Bottom-up and top-down cognitive rehabilitation following mild traumatic brain injury - Occupational therapists' perspective: An online survey study

2021 ◽  
Vol 53 (2) ◽  
pp. 56
Author(s):  
AshaK Vas ◽  
Anna Luedtke ◽  
Eryn Ortiz ◽  
Marsha Neville
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Cognitive Rehabilitation ◽  
Online Survey ◽  
Occupational Therapists ◽  
Survey Study ◽  
Top Down ◽  
Bottom Up

Cognitive Rehabilitation Following Traumatic Brain Injury: A Survey of Current Practice in Australia

2018 ◽  
Vol 20 (1) ◽  
pp. 24-36 ◽  
Author(s):  
Marina Downing ◽  
Peter Bragge ◽  
Jennie Ponsford
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family Involvement ◽  
Cognitive Rehabilitation ◽  
Online Survey ◽  
Current Practice ◽  
Occupational Therapists ◽  
Self Awareness ◽  
Compensatory Strategies ◽  
Team Collaboration

Background and Objective: As cognitive impairments represent the greatest impediment to participation following moderate–severe traumatic brain injury (TBI), cognitive rehabilitation is vital. Several sets of guidelines for cognitive rehabilitation have been published, including INCOG in 2014. However, little is known about current practice by therapists working with individuals with TBI. This study aimed to characterise current cognitive rehabilitation practices via an online survey of therapists engaged in rehabilitation in individuals with TBI.Method: The survey documented demographic information, current cognitive rehabilitation practice, resources used to inform cognitive rehabilitation, and reflections on cognitive rehabilitation provided.Results: The 221 Australian respondents were predominantly occupational therapists, neuropsychologists, and speech pathologists with an average 9 years of clinical experience in cognitive rehabilitation and TBI. Cognitive retraining and compensatory strategies were the most commonly identified approaches used in cognitive rehabilitation. Executive functioning was mostly targeted for retraining, whereas memory was targeted with compensatory strategies. Attentional problems were less frequently addressed. Client self-awareness, family involvement, team collaboration, and goal-setting were seen as important ingredients for success.Conclusion: Clinical practice of cognitive rehabilitation in Australia is broadly consistent with guidelines. However, addressing the impediments to its delivery is important to enhance the quality of life for individuals with TBI.

Cognitive Rehabilitation for Military Service Members With Mild Traumatic Brain Injury

2017 ◽  
Vol 32 (3) ◽  
pp. E1-E15 ◽  
Author(s):  
Douglas B. Cooper ◽  
Amy O. Bowles ◽  
Jan E. Kennedy ◽  
Glenn Curtiss ◽  
Louis M. French ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Military Service ◽  
Cognitive Rehabilitation ◽  
Service Members ◽  
Military Service Members

Mild Traumatic Brain Injury and Postconcussive Symptom Endorsement: A Parallel Comparison Between Two Nonclinical Cohorts

2020 ◽  
Author(s):  
R Elisabeth Cornwell ◽  
Jorge I Arango ◽  
C B Eagye ◽  
Candace Hill-Pearson ◽  
Karen Schwab ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Epidemiological Studies ◽  
Emergency Department Visits ◽  
Survey Study ◽  
Military Health ◽  
History Of ◽  
The Military ◽  
The Impact

ABSTRACT Introduction The prevalence of mild traumatic brain injury (mTBI) is commonly estimated based on indirect metrics such as emergency department visits and self-reporting tools. The study of postconcussive symptoms faces similar challenges because of their unspecific character and indistinct causality. In this article, we compare two nonclinical, epidemiological studies that addressed these two elements and were performed within a relatively narrow period in the state of Colorado. Materials and Methods De-identified datasets were obtained from a random digit-dialed survey study conducted by the Craig Hospital and a study surveying soldiers returning from deployment by Defense and Veteran Traumatic Brain Injury Center. Information pertinent to participants’ demographics, a history of mTBI, and symptom endorsement was extracted and homogenized in order to establish a parallel comparison between the populations of the two studies. Results From the 1,558 (Warrior Strong, 679; Craig Hospital, 879) records selected for analysis, 43% reported a history of at least one mTBI. The prevalence was significantly higher among individuals from the Defense and Veteran Traumatic Brain Injury Center study independent of gender or race. Repetitive injuries were reported by 15% of the total combined cohort and were more prevalent among males. Symptom endorsement was significantly higher in individuals with a positive history of mTBI, but over 80% of those with a negative history of mTBI endorsed at least one of the symptoms interrogated. Significant differences were observed between the military and the civilian populations in terms of the types and frequencies of the symptoms endorsed. Conclusions The prevalence of mTBI and associated symptoms identified in the two study populations is higher than that of previously reported. This suggests that not all individuals sustaining concussion seek medical care and highlights the limitations of using clinical reports to assess such estimates. The lack of appropriate mechanisms to determine symptom presence and causality remains a challenge. However, the differences observed in symptom reporting between cohorts raise questions about the nature of the symptoms, the impact on the quality of life for different individuals, and the effects on military health and force readiness.

scholarly journals Cognitive Rehabilitation Following Mild Traumatic Brain Injury using Hypnotic Suggestion

2019 ◽  
Author(s):  
Jonas Kristoffer Lindeløv
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Cognitive Rehabilitation ◽  
Digit Span ◽  
Depression Scale ◽  
Cost Effective ◽  
Future Research ◽  
Neurological Patient ◽  
Hypnotic Suggestion

Introduction: Cost-effective rehabilitation of persistent cognitive problems following Mild Traumatic Brain Injury (MTBI) remains elusive. Method: Here, we extend previous findings on hypnotic suggestion for neurological patient groups by administering it to 22 participants suffering from persistent reduced vocational performance following MTBI. Results: Following eight weekly 1-hour treatments, we observed large effects on the Mental Fatigue Scale and Digit Span. There were medium-sized effects on the Hospital Anxiety and Depression Scale, but no effect on the Trail Making Test. Effect sizes were larger for participants with no ongoing litigation. Conclusion: In terms of effectiveness, the results compare well to conventional treatments for MTBI. We discuss limitations and propose avenues for future research.

A-140 Computer Based Cognitive Rehabilitation Interventions for Visual Attention Following Mild Traumatic Brain Injury

2021 ◽  
Vol 36 (6) ◽  
pp. 1193-1193
Author(s):  
Alia Westphal ◽  
Jason Bailie ◽  
Melissa Caswell ◽  
Juan Lopez ◽  
Angela Basham ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Visual Attention ◽  
Mild Traumatic Brain Injury ◽  
Cognitive Rehabilitation ◽  
Service Members ◽  
Rehabilitation Programs ◽  
Cohen’S D ◽  
History Of ◽  
Cohen's D

Abstract Background Service members with a history of mild traumatic brain injury (mTBI) frequently report problems paying attention. In combat and training settings, visual attention is critical given the demand to warfighter performance. Many computerized cognitive rehabilitation programs exist, however the impact of their effectiveness on improving visual attention is unknown. Methods A randomized controlled trial consisted of 22 active-duty service members with a history of mTBI. Participants were randomized to Lumosity (N = 8) which focused on multiple cognitive domains or UCR which has a specific focus on visual attention (N = 14). Cognitive assessment was completed at baseline and following treatment. The Neuropsychological Assessment Battery (NAB) Driving Scenes subtest was used as the primary assessment of visual attention. All participants passed a validity measure pre and post assessment. Results A one-way ANOVA revealed that performance on NAB Driving Scenes improved for all participants after treatment (F = 4.18, p = 0.046); however, when computer program type was analyzed there was no interaction (F = 0.32, p = 0.860). Participants who completed the UCR intervention improved from M = 41.64, SD = 11.58 to M = 46.79, SD = 14.52, Cohen’s d = 0.43. For the Lumosity condition, there was a medium effect size (Cohen’s d = 0.46) from baseline (M = 38.63, SD = 14.33) to post treatment (M = 44.75, SD = 9.47) Conclusions The results indicated that both programs proved effective at improving visual attention symptoms. These findings provide support for the use of computerized cognitive rehabilitation programs as a form of intervention for mTBI.

scholarly journals Randomised controlled clinical trial of a structured cognitive rehabilitation in patients with attention deficit following mild traumatic brain injury: study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028711
Author(s):  
Norhamizan Hamzah ◽  
Vairavan Narayanan ◽  
Norlisah Ramli ◽  
Nor Atikah Mustapha ◽  
Nor Adibah Mohammad Tahir ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Outcome Measures ◽  
Mild Traumatic Brain Injury ◽  
Study Protocol ◽  
Effect Size ◽  
Cognitive Rehabilitation ◽  
Previous History ◽  
Psychological Status ◽  
Control Group

ObjectivesTo measure the clinical, structural and functional changes of an individualised structured cognitive rehabilitation in mild traumatic brain injury (mTBI) population.SettingA single centre study, Malaysia.ParticipantsAdults aged between 18 and 60 years with mTBI as a result of road traffic accident, with no previous history of head trauma, minimum of 9 years education and abnormal cognition at 3 months will be included. The exclusion criteria include pre-existing chronic illness or neurological/psychiatric condition, long-term medication that affects cognitive/psychological status, clinical evidence of substance intoxication at the time of injury and major polytrauma. Based on multiple estimated calculations, the minimum intended sample size is 50 participants (Cohen’s d effect size=0.35; alpha level of 0.05; 85% power to detect statistical significance; 40% attrition rate).InterventionsIntervention group will receive individualised structured cognitive rehabilitation. Control group will receive the best patient-centred care for attention disorders. Therapy frequency for both groups will be 1 hour per week for 12 weeks.Outcome measuresPrimary:Neuropsychological Assessment Battery-Screening Module (S-NAB) scores.Secondary:Diffusion Tensor Imaging (DTI) parameters and Goal Attainment Scaling score (GAS).ResultsResults will include descriptive statistics of population demographics, CogniPlus cognitive program and metacognitive strategies. The effect of intervention will be the effect size of S-NAB scores and mean GAS T scores. DTI parameters will be compared between groups via repeated measure analysis. Correlation analysis of outcome measures will be calculated using Pearson’s correlation coefficient.ConclusionThis is a complex clinical intervention with multiple outcome measures to provide a comprehensive evidence-based treatment model.Ethics and disseminationThe study protocol was approved by the Medical Research Ethics Committee UMMC (MREC ID NO: 2016928–4293). The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberNCT03237676

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