scholarly journals Feasibility and Acceptability of the Multicontext Approach for Individuals with Acquired Brain Injury in Acute Inpatient Rehabilitation

2020 ◽  
Author(s):  
Abhishek Jaywant ◽  
Chelsea Steinberg ◽  
Alyson Lee ◽  
Joan Toglia
Keyword(s):  
Brain Injury ◽  
Executive Functioning ◽  
Self Regulation ◽  
Case Series ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Executive Dysfunction ◽  
Strategy Use ◽  
Self Report ◽  
Guided Questioning

The Multicontext (MC) approach, a metacognitive intervention designed to improve awareness, strategy use, and executive functioning, may be beneficial for individuals with acquired brain injury (ABI) undergoing acute inpatient rehabilitation. The goal of this study was to provide evidence of feasibility, acceptability, and patient perceived benefit of the MC approach. A case series of eight individuals with acquired brain injury and at least mild executive functioning impairment were recruited from an acute inpatient rehabilitation unit. The MC approach - involving guided questioning and patient self-generation of strategies within everyday functional cognitive tasks - was implemented within routine occupational therapy. Outcome measures were self-report of treatment satisfaction, the Self-Regulation Skills Interview, and the Weekly Calendar Planning Activity. Participants rated the MC approach as highly satisfying and engaging. They described subjective improvements in their ability to use executive functioning strategies. The MC approach was associated with improvement in awareness, strategy use, and executive functioning at the conclusion of treatment. The MC approach may be a beneficial structured intervention for individuals with acquired brain injury and executive dysfunction undergoing acute inpatient rehabilitation. Further evaluation with larger samples in controlled trials is warranted.

scholarly journals Long-Term Use and Perceived Benefits of Goal-Oriented Attentional Self-Regulation Training in Chronic Brain Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Fred Loya ◽  
Tatjana Novakovic-Agopian ◽  
Deborah Binder ◽  
Annemarie Rossi ◽  
Scott Rome ◽  
...  
Keyword(s):  
Brain Injury ◽  
Self Regulation ◽  
Intervention Development ◽  
Chronic Phase ◽  
Executive Dysfunction ◽  
Primary Objective ◽  
Strategy Use ◽  
Functional Changes ◽  
Perceived Benefit

Primary Objective. To investigate the long-term use and perceived benefit(s) of strategies included in Goal-Oriented Attentional Self-Regulation (GOALS) training (Novakovic-Agopian et al., 2011) by individuals with acquired brain injury (ABI) and chronic executive dysfunction. Research Design. Longitudinal follow-up of training. Methods and Procedures. Sixteen participants with chronic ABI participated in structured telephone interviews 20 months (range 11 to 31 months) following completion of GOALS training. Participants responded to questions regarding the range of strategies they continued to utilize, perceived benefit(s) of strategy use, situations in which strategy use was found helpful, and functional changes attributed to training. Results. Nearly all participants (94%) reported continued use of at least one trained strategy in their daily lives, with 75% of participants also reporting improved functioning resulting from training. However, there was considerable variability with respect to the specific strategies individuals found helpful as well as the perceived impact of training on overall functioning. Conclusions. GOALS training shows promising long-term benefits for individuals in the chronic phase of brain injury. Identifying individual- and injury-level factors that account for variability in continued strategy use and the perceived long-term benefits of training will help with ongoing intervention development.

scholarly journals Impaired awareness of deficits and cognitive strategy use in occupational performance of persons with acquired brain injury (ABI)

2020 ◽  
Vol 48 (2) ◽  
pp. 101-115
Author(s):  
Sabine van Erp ◽  
Esther Steultjens
Keyword(s):  
Brain Injury ◽  
Self Regulation ◽  
Cognitive Strategy ◽  
Acquired Brain Injury ◽  
Strategy Use ◽  
Strategy Training ◽  
Occupational Performance ◽  
Content Type ◽  
Impaired Awareness ◽  
Assessment Results

Purpose This study aims to explore the difference in cognitive strategy use during observed occupational performance between and within different levels of impaired awareness of deficits of individuals with acquired brain injury (ABI). Design/methodology/approach A cross-sectional study (N = 24) of individuals with ABI receiving rehabilitation and with the capacity to demonstrate goal-directed behaviour (Allen cognitive level screen score = 4.0) was undertaken. Cognitive strategy use during occupational performance of daily activities (measured with the perceive, recall, plan and perform [PRPP]) was evaluated between and within different awareness levels (awareness levels measured by the self-regulation skill interview). Statistical analyses, using independent t-test, Mann Whitney U test, ANOVA and Friedman test, were executed. Findings Significant differences were shown for both strengths and weaknesses in cognitive strategy use between emergent (n = 13) and anticipatory awareness (n = 11) groups on PRPP items “perceive”, “sensing” and “mapping”; and “searches”, “recall steps”, “identify obstacles”, “calibrates”, “stops”, “continues” and “persists”. Within emergent awareness group, participants scored lowest related to “perceive”, “plan”, “sensing”, “mapping”, “programming” and “evaluating”. Within anticipatory awareness group, participants scored lowest related to “plan”, “programming” and “evaluating”. Practical implications This study showed differences in cognitive strategy application during task performance in individuals with emergent or anticipatory awareness deficits that fit with theoretical expectations. It is recommended to make use of the PRPP assessment results (strengths and weaknesses in cognitive strategy application) to support the level of awareness determination. The PRPP assessment results and the level of awareness tailor the clinical reasoning process for personalised intervention planning and cognitive strategy training. Originality/value Because impaired awareness has so much impact on the course and outcome of rehabilitation (Rotenberg-Shpigelman et al., 2014), in clinical practice, it is of paramount importance to be aware of the level of awareness of the client (Smeets et al., 2017) and the effect on occupational performance.

scholarly journals Effects of a multifaceted treatment program for executive dysfunction after acquired brain injury on indications of executive functioning in daily life

2009 ◽  
Vol 16 (1) ◽  
pp. 118-129 ◽  
Author(s):  
JACOBA M. SPIKMAN ◽  
DANIELLE H.E. BOELEN ◽  
KIRSTEN F. LAMBERTS ◽  
WIEBO H. BROUWER ◽  
LUCIANO FASOTTI
Keyword(s):  
Brain Injury ◽  
Executive Functioning ◽  
Daily Life ◽  
Real Life ◽  
Acquired Brain Injury ◽  
Executive Dysfunction ◽  
Well Being ◽  
Post Treatment ◽  
Strategy Training ◽  
Experimental Group

AbstractA multicenter randomized control trial (RCT) was conducted to evaluate the effects of a treatment for dysexecutive problems after acquired brain injury (ABI) on daily life functioning. Seventy-five ABI patients were randomly allocated to either the experimental treatment, multifaceted strategy training for executive dysfunction, or a control treatment, computerized cognitive function training. Assessment took place before, directly after, and 6 months post-treatment. The primary outcome measure, the Role Resumption List (RRL), and two other follow-up measures, the Treatment Goal Attainment (TGA) and the Executive Secretarial Task (EST), were indications of daily life executive functioning. The experimental group improved significantly more over time than the controls on the RRL and attained significantly higher scores on the TGA and EST. We conclude that our treatment has resulted in significant improvements of executive functioning in daily life, lasting at least 6 months post-treatment. Although control patients’ satisfaction and subjective well-being were at the same level, the experimental group had better abilities to set and accomplish realistic goals, to plan, initiate, and regulate a series of real-life tasks, and to resume previous roles with respect to work, social relations, leisure activities, and mobility. (JINS, 2010, 16, 118–129.)

Patient inclusion in goal setting during early inpatient rehabilitation after acquired brain injury

2011 ◽  
Vol 26 (2) ◽  
pp. 165-173 ◽  
Author(s):  
Catherine Dalton ◽  
Rachel Farrell ◽  
Annette De Souza ◽  
Evelyn Wujanto ◽  
Ann McKenna-Slade ◽  
...  
Keyword(s):  
Brain Injury ◽  
Goal Setting ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation

scholarly journals Feasibility of motor-assisted elliptical to improve walking, fitness and balance following pediatric acquired brain injury: A case series

2021 ◽  
pp. 1-13
Author(s):  
Judith M. Burnfield ◽  
Guilherme M. Cesar ◽  
Thad W. Buster
Keyword(s):  
Brain Injury ◽  
Cardiovascular Response ◽  
Case Series ◽  
Acquired Brain Injury ◽  
Future Research ◽  
Arm Support ◽  
Scale Scores ◽  
Balance Deficits ◽  
Walking Velocity ◽  
Vas Scores

PURPOSE: Walking, fitness, and balance deficits are common following acquired brain injury (ABI). This study assessed feasibility, acceptability, and usefulness of a modified motor-assisted elliptical (ICARE) in addressing walking, fitness, and balance deficits in children with chronic ABIs. METHODS: Three children (>  5 years post-ABI) completed 24 ICARE exercise sessions (exercise time, speed, and time overriding motor-assistance gradually increased) to promote mass repetition of gait-like movements and challenge cardiorespiratory fitness. Parents’ and children’s perceptions of ICARE’s safety, comfort, workout, and usability were assessed. Cardiovascular response, gait and balance outcomes were assessed. RESULTS: No adverse events occurred. Parent’s Visual Analogue Scale (VAS) scores of perceived device safety (range 80–99), workout (range 99–100), and usability (range 75–100) were high, while comfort were 76–80 given commercial harness fit and arm support. Children’s VAS scores all exceeded 89. Comfortable walking velocity, 2-Minute Walk Test, fitness, and Pediatric Balance Scale scores improved post-training, with many outcomes surpassing established minimal clinically important differences. CONCLUSION: Following engagement in moderate- to vigorous-intensity exercise promoting repetitive step-like movements on a specially adapted motor-assisted elliptical, three children with chronic ABI demonstrated improvements in walking, fitness and balance. Future research in community-based environments with a larger cohort of children with ABI is needed.

scholarly journals Changes in Caregivers Lifestyle after Severe Acquired Brain Injury: A Preliminary Investigation

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
M. D’Ippolito ◽  
M. Aloisi ◽  
E. Azicnuda ◽  
D. Silvestro ◽  
M. Giustini ◽  
...  
Keyword(s):  
Brain Injury ◽  
Preliminary Investigation ◽  
Leisure Activities ◽  
Primary Caregivers ◽  
Acquired Brain Injury ◽  
Lifestyle Changes ◽  
Self Report ◽  
Severe Acquired Brain Injury ◽  
Significant Difference ◽  
Additional Support

Introduction. Severe acquired brain injury (sABI) is considered the most common cause of death and disability worldwide. sABI patients are supported by their caregivers who often exhibit high rates of psychological distress, mood disorders, and changes in relationship dynamics and family roles.Objectives. To explore lifestyle changes of caregivers of sABI patients during the postacute rehabilitation, by investigating possible differences between primary and secondary caregivers. Primary caregivers spend most of the time with the patient, providing daily care and taking most responsibility for the day-to-day decisions, while secondary caregivers are those who provide additional support.Methods. Three hundred forty-seven caregivers of sABI patients were asked to fill in an unpublished self-report questionnaire to explore their possible lifestyles changes.Results. A statistically significant difference was found between primary and secondary caregivers in time spent in informal caregiving (p<0.001). The primary caregivers reduced all leisure activities compared to secondary carers (p<0.05).Conclusions. By comparing the percentage of leisure activities performed by caregiversbeforeandafterthe patient’s sABI onset, all caregivers showed high percentages of changes in lifestyle and habits, even though primary caregivers reported more negative lifestyle changes than secondary caregivers. Further studies are needed to investigate needs and burden experienced by caregivers of sABI patients during the postacute rehabilitation phase, also in relation to the patients’ outcome, to address support interventions for them and improve their quality of life.

Right people, right time? a qualitative study of service access experiences of adults with acquired brain injury following discharge from inpatient rehabilitation

2020 ◽  
pp. 1-16
Author(s):  
Michele Foster ◽  
Melissa Legg ◽  
Eloise Hummell ◽  
Letitia Burridge ◽  
Kirsty Laurie
Keyword(s):  
Brain Injury ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Service Access ◽  
Personal Recovery ◽  
Structured Interviews ◽  
Perceived Needs ◽  
Specialist Services ◽  
Positive Experiences

Abstract Purpose: The intention of this paper is to develop the personal concept of appropriate access. We report on the service access experiences and opportunities of adults with an acquired brain injury after leaving inpatient rehabilitation. The benefits of appropriate access underpin standards in early and long-term recovery, though users’ access needs are highly personal. Methods: The study used a qualitative design involving 16 semi-structured interviews with Australian adults with an acquired brain injury after discharge from inpatient brain rehabilitation. Data were thematically analysed. Results: Three main themes were derived from the analysis. Theme 1 shows that participants valued being steered to services that providers thought appropriate for them early after discharge from inpatient rehabilitation. Theme 2 highlights the tensions between timing and personal recovery and perceived needs. Theme 3 captures participants’ insights into the challenges of gaining access vis-a-vis what the system offers and the enablers of actualising appropriate access. Conclusion: The positive experiences of being directed to specialist services early after discharge suggest that continuity of care constitutes appropriateness of access for participants in this study. However, it is also clear that continuity should not displace flexibility in the timing of services, to accord with individuals’ perceived needs. This, in addition to enablement of access opportunities, through funding and transport, are important in maintaining a personalised approach.

Sign in / Sign up

Export Citation Format

Share Document