Cognitive training for post-acute traumatic brain injury: A systematic review and meta-analysis

Objective: to quantitatively aggregate effects of cognitive training (ct) on cognitive and functional outcome measures in patients with traumatic brain injury (tbi) more than 12-months post-injury. design: we systematically searched six databases for non-randomized and randomized controlled trials of ct in tbi patients at least 12-months post-injury reporting cognitive and/or functional outcomes. main measures: efficacy was measured as standardized mean difference (hedges’ g) of post-training change. we investigated heterogeneity across studies using subgroup analyses and meta-regressions. results: fourteen studies encompassing 575 patients were included. the effect of ct on overall cognition was small and statistically significant (g = 0.22,95%ci0.05 to 0.38; p = 0.01),with low heterogeneity (i2 = 11.71%) and no evidence of publication bias. a moderate effect size was found for overall functional outcomes (g = 0.32,95%ci0.08 to 0.57,p = 0.01) with low heterogeneity (i2 = 14.27%) and possible publication bias. statistically significant effects were also found only for executive function (g = 0.20,95%ci 0.02 to 0.39,p = 0.03) and verbal memory (g = 0.32,95%ci 0.14 to 0.50,p < 0.01). conclusion: despite limited studies in this field,this meta-analysis indicates that ct is modestly effective in improving cognitive and functional outcomes in patients with post-acute tbi and should therefore play a more significant role in tbi rehabilitation. © 2016 hallock,collins,lampit,deol,fleming and valenzuela.