Poster 108 Neuropsychological Rehabilitation to Enhance Quality of Life, Perceived Control and Psychological Well-Being

e48 Design: Pilot intervention. Setting: Research facility in a suburban medical center Participants: 11 community-dwelling adult volunteers (55% male; age 4515) with chronic mild-to-severe TBI. Interventions: Participants independently completed the Lumosity 40session Basic Training course. Main Outcome Measure(s): Attention Network Test, a computer-based test that measures the performance efficiency of three neuroanatomical attention networks: alerting, orienting, executive. Results: Paired samples t-tests showed significant improvements in overall reaction time (pZ0.006), orienting attention (pZ0.024) and executive attention (pZ0.041). Pearson correlations showed that program utilization (average number of days to begin training, average number of days per week, average number of weeks to complete the 40-session course) was not related to pre-post changes in attention network scores or overall reaction time. Conclusions: Forty sessions of independently utilized computer-based cognitive training led to significant improvements in orienting and executive attention network efficiency in individuals with chronic moderate-to-severe TBI. Improvements were not related to variations in program utilization. The effects of this computer-based cognitive intervention are robust enough to tolerate variations in participant-determined utilization. Key Words: Traumatic Brain Injury, computer-based cognitive training, attention networks. Disclosure: Yelena Goldin has nothing to disclose. Poster 108 Neuropsychological Rehabilitation to Enhance Quality of Life, Perceived Control and Psychological Well-Being Jennifer Strang (Northern Regional Medical Command), Heechin Chae Objective: The purpose of the study is to examine the effects of EEG neurofeedback training (NFT) and computerized cognitive retraining (CR) on quality of life, perceived control, and psychological well-being in patients diagnosed with posttraumatic stress disorder (PTSD), mild traumatic brain injury (mTBI), and/or related diagnoses (e.g., anxiety disorder, cognitive disorder). The pre- and post-treatment self-report questionnaire data of 29 active duty service members was examined. Participants completed 20 hours of NFT, CR, or a combination of the two modalities; specific training goals were individualized and based on the major problem areas identified by their referring provider. A series of Wilcoxon matched pairs tests were computed to compare questionnaire scores pre- and post-intervention. Results indicated a statistically significant increase in scores on measures assessing positive affect, satisfaction with life, and quality of life in the physical, psychological, and environmental domains. Scores were significantly reduced on measures of negative affect and negative perceived control. There was no change in quality of life in the social domain or in positive perceived control. This was a pilot study to determine the feasibility of a full study, and it is recognized that interpretation of the results is limited. Nonetheless, the current results suggest that adjunctive neuropsychological therapies, such as NFT and CR, may contribute to improved quality of life, perceived control and psychological well-being in active duty service members with the aforementioned diagnoses. Future research should include a control group, a more standardized treatment process, and a more homogeneous sample. Design: The study is a retrospective within-subjects design using deidentified data sets to compare pre- and post-treatment self-report questionnaire data. Setting: The setting is the NeuroCognitive Enrichment Program (NCEP) in the Traumatic Brain Injury Clinic, Fort Belvoir Community Hospital (FBCH), Fort Bevoir, VA. FBCH is a military treatment facility in the metropolitan Washington, DC area. All branches of the military are eligible to receive treatment at this facility.

Traumatic Brain Injury (TBI) Diagnosis Participants: Participants were 29 male and female military service members and retirees age 18 and older who came to the FBCH Behavioral Health and Traumatic Brain Injury Clinics for evaluation and treatment of cognitive and/or emotional concerns and were referred to NCEP by a behavioral health or TBI provider for adjunctive treatment. Participant diagnoses included mild traumatic brain injury, posttraumatic stress disorder, anxiety disorder, cognitive disorder, and adjustment disorder. Interventions: Participants completed 20 hours of EEG neurofeedback training, computerized cognitive rehabilitation, or a combination of the two modalities; specific training goals were individualized and based on the major problem areas identified by their referring provider (e.g., attention, processing speed, immediate and delayed memory). Main Outcome Measure(s):  Positive and Negative Affect Scale (PANAS; Watson, Clark, & Teller, 1988)  Satisfaction with Life Scale (SWLS; Diener, Emmons, Larsen, & Griffon, 1985)  Structure of Coping Scale (Pearlin & Schooler, 1978)  WHOQOL-BREF U.S. Version (World Health Organization, 1997) Results: Results indicated a statistically significant increase in scores on measures assessing positive affect, satisfaction with life, and quality of life in the physical, psychological, and environmental domains. Scores were significantly reduced on measures of negative affect and negative perceived control. There was no change in quality of life in the social domain or in positive perceived control. Conclusions: This was a pilot study to determine the feasibility of a full study, and it is recognized that interpretation of the results is limited. Nonetheless, the current results suggest that adjunctive neuropsychological therapies, such as NFT and CR, may contribute to improved quality of life, perceived control and psychological well-being in active duty service members with the aforementioned diagnoses. Future research should include a control group, a more standardized treatment process, and a more homogeneous sample. Key Words: cognitive rehabilitation, neurofeedback Disclosure: Jennifer Strang has nothing to disclose. Poster 109 Factors Contributing to Utilization of Computer-based Cognitive Training after Traumatic Brain Injury Daniel Saldana (JFK Johnson Rehabilitation Institute), Yelena Goldin, Keith Ganci, Keith Cicerone Objectives: Examine the relationship of demographic variables (age, education, sex) and injury severity to utilization of a computer-based cognitive training program in individuals with chronic traumatic brain injury (TBI). Design: Pilot Intervention. Setting: Research facility in a suburban medical center. Participants: 17 (71% male, age 4115) community dwelling volunteers with chronic mild-severe TBI. Interventions: Lumosity Basic Training (BT) course (40-sessions) completed independently, with the option to continue using Lumosity beyond study requirements. Main Outcome Measures: Utilization of Lumosity BT (days to begin training; weeks to complete BT; BT sessions per week). Utilization of Lumosity following BT completion (weeks trained following BT, weekly number of sessions following BT). Results: Gender had small effects on days to begin training (dZ0.4; women>men) and weeks to complete BT (dZ0.4; womenmen). Gender also had, a large effect (dZ1.4; men>women) on weeks trained after BT, and a medium effect (dZ0.6; men>women) on weekly number of sessions after BT. There was a significant (pZ0.03) inverse relationship between years of education and weeks trained after BT. Age was not

www.archives-pmr.org