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George K. Hung, Neil K. Agarwal, Bilal Nadeem, Satvik Shah, Kenneth J. Ciuffreda; Effects of Video-Based Training on Traumatic Brain Injury Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4707.
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To assess in a pilot study the effectiveness of video-based training on traumatic brain-injured (TBI) patients at a hospital-based extended recovery unit (JFK Hartwyck Rehabilitation Center, Edison, NJ).
Two patients with moderate traumatic brain injury, and one patient with a brain tumor and subsequent stroke, were recruited from the hospital patient population. Ages were 19, 23, and 18 years, respectively. Three normal individuals of similar ages served as controls. A special keyboard was designed with 3 active function keys. Six specific computer-driven video-based cognitive training procedures were developed: size comparison, figure identification, three-figure movement identification, location matching, occupation matching, and monetary-amount matching. The 15 minutes-duration training sessions were conducted at weekly intervals over a twelve-week period. Reaction time (msec) and correctness of response (%) were quantitatively assessed. In the controls, testing was performed under fatigued and non-fatigued conditions to assess if the patient responses could be related to fatigue, as well as brain injury.
Patients’ overall mean reaction time decreased exponentially during the 12-week training period, with performance reaching an asymptotic level of about 2 sec. This was still longer than the 1 sec mean level found in the control subjects under both the normal fatigue (p < 0.01) and non-fatigue (p < 0.01) conditions across all procedures. There was no significant difference between the normals under the fatigue and non-fatigue conditions (p = 0.52). Further, there was no difference in the percentage of correct responses (~ 90 %) between the patients and normals under all conditions.
The findings indicated that patients with TBI exhibited a cognitive deficit (as measured by reaction time) when compared to normals, which was reduced with training. Moreover, this deficit cannot be characterized as being similar to the fatigue condition in normals. Although requiring longer mean time for task completion, the TBI patients nevertheless achieved similar accuracy as normals (~90%). Further testing will be conducted in the future using different, and more difficult, test conditions and tasks.
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