A randomised controlled trial of a web-based multi-modal therapy program to improve executive functioning in children and adolescents with acquired brain injury

作者：Piovesana, Adina^*; Ross, Stephanie; Lloyd, Owen; Whittingham, Koa; Ziviani, Jenny; Ware, Robert S.; McKinlay, Lynne; Boyd, Roslyn N.

来源：Clinical Rehabilitation, 2017, 31(10): 1351-1363.

DOI：10.1177/0269215517695373

• Executive functioning
• acquired brain injury
• intervention
• RCT
• children and adolescents

Objective: To examine the efficacy of a multi-modal web-based therapy program, Move it to improve it (Mitii (TM)) delivered at home to improve Executive Functioning (EF) in children with an acquired brain injury (ABI).
Design: Randomised Waitlist controlled trial.
Setting: Home environment.
Participants: Sixty children with an ABI were matched in pairs by age and intelligence quotient then randomised to either 20-weeks of Mitii (TM) training or 20 weeks of Care As Usual (waitlist control; n= 30; 17 males; mean age= 11y, 11m (+/- 2y, 6m); Full Scale IQ= 76.24 +/- 17.84). Fifty-eight children completed baseline assessments (32 males; mean age= 11.87 +/- 2.47; Full Scale IQ= 75.21 +/- 16.76).
Main Measures: Executive functioning was assessed on four domains: attentional control, cognitive flexibility, goal setting, and information processing using subtests from the Wechsler Intelligence Scale for Children (WISC-IV), Delis-Kaplan Executive Functioning System (D-KEFS), Comprehensive Trail Making Test (CTMT), Tower of London (TOL), and Test of Everyday Attention for Children (Tea-Ch). Executive functioning performance in everyday life was assessed via parent questionnaire (Behaviour Rating Inventory of Executive Functioning; BRIEF).
Results: No differences were observed at baseline measures. Groups were compared at 20-weeks using linear regression with no significant differences found between groups on all measures of EF. Out of a potential total dose of 60 hours, children in the Mitii (TM) group completed a mean of 17 hours of Mitii (TM) intervention.
Conclusion: Results indicate no additional benefit to receiving Mitii (TM) compared to standard care. Mitii (TM), in its current form, was not shown to improve EF in children with ABI.

• 出版日期2017-10