Evaluating an intervention to increase meaningful activity after severe traumatic brain injury: A single-case experimental design with direct inter-subject and systematic replications

2018 ◽  
Vol 30 (4) ◽  
pp. 641-672 ◽  
Author(s):  
Robyn L Tate ◽  
Donna Wakim ◽  
Linda Sigmundsdottir ◽  
Wendy Longley
2021 ◽  
pp. 155005942110682
Author(s):  
Rebecca D White ◽  
Robert P Turner ◽  
Noah Arnold ◽  
Annie Bernica ◽  
Brigitte N Lewis ◽  
...  

In 2014, a 26-year-old male was involved in a motor vehicle accident resulting in a severe traumatic brain injury (TBI). The patient sustained a closed-head left temporal injury with coup contrecoup impact to the frontal region. The patient underwent a left side craniotomy and was comatose for 26 days. After gaining consciousness, he was discharged to a brain injury treatment center that worked with physical, speech, and occupational issues. He was discharged after eight months with significant speech, ambulation, spasticity, and cognitive issues as well as the onset of posttraumatic epilepsy. His parents sought hyperbaric oxygen treatment (HBOT) from a doctor in Louisiana. After 165 dives, the HBOT doctor recommended an addition of neurofeedback (NFB) therapy. In March 2019 the patient started NFB therapy intermixed with HBOT. The combination of NFB and HBOT improved plasticity and functionality in the areas of injury and the correlated symptoms including short-term memory, personality, language, and executive function, as well as significantly reducing the incidence of seizures. Severe brain injuries often leave lasting deficits with little hope for major recovery and there is a need for further research into long-term, effective neurological treatments for severe brain injuries. These results suggest that HBOT combined with NFB may be a viable option in treating severe brain injuries and should be investigated.


2014 ◽  
Vol 15 (3) ◽  
pp. 190-201 ◽  
Author(s):  
Jacinta M. Douglas ◽  
Lucy Knox ◽  
Carren De Maio ◽  
Helen Bridge

Background and aims: Impaired communication is a well-documented and enduring consequence of traumatic brain injury (TBI). As a result of this impairment, people with TBI frequently experience communication breakdown and associated stress. Typically, we use communication-specific coping strategies in situations characterised by communication breakdown. Productive strategies enhance message transfer; non-productive strategies do little to resolve problems and frequently result in negative social interaction. This research aimed to evaluate the effectiveness of a new treatment, Communication-specific Coping Intervention (CommCope-I), which specifically targets coping in the context of communication breakdown.Method: Single-case experimental design (A–B–A with follow-up using multiple probes) across two participants was used. Participants were Samantha, a 30-year-old woman who had sustained severe TBI 8 years previously, and Thomas, a 34-year-old man who had sustained severe TBI when he was 29 years old. CommCope-I is a 6-week programme which targets personally relevant productive coping strategies identified collaboratively with the client. Productive coping scripts are developed and practised through a series of graded scenarios that are evaluated with the aid of video recording.Results: Percentage of non-overlapping corrected data (PNCD) was used to analyse the results. PNCD involves a data-correction procedure to remove baseline trend from the data series prior to calculating the change produced as a result of intervention. A large treatment effect was demonstrated in both participants (PNCD: end of treatment Samantha = 100%, Thomas = 100%, 3-month follow-up Samantha = 100%, Thomas = 100%). These results are consistent with highly effective treatment.Conclusions: This study provides sound phase-1 evidence for the effectiveness of CommCope-I.


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