Ecologically Valid Assessment of Executive Dysfunction Using a Novel Virtual Reality Task in Patients with Acquired Brain Injury

AbstractThis study aimed to identify the consequences of fatigue, fatigability, cognitive and executive functioning, and emotional state on health-related quality of life (HRQoL) in a clinical group of outpatients after acquired brain injury (ABI). This cross-sectional retrospective study included assessing outpatients at a rehabilitation clinic with WAIS-III working memory and coding subtests, and self-rating scales (Fatigue Impact Scale, Dysexecutive Questionnaire, Hospital Anxiety and Depression Scale, and the dimension of health-related quality of life from EQ-5D-3L). The predictive variables were investigated using a binary logistic regression with HRQoL as the dependent variable. Descriptive statistics and correlations were analyzed. Participants reported a lower than average HRQoL (95%), fatigue (90%), and executive dysfunction (75%). Fatigue had a significant impact and explained 20–33% of the variance in HRQoL with a moderate significance on depression (p = 0.579) and executive dysfunction (p = 0.555). Cognitive and executive function and emotional state showed no association with HRQoL. A lower HRQoL, as well as fatigue and cognitive and executive dysfunctions, are common after ABI, with fatigue is a partial explanation of a lower HRQoL.

Download Full-text

Scoping review of the Multiple Errands Test: Is it relevant to youths with acquired brain injury?

British Journal of Occupational Therapy ◽

10.1177/0308022618791714 ◽

2018 ◽

Vol 81 (12) ◽

pp. 673-686 ◽

Cited By ~ 1

Author(s):

Vanessa L Hanberg ◽

Diane E MacKenzie ◽

Brenda K Merritt

Keyword(s):

Brain Injury ◽

Scoping Review ◽

Clinical Utility ◽

Hospital Setting ◽

Community Setting ◽

Acquired Brain Injury ◽

Executive Dysfunction ◽

Measurement Properties ◽

Severe Acquired Brain Injury ◽

Multiple Errands Test

Introduction For youths who sustain acquired brain injuries, distinguishing typical development of executive function from the impairment(s) can be a challenging but critical assessment consideration. Occupational therapists working with individuals after brain injury can use the Multiple Errands Test as a performance-based assessment of the effect of executive dysfunction in the real world. Although numerous test versions exist for different settings and diagnostic populations, their relevance to youths is unclear. We surveyed the non-virtual reality literature for test versions to determine the measurement properties and clinical utility for assessing youths in a community setting. Method A scoping review was completed to summarize study purpose/design, Multiple Errands Test structure, assessment environment, sample characteristics, psychometric properties, clinical utility and main findings of the test versions. Results We included 10 quantitative studies and found the strongest reliability and validity evidence for male adults with moderate to severe acquired brain injury, in a hospital setting. Multiple Errands Test versions can distinguish people with brain injury from controls and identify challenges in the home and community. No studies examined the test performance of younger participants. Conclusion This review highlights the research of several Multiple Errands Test versions and identifies gaps in that research, including the need for development of a test version for youths in a community setting.

Download Full-text

Paediatric goal management training in patients with acquired brain injury: study protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2019-029273 ◽

2019 ◽

Vol 9 (8) ◽

pp. e029273

Author(s):

Ruth Elizabeth Hypher ◽

Anne Elisabeth Brandt ◽

Kari Risnes ◽

Torstein Baade Rø ◽

Eva Skovlund ◽

...

Keyword(s):

Executive Function ◽

Brain Injury ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Acquired Brain Injury ◽

Executive Dysfunction ◽

Management Training ◽

Goal Management ◽

Randomised Controlled ◽

Goal Management Training

IntroductionCompromised integrity of the brain due to paediatric acquired brain injury (pABI) has been associated with cognitive impairment, particularly executive dysfunction, in addition to somatic and emotional symptoms and reduced everyday function. Goal Management Training (GMT) is a cognitive rehabilitation intervention for improving executive function (EF) that has received empirical support in studies of adults with ABI. The purpose of the present study is to determine the efficacy of a recently developed paediatric version of GMT (pGMT) for children and adolescents with ABI and reported executive dysfunction.Methods and analysisThis study protocol describes a parallel randomised controlled trial including allocation concealment and assessor blinding. Eighty survivors after pABI, aged 10–17 years at the time of intervention, will be recruited. Participants will be randomly allocated to either pGMT (n=40) or a psychoeducative control intervention (n=40; paediatric Brain Health Workshop). Both interventions consist of seven group sessions for participants and parents, followed by external cueing and telephone counselling. The study also includes involvement of teachers. Assessments will be performed at baseline, immediately postintervention and at 6 months’ follow-up. Primary outcome measure will be changes in daily life EF as reported by parents (The Behavior Rating Inventory of Executive Function). Secondary outcomes include other assessments of EF (neuropsychological tests and questionnaires). Furthermore, we aim to assess generalisation effects of pGMT on other cognitive functions, as well as emotional, behavioural, adaptive and family function, academic performance, fatigue and quality of life.Ethics and disseminationResults from this study will be disseminated to relevant research, clinical, health service and patient communities through publications in peer-reviewed and popular science journals, in addition to presentations at scientific conferences. The study will be conducted in accordance with the Helsinki declaration and the Ethical Research Involving Children (ChildWatch International and Unicef). In accordance to Good Clinical Practice our study includes safety and quality monitoring guarantees in compliance with research ethics and safety. The trial will be reported in accordance with the Consolidated Standards of Reporting Trials 2010 statement and Standard Protocol Items for Reporting in Trials recommendations, in addition to being registered at ClinicalTrials.gov. The study has been approved by the Regional Committees for Medical and Health Research Ethics Norway (2017/772).Trial registration numberNCT03215342.

Download Full-text