Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): A randomised controlled feasibility study for low mood in acquired brain injury

Abstract Background: Acquired brain injury (ABI) affects approximately 79.3 million individuals annually and is linked with elevated rates of depression and low mood. Existing methods for treating depression in ABI have shown mixed efficacy. Behavioural Activation (BA) is a potentially promising intervention. Its premise is that individuals with low mood avoid planning and engaging in activities due to low expectations of a positive outcome. Consequently, their exposure to positive reinforcement is reduced, exacerbating low mood. BA aims to break this cycle by encouraging activity planning and engagement. It is unknown whether cognitive demands of traditional BA may undermine efficacy in ABI. Here we assess the feasibility and acceptability of two groups designed to increase activity engagement. In the Activity Planning Group (traditional BA) the importance of meaningful and positive activity will be discussed and participants encouraged to plan/engage in activities in everyday life. The Activity Engagement Group (experiential BA) instead focuses on engagement in positive experiences (crafts, games, discussion) within the group. The primary aims are to evaluate the feasibility and acceptability of the two groups in ABI. A secondary aim is to explore relative efficacy of the groups compared to an equivalent period of waitlist controls. Method: This study outlines a parallel-arm feasibility pilot trial for individuals with low mood and ABI that compares a traditional vs experiential BA group vs. waitlist controls. Adults (>18 years) will be recruited from local ABI services and randomised to condition. Feasibility and acceptability will be assessed via recruitment, retention, attendance, and participant feedback. Groups will be compared (pre- and post-intervention and 1 month follow-up) by assessing self-reported activity engagement. Secondary outcomes include self-report measures of depression, anxiety, post-traumatic distress related to the ABI, motivation, participation, and sense of control over one’s life.Ethics and Dissemination: The trial has been approved by the Health Research Authority of the NHS in the UK (East of England – Cambridge Central, REF: 18/EE/0305). Results will inform future research on interventions for mood in ABI and be disseminated broadly via peer-reviewed journals, conference presentations, and social media.

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Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): a randomised controlled pilot feasibility trial for low mood in acquired brain injury

Pilot and Feasibility Studies ◽

10.1186/s40814-020-00660-8 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Andrea Kusec ◽

Fionnuala C. Murphy ◽

Polly V. Peers ◽

Cara Lawrence ◽

Emma Cameron ◽

...

Keyword(s):

Brain Injury ◽

Positive Reinforcement ◽

Acquired Brain Injury ◽

Self Report ◽

Feasibility Trial ◽

Future Research ◽

Post Intervention ◽

Activity Engagement ◽

Low Mood ◽

Activity Planning

Abstract Background Acquired brain injury (ABI) affects approximately 79.3 million individuals annually and is linked with elevated rates of depression and low mood. Existing methods for treating depression in ABI have shown mixed efficacy. Behavioural activation (BA) is a potentially promising intervention. Its premise is that individuals with low mood avoid planning and engaging in activities due to low expectations of a positive outcome. Consequently, their exposure to positive reinforcement is reduced, exacerbating low mood. BA aims to break this cycle by encouraging activity planning and engagement. It is unknown whether cognitive demands of traditional BA may undermine efficacy in ABI. Here, we assess the feasibility and acceptability of two groups designed to increase activity engagement. In the activity planning group (traditional BA), the importance of meaningful and positive activity will be discussed and participants encouraged to plan/engage in activities in everyday life. The activity engagement group (experiential BA) instead focuses on engagement in positive experiences (crafts, games, discussion) within the group. The primary aims are to evaluate the feasibility and acceptability of the two groups in ABI. A secondary aim is to explore relative efficacy of the groups compared to an equivalent period of waitlist controls. Method This study outlines a parallel-arm pilot feasibility trial for individuals with low mood and ABI that compares a traditional vs experiential BA group vs waitlist controls. Adults (≥ 18 years) will be recruited from local ABI services and randomised to condition. Feasibility and acceptability will be assessed via recruitment, retention, attendance and participant feedback. Groups will be compared (pre- and post-intervention and 1 month follow-up) by assessing self-reported activity engagement. Secondary outcomes include self-report measures of depression, anxiety, post-traumatic distress related to the ABI, motivation, participation and sense of control over one’s life. Ethics and dissemination The trial has been approved by the Health Research Authority of the NHS in the UK (East of England—Cambridge Central, REF 18/EE/0305). Results will inform future research on interventions for mood in ABI and be disseminated broadly via peer-reviewed journals, conference presentations and social media. Trial registration ClinicalTrials.gov, NCT03874650 pre-results. Protocol version 2.1, March 5, 2019

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Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): A randomised controlled pilot feasibility trial for low mood in acquired brain injury

10.21203/rs.2.23122/v3 ◽

2020 ◽

Author(s):

Andrea Kusec ◽

Fionnuala C. Murphy ◽

Polly V. Peers ◽

Cara Lawrence ◽

Emma Cameron ◽

...

Keyword(s):

Brain Injury ◽

Positive Reinforcement ◽

Acquired Brain Injury ◽

Self Report ◽

Feasibility Trial ◽

Future Research ◽

Post Intervention ◽

Activity Engagement ◽

Low Mood ◽

Activity Planning

Abstract Background: Acquired brain injury (ABI) affects approximately 79.3 million individuals annually and is linked with elevated rates of depression and low mood. Existing methods for treating depression in ABI have shown mixed efficacy. Behavioural Activation (BA) is a potentially promising intervention. Its premise is that individuals with low mood avoid planning and engaging in activities due to low expectations of a positive outcome. Consequently, their exposure to positive reinforcement is reduced, exacerbating low mood. BA aims to break this cycle by encouraging activity planning and engagement. It is unknown whether cognitive demands of traditional BA may undermine efficacy in ABI. Here we assess the feasibility and acceptability of two groups designed to increase activity engagement. In the Activity Planning Group (traditional BA) the importance of meaningful and positive activity will be discussed and participants encouraged to plan/engage in activities in everyday life. The Activity Engagement Group (experiential BA) instead focuses on engagement in positive experiences (crafts, games, discussion) within the group. The primary aims are to evaluate the feasibility and acceptability of the two groups in ABI. A secondary aim is to explore relative efficacy of the groups compared to an equivalent period of waitlist controls. Method: This study outlines a parallel-arm pilot feasibility trial for individuals with low mood and ABI that compares a traditional vs experiential BA group vs. waitlist controls. Adults (≥18 years) will be recruited from local ABI services and randomised to condition. Feasibility and acceptability will be assessed via recruitment, retention, attendance, and participant feedback. Groups will be compared (pre- and post-intervention and 1 month follow-up) by assessing self-reported activity engagement. Secondary outcomes include self-report measures of depression, anxiety, post-traumatic distress related to the ABI, motivation, participation, and sense of control over one’s life. Ethics and Dissemination: The trial has been approved by the Health Research Authority of the NHS in the UK (East of England – Cambridge Central, REF: 18/EE/0305). Results will inform future research on interventions for mood in ABI and be disseminated broadly via peer-reviewed journals, conference presentations, and social media.

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Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): A randomised controlled pilot feasibility trial for low mood in acquired brain injury

10.21203/rs.2.23122/v2 ◽

2020 ◽

Author(s):

Andrea Kusec ◽

Fionnuala C. Murphy ◽

Polly V. Peers ◽

Cara Lawrence ◽

Emma Cameron ◽

...

Keyword(s):

Brain Injury ◽

Positive Reinforcement ◽

Acquired Brain Injury ◽

Self Report ◽

Feasibility Trial ◽

Future Research ◽

Post Intervention ◽

Activity Engagement ◽

Low Mood ◽

Activity Planning

Abstract Background: Acquired brain injury (ABI) affects approximately 79.3 million individuals annually and is linked with elevated rates of depression and low mood. Existing methods for treating depression in ABI have shown mixed efficacy. Behavioural Activation (BA) is a potentially promising intervention. Its premise is that individuals with low mood avoid planning and engaging in activities due to low expectations of a positive outcome. Consequently, their exposure to positive reinforcement is reduced, exacerbating low mood. BA aims to break this cycle by encouraging activity planning and engagement. It is unknown whether cognitive demands of traditional BA may undermine efficacy in ABI. Here we assess the feasibility and acceptability of two groups designed to increase activity engagement. In the Activity Planning Group (traditional BA) the importance of meaningful and positive activity will be discussed and participants encouraged to plan/engage in activities in everyday life. The Activity Engagement Group (experiential BA) instead focuses on engagement in positive experiences (crafts, games, discussion) within the group. The primary aims are to evaluate the feasibility and acceptability of the two groups in ABI. A secondary aim is to explore relative efficacy of the groups compared to an equivalent period of waitlist controls. Method: This study outlines a parallel-arm pilot feasibility trial for individuals with low mood and ABI that compares a traditional vs experiential BA group vs. waitlist controls. Adults (>18 years) will be recruited from local ABI services and randomised to condition. Feasibility and acceptability will be assessed via recruitment, retention, attendance, and participant feedback. Groups will be compared (pre- and post-intervention and 1 month follow-up) by assessing self-reported activity engagement. Secondary outcomes include self-report measures of depression, anxiety, post-traumatic distress related to the ABI, motivation, participation, and sense of control over one’s life. Ethics and Dissemination: The trial has been approved by the Health Research Authority of the NHS in the UK (East of England – Cambridge Central, REF: 18/EE/0305). Results will inform future research on interventions for mood in ABI and be disseminated broadly via peer-reviewed journals, conference presentations, and social media. Trial Registration: NCT03874650 Pre-results.Protocol Version: 2.1, March 5 2019Funding Source: Medical Research Council Cognition and Brain Sciences Unit Intramural funding (TM) and the Gates Cambridge Trust (AK).

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

Journal of Pediatric Rehabilitation Medicine ◽

10.3233/prm-200717 ◽

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.

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Evaluating the feasibility and efficacy of the Amsterdam memory and attention training for children (Amat-c) following acquired brain injury (ABI): protocol for a pilot study with online clinician support

Brain Impairment ◽

10.1017/brimp.2021.13 ◽

2021 ◽

pp. 1-12

Author(s):

Cathy Catroppa ◽

Edith Botchway ◽

Nicholas P. Ryan ◽

Vicki Anderson ◽

Elle Morrison ◽

...

Keyword(s):

Brain Injury ◽

Repeated Measures ◽

Clinical Care ◽

Acquired Brain Injury ◽

Attention Training ◽

Control Group ◽

Attention And Memory ◽

Post Intervention ◽

Memory And Attention ◽

Clinician Support

Abstract Background: Attention and memory deficits are common following paediatric acquired brain injury (ABI). However, there are few evidence-based interventions to improve these domains and benefit the everyday life of children post-injury. The Amsterdam Memory and Attention Training for children (Amat-c) has been translated from Dutch to English and shown to improve attention and memory skills in children following ABI. This protocol describes a study to expand accessibility of the program by using online, clinician-supported delivery with children post-ABI. Method/design: The study is a randomized controlled trial. Participants will be 40 children aged 8–16 a minimum of one-year post-ABI. Participants in the treatment group will complete 18 weekly sessions of the Amat-c program with weekly online clinician support. Participants in the active-control group will be administered ABI psychoeducation via a booklet for parents, with weekly online clinician contact. Attention and memory will be assessed at three time points up to six months post-intervention. Results: Analysis will be repeated measures multivariate planned comparisons; using the Statistical Package for the Social Sciences (IBM SPSS Statistics) General Linear Model procedure will compare pre- and post-intervention and six-month follow-up outcomes. Discussion: If shown efficacious in improving attention and memory, our team will then take a key role in implementing Amat-c into clinical care.

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

BioMed Research International ◽

10.1155/2018/2824081 ◽

2018 ◽

Vol 2018 ◽

pp. 1-14 ◽

Cited By ~ 3

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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Returning to work after acquired brain injury: A mixed method case study

Journal of Vocational Rehabilitation ◽

10.3233/jvr-211164 ◽

2021 ◽

pp. 1-16

Author(s):

Valerie Burke ◽

Laura O’Rourke ◽

Emer Duffy

Keyword(s):

Brain Injury ◽

Self Efficacy ◽

Acquired Brain Injury ◽

Future Research ◽

Control Group ◽

Work Skills ◽

Mixed Methods Case Study ◽

Signed Rank ◽

Returning To Work

BACKGROUND: Vocation is a meaningful area of rehabilitation after Acquired Brain Injury (ABI). There is a discrepancy between the number of individuals with an ABI who feel able to work and those who are employed in Ireland. Research suggests that Vocational Rehabilitation (VR) programs enhance Return to Work (RTW) outcomes after ABI, however existing literature is limited. OBJECTIVE: This study explores the experience of engaging in VR post ABI, and its impact upon work self-efficacy. METHODS: A mixed methods case study design was selected to represent the individuality of ABI presentations. Participants completed a qualitative interview at VR follow up (N = 2) and the Work Self-Efficacy Inventory at pre/post VR. RESULTS: Four overarching themes emerged including Stigma, Adjustment, Support and Readiness. RTW challenges included fatigue, accepting support, adjusting to work and stigma. RTW benefits included routine, pride in work, skills development, and empowerment. Wilcoxon signed rank indicated that work self-efficacy scores mildly improved post VR. CONCLUSIONS: This research may inform VR Programs and offers pragmatic clinical implications based on the data. Future research should consider the role that readiness plays in facilitating RTW. Limitations include sample size, a lack of longitudinal data and control group.

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A Preliminary Exploration of Goal-setting in Community-based Rehabilitation for People with Brain Impairment

Brain Impairment ◽

10.1375/brim.5.1.30.35404 ◽

2004 ◽

Vol 5 (1) ◽

pp. 30-41 ◽

Cited By ~ 15

Author(s):

Pim Kuipers ◽

Glenys Carlson ◽

Sandra Bailey ◽

Anshu Sharma

Keyword(s):

Brain Injury ◽

Goal Setting ◽

Service Provider ◽

Service Providers ◽

Acquired Brain Injury ◽

Rehabilitation Service ◽

Future Research ◽

Training Experience ◽

Community Based ◽

Community Based Rehabilitation

AbstractCommunity-based rehabilitation for people with acquired brain injury (ABI) is largely driven by goals set in the course of rehabilitation by clients and service providers. A preliminary study investigating the perspectives and practice of experienced rehabilitation coordinators was undertaken to explore issues that influence goal-setting in community rehabilitation settings. Detailed interviews and subsequent rounds of clarification were conducted with six experienced rehabilitation coordinators. Key themes identified through inductive analysis include cognitive influences, other client influences, service provider influences and the client-service provider relationship in the goal-setting process. Based on the findings, a preliminary descriptive schema of goal-setting in a community-based rehabilitation service for people with acquired brain injury is suggested. Factors such as training, experience, and values of the rehabilitation coordinators are also discussed in terms of their influence on goal-setting. Some strategies to assist a person with ABI to identify and work towards achieving realistic goals are identified. Suggestions for enhancing community-based rehabilitation practices with people with ABI, and scope for future research are noted. This paper constitutes a general overview of goal-setting in community-based ABI rehabilitation.

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Support for family members who are caregivers to relatives with acquired brain injury

Journal of Mind and Medical Sciences ◽

10.22543/7674.81.p7685 ◽

2021 ◽

Vol 8 (1) ◽

pp. 76-85

Author(s):

Janet Walker ◽

Lourens Schlebusch ◽

Bernhard Gaede

Keyword(s):

Brain Injury ◽

Suicidal Ideation ◽

Family Caregivers ◽

Qualitative Data ◽

Family Members ◽

Acquired Brain Injury ◽

Well Being ◽

Self Report ◽

Cross Sectional ◽

Significance Level

Objectives. Family members caring for a patient with acquired brain injury (ABI) are coping with inordinate levels of stress partially due to their lack of understanding of the neuropsychological effects of acquired brain injury in the patient. The objective of this research is to show that as the caregivers’ stress levels increase, there is an increase in suicidal ideation. This highlights the causal relationship between unhealthy stress and reduced psychological well-being in these caregivers. In addition, qualitative research evidence regarding the caregivers’ views of their main sources of stress are presented. Methods. The participants were a random sample of 80 family caregivers of patients with acquired brain injury, out of whom 72.5% (58) are primary caregivers and 27.5% (22) are secondary caregivers. A mixed methodology was utilized. It comprised cross-sectional descriptive and phenomenological approaches. Quantitative data were obtained from two standardized measures: The Stress Symptom Checklist (SSCL) and item 9 of the Beck Depression Inventory. The qualitative data were derived from self-report procedures that were part of a structured questionnaire administered individually during the interviews. Results. The Kruskal-Wallis test with a significance level of p = .05 was used to compare the stress and suicidal ideation scores, which revealed that increasing levels of stress led to increased suicidality. The analysis of the qualitative data revealed five themes which were identified as the triggers of the caregivers’ profound stress. Most caregivers felt that it was predominantly the patient’s neuropsychological deficits, such as emotions and/or moods, cognitive ability, behavior and personality, executive function, and social factors that caused them profound stress. Conclusions. Support and education are needed to help family caregivers understand the neuropsychological impact of acquired brain injury on the patient. Once caregivers have an improved understanding and receive better support from healthcare providers, they should experience less stress and be better prepared to provide the appropriate support to patients with acquired brain injury.

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Reducing Sedentary Time for Obese Older Adults: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.8883 ◽

2017 ◽

Author(s):

Dori E Rosenberg ◽

Amy K Lee ◽

Melissa Anderson ◽

Anne Renz ◽

Theresa E Matson ◽

...

Keyword(s):

Older Adults ◽

Behavioral Interventions ◽

Sedentary Time ◽

Controlled Trial ◽

Pilot Trial ◽

Self Report ◽

Sitting Time ◽

Future Research ◽

Innovative Strategy ◽

Novel Approaches

BACKGROUND Older adults have high rates of obesity and are prone to chronic health conditions. These conditions are in part due to high rates of sedentary time (ST). As such, reducing ST could be an innovative strategy for improving health outcomes among obese older adults. To test this theory, we developed a novel, technology-enhanced intervention to reduce sitting time (I-STAND) and pilot tested it to assess the feasibility, acceptability, and preliminary effects of the intervention on ST and biometric outcomes. OBJECTIVE The current paper aims to describe the rationale, design, and methods of the I-STAND sitting reduction pilot trial. METHODS Older adults with obesity (n=60) were recruited from a large health care system and randomized to receive I-STAND or a healthy living intervention. I-STAND combined personal coaching with a technology-enhanced intervention (Jawbone UP band) to cue breaks from sitting. Participants completed self-report and biometric assessments at baseline and 3 months. Additional qualitative results were collected from a subset of I-STAND participants (n=22) to further inform the feasibility and acceptability of the interventions. The primary outcome was total hours of daily sitting time measured by the activPAL device. Secondary outcomes included sit-to-stand transitions, bouts of sitting longer than 30 minutes, physical function, blood pressure, fasting glucose, cholesterol, and depressive symptoms. RESULTS Study enrollment has ended and data processing is underway. CONCLUSIONS Data from randomized trials on sitting reduction are needed to inform novel approaches to health promotion among older adults with obesity. Our trial will help fill this gap. The methods used in our study can guide future research on using technology-based devices to assess or prompt sedentary behavior reduction, or those interested in behavioral interventions targeting obese older adults with novel approaches CLINICALTRIAL ClinicalTrials.gov: NCT02692560; https://clinicaltrials.gov/ct2/show/NCT02692560 (Archived by WebCite at http://www.webcitation.org/6wppLTWAl)

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