Virtual Reality for Pediatric Traumatic Brain Injury Rehabilitation: A Systematic Review

Objective. Pediatric traumatic brain injury (TBI) is associated with physical and psychobehavioral impairment in children. Effective rehabilitation programs postinjury are critical for children with TBI. Virtual reality (VR) has been increasingly adopted for brain injury rehabilitation. However, scientific synthesis is lacking in evaluating its effectiveness in pediatric TBI rehabilitation. This article aimed to conduct a systematic review on the effectiveness of VR-based pediatric TBI rehabilitation. Methods. A systematic literature search was conducted in PubMed, PsycInfo, SCOPUS, CENTRAL, BioMed Central, CiNAHL, and Web of Science through November 2015. Personal libraries and relevant references supplemented the search. Two authors independently reviewed the abstracts and/or full text of 5824 articles. Data extraction and qualitative synthesis was conducted along with quantitative assessment of research quality by 2 authors. Results. A positive impact was found for VR-based interventions on children’s physical rehabilitation post-TBI. The quality of research evidence was moderate, which largely suffered from small samples, lack of immersive VR experience, and lack of focus on socioemotional outcomes post-TBI. Conclusions. The present review identified positive effects of VR interventions for pediatric TBI rehabilitation especially in physical outcomes. Future research should include larger samples and broader post-TBI outcomes in children using VR-based interventions.

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A Conceptual Framework of Social Communication: Clinical Applications to Pediatric Traumatic Brain Injury

Seminars in Speech and Language ◽

10.1055/s-0040-1701683 ◽

2020 ◽

Vol 41 (02) ◽

pp. 143-160

Author(s):

Catherine Wiseman-Hakes ◽

Lisa Kakonge ◽

Meghan Doherty ◽

Miriam Beauchamp

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Conceptual Framework ◽

Social Communication ◽

Clinical Applications ◽

Future Research ◽

Sex And Gender ◽

Pediatric Traumatic Brain Injury ◽

Communication Impairments ◽

Pediatric Tbi

AbstractSocial communication impairments are common following pediatric traumatic brain injury (TBI) and can lead to social isolation, and poor social outcomes. Social communication has been documented as a persistent area of need in terms of proper assessment and intervention; however, this is not consistently addressed in clinical practice. While there is a body of evidence regarding social communication impairments and pediatric TBI, this area is not yet fully understood and remains underrecognized. To meet this gap, we provide a conceptual framework of social communication from a neurodevelopmental perspective, which can be applied to better understand the social communication impairments associated with pediatric TBI. We propose a general model of social communication with component constructs and consideration of internal factors such as sex and gender. These can inform considerations, clinical applications, and future research in assessment and evidence-based interventions within the domain of social communication.

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Rapid-sequence MRI for evaluation of pediatric traumatic brain injury: a systematic review

Journal of Neurosurgery Pediatrics ◽

10.3171/2021.2.peds20852 ◽

2021 ◽

pp. 1-9

Author(s):

Brice A. Kessler ◽

Jo Ling Goh ◽

Hengameh B. Pajer ◽

Anthony M. Asher ◽

Weston T. Northam ◽

...

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Brain Mri ◽

Skull Fractures ◽

Pediatric Traumatic Brain Injury ◽

Rapid Sequence ◽

Mri Protocol ◽

Ionizing Radiation Exposure ◽

Pediatric Tbi

OBJECTIVE Rapid-sequence MRI (RSMRI) of the brain is a limited-sequence MRI protocol that eliminates ionizing radiation exposure and reduces imaging time. This systematic review sought to examine studies of clinical RSMRI use for pediatric traumatic brain injury (TBI) and to evaluate various RSMRI protocols used, including their reported accuracy as well as clinical and systems-based limitations to implementation. METHODS PubMed, EMBASE, and Web of Science databases were searched, and clinical articles reporting the use of a limited brain MRI protocol in the setting of pediatric head trauma were identified. RESULTS Of the 1639 articles initially identified and reviewed, 13 studies were included. An additional article that was in press at the time was provided by its authors. The average RSMRI study completion time was variable, spanning from 1 minute to 16 minutes. RSMRI with “blood-sensitive” sequences was more sensitive for detection of hemorrhage compared with head CT (HCT), but less sensitive for detection of skull fractures. Compared with standard MRI, RSMRI had decreased sensitivity for all evidence of trauma. CONCLUSIONS Protocols and uses of RSMRI for pediatric TBI were variable among the included studies. While traumatic pathology missed by RSMRI, such as small hemorrhages and linear, nondisplaced skull fractures, was frequently described as clinically insignificant, in some cases these findings may be prognostically and/or forensically significant. Institutions should integrate RSMRI into pediatric TBI management judiciously, relying on clinical context and institutional capabilities.

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Pediatric traumatic brain injury rehabilitation: challenges in care delivery

Neurorehabilitation ◽

10.1016/s1053-8135(97)00020-6 ◽

1997 ◽

Vol 9 (2) ◽

pp. 105-112 ◽

Cited By ~ 6

Author(s):

J Christensen

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Care Delivery ◽

Pediatric Traumatic Brain Injury ◽

Injury Rehabilitation

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Longitudinal Growth Curve Trajectories of Family Dynamics after Pediatric Traumatic Brain Injury in Mexico

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228508 ◽

2020 ◽

Vol 17 (22) ◽

pp. 8508

Author(s):

Grace B. McKee ◽

Laiene Olabarrieta-Landa ◽

Paula K. Pérez-Delgadillo ◽

Ricardo Valdivia-Tangarife ◽

Teresita Villaseñor-Cabrera ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Family Functioning ◽

Growth Curve ◽

Family Members ◽

Family Satisfaction ◽

Health Concern ◽

Pediatric Traumatic Brain Injury ◽

Large Hospital ◽

Pediatric Tbi

Pediatric traumatic brain injury (TBI) represents a serious public health concern. Family members are often caregivers for children with TBI, which can result in a significant strain on familial relationships. Research is needed to examine aspects of family functioning in the context of recovery post-TBI, especially in Latin America, where cultural norms may reinforce caregiving by family members, but where resources for these caregivers may be scarce. This study examined caregiver-reported family satisfaction, communication, cohesion, and flexibility at three time points in the year post-injury for 46 families of a child with TBI in comparison to healthy control families. Families experiencing pediatric TBI were recruited from a large hospital in Guadalajara, Mexico, while healthy controls were recruited from a local educational center. Results from multilevel growth curve models demonstrated that caregivers of children with a TBI reported significantly worse family functioning than controls at each assessment. Families experiencing pediatric TBI were unable to attain the level of functioning of controls during the time span studied, suggesting that these families are likely to experience long-term disruptions in family functioning. The current study highlights the need for family-level intervention programs to target functioning for families affected by pediatric TBI who are at risk for difficulties within a rehabilitation context.

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Predictors of discharge destination from acute care in patients with traumatic brain injury

BMJ Open ◽

10.1136/bmjopen-2017-016694 ◽

2017 ◽

Vol 7 (8) ◽

pp. e016694 ◽

Cited By ~ 3

Author(s):

Sareh Zarshenas ◽

Laetitia Tam ◽

Angela Colantonio ◽

Seyed Mohammad Alavinia ◽

Nora Cullen

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Acute Care ◽

English Language ◽

Healthcare Providers ◽

Trial Registration ◽

Future Research ◽

Reference List ◽

Registration Number

IntroductionMany studies have assessed the predictors of morbidity/mortality of patients with traumatic brain injury (TBI) in acute care. However, with the increasing rate of survival after TBI, more attention has been given to discharge destinations from acute care as an important measure of clinical priorities. This study describes the design of a systematic review compiling and synthesising studies on the prognostic factors of discharge settings from acute care in patients with TBI.Methods and analysisThis systematic review will be conducted on peer-reviewed studies using seven databases including Medline/Medline in-Process, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PsycINFO, CINAHL and Supplemental PubMed. The reference list of selected articles and Google Scholar will also be reviewed to determine other relevant articles. This study will include all English language observational studies that focus on adult patients with TBI in acute care settings. The quality of articles will be assessed by the Quality in Prognostic Studies tool.Ethics and disseminationThe results of this review will provide evidence that may guide healthcare providers in making more informed and timely discharge decisions to the next level of care for patient with TBI. Also, this study will provide valuable information to address the gaps in knowledge for future research.Trial registration numberTrial registration number (PROSPERO) is CRD42016033046.

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Neuromodulation for Mild Traumatic Brain Injury Rehabilitation: A Systematic Review

Frontiers in Human Neuroscience ◽

10.3389/fnhum.2020.598208 ◽

2020 ◽

Vol 14 ◽

Author(s):

Francesca Buhagiar ◽

Melinda Fitzgerald ◽

Jason Bell ◽

Fiona Allanson ◽

Carmela Pestell

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Post Intervention ◽

Persistent Symptoms ◽

Positive Effects ◽

The Brain

Background: Mild traumatic brain injury (mTBI) results from an external force to the head or body causing neurophysiological changes within the brain. The number and severity of symptoms can vary, with some individuals experiencing rapid recovery, and others having persistent symptoms for months to years, impacting their quality of life. Current rehabilitation is limited in its ability to treat persistent symptoms and novel approaches are being sought to improve outcomes following mTBI. Neuromodulation is one technique used to encourage adaptive neuroplasticity within the brain.Objective: To systematically review the literature on the efficacy of neuromodulation in the mTBI population.Method: A systematic review was conducted using Medline, Embase, PsycINFO, PsycARTICLES and EBM Review. Preferred Reporting Items for Systematic Reviews and the Synthesis Without Meta-analysis reporting guidelines were used and a narrative review of the selected studies was completed. Fourteen articles fulfilled the inclusion criteria which were published in English, investigating an adult sample and using a pre- and post-intervention design. Studies were excluded if they included non-mild TBI severities, pediatric or older adult populations.Results: Thirteen of fourteen studies reported positive reductions in mTBI symptomatology following neuromodulation. Specifically, improvements were reported in post-concussion symptom ratings, headaches, dizziness, depression, anxiety, sleep disturbance, general disability, cognition, return to work and quality of life. Normalization of working memory activation patterns, vestibular field potentials, hemodynamics of the dorsolateral prefrontal cortex and excessive delta wave activity were also seen. The studies reviewed had several methodological limitations including small, heterogenous samples and varied intervention protocols, limiting generalisability. Further research is required to understand the context in which neuromodulation may be beneficial.Conclusions: While these positive effects are observed, limitations included unequal representation of neuromodulation modalities in the literature, and lack of literature describing the efficacy of neuromodulation on the development or duration of persistent mTBI symptoms. Better clarity regarding neuromodulation efficacy could have a significant impact on mTBI patients, researchers, clinicians, and policy makers, facilitating a more productive post-mTBI population. Despite the limitations, the literature indicates that neuromodulation warrants further investigation. PROSPERO registration number: CRD42020161279.

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Predictors of Emotional Distress in Family Caregivers of Persons with Traumatic Brain Injury: A Systematic Review

Brain Impairment ◽

10.1017/brimp.2013.12 ◽

2013 ◽

Vol 14 (1) ◽

pp. 113-129 ◽

Cited By ~ 17

Author(s):

Angelle M. Sander ◽

Kacey Little Maestas ◽

Allison N. Clark ◽

Whitney N. Havins

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Family Caregivers ◽

Emotional Distress ◽

Future Research ◽

Class Iii ◽

Class B ◽

Assessment And Treatment ◽

Severe Tbi

The purpose of the current paper was to conduct a systematic review of the literature on predictors of emotional distress in caregivers of persons with traumatic brain injury (TBI), and to provide evidence-based classification for prognostic variables to guide future research and clinical practice. A search was conducted using PubMed, CINAHL and PsycINFO databases. The citations of resulting articles were also reviewed. Twenty-eight articles met inclusion criteria and were retained for review. Reviews were conducted in accordance with the 2011 edition of the American Academy of Neurology (AAN) Guidelines for classifying evidence for prognostic studies. Data abstraction revealed one Class I study, four Class II studies, eight Class III studies, and 15 Class IV studies. Results of the review indicated that caregivers’ report of neurobehavioural problems in the person with injury is a probable predictor of emotional distress for caregivers of persons with complicated mild, moderate or severe TBI (Class B evidence). The level of participation in the person with injury, level of support needed by the person with injury, and family systems functioning are probably predictors of emotional distress for caregivers of persons with severe TBI (Class B evidence). Executive functioning impairment in the person with injury, pre-injury emotional distress in caregivers, caregiver age, caregivers’ use of emotion-focused coping, and social support may possibly be risk factors for caregivers’ emotional distress (Class C evidence). Recommendations for future research and implications for assessment and treatment of family caregivers are discussed.

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