Cognitive Rehabilitation: How it is and how it might be

1997 ◽  
Vol 3 (5) ◽  
pp. 487-496 ◽  
Author(s):  
BARBARA A. WILSON
Keyword(s):  
Cognitive Psychology ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Theoretical Models ◽  
Cognitive Difficulties ◽  
The Third ◽  
Rehabilitation Programs ◽  
Brain Injured ◽  
Rehabilitation Model ◽  
Basic Philosophy

This paper suggests there are, at present, four main kinds of cognitive rehabilitation programs for brain injured people. The first attempts to rehabilitate cognitive deficits through drills and exercises. The second uses theoretical models from cognitive psychology to identify deficits in order to remediate them. The third is primarily a patient-driven approach that uses a combination of learning theory, cognitive psychology, and neuropsychology to identify and remediate cognitive difficulties. The fourth is the holistic approach that has, as its basic philosophy, a belief that cognitive functions cannot be divorced from emotion, motivation, or other noncognitive functions, and consequently all aspects of functioning should be addressed in rehabilitation programs. Despite some overlap between these approaches, there are major differences. The two main arguments offered in this paper are (1) that the first two approaches do not lead to good clinical rehabilitation practice; and (2) that a synthesis of the second two approaches would result in the best cognitive rehabilitation model. (JINS, 1997, 3, 487–496.)

THE AMELIORATION OF BEHAVIORAL DISTURBANCES IN TBI PATIENTS WITH CHRONIC FRONTAL SYNDROME AFTER TREATMENT IN DIFFERENT REHABILITATION PROGRAMS

2019 ◽  
Vol 17 (3) ◽  
pp. 245-260
Author(s):  
Maria Pąchalska ◽  
Jolanta Góral-Półrola ◽  
Andrzej Mirski ◽  
Celestyna Grzywniak ◽  
Maria Łuckoś ◽  
...  
Keyword(s):  
Social Skills ◽  
Behavioral Disorders ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Rehabilitation Program ◽  
Post Injury ◽  
Neuropsychological Rehabilitation ◽  
Comprehensive Program ◽  
Rehabilitation Programs ◽  
Group A

We evaluated the effectiveness of three different rehabilitation programs for chronic behavioral disorders in traumatic brain injury (TBI) patients with orbito-frontal damage (OFC), incurred from 13 to 15 years prior to enrollment. From among 547 adult patients with severe TBIs treated neurosurgically from 1999 to 2003, 60 were selected for the study, divided into three groups of 20, matched for age and sex. Each group received one of three different rehabilitation protocols. Group A received a comprehensive program with two components: (1) a 6-month early neuropsychological rehabilitation program targeting cognitive deficits, beginning immediately post-injury, and (2) the “Academy of Life” program, with weekly meetings aimed at reducing behavioral disorders in social transactions. Group B received only cognitive rehabilitation, while Group C received only the “Academy of Life” progam. The Frontal Behavioral Inventory (FBInv) was used to assess behavioral disorders at baseline and again after completion of the study. At baseline, all 60 patients still displayed all or most of the common behavioral symptoms characteristic of frontal syndrome. The improvement achieved by group A (the comprehensive program) was significantly better upon completion of the study than that shown by the patients in groups B (cognitive only) and C (social skills only). A comprehensive program of rehabilitation, which combines early neuropsychological rehabilitation of cognitive deficits with the “Academy of Life” program, aimed at improving social skills, proved to be more effective than either of these two components administered without the other

scholarly journals Cognition in multiple sclerosis

Neurology ◽  
2018 ◽  
Vol 90 (6) ◽  
pp. 278-288 ◽  
Author(s):  
James F. Sumowski ◽  
Ralph Benedict ◽  
Christian Enzinger ◽  
Massimo Filippi ◽  
Jeroen J. Geurts ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Clinical Care ◽  
Theoretical Models ◽  
Scientific Basis ◽  
Evidence Based ◽  
Extensive Literature ◽  
Current State ◽  
Neural Bases

Cognitive decline is recognized as a prevalent and debilitating symptom of multiple sclerosis (MS), especially deficits in episodic memory and processing speed. The field aims to (1) incorporate cognitive assessment into standard clinical care and clinical trials, (2) utilize state-of-the-art neuroimaging to more thoroughly understand neural bases of cognitive deficits, and (3) develop effective, evidence-based, clinically feasible interventions to prevent or treat cognitive dysfunction, which are lacking. There are obstacles to these goals. Our group of MS researchers and clinicians with varied expertise took stock of the current state of the field, and we identify several important practical and theoretical challenges, including key knowledge gaps and methodologic limitations related to (1) understanding and measurement of cognitive deficits, (2) neuroimaging of neural bases and correlates of deficits, and (3) development of effective treatments. This is not a comprehensive review of the extensive literature, but instead a statement of guidelines and priorities for the field. For instance, we provide recommendations for improving the scientific basis and methodologic rigor for cognitive rehabilitation research. Toward this end, we call for multidisciplinary collaborations toward development of biologically based theoretical models of cognition capable of empirical validation and evidence-based refinement, providing the scientific context for effective treatment discovery.

Interrelations between cognitive dysfunction and motor symptoms of Parkinson’s disease: behavioral and neural studies

2016 ◽  
Vol 27 (5) ◽  
pp. 535-548 ◽  
Author(s):  
Ahmed A. Moustafa ◽  
Srinivasa Chakravarthy ◽  
Joseph R. Phillips ◽  
Jacob J. Crouse ◽  
Ankur Gupta ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Dysfunction ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Precision Grip ◽  
Motor Deficits ◽  
Motor Symptoms ◽  
Rehabilitation Programs ◽  
Cardinal Symptoms

AbstractParkinson’s disease (PD) is characterized by a range of motor symptoms. Besides the cardinal symptoms (tremor, bradykinesia/akinesia, and rigidity), PD patients also show other motor deficits, including gait disturbance, speech deficits, and impaired handwriting. However, along with these key motor symptoms, PD patients also experience cognitive deficits in attention, executive function, working memory, and learning. Recent evidence suggests that these motor and cognitive deficits of PD are not completely dissociable, as aspects of cognitive dysfunction can impact motor performance in PD. In this article, we provide a review of behavioral and neural studies on the associations between motor symptoms and cognitive deficits in PD, specifically akinesia/bradykinesia, tremor, gait, handwriting, precision grip, and speech production. This review paves the way for providing a framework for understanding how treatment of cognitive dysfunction, for example cognitive rehabilitation programs, may in turn influence the motor symptoms of PD.

scholarly journals Neuroplastic Changes Induced by Cognitive Rehabilitation in Traumatic Brain Injury: A Review

2017 ◽  
Vol 31 (9) ◽  
pp. 800-813 ◽  
Author(s):  
Valentina Galetto ◽  
Katiuscia Sacco
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Training ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Cerebral Activation ◽  
Rehabilitation Programs ◽  
Brain Changes ◽  
The Impact

Background. Cognitive deficits are among the most disabling consequences of traumatic brain injury (TBI), leading to long-term outcomes and interfering with the individual’s recovery. One of the most effective ways to reduce the impact of cognitive disturbance in everyday life is cognitive rehabilitation, which is based on the principles of brain neuroplasticity and restoration. Although there are many studies in the literature focusing on the effectiveness of cognitive interventions in reducing cognitive deficits following TBI, only a few of them focus on neural modifications induced by cognitive treatment. The use of neuroimaging or neurophysiological measures to evaluate brain changes induced by cognitive rehabilitation may have relevant clinical implications, since they could add individualized elements to cognitive assessment. Nevertheless, there are no review studies in the literature investigating neuroplastic changes induced by cognitive training in TBI individuals. Objective. Due to lack of data, the goal of this article is to review what is currently known on the cerebral modifications following rehabilitation programs in chronic TBI. Methods. Studies investigating both the functional and structural neural modifications induced by cognitive training in TBI subjects were identified from the results of database searches. Forty-five published articles were initially selected. Of these, 34 were excluded because they did not meet the inclusion criteria. Results. Eleven studies were found that focused solely on the functional and neurophysiological changes induced by cognitive rehabilitation. Conclusions. Outcomes showed that cerebral activation may be significantly modified by cognitive rehabilitation, in spite of the severity of the injury.

Learning from our successes and failures: Reflections and comments on “Cognitive Rehabilitation: How it is and how it might be”

1997 ◽  
Vol 3 (5) ◽  
pp. 497-499 ◽  
Author(s):  
GEORGE P. PRIGATANO
Keyword(s):  
Cognitive Psychology ◽  
Present State ◽  
Learning Theory ◽  
Cognitive Rehabilitation ◽  
Holistic Approach ◽  
Neuropsychological Rehabilitation ◽  
Brain Injured ◽  
The Everyday ◽  
Basic Approaches ◽  
Everyday Problems

Barbara A. Wilson's article in this issue is a thoughtful and scholarly commentary on the present state of cognitive rehabilitation. Her review of the meaning of the term “rehabilitation,” and her reminder that we are better at treating disabilities than impairments after brain damage, set the background for her four major points. First, there are currently four basic approaches to cognitive rehabilitation. Second, two of these approaches are of little help to patients. Third, combining learning theory, cognitive psychology, and neuropsychology is helpful in dealing with the “everyday problems of brain-injured people.” Finally, this latter approach combined with the holistic approach is promising, especially given that patients' personality disturbances must be considered if neuropsychological rehabilitation is to be effective.

STEM Education Problem Through Striking Differences Between Physics and Biology

2019 ◽  
Author(s):  
Adib Rifqi Setiawan
Keyword(s):  
Nature Of Science ◽  
Stem Education ◽  
Functional Relationship ◽  
Theoretical Models ◽  
Natural Sciences ◽  
Physical Sciences ◽  
P Values ◽  
The Third ◽  
Differences Of Opinion ◽  
Biological Education

This work argues that fundamental differences of opinion as to the nature of science affect whether the “S” in STEM can really apply to all the natural sciences, which will affect how we structure and implement improvements in STEM education. The first part of the argument deals with often-taught definitions of words like “law” and “theory” that don’t really apply to much of physics. In the second part, we notes that mathematics remains inseparable from education in the physical sciences, but this is not the case in biology. Moreover, an appreciation for the worth of mathematical or theoretical models, even disjoint from experiments, is not generally a part of biological education. The third part is “the tyranny of hypotheses.” One of the “cultural” shocks I’ve had moving into biological fields is constantly hearing people talk about “hypotheses” and seeing a steady stream of bar graphs with asterisks and p-values. In physics, one almost never discusses hypotheses; rather, one test relationships between parameters, either analyzing them within some mechanistic framework, or empirically determining what the underlying functional relationship is.

scholarly journals Physiotherapy versus Consecutive Physiotherapy and Cognitive Treatment in People with Parkinson’s Disease: A Pilot Randomized Cross-Over Study

2021 ◽  
Vol 11 (8) ◽  
pp. 687
Author(s):  
Valentina Varalta ◽  
Paola Poiese ◽  
Serena Recchia ◽  
Barbara Montagnana ◽  
Cristina Fonte ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Group ◽  
Cognitive Rehabilitation ◽  
Rating Scale ◽  
Verbal Learning ◽  
Functional Mobility ◽  
Cognitive Treatment ◽  
Rehabilitation Programs ◽  
Significant Difference

Background: Parkinson’s disease (PD) is characterized by motor and cognitive dysfunctions that can usually be treated by physiotherapy or cognitive training, respectively. The effects of consecutive physiotherapy and cognitive rehabilitation programs on PD deficits are less investigated. Objective: We investigated the effects of 3 months of physiotherapy (physiotherapy treatment group) or consecutive physiotherapy and cognitive (physiotherapy and cognitive treatment group) rehabilitation programs on cognitive, motor, and psychological aspects in 20 PD patients. Methods: The two groups switched programs and continued rehabilitation for another 3 months. The outcomes were score improvement on cognitive (Montreal Cognitive Assessment, Frontal Assessment Battery, Trail Making Test, Verbal Phonemic Fluency, Digit Span, and Rey Auditory Verbal Learning), motor (Unified Parkinson’s Disease Rating Scale-III, Berg Balance Scale, Two-Minute Walking Test, and Time Up and Go), and psychological (Beck Depression Inventory and State-Trait Anxiety Inventory) scales. Results: Between-group comparison revealed a significant difference in functional mobility between the two rehabilitation programs. Improvements in walking abilities were noted after both interventions, but only the patients treated with consecutive training showed better performance on functional mobility and memory tasks. Conclusion: Our findings support the hypothesis that consecutive physiotherapy plus cognitive rehabilitation may have a greater benefit than physiotherapy alone in patients with PD.

scholarly journals A relação entre ciência e tecnologia a partir de três modelos teóricos distintos

DoisPontos ◽  
2015 ◽  
Vol 12 (1) ◽  
Author(s):  
Gilmar Evandro Szczepanik
Keyword(s):  
Theoretical Model ◽  
Science And Technology ◽  
Theoretical Models ◽  
The Third

resumo: Este artigo tem por objetivo explorar as possíveis relações estabelecidas entre ciência e a tecnologia a partir de três modelos teóricos distintos. O primeiro modelo teórico é chamado de hierárquico e pressupõe uma relação de subordinação entre ciência e a tecnologia. O segundo modelo é denominado de não hierárquico e sustenta que ciência e a tecnologia se encontram fundidas de tal modo que não faz mais sentido tentar entendê-las separadamente. Por fim, o terceiro modelo teórico designado de emancipatório explora alguns elementos que permitem compreender a ciência e a tecnologia ainda como atividades distintas, embora possam trabalhar conjuntamente algumas vezes.Abstract:  This paper aims to  understand the possible  relations between science and technology from three different theoretical models. The first theoretical model is called hierarchical and implies a subordinate relationship between science and technology. The second model  is  called non-hierarchical  and argues  that  science  and technology are fused so that it makes more sense to try to understand them separately. Finally, the third theoretical model is called emancipatory  and explores some elements that allow us to understand science and technology as separate activities, although they may sometimes work together. 

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