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Benefits of Categorization Training in Patients With Traumatic Brain Injury During Post–acute Rehabilitation: Additional Evidence From a Randomized Controlled Trial

Constantinidou, Fofi PhD; Thomas, Robin D. PhD; Robinson, Lacy MA, CCC-S

The Journal of Head Trauma Rehabilitation: September-October 2008 - Volume 23 - Issue 5 - p 312–328
doi: 10.1097/01.HTR.0000336844.99079.2c

Background Preliminary research with the Categorization Program (CP) indicated that this therapeutic modality is beneficial in improving cognitive abilities in survivors of moderate-to-severe traumatic brain injury (TBI). This study provides additional evidence for the use of the CP in postacute TBI cognitive rehabilitation.

Methods Twenty-one participants in the experimental group received the CP training, and 14 participants in the control group received the conventional treatment used at their rehabilitation center. Following neuropsychological testing, participants began their therapy program.

Results There was no significant difference in the baseline performance of the 2 TBI groups on any of the measures. CP-dependent measures correlated significantly with several neuropsychological tests. Both groups improved in their neuropsychological test performance and on functional outcomes tests. However, subjects in the experimental group improved on more tests than participants in the control group. Posttest performance of subjects in the TBI control group was significantly lower on the CP Test 1 and CP Test 2 as compared with the experimental group. Furthermore, the performance of participants in the CP group improved across the 3 probe tasks demonstrating generalizability to new tasks; the performance of participants in the control group did not improve.

Conclusions The CP is an effective therapy method to reduce categorization impairment and improve cognitive performance of survivors of TBI who are enrolled in postacute rehabilitation. This study contributes to the growing body of evidence supporting cognitive rehabilitation efforts after TBI.

From the Department of Speech Pathology and Audiology (Dr Constantinidou) and Department of Psychology (Dr Thomas), Miami University, Oxford, Ohio; Department of Psychology, University of Cyprus, Nicosia, Cyprus (Dr Constantinidou); and Genesis Healthcare System, Zanesville, Ohio (Mrs Robinson).

Corresponding author: Fofi Constantinidou, PhD, Department of Psychology, University of Cyprus, 75 Kallipoleos, PO Box 20537, Nicosia 1678, Cyprus (e-mail:

This research was a part of a larger project supported by grants from The National Institute of Child Health and Human Development, National Institutes of Health (no. R15HD044554A01A1), and the Center for Neuro Skills, Bakersfield, CA. The authors express their thanks and appreciation to the professionals and patients at the following sites for their contributions: Center for Neuro Skills (CNS), Bakersfield, CA; CNS, Dallas, TX; Center for Comprehensive Services (CCS), Carbondale, IL; Casa Colina Centers for Rehabilitation, Pomona, CA; and Special Tree Rehabilitation Services, Romulus, MI. We are grateful to Dr Mark Ashley, ScD, (President & CEO, CNS) for his continued support of this project and to Zenobia Mehta, MA, CCC-S (CNS); Kristin Herman, MA, CCC-S (CNS); April Abbot, MBA (CNS); Kate Kowalczyk, MA, CCC-S (Special Tree Rehabilitation Services); and Michelle Vaughn, MA, CCC-S (CCS) for their special efforts in patient recruitment. The authors are thankful also to the many undergraduate and graduate students in the NeuroCognitive Disorders Laboratory (under the supervision of Dr Constantinidou) at Miami University, including Jessica Kluener, who contributed endless hours for the preparation of stimuli as well with data collection and data management.

© 2008 Lippincott Williams & Wilkins, Inc.