Soule Alexa C, Fish Taryn J, Thomas Kevin G F, Schrieff-Brown Leigh
Department of Psychology, ACSENT Laboratory, University of Cape Town, Cape Town, South Africa.
Department of Psychology, ACSENT Laboratory, University of Cape Town, Cape Town, South Africa.
Arch Phys Med Rehabil. 2025 Mar;106(3):433-443. doi: 10.1016/j.apmr.2024.07.010. Epub 2024 Aug 2.
To determine the extent and efficacy of attentional training as a form of neuropsychological rehabilitation to ameliorate attention deficits in adults with moderate-to-severe traumatic brain injury.
Articles published in Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PubMed, PsycINFO, Scopus, and Web of Science were searched between January 17, and February 27, 2021.
Two reviewers blindly assessed studies for eligibility according to the following criteria: any article evaluating the efficacy of any type of behavioral intervention that targeted attention (by means of cognitive rehabilitative, psychoeducational, or neuropsychological strategies, at either an individual or group level) in adults who had sustained a formally documented moderate-to-severe traumatic brain injury.
Methodological quality of each article was blindly assessed by 2 reviewers. Data were extracted from each study, including study type, sample size, sample characteristics, summary of intervention, measures used to assess attention, statistical outcomes and results, effect size, conclusion, and limitations.
7314 articles were retrieved from databases, 4325 articles remained after duplicate removal, and finally 21 articles met eligibility criteria and were included in this review. Articles represented varied methodological quality in group or single subject design. Irrespective of the heterogeneity regarding intervention types and attentional outcome measures used across the studies, overall findings suggest that attentional gains can be made in this sample, irrespective of time since injury, age, and injury severity. Further, a growing interest in technology-based interventions is frequently used and holds promise to bettering rehabilitation efforts. However, there is still limited evidence supporting the ecological validity of attentional training interventions (eg, the transfer of treatment effects to daily activities).
This article plays a crucial role in informing ongoing rehabilitation practices, guiding clinicians with evidence-based strategies and shaping future research directions for more effective attentional training guidelines.
确定注意力训练作为一种神经心理康复形式，在改善中重度创伤性脑损伤成人注意力缺陷方面的程度和效果。
检索了2021年1月17日至2月27日期间发表在《护理及相关健康文献累积索引》、《考克兰图书馆》、《PubMed》、《PsycINFO》、《Scopus》和《科学网》上的文章。
两名评审员根据以下标准盲目评估研究的 eligibility：任何评估针对注意力的任何类型行为干预（通过认知康复、心理教育或神经心理策略，在个体或群体层面）在有正式记录的中重度创伤性脑损伤成人中的效果的文章。
两名评审员盲目评估每篇文章的方法学质量。从每项研究中提取数据，包括研究类型、样本量、样本特征、干预总结、用于评估注意力的措施、统计结果和结果、效应大小、结论和局限性。
从数据库中检索到7314篇文章，去除重复后剩下4325篇文章，最终21篇文章符合eligibility标准并纳入本综述。文章在组设计或单受试者设计中代表了不同的方法学质量。尽管研究中使用的干预类型和注意力结果测量存在异质性，但总体结果表明，该样本可以获得注意力改善，无论受伤时间、年龄和损伤严重程度如何。此外，对基于技术的干预的兴趣日益增加，这些干预经常被使用，并有望改善康复效果。然而，支持注意力训练干预生态效度（例如，治疗效果向日常活动的转移）的证据仍然有限。
本文在为正在进行的康复实践提供信息、用循证策略指导临床医生以及为更有效的注意力训练指南塑造未来研究方向方面发挥着关键作用。
