Objective:

To evaluate the latest evidence on Attention Process Training (APT) from the past decade across various conditions affecting cognitive function.

Background:

Attention is a multifaceted cognitive ability influenced by numerous factors. APT-based neurorehabilitation acknowledges this complexity by categorizing attention into five distinct types. While APT has been primarily used after brain injuries, its efficacy and mechanisms in other conditions remain less understood.

Design/Methods:

We conducted a comprehensive literature review in PubMed to assess the efficacy of APT across various conditions over the past decade, with no age or language restrictions. We included only case-control, cohort studies, and randomized controlled trials (RCTs). Quality was evaluated using the Risk of Bias 2 (RoB 2) tool for RCTs and the Newcastle-Ottawa scale for observational studies.

Results:

We selected 19 of the most relevant studies from the past two decades, including 10 RCTs, 3 cohort studies, and 6 case-control studies. All RCTs had fewer than 100 patients in the intervention arm, with most (6/10) evaluating APT in patients with traumatic brain injury (TBI) and showing overall positive results. Only one trial involved children with TBI. Two trials examined APT in patients with mild cognitive impairment and subcortical vascular changes, but no significant improvement was found. One trial on aphasia post-stroke had a small sample size (4 patients), limiting its conclusions. Another trial in cancer-related cognitive impairment showed no significant effect. Several observational studies indicated a significant correlation between early neurorehabilitation and positive outcomes. Quality assessment revealed a medium to high risk of bias.

Conclusions:

The efficacy of APT is influenced by the condition and individual factors. There is robust evidence supporting its effectiveness in adult TBI rehabilitation, and moderate evidence suggesting positive effects in children. Early initiation of treatment appears to be the most critical factor in determining therapeutic success.