Remembering to Remember: A Systematic Review and Meta-Analysis on Prospective Memory Rehabilitation in Adults with Acquired Brain Injury

Abstract Prospective memory (PM) - the ability to remember to carry out intended activities - is often impaired following acquired brain injury (ABI), yet its rehabilitation remains challenging. WE conducted a systematic review and meta-analysis to evaluate the effectiveness, durability, and real-life impact of PM interventions in adults with non-progressive ABI. Following PRISMA guidelines, five databases were searched for studies published between January 2008 and December 2024. Twenty-seven studies met inclusion criteria, including 14 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 (e.g., memory aids, metacognitive training) and restitutive methods (e.g., computerized training, virtual reality). PM outcomes were measured using validated tools such as the Cambridge Prospective Memory Test and Rivermead Behavioural Memory Test. The pooled analysis showed a moderate, statistically significant effect of rehabilitation on PM performance. However, evidence for long-term maintenance and generalization to daily life was limited. Risk of bias was assessed with the Cochrane tool, and overall evidence quality was rated moderate using GRADE. These findings support the clinical value of cognitive rehabilitation for PM deficits after ABI, while highlighting the need for more consistent methodologies and long-term outcome data.