Application of errorless learning in memory rehabilitation in patients with brain injury

Aim: To evaluate the effect of errorless learning on memory rehabilitation combined with enriched environment in patients with brain injury, study which memory process will be more effective by using this training method; and compare difference between computer-assisted memory rehabilitation and a face-to-face therapist-administered programme of identical training content. Methods: A total of 30 patients with memory retention disorder following brain injury were selected from Third Affiliated Hospital of Sun Yat-sen University, Zhujiang Hospital, South Hospital, First Affiliated Hospital of Guangdong Medical College, and Guangzhou Center for trauma Rehabilitation from March to December 2004. They were all 18 - 55 years of age with stable condition following brain injury of 3 - 6 months, and their attention could lasted for more than 5 minutes. All 30 patients were divided randomly into three groups: computer-assisted memory training group, therapist administered memory training group and control group, and 10 patients in each. The patients in computer-assisted memory training and therapist administered memory training groups were trained with 20 memory-training courses related to errorless learning, one course per day for 45 minutes, and all the courses finished in one month. Patients in control group received introductions related to memory training. The neurobehavioral cognitive status examination, Rivermead behavioral memory test and the Hong Kong list learning test (encoding, storage and retrieval processes in random and block conditions) were used to test memory function pre- and post-training. The difference was calculated to compare the training effects. Results: All patients finished the experiment. The total score on Rivermead behavioral memory test in computer-assisted memory training and therapist administered memory training groups(5.10 ± 2.92, 3.70 ± 2.58) increased significantly as compared with that in control group(1.16 ± 0.37, F = 11.03, P = 0.000). The score on difference of neurobehavioral cognitive status examination at pre- and post-training in computer-assisted memory training and therapist administered memory training groups(2.00 ± 2.26, 2.90 ± 2.23) was higher as compared with that in control group (0.90 ± 0.73), but there was no significant difference(F = 2.714, P = 0.084). The score on random storage, encoding, and storage processes in computer-assisted memory training group(3.75 ± 3.03, 2.83 ± 2.11, 3.90 ± 3.79) increased obviously as compared with that in therapist administered memory training group(1.35 ± 1.37, 0.80 ± 1.12, 1.30 ± 2.68) and control group(0.05 ± 0.28, 0.37 ± 1.37, 0.10 ± 1.07). The score on encoding and retrieval processes after training was higher in computer-assisted memory training group(2.33 ± 2.20, 0.28 ± 0.14) and therapist administered memory training group(1.10 ± 0.99, 0.21 ± 0.25) as compared with that in control group(0.33 ± 0.72, 0.07 ± 0.11, P < 0.05). Conclusion: The errorless learning combined with enriched environment is a better method to improve memory function following brain injury. The errorless learning combined with computer-assisted memory training can effectively improve the instant memory and ability of storage as compared with that combined with therapist administered memory training.Department of Rehabilitation Science