Krasny-Pacini Agata, Chevignard Mathilde, Evans Jonathan
University Rehabilitation Center Clemenceau , Strasbourg , France .
Disabil Rehabil. 2014;36(2):105-16. doi: 10.3109/09638288.2013.777807. Epub 2013 Apr 18.
To determine if Goal Management Training (GMT) is effective for the rehabilitation of executive functions following brain injury when administered alone or in combination with other interventions.
Systematic review, with quality appraisal specific to executive functions research and calculation of effect sizes.
Twelve studies were included. Four studies were "Proof-of-principle" studies, testing the potential effectiveness of GMT and eight were rehabilitation studies. Effectiveness was greater when GMT was combined with other interventions. The most effective interventions appeared to be those combing GMT with: Problem Solving Therapy; personal goal setting; external cueing or prompting apply GMT to the current task; personal homework to increase patients' commitment and training intensity; ecological and daily life training activities rather than paper-and-pencil, office-type tasks. Level of support for GMT was higher for studies measuring outcome in terms of increases in participation in everyday activities rather than on measures of executive impairment.
Comprehensive rehabilitation programs incorporating GMT, but integrating other approaches, are effective in executive function rehabilitation following brain injury in adults. There is insufficient evidence to support use of GMT as a stand-alone intervention.
确定目标管理训练（GMT）单独使用或与其他干预措施联合使用时，对脑损伤后执行功能的康复是否有效。
进行系统评价，并对执行功能研究进行质量评估及效应量计算。
纳入12项研究。4项为“原理验证”研究，测试GMT的潜在有效性，8项为康复研究。GMT与其他干预措施联合使用时效果更佳。最有效的干预措施似乎是将GMT与以下措施相结合：问题解决疗法；个人目标设定；外部提示或在当前任务中应用GMT；增加患者投入度和训练强度的个人作业；生态及日常生活训练活动，而非纸笔类、办公室类型的任务。对于以日常活动参与度增加来衡量结果的研究，对GMT的支持程度高于以执行功能损伤指标衡量的研究。
纳入GMT但整合其他方法的综合康复方案，对成人脑损伤后的执行功能康复有效。尚无足够证据支持将GMT作为单一干预措施使用。
