Exploring Patient Engagement: A Service Evaluation on Use of Rehacom in Conjunction with Conventional Cognitive Rehabilitation in Acquired Brain Injury Patients at University Hospitals of Leicester

Abstract

Background: Acquired Brain Injuries (ABIs) significantly impact cognitive function, emotional regulation, and daily living activities, posing a substantial burden on individuals and the healthcare system. Cognitive Rehabilitation (CR) aims to address these impairments, with Computer-Assisted Cognitive Rehabilitation (CACR) tools like RehaCom emerging as promising interventions. Objective: This study evaluates adherence to RehaCom in a Neurorehabilitation inpatient setting, exploring patient engagement, barriers to participation, and potential benefits when integrated with conventional CR. Methods: A Service Evaluation was conducted at a UK Neurorehabilitation Unit (NRU) involving 27 patients with ABI, aged 20–80 years, and a Montreal Cognitive Assessment (MoCA) score of <26. Participants completed weekly RehaCom sessions alongside traditional CR over five weeks after completing RehaCom screening. Adherence was assessed through screening completion, session attendance, engagement duration, and patient-reported outcomes. Results: Of the 27 participants, 22.2% were unable to complete the RehaCom screening due to agitation, cognitive deficits leading to non-completion of task or challenges with computer controls. An additional 22.2% engaged in sessions but failed to meet the minimum engagement threshold of 15 minutes. Only 29.6% completed all five weekly sessions, with higher MoCA scores correlating with better adherence. Three main barriers for variable adherence to RehaCom use were cognitive impairment, fatigue and patient preferences for conventional therapy. Conclusion: RehaCom shows promise as a CR tool, but its detailed screening and task complexity may hinder engagement in patients with significant cognitive challenges. Higher MoCA scores predict better adherence, indicating its targeted utility for certain patient subgroups. Future research should explore modifications to enhance usability, integrate education about its benefits, and evaluate longterm outcomes in diverse populations.