Journal of the International Neuropsychological Society

Research Articles

Effects of a multifaceted treatment program for executive dysfunction after acquired brain injury on indications of executive functioning in daily life

JACOBA M. SPIKMANa1a2 c1, DANIELLE H.E. BOELENa3a4, KIRSTEN F. LAMBERTSa1, WIEBO H. BROUWERa1a2 and LUCIANO FASOTTIa3a4

a1 Department of Neurology, Unit Neuropsychology, University Medical Center Groningen, the Netherlands

a2 Department of Clinical Neuropsychology, University of Groningen, the Netherlands

a3 Sint Maartenskliniek, Research Development and Education, Nijmegen, the Netherlands

a4 Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands

Abstract

A multicenter randomized control trial (RCT) was conducted to evaluate the effects of a treatment for dysexecutive problems after acquired brain injury (ABI) on daily life functioning. Seventy-five ABI patients were randomly allocated to either the experimental treatment, multifaceted strategy training for executive dysfunction, or a control treatment, computerized cognitive function training. Assessment took place before, directly after, and 6 months post-treatment. The primary outcome measure, the Role Resumption List (RRL), and two other follow-up measures, the Treatment Goal Attainment (TGA) and the Executive Secretarial Task (EST), were indications of daily life executive functioning. The experimental group improved significantly more over time than the controls on the RRL and attained significantly higher scores on the TGA and EST. We conclude that our treatment has resulted in significant improvements of executive functioning in daily life, lasting at least 6 months post-treatment. Although control patients’ satisfaction and subjective well-being were at the same level, the experimental group had better abilities to set and accomplish realistic goals, to plan, initiate, and regulate a series of real-life tasks, and to resume previous roles with respect to work, social relations, leisure activities, and mobility. (JINS, 2010, 16, 118–129.)

(Received November 28 2008)

(Reviewed September 16 2009)

(Accepted September 16 2009)

Correspondence:

c1 Correspondence and reprint requests to: Jacoba M. Spikman, Department of Neurology, Unit Neuropsychology, University Medical Center Groningen (UMCG), PO Box 30.001, 9700 RB Groningen, The Netherlands. E-mail: j.m.spikman@rug.nl