Article

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.

Langue : ANGLAIS