scholarly journals Activity, Participation, and Goal Awareness After Acquired Brain Injury: A Prospective Observational Study of Inpatient Rehabilitation

2021 ◽  
Vol 45 (6) ◽  
pp. 413-421
Author(s):  
Zoe Adey-Wakeling ◽  
Laura Jolliffe ◽  
Elizabeth O’Shannessy ◽  
Peter Hunter ◽  
Jacqui Morarty ◽  
...  
Keyword(s):  
Brain Injury ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Program ◽  
Activity Participation ◽  
Activity Levels ◽  
Rehabilitation Unit ◽  
Injury Rehabilitation

Objective To examine the frequency and timing of inpatient engagement in meaningful activities within rehabilitation (within and outside of structured therapy times) and determine the associations between activity type, goal awareness, and patient affect.Methods This prospective observational study performed behavioral mapping in a 42-bed inpatient brain injury rehabilitation unit by recording patient activity every 15 minutes (total 42 hours). The participants were randomly selected rehabilitation inpatients with acquired brain injury; all completed the study. The main outcome measures included patient demographics, observation of activity, participation, goal awareness, and affect.Results The inpatients spent 61% of the therapeutic day (8:30 to 16:30) in their single room and were alone 49% of the time. They were physically socially inactive for 76% and 74% of their awake time, respectively, with neutral affect observed for about half of this time. Goal-related activities were recorded for only 25% of the inpatients’ awake time. The odds of physical activity were 10.3-fold higher among in patients receiving support to address their goals within their rehabilitation program (odds ratio=10.3; 95% confidence interval, 5.02–21.16).Conclusion Inpatients in a mixed brain injury rehabilitation unit spent a large amount of their awake hours inactive and only participated in goal-related activities for a quarter of their awake time. Rehabilitation models that increase opportunities for physical, cognitive, and social activities outside of allied health sessions are recommended to increase overall activity levels during inpatient rehabilitation.

scholarly journals Assessment of Intensive Inpatient Rehabilitation Program in Acquired Brain Injury Patients using UK FIM+FAM Scale: A Retrospective Study

2021 ◽  
Author(s):  
Harleen Uppal ◽  
Shipra Chaudhary ◽  
Siddharth Rai
Keyword(s):  
Brain Injury ◽  
Functional Outcome ◽  
Outcome Measure ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
P Value ◽  
Functional Outcome Measure ◽  
The Uk

Introduction: Acquired Brain Injury (ABI) can lead to a combination of physical, cognitive, and behavioural impairments and requires comprehensive and structured inpatient rehabilitation program. A multidisciplinary rehabilitation program can deal comprehensively with all these issues together rather than focussing on a single aspect like motor function. Number of people suffering from Traumatic Brain Injury (TBI) in India has been documented to be between 1.5 million to two million per year whereas out of this approximately one million die due to TBI. The rationale of the present study was to document the outcome of multidisciplinary inpatient rehabilitation program objectively using a standard functional outcome measure. Aim: To determine the change in functional outcomes of ABI patients being rehabilitated with a multidisciplinary inpatient neurorehabilitation program using UK version of Functional Independence Measure and Functional Assessment Measure (UK FIM+FAM). Materials and Methods: The retrospective observational study was conducted in Medanta Hospital, Gurugram, Haryana, India, from September 2017 to June 2018. Retrospective analysis of previously maintained data was done from June 2018 to November 2018. Data was collected from the Department of Neurorehabilitation. Demographic data was collected including age, sex, type of injury, time from injury to admission and duration of stay in the neurorehabilitation unit. Functional outcome measure used in the study was the UK FIM+FAM. Data was collected in paper forms and collated in Microsoft Excel and transferred to IBM® Statistical Package for the Social Sciences (SPSS)® version 22.0 (IBM Corp., Armonk, NY) for analysis. The UK FIM+FAM data was analysed as aggregate total scores and motor and cognitive subscales. Non parametric tests were used as UK FIM+FAM is an ordinal scale. The test used to measure the change in score was Wilcoxon Test. The p-value <0.05 was considered statistically significant. Results: Total number of patients who were analysed in the study were 45. Motor subset of scores showed significant improvement from admission (50) to discharge (72) (p-value=0.001). Similarly, the cognitive subset of scores also showed a significant improvement from admission (58) to discharge (68, p value=0.002). Apart from motor and cognitive subscales of UK FIM+FAM, change in score in sub divisions of self-care and transfers showed the maximum change with p-value=0.001. Other sub divisions of locomotion, sphincter, communication, psychological and cognition also showed a significant difference of p-value <0.05. Conclusion: A physiatrist led intensive interdisciplinary inpatient rehabilitation program for patients with ABI may significantly reduce residual disability and improve functional independence. Such a program is not only effective in high income countries but also in Low Middle Income Countries (LMIC).

Time use and physical activity in a specialised brain injury rehabilitation unit: an observational study

Brain Injury ◽  
2018 ◽  
Vol 32 (7) ◽  
pp. 850-857 ◽  
Author(s):  
Leanne Hassett ◽  
Siobhan Wong ◽  
Emma Sheaves ◽  
Maysaa Daher ◽  
Andrew Grady ◽  
...  
Keyword(s):  
Physical Activity ◽  
Brain Injury ◽  
Observational Study ◽  
Time Use ◽  
Rehabilitation Unit ◽  
Injury Rehabilitation

scholarly journals Rasch Analysis and Functional Measurement in Post-Hospital Brain Injury Rehabilitation

2017 ◽  
Vol 6 (6) ◽  
pp. 50
Author(s):  
Frank D. Lewis ◽  
Gordon J. Horn
Keyword(s):  
Brain Injury ◽  
Rasch Analysis ◽  
Item Difficulty ◽  
Reliability And Validity ◽  
Acquired Brain Injury ◽  
Statistical Technique ◽  
Rehabilitation Program ◽  
Injury Rehabilitation ◽  
Fit Statistics ◽  
Supported Living

Rasch analysis is a statistical technique used in determining statistical properties of functional measures for use in research and treatment. The technique was used in the current study to determine the reliability and validity of the Mayo Portland Adaptability Inventory-Version 4 (MPAI-4) for use with three different acquired brain injury samples. Subjects were 777 adults (each group comprised of 259 individuals) with acquired brain injury treated in one of three rehabilitation program types: Neurorehabilitation (NR), Neurobehavioral (NB), or Supported Living (SL). The MPAI-4 was administered to each participant upon admission to program. Rasch analysis was conducted to assess item fit, reliability, and separation statistics for MPAI-4 assessments conducted within each program. Item difficulty values were examined to determine if the MPAI-4 differentiated among groups based on deficit profiles. The results revealed that for each group, fit statistics fell with appropriate levels (0.5 – 1.5) for at least 24 of 29 items. Rasch person reliability statistics were 0.89 for NR and NB, and 0.90 for SL. Item reliability was 0.99 for each of the groups. Item difficulty values accurately differentiated the three groups based on their specific deficit profiles expected. Specifically, NR participants’ greatest deficits demonstrated by the MPAI-4 were within cognitive and physical functions. For the NB participants, the greater deficits demonstrated were within the behavioral and adjustment items. Supported Living participants had the most limitation within the instrumental activities of daily living items. As in prior research findings, the current Rasch analysis supported the use of the MPAI-4 within this heterogeneous, acquired brain injury population. This unique statistical approach translates to treatment priorities that may assist clinicians with identifying treatment goals specific to unique treatment group characteristics (e.g., NR, NB, and SL).

scholarly journals Later sleep timing predicts accelerated summer weight gain among elementary school children: a prospective observational study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jennette P. Moreno ◽  
Javad Razjouyan ◽  
Houston Lester ◽  
Hafza Dadabhoy ◽  
Mona Amirmazaheri ◽  
...  
Keyword(s):  
Physical Activity ◽  
Observational Study ◽  
Sleep Duration ◽  
Obesity Prevention ◽  
Prospective Observational Study ◽  
Light Exposure ◽  
Activity Level ◽  
Activity Levels ◽  
School Year ◽  
Children’S Sleep

Abstract Objectives and background Social demands of the school-year and summer environment may affect children’s sleep patterns and circadian rhythms during these periods. The current study examined differences in children’s sleep and circadian-related behaviors during the school-year and summer and explored the association between sleep and circadian parameters and change in body mass index (BMI) during these time periods. Methods This was a prospective observational study with 119 children ages 5 to 8 years with three sequential BMI assessments: early school-year (fall), late school-year (spring), and beginning of the following school-year in Houston, Texas, USA. Sleep midpoint, sleep duration, variability of sleep midpoint, physical activity, and light exposure were estimated using wrist-worn accelerometry during the school-year (fall) and summer. To examine the effect of sleep parameters, physical activity level, and light exposure on change in BMI, growth curve modeling was conducted controlling for age, race, sex, and chronotype. Results Children’s sleep midpoint shifted later by an average of 1.5 h during summer compared to the school-year. After controlling for covariates, later sleep midpoints predicted larger increases in BMI during summer, (γ = .0004, p = .03), but not during the school-year. Sleep duration, sleep midpoint variability, physical activity levels, and sedentary behavior were not associated with change in BMI during the school-year or summer. Females tended to increase their BMI at a faster rate during summer compared to males, γ = .06, p = .049. Greater amounts of outdoor light exposure (γ = −.01, p = .02) predicted smaller increases in school-year BMI. Conclusions Obesity prevention interventions may need to target different behaviors depending on whether children are in or out of school. Promotion of outdoor time during the school-year and earlier sleep times during the summer may be effective obesity prevention strategies during these respective times.

Clinical course of SARS-CoV-2 infection in patients with severe acquired brain injury and a disorder of consciousness: an observational study

Brain Injury ◽  
2021 ◽  
Vol 35 (5) ◽  
pp. 520-529
Author(s):  
Antonio Caronni ◽  
Emanuele Liaci ◽  
Anna Bianchi ◽  
Alessandro Viganò ◽  
Francesco Marenco ◽  
...  
Keyword(s):  
Brain Injury ◽  
Observational Study ◽  
Clinical Course ◽  
Acquired Brain Injury ◽  
Disorder Of Consciousness ◽  
Severe Acquired Brain Injury

Semi-quantitative Cough Strength Score as a Predictor for Extubation Outcome in Traumatic Brain Injury: A Prospective Observational Study

2018 ◽  
Vol 29 (2) ◽  
pp. 273-279
Author(s):  
Abdelrady S. Ibrahim ◽  
Mohamed G. Aly ◽  
Khaled A. Abdel-Rahman ◽  
Mona A. Mohamed ◽  
Mogedda M. Mehany ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Extubation Outcome ◽  
Cough Strength

Patient inclusion in goal setting during early inpatient rehabilitation after acquired brain injury

2011 ◽  
Vol 26 (2) ◽  
pp. 165-173 ◽  
Author(s):  
Catherine Dalton ◽  
Rachel Farrell ◽  
Annette De Souza ◽  
Evelyn Wujanto ◽  
Ann McKenna-Slade ◽  
...  
Keyword(s):  
Brain Injury ◽  
Goal Setting ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation

scholarly journals Impact of Post-Stroke Recanalization on General and Upper Limb Functioning: A Prospective, Observational Study

2021 ◽  
Vol 13 (1) ◽  
pp. 46-58
Author(s):  
João Paulo Branco ◽  
Filipa Rocha ◽  
João Sargento-Freitas ◽  
Gustavo C. Santo ◽  
António Freire ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Observational Study ◽  
Acute Ischemic Stroke ◽  
Upper Limb ◽  
Functional Recovery ◽  
Prospective Observational Study ◽  
Positive Impact ◽  
Rehabilitation Program ◽  
Patient Functioning ◽  
The Impact

The objective of this study is to assess the impact of recanalization (spontaneous and therapeutic) on upper limb functioning and general patient functioning after stroke. This is a prospective, observational study of patients hospitalized due to acute ischemic stroke in the territory of the middle cerebral artery (n = 98). Patients completed a comprehensive rehabilitation program and were followed-up for 24 weeks. The impact of recanalization on patient functioning was evaluated using the modified Rankin Scale (mRS) and Stroke Upper Limb Capacity Scale (SULCS). General and upper limb functioning improved markedly in the first three weeks after stroke. Age, gender, and National Institutes of Health Stroke Scale (NIHSS) score at admission were associated with general and upper limb functioning at 12 weeks. Successful recanalization was associated with better functioning. Among patients who underwent therapeutic recanalization, NIHSS scores ≥16.5 indicate lower general functioning at 12 weeks (sensibility = 72.4%; specificity = 78.6%) and NIHSS scores ≥13.5 indicate no hand functioning at 12 weeks (sensibility = 83.8%; specificity = 76.5%). Recanalization, either spontaneous or therapeutic, has a positive impact on patient functioning after acute ischemic stroke. Functional recovery occurs mostly within the first 12 weeks after stroke, with greater functional gains among patients with successful recanalization. Higher NIHSS scores at admission are associated with worse functional recovery.

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