Measuring Impairment-Specific Gains in Individual Cognitive Rehabilitation Through a Systematic Therapy Protocol.

IF 2.3 3区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY American Journal of Speech-Language Pathology Pub Date : 2024-11-04 Epub Date: 2024-10-01 DOI:10.1044/2024_AJSLP-23-00421

Riya Saxena, Christianna Gilbert, Swathi Kiran, Claire Cordella

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Abstract

Purpose: This study investigated treatment-induced performance gains in memory function following therapy through the Intensive Cognitive Communication Rehabilitation (ICCR) program for young adults with acquired brain injury (ABI). We aimed to determine the utility of a novel approach to measuring memory performance improvement across semesters of therapy using (a) systematic treatment tasks called Individualized Quantitative Protocols (IQPs) as compared to (b) standardized measures of memory function.

Method: Retrospective IQP data spanning five consecutive ICCR semesters were collected from patients (N = 13) with ABI. Raw task-accuracy data were scaled to account for task difficulty gradation. Linear mixed-effects models (LMMs) were used to evaluate the degree of memory improvement-measured by scaled IQP scores-as a function of therapy duration, age, time postinjury, and aphasia; pre- to posttreatment effect sizes were also calculated. For comparison, similar LMMs were run using standardized metrics of memory abilities as the outcome measure.

Results: Results showed significant treatment-induced improvements, with gains at the session level (β = 2.76; t = 2.23; p = .047), when improvement was measured using IQP scaled scores. Standardized metrics did not show significant improvement as a function of therapy. Effect size analysis mirrored LMM results, with a large (d = 0.92, 95% confidence interval [0.35, 1.49]) pre- to posttreatment effect when change was measured using IQP scaled scores and a small effect for standardized measures.

Conclusions: This preliminary study demonstrates the utility of a granular, individualized metric to index significant impairment-based performance gains following ICCR treatment. These results introduce promise for future analysis of complex treatment data. Additionally, they provide another lens with which to assess treatment progress and its significance.

Supplemental material: https://doi.org/10.23641/asha.27045937.

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通过系统性治疗方案衡量个人认知康复中针对障碍的进步。

目的：本研究调查了后天性脑损伤（ABI）青壮年患者在接受强化认知交流康复（ICCR）项目治疗后，因治疗引起的记忆功能提高情况。我们旨在确定一种新方法的效用，即使用（a）称为 "个性化定量方案"（IQPs）的系统性治疗任务与（b）标准化记忆功能测试方法，来衡量各学期治疗过程中记忆功能的改善情况：方法：收集 ABI 患者（13 人）连续五个 ICCR 学期的回顾性 IQP 数据。原始任务准确性数据按比例计算，以考虑任务难度分级。线性混合效应模型（LMMs）用于评估记忆力改善的程度--以标度 IQP 分数来衡量--与治疗时间、年龄、伤后时间和失语症的函数关系；还计算了治疗前与治疗后的效应大小。为了进行比较，还使用记忆能力的标准化指标作为结果衡量标准，进行了类似的 LMM 分析：结果表明，当使用 IQP 标度分数衡量改善情况时，治疗引起的改善效果显著，在疗程水平上的收益为 (β = 2.76; t = 2.23; p = .047)。标准化指标并未显示出治疗效果的显著改善。效应大小分析反映了 LMM 的结果，当使用 IQP 标度分数衡量变化时，治疗前对治疗后的效应较大（d = 0.92，95% 置信区间 [0.35，1.49]），而标准化指标的效应较小：这项初步研究表明，在接受 ICCR 治疗后，一种细化的、个性化的指标可以反映出基于损伤的显著能力提升。这些结果为今后分析复杂的治疗数据带来了希望。此外，它们还为评估治疗进展及其意义提供了另一个视角。补充材料：https://doi.org/10.23641/asha.27045937。

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来源期刊

American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION

CiteScore

4.30

自引率

11.50%

发文量

353

审稿时长

>12 weeks

期刊介绍： Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.