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The protocol and design of a randomised controlled study on training of attention within the first year after acquired brain injury

Aniko Bartfai*, Gabriela Markovic, Kristina Sargenius Landahl and Marie-Louise Schult

Author Affiliations

Karolinska Institutet, Department of Clinical Sciences Danderyd Hospital, Division of Rehabilitation, Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm 182 88, Sweden

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BMC Neurology 2014, 14:102  doi:10.1186/1471-2377-14-102

Published: 8 May 2014



To describe the design of the study aiming to examine intensive targeted cognitive rehabilitation of attention in the acute (<4 months) and subacute rehabilitation phases (4–12 months) after acquired brain injury and to evaluate the effects on function, activity and participation (return to work).


Within a prospective, randomised, controlled study 120 consecutive patients with stroke or traumatic brain injury were randomised to 20 hours of intensive attention training by Attention Process Training or by standard, activity based training. Progress was evaluated by Statistical Process Control and by pre and post measurement of functional and activity levels. Return to work was also evaluated in the post-acute phase. Primary endpoints were the changes in the attention measure, Paced Auditory Serial Addition Test and changes in work ability. Secondary endpoints included measurement of cognitive functions, activity and work return. There were 3, 6 and 12-month follow ups focussing on health economics.


The study will provide information on rehabilitation of attention in the early phases after ABI; effects on function, activity and return to work. Further, the application of Statistical Process Control might enable closer investigation of the cognitive changes after acquired brain injury and demonstrate the usefulness of process measures in rehabilitation. The study was registered at Protocol.

Trial registration

NCT02091453, registered: 19 March 2014.

Brain injury; Attention; Statistical process control; Cognitive rehabilitation; Early rehabilitation; Work return; Health economics