Evaluating The Effectiveness of Compensatory Interventions in Adults With Acquired Brain Injury: A Systematic Review and Meta-Analysis of Memory and Everyday Impact Outcomes

Adults with acquired brain injury (ABI) often experience memory impairments that are persistent and difficult to treat. Although evidence has shown that rehabilitation programs may improve cognitive performance in persons with ABI, there is an opportunity to look more closely at the benefits provided by specific interventions. We conducted a systematic review and meta-analysis to evaluate whether compensation-based memory programs improve memory or everyday impact outcomes in adults with ABI. The review was limited to published, English-language controlled trials that evaluated compensatory memory interventions for adults (18+) with ABI using at least one memory or everyday impact outcome. The final search was conducted in April 2021 using PsychINFO, Medline, EMBASE, the Cochrane Review database, Google Scholar, and the reference lists of relevant articles. Of 2817 identified articles, 22 controlled trials met inclusion criteria, of which 12 provided sufficient data to include in the meta-analyses. A risk of bias assessment using the Effective Public Health Practice Project tool identified common problems with recruitment and masking procedures. Results from the meta-analyses indicate that compared to controls, these interventions produce positive effects on outcomes of immediate verbal recall (g = 0.43, 95% CI [0.134, 0.723]), participant-reported memory (g = 0.28, 95% CI [0.131, 0.468]), and strategy use (g = 0.39, 95% CI [0.057, 0.727]), and that these improvements are maintained at follow-up. Future research focusing on specific subsets of ABI populations and a broader range of participant-reported outcomes is needed. This review was pre-registered in the PROSPERO database for systematic reviews (Registration number: CRD42020197592).