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.

scholarly journals Cognitive rehabilitation effectiveness for severe to moderate traumatic brain injury: case series

2021 ◽  
Vol 8 (7) ◽  
pp. 437-441
Author(s):  
Ahlam Ibrahim Hamami
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Rehabilitation ◽  
Case Series ◽  
Holistic Approach ◽  
Rehabilitation Program ◽  
Computer Assisted ◽  
Neuropsychological Rehabilitation ◽  
Case Series Study ◽  
Series Study

Objective: This case series study aimed to investigate the effectiveness of a holistic approach of a computer-assisted and traditional neuropsychological rehabilitation program in improving some cognitive functions in patients who sustained a traumatic brain injury (TBI). Methods: The case series study followed a single-case design, with an A-B-A-B design and was conducted in the rehabilitation center at King Fahad Medical City-Saudi Arabia between Aug 2015 and March 2016. Participants comprised 5 males with moderate-to-severe TBI and persistent cognitive impairments. The computerized model included known software programs for cognitive rehabilitation to improve this rehabilitation process. The program period was six weeks for each case, all focusing on executive functions, memory, and attention. Results: three out of the five cases improved remarkably in their attentional, executive, and related memory functions; with one showing moderate improvement and the five-case showing little improvement. Conclusion: The holistic approach of the neuropsychological rehabilitation program is effective for some TBI cases in improving their cognitive and psychosocial functioning, alongside vocational outcomes, as reported in the follow-up interviews of the patients and their families. More research is required to contribute to the current literature and for the study's findings to be further analyzed for these interventions.

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.)

Toward An Islamic Alternative In Thought and Knowledge

1989 ◽  
Vol 6 (1) ◽  
pp. 1-12
Author(s):  
Taha Jabir Al Alwani
Keyword(s):  
Present State ◽  
Traditional Approach ◽  
World View ◽  
Cultural Transformation ◽  
Modern Culture ◽  
Selective Approach ◽  
Cultural Systems ◽  
Eclectic Approach ◽  
Basic Approaches ◽  
The Many

IntroductionCurrent developments and the many acute problems facing the MuslimUmmah, especially at the intellectual level, present a serious challenge toIslam. This is why an attempt to outline an intellectual Islamic alternativein thought and knowledge has never been so urgent and imperative. Thiwill, insha 'Allah, help in formulating a clear and coordinated policy withregard to cultural transformation based on firm principles and sound strategy.It is also hoped that this policy will lead to scientific findings.By way of introduction, I will give a brief description of the state ofknowledge and thought. and of the educational and cultural systems in thecontemporary Arab and Muslim world.The Present State of ThoughtWhen examining the present state of thought among the Muslim peoples.three basic approaches can be identified:• The first can be described as the traditionalist approach which,by and large, considers the "traditional'' thought of the Ummahto be self-sufficient and capable of being presented asit is or with very little alteration. This approach suggeststhat the Ummah's contemporary intellectual life can be formedand organized and that the structure of its civilization canbe built on this basis. This approach i often described asthe approach of authenticity.• The second approach considers contemporary Western thoughtand its world-view-its concepts of existence, of life and ofman-to be universal, without it a modern culture and civilizationcannot be built. This tendency maintains that Westernthought must be adopted in toto, and any consequent negativeaspects are the price that must be paid if a modern cultureand civilization are to be established. This view is oftendescribed as mcdemistic.• The third trend, or the eclectic approach, advocates yetanother view. It contends that one must select from traditionalthought what is most sound, and from "modern" contemporarythought that which one considers and proves tobe correct, and weld the two to form an intellectual structurethat will provide a guaranteed basis for achieving what isrequired.However, the traditional approach, in the manner it has been presentedand applied, did not help to prevent the Ummah from falling into Lhe stateof decline and failure from which it is still suffering. Likewise, Western thought,as it also is presented and applied, cannot protect the Ummah from its inherentadverse, harmful and even disastrous effects. The advocates of theeclectic selective approach have not yet presented the details of this proposedblend, let alone tried to put it into effect. All this is conducive to the widerangingquestion: Is the Umrnah going through a serious intellectual crisis;and . if so, what is the way out of it? ...

scholarly journals Neuropsychological rehabilitation in a patient with ruptured anterior communicating artery aneurysm: 48 month outcomes

2007 ◽  
Vol 1 (4) ◽  
pp. 407-411 ◽  
Author(s):  
Silvia A. Prado Bolognani ◽  
Priscila Covre ◽  
Daniella Landucci-Moreira ◽  
Thiago S. Rivero ◽  
Sonia Maria Dozzi Brucki ◽  
...  
Keyword(s):  
Cognitive Rehabilitation ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Anterior Communicating Artery ◽  
Post Intervention ◽  
Efficient Manner ◽  
Neuropsychological Rehabilitation ◽  
Personality Changes ◽  
Supportive Family ◽  
Favorable Neurological Outcome

Abstract The neurobehavioral impairments associated with aneurysms of the anterior communicating artery (ACoA) are severe amnesia, executive problems and personality changes. Although most patients achieve a favorable neurological outcome, those cognitive deficits usually prevent return to previous activities and levels of social integration. Objectives: To report the outcomes of a neuropsychological and behavioral intervention in a 55 year-old man with very severe memory and executive dysfunctions following ACoA aneurysm rupture. Methods: Neuropsychological intervention focused in functional adjustment in everyday life was used, including individual sessions with the patient, discussion sessions with caregivers and also work with patient at home, aiming generalization of the rehabilitation strategies. Neuropsychological and functional assessments were conducted pre and post intervention. Results: Important improvements were seeing in behavior and daily living performance after treatment. Conclusions: A neuropsychological rehabilitation approach focused on goals based on the family and caregivers necessities is an efficient manner in which to carry out cognitive rehabilitation in severe cases. The importance of a supportive family should be stressed.

scholarly journals Group cognitive rehabilitation to reduce the psychological impact of multiple sclerosis on quality of life: the CRAMMS RCT

2020 ◽  
Vol 24 (4) ◽  
pp. 1-182 ◽  
Author(s):  
Nadina B Lincoln ◽  
Lucy E Bradshaw ◽  
Cris S Constantinescu ◽  
Florence Day ◽  
Avril ER Drummond ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Confidence Interval ◽  
Usual Care ◽  
Cognitive Rehabilitation ◽  
Rehabilitation Programme ◽  
Everyday Memory ◽  
Impact Scale ◽  
The Everyday ◽  
Everyday Memory Questionnaire ◽  
Memory Questionnaire

Background People with multiple sclerosis have problems with memory and attention. The effectiveness of cognitive rehabilitation has not been established. Objectives The objectives were to assess the clinical effectiveness and cost-effectiveness of a cognitive rehabilitation programme for people with multiple sclerosis. Design This was a multicentre, randomised controlled trial in which participants were randomised in a ratio of 6 : 5 to receive cognitive rehabilitation plus usual care or usual care alone. Participants were assessed at 6 and 12 months after randomisation. Setting The trial was set in hospital neurology clinics and community services. Participants Participants were people with multiple sclerosis who had cognitive problems, were aged 18–69 years, could travel to attend group sessions and gave informed consent. Intervention The intervention was a group cognitive rehabilitation programme delivered weekly by an assistant psychologist to between four and six participants for 10 weeks. Main outcome measures The primary outcome was the Multiple Sclerosis Impact Scale – Psychological subscale at 12 months. Secondary outcomes included results from the Everyday Memory Questionnaire, the 30-Item General Health Questionnaire, the EuroQol-5 Dimensions, five-level version and a service use questionnaire from participants, and the Everyday Memory Questionnaire – relative version and the Modified Carer Strain Index from a relative or friend of the participant. Results Of the 449 participants randomised, 245 were allocated to cognitive rehabilitation (intervention group) and 204 were allocated to usual care (control group). Of these, 214 in the intervention group and 173 in the control group were included in the primary analysis. There was no clinically important difference in the Multiple Sclerosis Impact Scale – Psychological subscale score between the two groups at the 12-month follow-up (adjusted difference in means –0.6, 95% confidence interval –1.5 to 0.3; p = 0.20). There were no important differences between the groups in relation to cognitive abilities, fatigue, employment, or carer strain at follow-up. However, there were differences, although small, between the groups in the Multiple Sclerosis Impact Scale – Psychological subscale score at 6 months (adjusted difference in means –0.9, 95% confidence interval –1.7 to –0.1; p = 0.03) and in everyday memory on the Everyday Memory Questionnaire as reported by participants at 6 (adjusted difference in means –5.3, 95% confidence interval –8.7 to –1.9) and 12 months (adjusted difference in means –4.4, 95% confidence interval –7.8 to –0.9) and by relatives at 6 (adjusted difference in means –5.4, 95% confidence interval –9.1 to –1.7) and 12 months (adjusted difference in means –5.5, 95% confidence interval –9.6 to –1.5) in favour of the cognitive rehabilitation group. There were also differences in mood on the 30-Item General Health Questionnaire at 6 (adjusted difference in means –3.4, 95% confidence interval –5.9 to –0.8) and 12 months (adjusted difference in means –3.4, 95% confidence interval –6.2 to –0.6) in favour of the cognitive rehabilitation group. A qualitative analysis indicated perceived benefits of the intervention. There was no evidence of a difference in costs (adjusted difference in means –£574.93, 95% confidence interval –£1878.93 to £729.07) or quality-adjusted life-year gain (adjusted difference in means 0.00, 95% confidence interval –0.02 to 0.02). No safety concerns were raised and no deaths were reported. Limitations The trial included a sample of participants who had relatively severe cognitive problems in daily life. The trial was not powered to perform subgroup analyses. Participants could not be blinded to treatment allocation. Conclusions This cognitive rehabilitation programme had no long-term benefits on quality of life for people with multiple sclerosis. Future work Future research should evaluate the selection of those who may benefit from cognitive rehabilitation. Trial registration Current Controlled Trials ISRCTN09697576. Funding This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 4. See the National Institute for Health Research Journals Library website for further project information.

The effectiveness of computer-assisted cognitive rehabilitation in brain-damaged patients

2013 ◽  
Vol 44 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Emilia Łojek ◽  
Anna Bolewska
Keyword(s):  
Quality Of Life ◽  
Neuropsychological Tests ◽  
Cognitive Rehabilitation ◽  
Computer Assisted ◽  
Attention And Memory ◽  
Neuropsychological Rehabilitation ◽  
Therapy Program ◽  
Memory Problems ◽  
Computer Tasks

AbstractThis study examined the effects of computer-assisted cognitive rehabilitation in a group of 16 brain-damaged patients. Therapeutic effectiveness was assessed by improvement on computer tasks, the results of neuropsychological tests and quality of life ratings. Participants suffered from mild to moderate attention and memory problems or aphasia. The procedure involved baseline assessment (pretest), a 15-week course of therapy conducted twice a week (30 hours in total) and posttest. Neuropsychological tests assessing attention, memory and language problems and quality of life ratings were administered twice: in pre- and posttests. Twelve healthy controls were also examined twice (with a 15-week interval) using the same battery of neuropsychological tests. The RehaCom program and the Polish computer therapy program for aphasics called Afa-System were used for rehabilitation. The computer-assisted rehabilitation tasks were selected individually for each patient. The results showed significant improvement on computer-assisted tasks in all braindamaged subjects. However, none or very little improvement was observed on neuropsychological tests and quality of life ratings. The results of the study confirm the importance of using different types of measures to estimate the effectiveness of computer-assisted neuropsychological rehabilitation as well as the necessity of applying various kinds of therapy to improve cognitive, emotional and social functioning in brain-damaged patients.

Historical Development of Neuropsychological Rehabilitation

2019 ◽  
Author(s):  
Donna M. Langenbahn ◽  
Joseph F. Rath ◽  
Leonard Diller
Keyword(s):  
Cognitive Abilities ◽  
Cognitive Rehabilitation ◽  
Patient Characteristics ◽  
Rehabilitation Medicine ◽  
The United States ◽  
Clinical Neuropsychology ◽  
Neuropsychological Rehabilitation ◽  
Emotional Factors ◽  
Current Trends ◽  
Psychosocial Difficulties

Psychologists who understand the nuances of impaired cognitive abilities, especially within the context of personality and emotional factors, are uniquely qualified to provide interventions for cognitive and psychosocial difficulties following brain injury. Such interventions fall under the labels cognitive rehabilitation and neuropsychological rehabilitation. Following a brief overview of the historical precursors of neuropsychological rehabilitation, the chapter focuses upon developments in the 20th century through the present, some European, mostly German and Russian, and primarily those in the United States. The manner in which the fields of clinical neuropsychology and rehabilitation medicine provided context and complemented the development of neuropsychological rehabilitation is highlighted. Current trends and future implications are addressed, with an emphasis on the examination of individual patient characteristics and therapy factors to optimize clinical outcomes.

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