a Sunnaas Rehabilitation Hospital , Nesoddtangen , Norway.
Neuropsychol Rehabil. 2014;24(1):26-60. doi: 10.1080/09602011.2013.847847. Epub 2013 Oct 30.
Executive dysfunction accounts for significant disability for many patients with spina bifida (SB), thus indicating the need for effective interventions aimed at improving executive functioning in this population. Goal Management Training™ (GMT) is a cognitive rehabilitation approach that targets disorganised behaviour resulting from executive dysfunction, and has received empirical support in studies of other patient groups. The purpose of this study was to determine if GMT would lead to perceived improved executive functioning in the daily lives of patients with SB, as evidenced by reduced report of dysexecutive problems in daily life on self- and informant questionnaires. Thirty-eight adults with SB were included in this randomised controlled trial (RCT). Inclusion was based upon the presence of executive functioning complaints. Experimental subjects (n = 24) received 21 hours of GMT, with efficacy of GMT being compared to results of subjects in a wait-list condition (n = 14). All subjects were assessed at baseline, post-intervention, and at six-month follow-up. Self-report measures indicated that the GMT group's everyday executive functioning improved significantly after training, lasting at least 6 months post-treatment. There were no significant effects on informant-report questionnaires. Overall, these findings indicate that executive difficulties in everyday life can be ameliorated for individuals with congenital brain dysfunction.
执行功能障碍导致许多脊柱裂(SB)患者出现显著残疾,这表明需要针对该人群的执行功能进行有效的干预。目标管理训练™(GMT)是一种认知康复方法,针对执行功能障碍导致的行为紊乱,在其他患者群体的研究中得到了实证支持。本研究旨在确定 GMT 是否会导致 SB 患者在日常生活中感知到执行功能的改善,表现在自我和知情人问卷中日常生活中执行功能障碍问题的报告减少。这项随机对照试验(RCT)纳入了 38 名 SB 成年人。纳入标准是存在执行功能障碍的投诉。实验组(n = 24)接受了 21 小时的 GMT,GMT 的疗效与等待组(n = 14)的结果进行了比较。所有受试者在基线、干预后和 6 个月随访时进行评估。自我报告的测量结果表明,GMT 组在训练后日常执行功能显著改善,至少持续治疗后 6 个月。知情人报告问卷没有显著影响。总体而言,这些发现表明,对于先天性脑功能障碍的个体,日常生活中的执行困难可以得到改善。