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Table 6.2 The Effect of Dual-Task Training on Speed of Processing Post ABI

Author Year

Country

Research Design

PEDro

Sample Size

Methods Outcome

Couillet et al. (2010)

France

RCT

PEDro=5

N=12

Population: severe TBI; Gender: Male=9, Female=3. Group 1 (n=5): Mean Age=23.8yr; Mean GCS=4.8; Mean Time Post Injury=6.3mo. Group 2 (n=7): Mean Age=26.7yr; Mean GCS=4.8; Mean Time Post Injury=16.1mo.

Intervention: Randomized AB versus BA design, where “A” represents the control phase and “B” represents the treatment (dual-task training) phase. In the dual-task phase, patients were trained to conduct two concurrent tasks simultaneously. Group 1 started with the control phase (AB) and Group 2 (BA) with the treatment phase. Each phase lasted 6 wk (4, 1 hr sessions/wk).

Outcome Measure: Test Battery for Attentional Performance (TAP: divided attention and flexibility subtests), Go-no go and Digit Span, Trail Making Test, Stroop Test, Brown-Peterson Paradigm, Rating Scale of Attentional Behaviour.

1.        Following training, there was a significant improvement in the 2 tasks that targeted divided attention (TAP-divided attention, Go-no go and Digit Span: p<0.0001 for both).

2.        The two groups differed significantly at 6 wk with those in the BA design doing better on TAP reaction times (p<0.01), the digit span dual-task (p<0.001), and the Rating Scale of Attentional Behaviour (p<0.01).

3.        There were significant differences between groups at 6 wks on the Stroop test (p<0.001) and the flexibility subtest of the TAP (p<0.001), but not the Trail Making Test or the Brown-Peterson task.

4.        Experimental training had no significant effects on non-target measures.

Stablum et al. (2000)

Italy

Case-Control

N=38

Population: Condition:

Chronic Head Injury (CHI)=10 [mean age:25.6 yr, time since injury: 27.8 months].

Anterior Communicating Artery Aneurysm (ACoA)=9 [mean age: 43.22 yr, time since injury=3.66 months].

Controls=19 (CHI study n=10, ACoA study n=9; Age Range: 14-68yr).

Intervention:

CHI study:

Neuropsychological assessments (i.e., Wisconsin Card Sorting Task (WCST), Paced Auditory Serial Addition Task (PASAT)) were conducted.

As well as a Dual-Task Paradigm: Participant had to indicate the position (right or left) of the stimuli and saying aloud if stimuli were congruent. Participants were evaluated at baseline, retest after treatment, and at 3 months follow-up.

ACoA study:

Neurological Assessments and Dual-task paradigm were conducted similar to the CHI study, but participants also performed a Continuous Performance Task (CPT) measuring inhibition responses in executive functioning.

Participants were evaluated at baseline, retest after treatment, and at 3 months and 12 months follow-up.

Outcome Measure: WCST, PASAT, CPT, dual-task cost.

CHI study:

1.        Significant difference between patients and controls on number of preservative errors (p<0.017) and categories (p<0.020) achieved in WCST, and PASAT mean time (p=0.031).

2.        Reaction time was slower for CHI patients than controls in dual-task (p<0.005); dual task cost significantly greater for CHI patients than controls (p<0.028).

3.        At retest and at 3-months follow-up reaction time was slower for CHI patients than controls (p<0.0001); but patients demonstrated a greater reduction in dual-task cost after treatment (54 vs 22 ms).

ACoA Study:

4.        ACoA patients had slower reaction times than controls on CPT (p<0.001).

5.        Reaction time for closed head injury (p<0.0001) and aneurysm (p<0.007) group significantly slower than control.

6.        Inhibiting a habitual response took ACoA patients significantly longer than controls on the CPT (p<0.011).

7.        The dual-task cost was greater for the ACoA group compared to the control group (p<0.0001).

8.        The dual-task cost was significantly greater at assessment than at retest, 3, and 12-month followup (p<0.0001); after treatment ACoA patients could co-ordinate two responses as efficiently as controls at 6-month re-assessment.