Evaluation of the Evidence for Rehabilitation Following Acquired Brain Injury

2005 ◽  
Vol 6 (3) ◽  
pp. 161-168
Author(s):  
Lynne Turner-Stokes
Keyword(s):  
Brain Injury ◽  
Research Evidence ◽  
Acquired Brain Injury ◽  
Rehabilitation Medicine ◽  
Keynote Address ◽  
Current Evidence ◽  
World Congress

AbstractThis article represents a summary of the George Burniston Oration of the Australian Faculty of Rehabilitation Medicine, which was given as a keynote address at the 6th World Congress on Brain Injury, Melbourne, May 2005. The paper concerns evaluation of the evidence for effectiveness of rehabilitation following acquired brain injury (ABI). It explores the current evidence available, and discusses a number of different review strategies which may be used to overcome the challenges of assimilating research evidence in this context.

scholarly journals Neuropsychological rehabilitation interventions for people with an acquired brain injury and their caregivers. A protocol for a systematic review of economic evaluation

2020 ◽  
Vol 3 ◽  
pp. 83
Author(s):  
Eileen Mitchell ◽  
Elayne Ahern ◽  
Sanjib Saha ◽  
Dominic Trepel
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Brain Injury ◽  
Evaluation Studies ◽  
Cost Benefit ◽  
Acquired Brain Injury ◽  
Current Evidence ◽  
Economic Evaluations ◽  
Systematic Review Methodology

Background: New emerging evidence has demonstrated the need for effective interventions to help people living with an acquired brain injury (ABI). Evidence on cost-effectiveness, which can help inform use of limited resources, is scarce in this area and therefore the purpose of this systematic review is to critically appraise and consolidate the current evidence on economic evaluations of ABI rehabilitation interventions. Methods: Systematic review methodology will be applied to identify, select and extract data from published economic evaluation studies (trial-based, non-trial based, simulation-based, decision model and trial-based model economic evaluations) of ABI treatment interventions in adults. A systematic literature search will be conducted on the following electronic databases: EMBASE, Econlit, CINAHL, Medline, Econlit, the National Health Service Economic Evaluation Database and PsyclNFO. This review will only include cost-effectiveness analysis studies (e.g., cost per life year gained), cost-benefit and cost minimisation analyses in which the designs were randomised controlled trials (RCTs), non-RCT studies, cost-utility analyses (e.g., cost per quality-adjusted life year (QALY) gained or cost per disability-adjusted life year averted), cohort studies, and modeling studies. Only studies that were published in English, associated with adults who have an ABI will be included. There will be no restrictions on perspective, sample size, country, follow-up duration or setting. The search strategy terms will include the following: acquired brain injury, brain*; cost*; or cost–benefit analysis*. Following data extraction, a narrative summary and tables will be used to summarize the characteristics and results of included studies. Discussion: The findings from this review will be beneficial to health policy decision makers when examining the evidence of economic evaluations in this field. In addition, it is anticipated that this review will identify gaps in the current economic literature to inform future-related research. Systematic review registration: PROSPERO CRD42020187469 (25th June 2020).

scholarly journals Nutritional and Rehabilitation goals in Acquired Brain Injury patients: a new decannulation protocol

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M d’Angelo ◽  
A Michelutti ◽  
E Biasutti ◽  
R Quattrin ◽  
S Brusaferro
Keyword(s):  
Brain Injury ◽  
Functional Independence Measure ◽  
Acquired Brain Injury ◽  
Rehabilitation Medicine ◽  
Functional Independence ◽  
Oral Feeding ◽  
Respiratory Complications ◽  
Outcome Indicators ◽  
Physical And Rehabilitation Medicine ◽  
Process And Outcome

Abstract Background One of the first goals for the rehabilitation of patients with Acquired Brain Injury (ABI) is the removal of the tracheocannula: the aim is not only to allow respiration by airways and reduce respiratory complications but also to obtain rehabilitation of dysphagia and verbal communication: for this purpose from July 2017 the ABI unit of the Institute of Physical and Rehabilitation Medicine ’Gervasutta” adopted a new decannulation protocol, recommended by the Italian Society of Physical Medicine and Rehabilitation (SIMFER). Methods Clinical data of ABI patients with tracheal cannula from May 2014 were collected as both process and outcome indicators associated with the adoption of the new protocol were defined. ABI patients were therefore divided into two groups depending on whether they were treated with or without the new procedure. Data have been processed with “Simple Interactive Statistical Analysis” (SISA) software. Results A sample of 141 patients with tracheocannula was analyzed; among these 57 (40.4%) were treated with the new decannulation protocol. No statistical significant differences were found between the two groups in terms of systemic or respiratory complications, Functional Independence Measure (FIM) or Level of Cognitive Functioning (LCF) at the entrance as well as for both the time (days) between entry or tracheotomy and decannulation. However decannulation rate is significantly higher when the new protocol is applied (OR = 1.8; 95% CI = 1.2- 9.8; p = 0.01) as the time (days) between entry and oral feeding resumption (p < 0.001; 95% CI = -10 - -34 days). Conclusions The introduction of the new protocol has allowed the achievement of both nutritional and rehabilitation goals with a significantly faster oral feeding resumption and an increase of decannulation rate and. Further efforts are needed to support its use in the future, with the aim of further improving of either process or outcome performances. Key messages Promising prospects for the decannulation of patients with acquired brain injury. Achievement of nutritional and rehabilitation goals.

scholarly journals Coproducing Knowledge of the Implementation of Complex Digital Health Interventions for Adults with Acquired Brain Injury and their Communication Partners: Protocol for a Mixed Methods Study

10.2196/35080 ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. e35080
Author(s):  
Melissa Miao ◽  
Emma Power ◽  
Rachael Rietdijk ◽  
Deborah Debono ◽  
Melissa Brunner ◽  
...  
Keyword(s):  
Brain Injury ◽  
Focus Groups ◽  
Implementation Research ◽  
Research Evidence ◽  
Digital Health ◽  
Acquired Brain Injury ◽  
Social Brain ◽  
Web Based ◽  
The Social ◽  
Communication Partners

Background The Social Brain Toolkit, conceived and developed in partnership with stakeholders, is a novel suite of web-based communication interventions for people with brain injury and their communication partners. To support effective implementation, the developers of the Social Brain Toolkit have collaborated with people with brain injury, communication partners, clinicians, and individuals with digital health implementation experience to coproduce new implementation knowledge. In recognition of the equal value of experiential and academic knowledge, both types of knowledge are included in this study protocol, with input from stakeholder coauthors. Objective This study aims to collaborate with stakeholders to prioritize theoretically based implementation targets for the Social Brain Toolkit, understand the nature of these priorities, and develop targeted implementation strategies to address these priorities, in order to support the Social Brain Toolkit’s implementation. Methods Theoretically underpinned by the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework of digital health implementation, a maximum variation sample (N=35) of stakeholders coproduced knowledge of the implementation of the Social Brain Toolkit. People with brain injury (n=10), communication partners (n=11), and clinicians (n=5) participated in an initial web-based prioritization survey based on the NASSS framework. Survey completion was facilitated by plain English explanations and accessible captioned videos developed through 3 rounds of piloting. A speech-language pathologist also assisted stakeholders with brain injury to participate in the survey via video teleconference. Participants subsequently elaborated on their identified priorities via 7 web-based focus groups, in which researchers and stakeholders exchanged stakeholder perspectives and research evidence from a concurrent systematic review. Stakeholders were supported to engage in focus groups through the use of visual supports and plain English explanations. Additionally, individuals with experience in digital health implementation (n=9) responded to the prioritization survey questions via individual interview. The results will be deductively analyzed in relation to the NASSS framework in a coauthorship process with people with brain injury, communication partners, and clinicians. Results Ethical approval was received from the University of Technology Sydney Health and Medical Research Ethics Committee (ETH20-5466) on December 15, 2020. Data were collected from April 13 to November 18, 2021. Data analysis is currently underway, with results expected for publication in mid-2022. Conclusions In this study, researchers supported individuals with living experience of acquired brain injury, of communicating with or clinically supporting someone post injury, and of digital health implementation, to directly access and leverage the latest implementation research evidence and theory. With this support, stakeholders were able to prioritize implementation research targets, develop targeted implementation solutions, and coauthor and publish new implementation findings. The results will be used to optimize the implementation of 3 real-world, evidence-based interventions and thus improve the outcomes of people with brain injury and their communication partners. International Registered Report Identifier (IRRID) DERR1-10.2196/35080

scholarly journals Coproducing Knowledge of the Implementation of Complex Digital Health Interventions for Adults with Acquired Brain Injury and their Communication Partners: Protocol for a Mixed Methods Study (Preprint)

2021 ◽  
Author(s):  
Melissa Miao ◽  
Emma Power ◽  
Rachael Rietdijk ◽  
Deborah Debono ◽  
Melissa Brunner ◽  
...  
Keyword(s):  
Brain Injury ◽  
Focus Groups ◽  
Implementation Research ◽  
Research Evidence ◽  
Digital Health ◽  
Acquired Brain Injury ◽  
Social Brain ◽  
Web Based ◽  
The Social ◽  
Communication Partners

BACKGROUND The Social Brain Toolkit, conceived and developed in partnership with stakeholders, is a novel suite of web-based communication interventions for people with brain injury and their communication partners. To support effective implementation, the developers of the Social Brain Toolkit have collaborated with people with brain injury, communication partners, clinicians, and individuals with digital health implementation experience to coproduce new implementation knowledge. In recognition of the equal value of experiential and academic knowledge, both types of knowledge are included in this study protocol, with input from stakeholder coauthors. OBJECTIVE This study aims to collaborate with stakeholders to prioritize theoretically based implementation targets for the Social Brain Toolkit, understand the nature of these priorities, and develop targeted implementation strategies to address these priorities, in order to support the Social Brain Toolkit’s implementation. METHODS Theoretically underpinned by the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework of digital health implementation, a maximum variation sample (N=35) of stakeholders coproduced knowledge of the implementation of the Social Brain Toolkit. People with brain injury (n=10), communication partners (n=11), and clinicians (n=5) participated in an initial web-based prioritization survey based on the NASSS framework. Survey completion was facilitated by plain English explanations and accessible captioned videos developed through 3 rounds of piloting. A speech-language pathologist also assisted stakeholders with brain injury to participate in the survey via video teleconference. Participants subsequently elaborated on their identified priorities via 7 web-based focus groups, in which researchers and stakeholders exchanged stakeholder perspectives and research evidence from a concurrent systematic review. Stakeholders were supported to engage in focus groups through the use of visual supports and plain English explanations. Additionally, individuals with experience in digital health implementation (n=9) responded to the prioritization survey questions via individual interview. The results will be deductively analyzed in relation to the NASSS framework in a coauthorship process with people with brain injury, communication partners, and clinicians. RESULTS Ethical approval was received from the University of Technology Sydney Health and Medical Research Ethics Committee (ETH20-5466) on December 15, 2020. Data were collected from April 13 to November 18, 2021. Data analysis is currently underway, with results expected for publication in mid-2022. CONCLUSIONS In this study, researchers supported individuals with living experience of acquired brain injury, of communicating with or clinically supporting someone post injury, and of digital health implementation, to directly access and leverage the latest implementation research evidence and theory. With this support, stakeholders were able to prioritize implementation research targets, develop targeted implementation solutions, and coauthor and publish new implementation findings. The results will be used to optimize the implementation of 3 real-world, evidence-based interventions and thus improve the outcomes of people with brain injury and their communication partners. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/35080

Use of Virtual Reality in Rehabilitation

2019 ◽  
pp. 11
Author(s):  
Fazah Akhtar Hanapiah
Keyword(s):  
Virtual Reality ◽  
Brain Injury ◽  
Low Cost ◽  
Acquired Brain Injury ◽  
Rehabilitation Medicine ◽  
Medical Rehabilitation ◽  
Post Intervention ◽  
Use Of Technology ◽  
Before And After ◽  
Severe Impairment

Recovery of severe impairment as a result of acquired brain injury from conditions such as stroke and trauma can be limited. However, with neuroplasticity and re-learning of lost skills, the impairment can be overcome or reduced. The use of technology in rehabilitation has become synonymous in most advanced rehabilitation facilities. The outcome of chronic impairment is dependent on the rehabilitation approaches and new ways to address conventional strategies using technology. Technology in rehabilitation is an exciting avenue for research. The use of 3-Dimensional Virtual Reality (3-D VR) in gaming has escalated in the past few years. However, the therapeutic use of 3-D VR in rehabilitation medicine is still lagging, although small studies have shown some potential on its use. We, at Faculty of Medicine UiTM embarked on a study to create a platform for 3-D VR application, (MRVR: Medical Rehabilitation Virtual Reality) with known neuroplastic strategies for individuals with acquired brain injury during rehabilitation. Outcome measures used will be that of standard and validated parameters before and after the application of MRVR. Specific aspects of rehabilita t ion parameters were addressed during the programme development. A low cost commercial 3-D VR system was chosen (HTC VIVE™) to be used for the MRVR and our team developed a number of therapeutic programmes. Individuals with brain injury undergo a sequence of immersive first person experience with the MRVR programme in a safe virtual environme nt. The MRVR also promote recovery through other theories of rehabilitation such as, enriched environment, imagery, increased engagement and participation, accessibility and gamificat ion. We hypothesize that individuals that uses MRVR will have improved outcome parameters post intervention. These findings will assist in changing the standards for neurorehabilitation, by improving functional outcome, productivity, quality of life and overall longevity of individuals with disability. This study is funded by UiTM Research Grant: 600-IRMI/DANA 5/3 BESTARI (057/2017)International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 11

scholarly journals Neuropsychological rehabilitation interventions for people with an acquired brain injury. A protocol for a systematic review of economic evaluation

2020 ◽  
Vol 3 ◽  
pp. 83
Author(s):  
Eileen Mitchell ◽  
Elayne Ahern ◽  
Sanjib Saha ◽  
Dominic Trepel
Keyword(s):  
Systematic Review ◽  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Brain Injury ◽  
Evaluation Studies ◽  
Cost Benefit ◽  
Acquired Brain Injury ◽  
Current Evidence ◽  
Economic Evaluations ◽  
Systematic Review Methodology

Background: New emerging evidence has demonstrated the need for effective interventions to help people living with an acquired brain injury (ABI). Evidence on cost-effectiveness, which can help inform use of limited resources, is scarce in this area and therefore the purpose of this systematic review is to critically appraise and consolidate the current evidence on economic evaluations of ABI rehabilitation interventions. Methods: Systematic review methodology will be applied to identify, select and extract data from published economic evaluation studies (trial-based, non-trial based, simulation-based, decision model and trial-based model economic evaluations) of ABI treatment interventions in adults. A systematic literature search will be conducted on the following electronic databases: EMBASE, Econlit, CINAHL, Medline, the National Health Service Economic Evaluation Database and PsyclNFO. This review will only include cost-effectiveness analysis studies (e.g., cost per life year gained), cost-benefit and cost minimisation analyses in which the designs were randomised controlled trials (RCTs), non-RCT studies, cost-utility analyses (e.g., cost per quality-adjusted life year (QALY) gained or cost per disability-adjusted life year averted), cohort studies, and modelling studies. Only studies that were published in the english language, associated with adults who have an ABI will be included. There will be no restrictions on perspective, sample size, country, follow-up duration or setting. The search strategy terms will include the following: acquired brain injury, brain*; cost*; or cost–benefit analysis*. Following data extraction, a narrative summary and tables will be used to summarize the characteristics and results of included studies. Discussion: The findings from this review will be beneficial to health policy decision makers when examining the evidence of economic evaluations in this field. In addition, it is anticipated that this review will identify gaps in the current economic literature to inform future-related research. Systematic review registration: PROSPERO CRD42020187469 (25th June 2020).

Training-the-Trainer on Assistive Technology for Cognition (ATC): Current Practices

2013 ◽  
Vol 23 (2) ◽  
pp. 90-94 ◽  
Author(s):  
Laurie Ehlhardt Powell ◽  
Tracey Wallace ◽  
Michelle ranae Wild
Keyword(s):  
Brain Injury ◽  
Assistive Technology ◽  
Acquired Brain Injury ◽  
Online Training ◽  
Evidence Based ◽  
Train The Trainer ◽  
Rehabilitation Professionals ◽  
Remote Locations ◽  
Training Package ◽  
And Training

Research shows that if clinicians are to deliver effective, evidence-based assistive technology for cognition (ATC) services to clients with acquired brain injury (ABI), they first need opportunities to gain knowledge and experience with ATC assessment and training practices (O'Neil-Pirozzi, Kendrick, Goldstein, & Glenn, 2004). This article describes three examples of train the trainer materials and programs to address this need: (a) a toolkit for trainers to learn more about assessing and training ATC; (b) a comprehensive, trans-disciplinary program for training staff to provide ATC services in a metropolitan area; and (c) an overview of an on-site/online training package for rehabilitation professionals working with individuals with ABI in remote locations.

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