Guiding patients with traumatic brain injury through the instrumental activities of daily living with the RehaGoal App: a feasibility study

Abstract

Purpose

Individuals with traumatic brain injuries (TBI) often experience executive function impairments that impact activities of daily living. Assistive technologies can help overcome these disabilities and Goal Management Training (GMT) provides an effective therapeutic approach for treating such impairments. To capture the benefits of GMT with assistive technology we developed the RehaGoal App. In this study, we investigate whether combining a modified GMT (mGMT) with the RehaGoal App is feasible in terms of study design, and preliminary evaluation of the attainment of self-defined goals. We also examine if the app produces useful metrics data, tests its usability, and gauges its potential for improving goal attainment.

Methods

We used a case study design to evaluate four individuals with impairments in executive functions after TBI. They underwent an 8-week mGMT and RehaGoal App intervention to achieve a self-defined goal. To investigate the intervention’s feasibility, we collected Goal Attainment Scale (GAS) scores at two-time points, neuropsychological data at study start, System Usability Scale (SUS) scores at study end, and metrics data throughout the study period.

Results

Participant retention and compliance rates were high. All participants improved on GAS. Metrics data was collected successfully and revealed different participant usage behaviours. Overall, the SUS scores of the participants indicated excellent app usability.

Conclusions

The intervention was feasible but the study design should be modified. Preliminary evaluation of GAS, SUS, and metrics data provided useful insights on user behaviour, app usability, and its role in achieving self-defined goals. The app received overall positive participant ratings.

IMPLICATION FOR REHABILITATION

• Metric data can be useful as it can give therapists additional opportunities to gain more information about the realization of intervention tasks between the therapy sessions allowing them to use this information to adjust therapy elements.

• RehaGoal App in combination with a modified GMT may be able to support participants with impairment in executive functions in completing the task of daily living.

• The study shows that the RehaGoal App is feasible in rehabilitation for a small sample size and that it may be scaled up in the future larger randomized controlled trial.

Keywords:

• Rehabilitation
• executive function
• traumatic brain injury
• goal management training
• assistive technology

Acknowledgements

We would like to thank Ralf Heindorf for establishing contact with the patients and organizational support, as well as all the staff of the Armgard practice in Bremen for their cooperation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work is supported by the funding initiative Niedersächsisches Vorab and the Ministry of Science and Culture of the German State of Lower Saxony (Grant ZN3224, https://securin.de/).