The First Attempt of Intensive Approaches in Cognitive Rehabilitation in Clients with Severe Traumatic Brain Injury

2010 ◽  
pp. 249-265
Author(s):  
Masako Fujii
Keyword(s):  
Traumatic Brain Injury ◽  
Environmental Factors ◽  
Support System ◽  
Social Life ◽  
Cognitive Rehabilitation ◽  
Attention And Memory ◽  
Large Organization ◽  
Severe Tbi ◽  
Intensive Approach ◽  
Paper Method

Cognitive rehabilitation (CR) was undertaken by two clients, A and B, using pen and paper method by an exclusive and intensive approach. Client A with very severe TBI showed improved attention and memory deficits and after undergoing a step-by-step trial, he finally landed a satisfactory job and maintained it, with the support of a large organization. Client B underwent CR with considerable effort by himself and attained a normal cognitive level but was still half way to the satisfactory social integration owing to an insufficient support system. Through the long process undergone by the two clients, it was suggested that environmental factors (support system) are extremely important for a satisfactory social life in severe TBI clients, together with the recovery of cognitive functions by CR.

Further Directions in Cognitive Rehabilitation in Community- and Home-based Daily Trainings in Clients with Severe Traumatic Brain Injury

2010 ◽  
pp. 266-281
Author(s):  
Masako Fujii
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Executive Functions ◽  
Severe Traumatic Brain Injury ◽  
Cognitive Rehabilitation ◽  
Reading Abilities ◽  
Home Based ◽  
Severe Tbi ◽  
One Year ◽  
Paper Method

Community- and home-based daily intense cognitive rehabilitation (CR) of traumatic brain injury (TBI) clients was initiated on the basis on knowledge mentioned in Chapter 17. In the CR, statistically significant changes were demonstrated in attention and reading abilities in sixteen severe TBI clients by one-year daily CR. Improvement of memory and executive functions required more training periods as shown later. The temporary minimum scores of four neuropsychological tests required for social reentry, namely, 50 in TEA, 15 in RBMT, 80 in BADS and 40 in JART, were determined as a goal of our CR. In addition to the drill (pen and paper) method mainly using workbooks, a more advanced program for CR, particularly in clients who reached the required level, was developed together with the clients.

scholarly journals Traumatic Brain Injury and Sexuality: User Experience Study of an Information Toolkit (Preprint)

2019 ◽  
Author(s):  
Pascale Marier-Deschênes ◽  
Marie-Pierre Gagnon ◽  
Julien Déry ◽  
Marie-Eve Lamontagne
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
User Experience ◽  
Attention And Memory ◽  
Semistructured Interview ◽  
User Centered Design ◽  
Functional Impairments ◽  
Group Discussions ◽  
Severe Tbi ◽  
Written Materials

BACKGROUND After having sustained a traumatic brain injury (TBI), individuals are at risk of functional impairments in information processing, abstract reasoning, executive functioning, attention, and memory. This affects different aspects of communicative functioning. Specific strategies can be adopted to improve the provision of health information to individuals with TBI, including the development of written materials and nonwritten media. OBJECTIVE A user-centered design was adopted to codevelop four audiovisual presentations, a double-sided information sheet, and a checklist aimed at informing individuals about post-TBI sexuality. The last phase of the project was the assessment of the user experience of the information toolkit, based on the User Experience Honeycomb model. METHODS Overall, two small group discussions and one individual semistructured interview were conducted with individuals with moderate to severe TBI. RESULTS The participants mentioned that the toolkit was easily usable and would have fulfilled a need for information on post-TBI sexuality during or after rehabilitation. They mostly agreed that the minimalist visual content was well-organized, attractive, and relevant. The information was easily located, the tools were accessible in terms of reading and visibility, and the content was also considered credible. CONCLUSIONS Aspects such as usability, usefulness, desirability, accessibility, credibility, and findability of information were viewed positively by the participants. Further piloting of the toolkit is recommended to explore its effects on the awareness of the potential sexual repercussions of TBI in individuals and partners.

HOME COMPUTERISED COGNITIVE TESTING FOR TBI IS FEASIBLE AND POPULAR

2015 ◽  
Vol 86 (11) ◽  
pp. e4.75-e4 ◽  
Author(s):  
Peter Jenkins ◽  
Jessica Fleminger ◽  
Sara De-Simoni ◽  
Amy Jolly ◽  
Nikos Gorgoraptis ◽  
...  
Keyword(s):  
Treatment Response ◽  
Neuropsychological Tests ◽  
Cognitive Rehabilitation ◽  
Neuropsychological Testing ◽  
Cognitive Testing ◽  
Clinical Psychologist ◽  
Attention And Memory ◽  
Information Processing Speed ◽  
Severe Tbi ◽  
Assess Treatment Response

Serial neuropsychological testing potentially provides a powerful tool for tracking disease progress and identifying treatment response. Formal neuropsychometric assessment by a clinical psychologist is ideal but impractical for regular testing. Remote computerised assessment resolves this difficulty by allowing frequent home assessment, but is potentially limited by patient compliance and practise effects. We study the feasibility of this approach in an on-going clinical trial investigating the effects of methylphenidate on cognition after traumatic brain injury (TBI): Dopamine's Role in Enhancing Attention and Memory (DREAM).A battery of neuropsychological tests was delivered on an iPad. 12 patients with moderate/severe TBI and on-going cognitive complaints completed 7 tasks assessing information processing speed, memory, attention and executive functions. The 25-minute-long battery was performed daily for 4 weeks, following an initial training period. Compliance was good, with over 80% of the sessions completed, and patients found it both beneficial and enjoyable. Despite optimising the battery to minimise learning effects, differing tasks showed varying degrees of practise effects.We demonstrate a proof of principle that TBI patients will enthusiastically complete regular computerised neuropsychological tests at home. This provides a potentially powerful tool to assess treatment response, but also offers the prospect of facilitating self-directed cognitive rehabilitation.

PP103 Characteristics Of Systems Applied To Language Rehabilitation

2017 ◽  
Vol 33 (S1) ◽  
pp. 120-121
Author(s):  
José Núñez ◽  
Ronald Rivas ◽  
Pedro Galvan ◽  
Benicio Grossling
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Rural Areas ◽  
Communication System ◽  
Communication Systems ◽  
Cognitive Rehabilitation ◽  
Low Cost ◽  
Augmentative Communication ◽  
Motor Deficit ◽  
Attention And Memory

INTRODUCTION:In Paraguay the main cause of Traumatic Brain Injury are the accidents in ground transportation. According to data from the Basic Health Indicators 2013 of the Ministry of Public Health and Social Welfare, the regions with the highest rate of accidents in ground transportation are located in the rural zone of the country. Linguistic or communication disorder, attention and memory are the first functions that must be rehabilitated. Is essential to improve the patient's language skills to intervene the other cognitive functions. The objective of this study is to determine if free augmentative communication systems have the characteristics necessary for the cognitive rehabilitation of the language to provide a low cost solution for Traumatic Brain Injury patients in rural areas of the country.METHODS:A list of seven characteristics that contributed to verbal comprehension and expression, reading and writing, logical-verbal reasoning and numeration and calculation were compiled and compared to the Gazespeaker, which is a free augmentative communication system.RESULTS:The Gazespeaker meets the seven characteristics required for language rehabilitation.CONCLUSIONS:For patients with Traumatic Brain Injury are required low cost tools and ease-to-use like the Gazespeaker. It is a good augmentative communication system which satisfies all the characteristics required for a good language rehabilitation. In addition, this free software allows the use of an eye tracking device that can be applied to patients with Traumatic Brain Injury and severe motor deficit.

scholarly journals Treatment of Patients in Coma and Exercises for Enhancing Cognitive Functions after Traumatic Brain Injury

2021 ◽  
Vol 9 (4) ◽  
pp. 01-03
Author(s):  
Theofilidis Antonis
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Functions ◽  
Cognitive Rehabilitation ◽  
Computer Assisted ◽  
Attention And Memory ◽  
Training Methods ◽  
Success Rates ◽  
Different Types ◽  
Specific Disorders

The neuropsychological training methods for the restoration of sensory losses after a TBI aim both at the restoration of the sensory losses and at the practice of the other senses to "compensate" for the dysfunctional sensation. Aim: The purpose of the study was to present treatment of patients in coma and exercises for enhancing cognitive functions after traumatic brain injury. Results: Electronically assisted treatment methods (Computer - Assisted Treatment, CAT) are now recognized methods, with high success rates in the rehabilitation of patients after TBI. Conclusions: Cognitive rehabilitation must be done taking into account a variety of neurofunctional abilities and weaknesses. Basic skills need to be stimulated before any approach to more complex ones can be made. The use of audiovisual media in general contributes both to the restoration of vision and compensatory restoration of functions as well as to the general restoration of the patient's cognitive functions. Cognitive rehabilitation to recover and improve attention and memory, offers a variety of different types of exercises for specific disorders. Exercise can vary in degree of difficulty depending on the patient's needs.

scholarly journals BPSD following traumatic brain injury

2013 ◽  
Vol 7 (3) ◽  
pp. 269-277
Author(s):  
Renato Anghinah ◽  
Fabio Rios Freire ◽  
Fernanda Coelho ◽  
Juliana Rhein Lacerda ◽  
Magali Taino Schmidt ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Behavioral Problems ◽  
Cognitive Rehabilitation ◽  
Psychiatric Symptoms ◽  
Psychological Symptoms ◽  
Relevant Information ◽  
Rehabilitation Service ◽  
Severe Tbi ◽  
The University

ABSTRACT Annually, 700,000 people are hospitalized with brain injury acquired after traumatic brain injury (TBI) in Brazil. Objective: We aim to review the basic concepts related to TBI, and the most common Behavioral and Psychological Symptoms of Dementia (BPSD) findings in moderate and severe TBI survivors. We also discussed our strategies used to manage such patients in the post-acute period. Methods: Fifteen TBI outpatients followed at the Center for Cognitive Rehabilitation Post-TBI of the Clinicas Hospital of the University of São Paulo were submitted to a neurological, neuropsychological, speech and occupational therapy evaluation, including the Mini-Mental State Examination. Rehabilitation strategies will then be developed, together with the interdisciplinary team, for each patient individually. Where necessary, the pharmacological approach will be adopted. Results: Our study will discuss options of pharmacologic treatment choices for cognitive, behavioral, or affective disorders following TBI, providing relevant information related to a structured cognitive rehabilitation service and certainly will offer an alternative for patients and families afflicted by TBI. Conclusion: Traumatic brain injury can cause a variety of potentially disabling psychiatric symptoms and syndromes. Combined behavioral and pharmacological strategies, in the treatment of a set of highly challenging behavioral problems, appears to be essential for good patient recovery.

scholarly journals Traumatic Brain Injury and Sexuality: User Experience Study of an Information Toolkit

10.2196/14874 ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. e14874
Author(s):  
Pascale Marier-Deschênes ◽  
Marie-Pierre Gagnon ◽  
Julien Déry ◽  
Marie-Eve Lamontagne
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
User Experience ◽  
Attention And Memory ◽  
Semistructured Interview ◽  
User Centered Design ◽  
Functional Impairments ◽  
Group Discussions ◽  
Severe Tbi ◽  
Written Materials

Background After having sustained a traumatic brain injury (TBI), individuals are at risk of functional impairments in information processing, abstract reasoning, executive functioning, attention, and memory. This affects different aspects of communicative functioning. Specific strategies can be adopted to improve the provision of health information to individuals with TBI, including the development of written materials and nonwritten media. Objective A user-centered design was adopted to codevelop four audiovisual presentations, a double-sided information sheet, and a checklist aimed at informing individuals about post-TBI sexuality. The last phase of the project was the assessment of the user experience of the information toolkit, based on the User Experience Honeycomb model. Methods Overall, two small group discussions and one individual semistructured interview were conducted with individuals with moderate to severe TBI. Results The participants mentioned that the toolkit was easily usable and would have fulfilled a need for information on post-TBI sexuality during or after rehabilitation. They mostly agreed that the minimalist visual content was well-organized, attractive, and relevant. The information was easily located, the tools were accessible in terms of reading and visibility, and the content was also considered credible. Conclusions Aspects such as usability, usefulness, desirability, accessibility, credibility, and findability of information were viewed positively by the participants. Further piloting of the toolkit is recommended to explore its effects on the awareness of the potential sexual repercussions of TBI in individuals and partners.

Challenges and Opportunities for Neuroimaging in Young Patients with Traumatic Brain Injury: a Coordinated Effort towards Advancing Discovery from the ENIGMA Pediatric Moderate/Severe TBI Group

2019 ◽  
Author(s):  
Emily L. Dennis ◽  
Karen Caeyenberghs ◽  
Robert F. Asarnow ◽  
Talin Babikian ◽  
Brenda Bartnik-Olson ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Meta Analysis ◽  
Young Patients ◽  
Future Research ◽  
Childhood And Adolescence ◽  
Developmental Issues ◽  
Challenges And Opportunities ◽  
Severe Tbi ◽  
Advance Research

Traumatic brain injury (TBI) is a major cause of death and disability in children in both developed and developing nations. Children and adolescents suffer from TBI at a higher rate than the general population; however, research in this population lags behind research in adults. This may be due, in part, to the smaller number of investigators engaged in research with this population and may also be related to changes in safety laws and clinical practice that have altered length of hospital stays, treatment, and access to this population. Specific developmental issues also warrant attention in studies of children, and the ever-changing context of childhood and adolescence may require larger sample sizes than are commonly available to adequately address remaining questions related to TBI. The ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Pediatric Moderate-Severe TBI (msTBI) group aims to advance research in this area through global collaborative meta-analysis. In this paper we discuss important challenges in pediatric TBI research and opportunities that we believe the ENIGMA Pediatric msTBI group can provide to address them. We conclude with recommendations for future research in this field of study.

scholarly journals Modulated Neuroprotection in Unresponsive Wakefulness Syndrome after Severe Traumatic Brain Injury

2021 ◽  
Vol 11 (8) ◽  
pp. 1044
Author(s):  
Cristina Daia ◽  
Cristian Scheau ◽  
Aura Spinu ◽  
Ioana Andone ◽  
Cristina Popescu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Severe Traumatic Brain Injury ◽  
Functional Independence ◽  
Unresponsive Wakefulness Syndrome ◽  
Coma Scale ◽  
Severe Tbi ◽  
Neuroprotective Treatment ◽  
Gcs Score

Background: We aimed to assess the effects of modulated neuroprotection with intermittent administration in patients with unresponsive wakefulness syndrome (UWS) after severe traumatic brain injury (TBI). Methods: Retrospective analysis of 60 patients divided into two groups, with and without neuroprotective treatment with Actovegin, Cerebrolysin, pyritinol, L-phosphothreonine, L-glutamine, hydroxocobalamin, alpha-lipoic acid, carotene, DL-α-tocopherol, ascorbic acid, thiamine, pyridoxine, cyanocobalamin, Q 10 coenzyme, and L-carnitine alongside standard treatment. Main outcome measures: Glasgow Coma Scale (GCS) after TBI, Extended Glasgow Coma Scale (GOS E), Disability Rankin Scale (DRS), Functional Independence Measurement (FIM), and Montreal Cognitive Assessment (MOCA), all assessed at 1, 3, 6, 12, and 24 months after TBI. Results: Patients receiving neuroprotective treatment recovered more rapidly from UWS than controls (p = 0.007) passing through a state of minimal consciousness and gradually progressing until the final evaluation (p = 0.000), towards a high cognitive level MOCA = 22 ± 6 points, upper moderate disability GOS-E = 6 ± 1, DRS = 6 ± 4, and an assisted gait, FIM =101 ± 25. The improvement in cognitive and physical functioning was strongly correlated with lower UWS duration (−0.8532) and higher GCS score (0.9803). Conclusion: Modulated long-term neuroprotection may be the therapeutic key for patients to overcome UWS after severe TBI.

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