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Effectiveness of environmental approaches in improving cognitive and related functional outcomes for adults with
Ella Waldman1,2, Jennie Ponsford1,2,3, Jessica Trevena-Peters1,2
1Monash University School of Psychology, Melbourne, Vic, Australia.
Objective:
This review aims to investigate which environmental approaches to cognitive rehabilitation are effective in improving cognitive and related functional outcomes for adults with traumatic brain injury (TBI), and to identify the components of these approaches.
Introduction:
Individuals with cognitive impairments after sustaining TBI often have limited self-awareness and capacity for goal-directed behavior. Therefore, they are less likely to benefit from cognitive rehabilitation approaches requiring active and self-directed engagement. These individuals may benefit from environmental approaches, which involve manipulating the environment (eg, modifying physical, social, or task-related aspects of an individual's surroundings) to support cognitive function, activity, and participation. However, the evidence base underpinning this is poorly understood, highlighting the need for research synthesis.
Eligibility Criteria:
This review will consider studies that include participants aged 18 years or older with a TBI and evaluate an environmental intervention. We will include randomized controlled trials written in English, irrespective of publication date or status. Outcomes of interest will include cognitive and related functional outcomes (eg, impairment, activity, participation).
Methods:
This review will follow the JBI methodology for systematic reviews of effectiveness. Information sources will include the Cochrane Controlled Register of Trials (CENTRAL), CINAHL (EBSCOhost), ClinicalTrials.gov, Embase (Ovid), PsycINFO (Ovid), MEDLINE (Ovid), and WHO International Clinical Trials Registry Platform (ICTRP). Two reviewers will independently select studies and extract data. Methodological quality will be appraised using the JBI Critical Appraisal Tool for Randomized Controlled Trials. We will use the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) to assess the certainty of evidence. Studies will be pooled with statistical meta-analysis where possible, accompanied by narrative synthesis.
Review Registration:
PROSPERO CRD42024592708.
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