EBP Compendium: Summary of Systematic Review

Ontario Mental Health Foundation; Medical Research Council of Canada; Dalhousie University
Effectiveness of Attention Rehabilitation after an Acquired Brain Injury: A Meta-Analysis

Park, N. W., & Ingles, J. L. (2001).
Neuropsychology, 15(2), 199-210.

Indicators of Review Quality:

The review addresses a clearly focused question No
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality No
Quality assessments are reproducible No

Description: This is a meta-analysis of quantitative studies investigating the effect of attention intervention on adults with acquired brain injury following stroke or traumatic brain injury. Treatments included cognitive exercises to directly retrain attention or functional tasks targeting specific skills that critically require attention.

Question(s) Addressed:

Question not specifically stated.

Population: Adults with an acquired brain injury following a stroke, traumatic brain injury, or surgical lesion.

Intervention/Assessment: “The treatment had to involve practice performing either cognitive exercises or specific skills that critically require attention” (p. 201).

Number of Studies Included: 30

Years Included: 1966 – June 1997



  • Treatment
    • Cognitive-Communication
      • Drill & Practice Attention Training; Specific Skill/Functional Training
        • The majority of studies included in this review utilized direct cognitive retraining exercises. Few studies were included utilizing a specific-skill training approach.
        • Treatments that directly retrain attention “produced only small, statistically non-significant improvements in performance in all general measures of cognitive function and in all specific measures of attention when improvement was determined using pre-post with control effect size estimates” (p. 205).
        • While the meta-analysis did not show support for the use of direct retraining, the authors proposed a number of factors which may contribute to the findings (i.e. studies limited to severely impaired populations, further published research post review).
        • The studies that targeted specific skill training requiring attention in treatment “showed statistically significant improvements after training and had considerably larger effects” (p. 206) compared to direct retraining treatment studies. Further research is warranted.

Keywords: Brain Injury, Stroke, Attention, Cognition, Cognitive Rehabilitation

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Added to Compendium: December 2011

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