‘Online therapy’ to reduce caregiver’s distress and to stimulate post-severe acquired brain injury motor and cognitive recovery: A Sicilian hospital experience in the COVID era

2021 ◽  
pp. 1357633X2199019
Author(s):  
Rosaria De Luca ◽  
Carmela Rifici ◽  
Patrizia Pollicino ◽  
Marcella Di Cara ◽  
Sabrina Miceli ◽  
...  
Keyword(s):  
Brain Injury ◽  
Functional Recovery ◽  
Ad Hoc ◽  
Distress Syndrome ◽  
Hospital Setting ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Motor Recovery ◽  
Online Therapy ◽  
Severe Acquired Brain Injury

Introduction Severe acquired brain injury(SABI) often results in the deterioration of physical, cognitive and emotional functions in the patient and a significant caregiver's distress syndrome, which is now amplified by the social isolation, depression and financial difficulties related to the COVID-19 pandemic. The use of web-based online-therapy has been shown to be useful to overcome caregiver's distress syndrome and further stimulate cognitive-motor recovery of SABI-patients. Our study aimed to investigate whether a systematic online Skype-therapy(OLST) may be of support in favoring global cognitive and sensory-motor recovery in SABI-patients and reducing caregiver distress. Methods Twenty-five SABI-subjects in inpatient regimen were provided with intensive OLST with the caregiver for 12 weeks in addition to standard neurorehabilitation. Each subject and caregiver was evaluated before and after the treatment by administering an ad hoc battery. Furthermore, 18 of 27 patients were provided with EEG recording in resting state. Results We found a significant reduction in caregiver's anxiety (p<0.0001) and burden(p<0.0001). Patients showed significant improvement in trunk control (p<0.0001), functional independence (p = 0.005), functional (p = 0.01) and global communication (p = 0.004), cognitive functioning (p = 0.001), and behavioral responsiveness (p = 0.0004). The training yielded a significant connectivity change within the fronto-centro-parietal areas in the delta frequency band (p<0.0001) and the centro-parieto-occipital areas in the alpha range (p = 0.004). Discussion OLST may be a useful and complementary treatment to optimize global cognitive and functional recovery in SABI-subjects and reduce caregivers' concerns in the Covid-era. OLST can foster cognitive-motor recovery potentially by favoring the plasticity-dependent functional recovery. Therefore, OLST could be proposed as a tool allowing social conversations also in the hospital setting.

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

2018 ◽  
Vol 81 (12) ◽  
pp. 673-686 ◽  
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.

The Community Approach to Participation: Outcomes Following Acquired Brain Injury Intervention

2009 ◽  
Vol 10 (3) ◽  
pp. 282-294 ◽  
Author(s):  
Sue Sloan ◽  
Libby Callaway ◽  
Dianne Winkler ◽  
Kirsten McKinley ◽  
Carlo Ziino ◽  
...  
Keyword(s):  
Brain Injury ◽  
Community Integration ◽  
Case Series ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Post Injury ◽  
Community Approach ◽  
Case Series Study ◽  
Severe Acquired Brain Injury ◽  
Community Environments

AbstractObjective: To investigate the participation outcomes of individuals with severe acquired brain injury (ABI) who were provided with up to 12 months of intervention based on the Community Approach to Participation (CAP). Method: A case series study design was undertaken with a total of 85 participants from two private practices specialising in community-based, CAP rehabilitation for people with severe ABI. Inclusion criteria were the person had sustained an acquired brain injury, was aged over 18 years and had received up to 12 consecutive months of CAP input from one of the two practices within a three-year period between January 2004 and January 2007. Twenty-six of the 85 participants were an average of 343 days post injury (Early group) and 59 of the participants were an average of 10.2 years post injury (Late group). They were living in a range of community environments and residential facilities. Initial participants were identified for the study in January 2005. Data were gathered using the Functional Independence Measure (FIM™), Community Integration Questionnaire (CIQ), and Role Checklist (RC Part 1) at two time points: prior to intervention (baseline), and after a 12-month period or at discharge (TI). Within the intervention period, all participants received a customised community occupational therapy (OT) rehabilitation program based on the key principles of the CAP. Intervention focused on participation goals of the individual, and development of the associated skills that underpinned valued role performance. Results: Participants each received an average of 51.01 hours of CAP OT during the 12-month period of intervention. Considerable improvement was seen in functional independence, community integration, and role participation after intervention in both the Early and Late groups. A statistically significant increase in FIM™ and CIQ total scores was found for all participants from Baseline to T1. The number of roles in which participants engaged increased on average by almost one role per participant following intervention, from a mean of 3.06 to 3.99. Increased participation in volunteer, home maintainer, participant in organisations and hobbyist roles were most common. Conclusion: Increased functional independence, community integration, and participation in both the Early and Late groups over a 12 month period demonstrates the potential for improved participation outcomes for people with complex needs following ABI, even many years post injury.

Clinical course of SARS-CoV-2 infection in patients with severe acquired brain injury and a disorder of consciousness: an observational study

Brain Injury ◽  
2021 ◽  
Vol 35 (5) ◽  
pp. 520-529
Author(s):  
Antonio Caronni ◽  
Emanuele Liaci ◽  
Anna Bianchi ◽  
Alessandro Viganò ◽  
Francesco Marenco ◽  
...  
Keyword(s):  
Brain Injury ◽  
Observational Study ◽  
Clinical Course ◽  
Acquired Brain Injury ◽  
Disorder Of Consciousness ◽  
Severe Acquired Brain Injury

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.

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