http://informahealthcare.com/bij ISSN: 0269-9052 (print), 1362-301X (electronic) Brain Inj, Early Online: 1–7 ! 2014 Informa UK Ltd. DOI: 10.3109/02699052.2014.934921 ORIGIANL ARTICLE Efficacy of memory rehabilitation therapy: A meta-analysis of TBI and stroke cognitive rehabilitation literature Madison Elliott & Frederick Parente Towson University, Towson, MD, USA Abstract Objective: To examine the efficacy of cognitive rehabilitation strategies specifically designed to improve memory after traumatic brain injury (TBI) and stroke vs. memory improvement with the passage of time. Design and methods: A meta-analysis was performed on 26 studies of memory retraining and recovery that were published between the years of 1985 and 2013. Effect sizes (ESs) from each study were calculated and converted to Pearson’s r and then analysed to assess the overall effect size and the relationship among the ESs, patient demographics and treatment interventions. Results: Results indicated a significant average ES (r ¼ 0.51) in the treatment intervention conditions, as well as a significant average ES (r ¼ 0.31) in the control conditions, in which participants did not receive any treatment. The largest ESs occurred in studies of stroke patients and studies concerning working memory rehabilitation. Conclusions: Results showed that memory rehabilitation was an effective therapeutic intervention, especially for stroke patients and for working memory as a treatment domain. However, the results also indicated that significant memory improvement occurred spontaneously over time. Keywords Cognitive rehabilitation, memory, meta-analysis, neurorehabilitation, remediation, stroke, TBI, working memory History Received 15 May 2013 Revised 14 March 2014 Accepted 6 June 2014 Published online 21 July 2014 Introduction to brain injury At least 5.3 million US citizens live with a permanent TBI- or stroke-related disability. Health professionals consider TBI to be one of the most debilitating injuries relative to other neurological disorders [1, 2]. Mar et al. [3] detailed the devastating societal and individual impact of neuro- logical trauma. Many factors contribute to a person’s recov- ery trajectory and, in the past decade, rehabilitation of cognitive processes has become significant in the treatment course [4, 5]. Although cognitive rehabilitation is increasingly popular, clinicians currently face major difficulties when identifying and treating cognitive impairments caused by brain injury or stroke. This is because brain-injured populations typically are a heterogeneous group with a multitude of deficits [6]. Evidence-based treatment guidelines are only as good as the research they rely on and published rehabilitation studies tend to be both elaborate and ambiguous in nature. Several professional committees, including members of the National Institutes of Health (NIH) and the Brain Injury- Interdisciplinary Special Interest Group (BI-ISIG) of the American Congress of Rehabilitation Medicine, have attempted to amalgamate this literature via published rehabilitation practice guidelines for TBI and stroke. These guidelines are based on findings from recently published systematic reviews, which generally examine a wide body of published studies that include diverse research designs [7]. Systematic reviews construct valuable inferences about the efficacy of rehabilitation strategies; but what they achieve in variety, they also lack in statistical rigour. Meta-analyses must exclude studies that do not provide group data for effect size (ES) and, therefore, cannot examine as many publications as a systematic review. Nevertheless, meta-analyses are becoming increasingly popular in review methodology in psychological and brain sciences and are recognized as a statistically reliable manner of testing objective observations across studies [8]. The purpose of the present investigation is to provide a meta-analytic review of cognitive rehabilitation strategies for the domain of memory in individuals with TBI and stroke. The authors’ goal is to contribute to future guidelines, as well as augment existing qualitative review findings from memory rehabilitation literature. Cognitive rehabilitation of memory Cognitive Rehabilitation Therapy (CRT) for brain injury and stroke is diverse, with numerous treatment and theoretical models. Treatments can be process-specific, aimed at improv- ing overall performance of a given activity, skill-based, Correspondence: Madison Elliott, Psychology Department, Towson University, 8000 York Road, Towson, MD 21252, USA. E-mail: mellio4@students.towson.edu Brain Inj Downloaded from informahealthcare.com by David Ainsworth on 07/25/14 For personal use only.