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March 23, 2018 For many people, a typical day involves juggling multiple tasks at work, driving to various appointments and cooking meals. The ability to plan, focus, stay organized and multi-task, known as executive function, plays a crucial role in completing daily responsibilities.

People with brain disorders frequently experience problems with executive functions, which significantly disrupts their everyday life and ability to be independent. Older adults have similar problems as these skills naturally decline over time.

Many have turned to brain-training games to boost these skills, but evidence of their effectiveness is limited. Baycrest’s Goal Management Training ® (GMT) aims to fill that gap.

Baycrest researchers have worked with eLearning experts to transform GMT, an in-person, evidence-based intervention, into an accessible, online brain-training program. Online GMT combines instructional education modules, training tasks and mindfulness exercises with therapist guidance to help people improve their ability to complete daily responsibilities.
“Executive functions play a key role in our lives, but there is no easily accessible, evidence-based rehabilitation tool for people looking to improve these skills,” says Dr. Brian Levine, co-developer of GMT, a clinical neuropsychologist and senior scientist at Baycrest’s Rotman Research Institute (RRI). “By having this brain training available to individuals at home, people around the world could use GMT to help prolong their independence, address their cognitive challenges earlier and reduce the load on our healthcare systems.”

Over the past 20 years, Dr. Levine has pursued research on GMT, which has become a leading rehabilitation method among older adults and patients with various brain disorders. Healthcare professionals worldwide have incorporated the treatment into their practices. More than 1,000 health practitioners have attended GMT workshops led by Dr. Levine in Canada, the United States and Europe.  Since 2012, Baycrest has sold GMT training kits for therapists to implement the program.

The in-person intervention has been evaluated in 58 peer-reviewed studies worldwide among adults with various health conditions, including stroke, traumatic brain injury, multiple sclerosis, spina bifida, Attention Deficit Hyperactivity Disorder (ADHD) and substance abuse, as well as in post-critical care patients. An in-depth analysis of these studies, recently published in the journal, Neuropsychological Rehabilitation, demonstrated that patients with GMT training demonstrated immediate signs of improvement and ongoing benefits months after training was complete. Besides improving executive function, GMT also boosted individuals’ short-term memory, daily life functioning and mental health.
“GMT is effective because it builds upon foundational cognitive neuroscience research demonstrating that an overarching goal allows people to stay focused on a certain task, despite background disruptions,” says Dr. Levine, who is also a professor of Psychology and Neurology at the University of Toronto. “Individuals have a difficult time completing day-to-day responsibilities when they are distracted. GMT helps individuals become aware of the problem and trains them to stop and refocus on their main objective.”

With support from the Centre for Aging and Brain Health Innovation, GMT’s online version is undergoing validation. The program is expected to be released in 2019. Dr. Levine has partnered with a number of organizations, such as the Heart and Stroke Foundation, the Canadian Partnership for Stroke Recovery, and the Canadian Association of Occupational Therapists, to distribute the online brain-training program to patients.

Meanwhile, GMT continues to be adopted by more healthcare institutions around the world. At Baycrest, it is being tested to rehabilitate the driving abilities of patients with mild cognitive impairment (cognitive decline with an increased risk of developing dementia) and with caregivers of patients with dementia and others with problems of executive function.

With additional funding, online GMT could expand its reach and develop more partnerships. It could be translated to different languages and customized for different brain disorders, as well as specific healthcare and community settings.

Support Dr. Levine’s work by donating online or calling the donations line at 416-785-2875.
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