A Systematic review and meta-analysis on prospective memory rehabilitation in adults with non-progressive acquired brain injury

Prospective memory (PM) is often impaired following acquired brain injury (ABI). However, its rehabilitation remains challenging for neuropsychologists. Following PRISMA guidelines, we conducted a systematic review and meta-analysis to evaluate the effectiveness, durability, and real-life impact of PM interventions in adults suffering from non-progressive ABI. Twenty-seven studies published between January 2008 and December 2024 met the inclusion criteria: fourteen randomized controlled trials (RCTs), seven non-randomized trials, four pre-post studies, and two case series. Ten RCTs were included in the meta-analysis. Interventions encompassed compensatory strategies and restitutive methods. PM outcomes were measured using validated tools (e.g., the Cambridge Prospective Memory Test and Rivermead Behavioural Memory Test). The pooled analysis showed a moderate, statistically significant effect of rehabilitation on PM performance. Some evidence of transfer were found but outcome measures are typically based on scales or questionnaires, which are subjective measures, rarely reported in detail, therefore unreliable in the case of patients with reduced awareness. Information about maintenance is scarce: a follow-up to a maximum of 12 months was conducted only in seven RCTs. Our results identified moderate heterogeneity across studies and multiple indicators pointed to the possible presence of publication bias. However, overall evidence quality was rated as moderate. Taken together, these findings support the clinical value of rehabilitation for PM deficits after ABI, while highlighting the need for more consistent methodologies and long-term outcome data.