Strategy Game Supporting Goal Management Training Intervention
Condition: Acquired Brain Injury; Executive Dysfunction; Neuropsychological Rehabilitation
MeSH terms: Brain Injuries
Study type: Interventional

Summary: 
      Many brain-injured patients referred for outpatient rehabilitation have difficulties with
      planning, problems solving, and reasoning. These difficulties can be characterized as
      executive deficits, which can vary from relatively mild to rather severe. Executive deficits
      lead to real-life everyday disorganization and difficulties in instrumental activities of
      daily living (IADL tasks). Goal Management Training (GMT) is a successful treatment for
      executive deficits and helps to structure activities in daily life. GMT entails learning and
      applying an algorithm, in which a daily task is subdivided into multiple steps to handle
      executive difficulties of planning, and problem solving. Patients are taught compensatory
      strategies not to strengthen the executive functions, but to enable them to minimize
      disabilities and participation problems and to function more independently in daily life. The
      currently implemented GMT treatment in the Netherlands is aimed at relearning two specific
      tasks. However, to adopt the GMT strategy and ensure maximal profitability for patients, they
      have to learn to use the algorithm in different situations and tasks, which requires a
      comprehensive, time-consuming and thus labour-intensive treatment. Along with this, brain
      games become increasingly attractive as an (add-on) intervention, most notably in an effort
      to develop home-based personalized care, and because of their machine learning algorithms
      which tailors the game to the level of the individual player. Until now, however, the
      rationale behind brain games is based on what can be considered the restorative approach
      (i.e. strengthening of executive problems) rather than practicing compensatory strategies,
      with no transfer to improvements in daily life functioning. The present study fills a gap in
      the literature by investigating a new developed treatment that incorporates GMT and a
      treatment supporting strategy game in a pilot sample of brain injured patients. The primary
      objective of this pilot study is to obtain an efficacy estimate and investigate the
      feasibility of GMT with a new game that incorporates strategy training in improving executive
      functions in a pilot sample of brain-injured patients. This study investigates usability and
      acceptability of our new developed GMT treatment to brain-injured patients in the chronic
      phase (>3 months post-onset), and obtains an efficacy estimate, focusing on transfer of
      treatment effects to untrained (instrumental) activities of daily living. Chronic
      brain-injured patients will be allocated to the game-supported GMT treatment or to an
      information group using block randomization. It will be an assessor blind study in which
      researchers responsible for assessing or analyzing data will be blind for the received
      treatment.
    


Intervention name(s): Game-Supported Goal Management Training; Information Group
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The investigational treatment is based on a compensatory strategy training named Goal Management Training (GMT). The investigational treatment will include GMT in combination with a compensatory strategy game which allows the patient to learn and apply the algorithm of GMT in a safe and controlled environment. This means that the multiple steps of the GMT will be learned during the treatment sessions under guidance of a therapist as well as in their own home environment by using the compensatory strategy game.; In the information group, patients are informed about non-specific consequences of acquired brain injury, aimed to increase patient's insight into their condition and with that improving functioning. The program consists of the following subjects: 1) cause of brain injury, 2) information processing and attention, 3) memory, 4) planning and performance, 5) fatigue, 6) changes in emotion and behavior and 7) processing and adjustments.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment