Video feedback on functional task performance improves self-awareness after traumatic brain injury: A randomized controlled trial

Background. Feedback is used in rehabilitation to improve self-awareness in people with traumatic brain injury (TBI), but there have been no comparisons of the different methods of providing feedback. Objective. To compare the effect of different methods of feedback on impaired self-awareness after TBI. Method. This was a randomized, assessor-blinded trial with concealed allocation. A total of 54 participants with TBI and impaired self-awareness (85% male) were recruited from inpatient and community rehabilitation settings. Participants performed a meal preparation task on 4 occasions and were randomly assigned to 1 of 3 feedback intervention groups: video plus verbal feedback, verbal feedback, or experiential feedback. The primary outcome was improvement in online awareness measured by the number of errors made during task completion. Secondary outcomes included level of intellectual awareness, self-perception of rehabilitation, and emotional status. Results. Receiving video plus verbal feedback reduced the number of errors more than verbal feedback alone (mean difference = 19.7 errors; 95% confidence interval [CI] = 9.2-30.1) and experiential feedback alone (mean difference = 12.4 errors; 95% CI = 1.8-23.0). Conclusion. The results suggest that the video plus verbal feedback approach used in this study was effective in improving self-awareness in people with TBI. The results also provide evidence that improvement in self-awareness was not accompanied by deterioration in emotional status.