Defense and Veterans Brain Injury Center.
Neuropsychology. 2013 Nov;27(6):666-79. doi: 10.1037/a0034117. Epub 2013 Sep 23.
We report preliminary findings on the efficacy of interactive metronome (IM) therapy for the remediation of cognitive difficulties in soldiers with persisting cognitive complaints following blast-related mild-to-moderate traumatic brain injury (TBI).
Forty-six of a planned sample of 50 active duty soldiers with persistent cognitive complaints following a documented history of blast-related TBI of mild-to-moderate severity were randomly assigned to receive either standard rehabilitation care (SRC) or SRC plus a 15-session standardized course of IM therapy. Primary outcome measures were Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Index Scores. Secondary outcome measures included selected subtests from the Delis-Kaplan Executive Functioning System (Trail Making Test and Color-Word Interference) and the Wechsler Adult Intelligence Scale-Fourth Edition (Symbol Search, Digit-Symbol Coding, Digit Span, and Letter-Number Sequencing) as well as the Integrated Visual and Auditory Continuous Performance Test.
Significant group differences (SRC vs. IM) were observed for RBANS Attention (p = .044), Immediate Memory (p = .019), and Delayed Memory (p = .031) indices in unadjusted analyses, with the IM group showing significantly greater improvement at Time 2 than the SRC group, with effect sizes in the medium-to-large range in the adjusted analyses for each outcome (Cohen's d = 0.511, 0.768, and 0.527, respectively). Though not all were statistically significant, effects in 21 of 26 cognitive outcome measures were consistently in favor of the IM treatment group (binomial probability = .00098).
The addition of IM therapy to SRC appears to have a positive effect on neuropsychological outcomes for soldiers who have sustained mild-to-moderate TBI and have persistent cognitive complaints after the period for expected recovery has passed.
我们报告了互动节拍器（IM）治疗对经历过爆震相关轻度至中度创伤性脑损伤（TBI）后持续存在认知障碍的士兵认知困难矫正效果的初步发现。
46 名现役士兵在经历过爆震相关轻度至中度 TBI 后出现持续认知障碍，并记录了病史，他们被随机分配接受标准康复护理（SRC）或 SRC 加 15 节标准化 IM 治疗课程。主要结局测量是重复性脑力状态评估测试（RBANS）指数评分。次要结局测量包括来自 Delis-Kaplan 执行功能系统（连线测试和颜色-单词干扰）和韦氏成人智力量表第四版（符号搜索、数字符号编码、数字跨度和字母数字序列）的选定子测验，以及综合视觉和听觉连续绩效测试。
在未调整分析中，SRC 与 IM 组在 RBANS 注意力（p =.044）、即刻记忆（p =.019）和延迟记忆（p =.031）指数上存在显著的组间差异，IM 组在第二次测试时的改善明显大于 SRC 组，在调整后的分析中，每个结果的效应大小均在中到大范围（Cohen's d 分别为 0.511、0.768 和 0.527）。尽管并非所有结果都具有统计学意义，但在 26 项认知结局测量中有 21 项的结果始终有利于 IM 治疗组（二项式概率 =.00098）。
在 SRC 中加入 IM 治疗似乎对经历过轻度至中度 TBI 并在预期恢复期后持续存在认知障碍的士兵的神经心理学结局产生积极影响。
