Telerehabilitation for addressing executive dysfunction after traumatic brain injury

Brain Inj. 2013;27(5):548-64. doi: 10.3109/02699052.2013.766927. Epub 2013 Mar 8.


Primary objective: To investigate the feasibility of implementing the Cognitive Orientation to daily Occupational Performance approach (CO-OP) in a telerehabilitation format and to examine its impact on community integration and executive dysfunction for adults with traumatic brain injury (TBI).

Research design: A pilot series of three case studies with 3-month follow-up was conducted.

Methods and procedures: Three adults (all males, >10 years post-TBI) and their significant others were recruited. The CO-OP intervention, a meta-cognitive approach, was delivered through videoconferencing via Internet to train three of five participant-identified goals. Two goals were not trained to allow examination of transfer. Outcome measures included the Canadian Occupational Performance Measure, the Mayo-Portland Adaptability Inventory-4 Participation Index, and the Dysexecutive Questionnaire. Descriptive statistical analysis was used.

Main outcomes and results: The CO-OP approach administered in a telerehabilitation format was found to be feasible. All participants indicated self-reported improvement in both trained and untrained goals. Trends toward fewer symptoms of executive dysfunction and greater community integration were demonstrated. All participants expressed satisfaction with the Internet delivery method.

Conclusions: Telerehabilitation shows promise as a way to deliver the CO-OP approach and may help promote community integration of individuals living with TBI. Further study is warranted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology*
  • Adult
  • Brain Injuries / epidemiology
  • Brain Injuries / psychology
  • Brain Injuries / rehabilitation*
  • Canada / epidemiology
  • Cognition Disorders / epidemiology
  • Cognition Disorders / psychology
  • Cognition Disorders / rehabilitation*
  • Feasibility Studies
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Occupational Therapy / methods*
  • Patient Participation
  • Patient Satisfaction
  • Pilot Projects
  • Program Evaluation
  • Software
  • Surveys and Questionnaires
  • Telemedicine* / methods
  • User-Computer Interface
  • Videoconferencing*