Comparison of attention process training and activity-based attention training after acquired brain injury: A randomized controlled study.

Objectives: To compare the effects of 2 interventions for attention deficits in people with acquired brain injury, Attention Process Training (APT) and Activity--based Attention Training (ABAT), on activity and participation.

Design: Randomized controlled study.

Patients: The study included 51 patients in out-patient rehabilitation 4-12 months after stroke or traumatic brain injury.

Methods: Intervention: 20 h of attention training.

Measurements: Assessment of Work Performance (AWP), Work Ability Index (WAI), Canadian Occupational Performance Measure (COPM), and Rating Scale of Attentional Behavior (RSAB).

Results: Between-group comparisons showed significantly improved process skills after APT: Mental Energy (p = 0.000, ES = 1.84), Knowledge (p = 0.003, ES = 1.78), Temporal Organization (p = 0.000, ES=1.43) and Adaptation (p = 0.001, ES = 1.59). For within-group comparisons significant improvement was found between pre- and post-measures for both groups on COPM Performance (APT: p = 0.001, ES=1.85; ABAT: p = 0.001, ES = 1.84) and Satisfaction (APT: p = 0.000, ES=1.92; ABAT: p = 0.000, ES = 2.40) and RSAB Total Score (ABAT: p = 0.027, ES = 0.81; APT: p = 0.007, ES = 1.03).

Conclusion: We found significant differences favouring APT before ABAT for process skills (AWP). There were no discernible differences in global measures of activity between the 2 approaches: both groups improved significantly, as indicated by ES. The results of this study highlight the complexities of influencing behaviour on the level of body functions while measuring effects on activity.