plus metacognitive skills training

GCSGlasgow Coma Scale

HRECHuman Research Ethics Committees

MSTMetacognitive skills training

PMProspective memory

PTAPost-traumatic amnesia

RCTRandomized controlled trial

RMRetrospective memory

SPRS-2Sydney Psychosocial Reintegration Scale version 2

TBITraumatic brain injury

Electronic supplementary materialThe online version of this article doi:10.1186-s13063-016-1758-6 contains supplementary material, which is available to authorized users.

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Author: Jennifer Fleming - Tamara Ownsworth - Emmah Doig - Lauren Hutton - Janelle Griffin - Melissa Kendall - David H. K. Shum


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