Design and Usability of a Digitalized Compensatory Goal Management Training for Individuals with Brain Injury: A User-Centered Approach
DOI:
https://doi.org/10.63144/ijt.2025.6718Keywords:
Brain injury, Executive function, Goal Management Training, Neuropsychological rehabilitation, Serious gamesAbstract
Although there is more evidence in neuropsychological rehabilitation for transfer of treatment effects to daily life when using compensatory strategy training, computerized programs for patients with acquired brain injury still focus on function training. Therefore, we developed Karman Line Plan, a digitalized version of an evidence-based compensatory Goal Management Training intervention for individuals with brain injury and executive function problems. Karman Line Plan consists of a digital environment (Plan Game) and a mobile application (Plan Tool). This study aims to describe the design process and evaluate the usability and acceptance of Karman Line Plan. The program was developed using a three-phase standardized user-centred design approach. Results indicate that Karman Line Plan is perceived as user-friendly and valuable by both patients and therapists. The findings emphasize the importance of involving the target patient population early in the development process to allow for early adjustments and meet end-user needs.
References
Bayley, M. T., Janzen, S., Harnett, A., Teasell, R., Patsakos, E., Marshall, S., Bragge, P., Velikonja, D., Kua, A., Douglas, J., Togher, L., Ponsford, J., & McIntyre, A. (2023). INCOG 2.0 guidelines for cognitive rehabilitation following traumatic brain injury: Methods, overview, and principles. Journal of Head Trauma Rehabilitation, 38(1), 7-23. https://doi.org/10.1097/HTR.0000000000000838
Bertens, D., Fasotti, L., Boelen, D. H., & Kessels, R. P. (2013). A randomized controlled trial on errorless learning in goal management training: Study rationale and protocol. BMC Neurology, 13(1), 64. https://doi.org/10.1186/1471-2377-13-64
Björkdahl, A., Åkerlund, E., Svensson, S., & Esbjörnsson, E. (2013). A randomized study of computerized working memory training and effects on functioning in everyday life for patients with brain injury. Brain Injury, 27(13-14), 1658-1665. https://doi.org/10.3109/02699052.2013.830196
Cicerone, K. D., Goldin, Y., Ganci, K., Rosenbaum, A., Wethe, J. V., Langenbahn, D. M., Malec, J. F., Bergquist, T. F., Kingsley, K., Nagele, D., Trexler, L., Fraas, M., Bogdanova, Y., & Harley, J. P. (2019). Evidence-based cognitive rehabilitation: systematic review of the literature from 2009 through 2014. Archives of Physical Medicine and Rehabilitation, 100(8), 1515-1533. https://doi.org/10.1016/j.apmr.2019.02.011
Cicerone, K. D., Langenbahn, D. M., Braden, C., Malec, J. F., Kalmar, K., Fraas, M., Felicetti, T., Laatsch, L., Harley, J. P., Bergquist, T., Azulay, J., Cantor, J., & Ashman, T. (2011). Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Archives of Physical Medicine and Rehabilitation, 92, 519–530. https://doi.org/10.1016/j.apmr.2010.11.015
Geusgens, C. A., Winkens, I., van Heugten, C. M., Jolles, J., & van den Heuvel, W. J. (2007). Occurrence and measurement of transfer in cognitive rehabilitation: A critical review. Journal of Rehabilitation Medicine, 39, 425–439. https://doi.org/10.2340/16501977-0092
Green, C. S., & Bavelier, D. (2008). Exercising your brain: A review of human brain plasticity and training induced learning. Psychology and Aging, 23(4), 692–701. https://doi.org/10.1037/a0014345
Holden, R. J., & Karsh, B. T. (2010). The technology acceptance model: Its past and its future in health care. Journal of Biomedical Informatics, 43(1), 159-172. https://doi.org/10.1016/j.jbi.2009.07.002
Johnson, L. W., & Weinberg, A. (2023). Cognitive rehabilitation approaches to traumatic brain Injury: A review of efficacy and outcomes. Medical Research Archives, 11(8). https://doi.org/10.18103/mra.v11i8.4199
Khaleghi, A., Aghaei, Z., & Mahdavi, M. A. (2021). A gamification framework for cognitive assessment and cognitive training: qualitative study. JMIR Serious Games, 9(2), e21900. https://doi.org/10.2196/21900
Kuil, M. N. V. D., Visser-Meily, J. M., Evers, A. W., & Ham, I. J. V. D. (2018). A usability study of a serious game in cognitive rehabilitation: A compensatory navigation training in acquired brain injury patients. Frontiers in Psychology, 9, 846. https://doi.org/10.3389/fpsyg.2018.00846
Levine, B., Robertson, I. H., Clare, L., Carter, G., Hong, J., Wilson, B. A., Duncan, J., & Stuss, D. T. (2000). Rehabilitation of executive functioning: An experimental–clinical validation of Goal Management Training. Journal of the International Neuropsychological Society, 6(3), 299-312. https://doi.org/10.1017/s1355617700633052
Lewis, J.R. (2018) The system usability scale: Past, present, and future, International Journal of Human–Computer Interaction, 34(7), 577-590. https://doi.org/10.1080/10447318.2018.1455307
Lundqvist, A., Grundström, K., Samuelsson, K., & Rönnberg, J. (2010). Computerized training of working memory in a group of patients suffering from acquired brain injury. Brain Injury, 24(10), 1173-1183. https://doi.org/10.3109/02699052.2010.498007
Mam Khezri, A., & Mikaeli Manieh, F. (2021). Investigation into effects of Lumosity on working memory, visual memory and executive functions among the elderly. Journal of Psychology and Psychiatry, 8(3), 25-38. https://doi.org/10.32598/shenakht.8.3.25
Procci, K., Chao, A., Bohnsack, J., Olsen, T., & Bowers, C. (2012). Usability in serious games: A model for small development teams. Computer Technology and Application, 3(4).
Robertson, I. H. (1996). Goal Management Training: A clinical manual. Cambridge, UK: PsyConsult.
Scholte E, & Noens I. (2011). BRIEF-A. Vragenlijst voor executieve functies bij volwassenen.
Sigmundsdottir, L., Longley, W. A., & Tate, R. L. (2016). Computerised cognitive training in acquired brain injury: A systematic review of outcomes using the International Classification of Functioning (ICF). Neuropsychological Rehabilitation, 26(5-6), 673-741. https://doi.org/10.1080/09602011.2016.1140657
Simons, D. J., Boot, W. R., Charness, N., Gathercole, S. E., Chabris, C. F., Hambrick, D. Z., & Stine-Morrow, E. A. L. (2016). Do “brain-training” programs work? Psychological Science in the Public Interest, 17(3), 103–186. https://doi.org/10.1177/1529100616661983
Stamenova, V., & Levine, B. (2018). Effectiveness of Goal Management Training® in improving executive functions: A meta-analysis. Neuropsychological Rehabilitation, 29(10), 1569-1599. https://doi.org/10.1080/09602011.2018.1438294
Stuss, D. T. (2011). Traumatic brain injury: Relation to executive dysfunction and the frontal lobes. Current Opinion in Neurology, 24(6), 584-589. https://doi.org/10.1097/WCO.0b013e32834c7eb9
Tuah, N. M., Ahmedy, F., Gani, A., & Yong, L. N. (2021). A survey on gamification for health rehabilitation care: Applications, opportunities, and open challenges. Information, 12(2), 91. https://doi.org/10.3390/info12020091
Van Heugten, C. M., Ponds, R. W., & Kessels, R. P. (2016). Brain training: Hype or hope?. Neuropsychological Rehabilitation, 26(5-6), 639-644. https://doi.org/10.1080/09602011.2016.1186101
Van Hooren, S. A., Valentijn, S. A., Bosma, H., Ponds, R. W., van Boxtel, M. P., Levine, B., Robertson, I., & Jolles, J. (2007). Effect of a structured course involving Goal Management Training in older adults: A randomised controlled trial. Patient Education and Counseling, 65(2), 205-213. https://doi.org/10.1016/j.pec.2006.07.010
Veisi-Pirkoohi, S., Hassani-Abharian, P., Kazemi, R., Vaseghi, S., Zarrindast, M. R., & Nasehi, M. (2020). Efficacy of RehaCom cognitive rehabilitation software in activities of daily living, attention and response control in chronic stroke patients. Journal of Clinical Neuroscience, 71, 101-107. https://doi.org/10.1016/j.jocn.2019.08.114
Westerberg, H., Jacobaeus, H., Hirvikoski, T., Clevberger, P., Östensson, M. L., Bartfai, A., & Klingberg, T. (2007). Computerized working memory training after stroke–A pilot study. Brain Injury, 21(1), 21-29. https://doi.org/10.1080/02699050601148726
Wilson, B. A. (2008). Neuropsychological rehabilitation. Annual Review of Clinical Psychology, 4, 141-162. https://doi.org/10.1146/annurev.clinpsy.4.022007.141212
Wilson, B. A., Winegardner, J., van Heugten, C. M., & Ownsworth, T. (Eds.). (2017). Neuropsychological rehabilitation: The international handbook. Psychology Press. https://doi.org/10.4324/9781315629537
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Copyright (c) 2025 Elise M. Verhoog, Roy P.C. Kessels, Luciano Fasotti, Dirk Bertens

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