Applying human factors methods and measures to cognitive rehabilitation for traumatic brain injury

Traumatic brain injury (TBI) is an extensive public health problem. Even a mild TBI (i.e. concussion) can induce long-term cognitive symptoms that can affect one’s ability to perform daily life activities. Cognitive rehabilitation improves outcomes of TBI patients across all severities. Though cognitive rehabilitation strives to deliver evidence-based therapy, few or no cognitive ergonomics or human factors performance evaluation tools have been implemented to quantitatively assess mental workload. Several therapy interventions have tasks that generate data that could benefit from the application of these human factors and ergonomics performance assessment tools. Two cognitive tasks, one commonly used in longitudinal therapy and one assessment common in neuropsychological assessments (Attention Process Training and the Rey-Osterreith Complex Figure Test, respectively), were examined to determine the data generated from those tasks and the current and potential uses of that data. Applicable tools included subjective mental workload measurements, error rate categorization, and data visualization. In addition to formative research, a quasi-experiment was performed to examine the relationship between mental workload and task performance. This research sought to examine the considerations for applying human factors tools to aid the clinician is assessing progress and patient challenges in common cognitive rehabilitation tasks. The intent of this research was to support clinicians in the delivery of evidence-based therapy by generating quantitative individual metrics to assist with tracking outcomes in order to determine the effectiveness of an intervention. This research integrated both examinations of the current therapy practice and first-hand experience with TBI rehabilitation