Johansson Berit, Tornmalm Marjana
Habilitering & Hälsa, Stockholm, Sweden.
Scand J Occup Ther. 2012 Mar;19(2):176-83. doi: 10.3109/11038128.2011.603352. Epub 2011 Aug 15.
Working memory deficits are common after brain injury and cause multiple problems for patients in daily life. Research has shown that it is possible to improve working memory functioning by training. The aim of this study was to examine whether patients with moderate to severe cognitive deficits after brain injury could profit from working memory training and if that training had any impact on their daily life activities. A training programme was designed consisting of computerized training software (Cogmed QM), coaching, education, and peer support. The design was a prospective cohort study in a naturalistic setting at an outpatient centre for persons with acquired brain injury.
Participants were 18 patients, aged 17-64, who had difficulties in daily life pertaining to working memory deficits. Data were collected pre- and post-training and at a six-month follow-up.
Despite relatively severe cognitive deficits patients were able to carry out a demanding training programme with positive results. The computerized training showed a significant improvement on trained working memory tasks. Patients starting at a low training level improved the most. Self-rating measurements and interviews indicated that patients experienced fewer cognitive problems in daily life after training. The effect was maintained at the six month follow-up. Training results were not affected by age or time post-injury (1-22 years).
工作记忆缺陷在脑损伤后很常见，给患者的日常生活带来诸多问题。研究表明，通过训练有可能改善工作记忆功能。本研究的目的是检验脑损伤后中度至重度认知缺陷患者是否能从工作记忆训练中获益，以及该训练对他们的日常生活活动是否有任何影响。设计了一个训练方案，包括计算机化训练软件（Cogmed QM）、辅导、教育和同伴支持。该设计是在一家后天性脑损伤患者门诊中心的自然环境中进行的前瞻性队列研究。
参与者为18名年龄在17 - 64岁之间、因工作记忆缺陷在日常生活中存在困难的患者。在训练前、训练后以及六个月随访时收集数据。
尽管存在相对严重的认知缺陷，患者仍能够完成一项要求较高的训练方案并取得积极成果。计算机化训练在训练的工作记忆任务上显示出显著改善。起始训练水平较低的患者改善最大。自我评定测量和访谈表明，训练后患者在日常生活中经历的认知问题减少。这种效果在六个月随访时得以维持。训练结果不受年龄或受伤后时间（1 - 22年）的影响。
