- Coping and adaptive strategies of traumatic brain injury survivors and primary caregivers. [JOURNAL ARTICLE]
- NeuroRehabilitation 2016 Jun 27.
Qualitative research methods allowed the investigator to contribute to the development of new theories and to examine change in processes over time, which added rich detail to existing knowledge of the use of coping and adaptive strategies by traumatic brain injury survivors and their primary caregivers (Ponsford, Sloan, & Snow, 2013). The advantages of phenomenological study were that it allows flexibility to explore and understand meanings attached by people to well-studied concepts such as coping, resiliency, and adaptation or compensation. Phenomenological study was sensitive to contextual factors. It also permitted the study of in-depth dynamics of coping and adaptive strategies of TBI survivors and primary caregivers, while understanding the social and psychological implications of the phenomenon.To explore the needs and deficits of adult traumatic brain injury (TBI) survivors and primary caregivers; and to identify their self-initiated coping and adaptive strategies. Significant to this study was the development of coping and adaptive strategies by the participants after their discharge from inpatient and rehabilitation treatment. The compensatory skills taught in treatment settings did not transfer to the home environment. Therefore, these strategies developed independently from previous treatment recommendations contributed to the development of theory related to rehabilitation and counseling. Distinctive to this study was the similarity of coping and adaptive strategies developed from both mild and severe traumatic brain injury survivors.This study consisted of eleven with TBI and six primary caregivers (N = 17), who participated in a series of semi-structured interviews aimed at discovering the coping and adaptive strategies utilized in dealing with the effects of brain injury. A Qualitative Phenomenological design was employed.Patience and understanding, support, and professional help were identified by TBI survivors and caregivers as being their most relevant needs. Self-reported deficits included short-term memory loss (STM), fatigue, anger, and personality changes, and the strategies that TBI survivors and caregivers identified tended to address their problems with these specific day-to-day deficits. Problem focused, emotion focused, and avoidant coping were utilized to some degree in their adjustment to home life and activities of daily living. Participants offered suggestions for mental health professionals addressing how to more effectively work with brain injury survivors and their primary caregivers.TBI survivors and caregivers had multiple self-reported unaddressed needs following their discharge from facility-based treatment. They reported spontaneously engaging in various coping and adaptive strategies to address their needs and deficits. However, further education regarding potential post-TBI challenges and strategies for addressing them are needed, including a need for community and mental health resources.
- The effectiveness of psychological interventions for aggressive behavior following acquired brain injury: A meta-analysis and systematic review. [JOURNAL ARTICLE]
- NeuroRehabilitation 2016 Jun 30.
The consequences of aggressive behavior following ABI have an impact at both an individual and systemic level. In contrast to other ABI sequelae, aggressive behavior has been shown to increase over time without appropriate timely interventions.The current meta-analysis aimed to systematically review the current literature examining psychological interventions for aggressive behavior following ABI. The meta-analysis also aimed to provide a statistical synthesis of the available evidence.Following the PRISMA guidelines, an electronic and ancestral search of the available literature identified eleven studies (N = 123) that met the inclusion criteria for the review. Non-overlap effect sizes (Tau-U) were calculated to synthesize the available evidence from single case experimental design studies (SCEDs; N = 7). Standardized mean difference effect sizes (d) were calculated to synthesize the available evidence from group studies (N = 4).A medium omnibus effect size (weighted d = -0.46, 95% CI: -0.69 <> -0.24) was found for group studies. Similarly, the overall effect size (Tau-U) for SCEDs was -0.59 (95% CI: -0.72 <> -0.46), indicating a 59% reduction in aggressive behaviour compared to baseline.The findings of the meta-analysis suggest that psychological interventions for aggressive behavior are at least moderately effective at reducing aggressive behavior following ABI.
- Functional assessment of immediate task planning and execution by adults with acquired brain injury. [JOURNAL ARTICLE]
- NeuroRehabilitation 2016 Jun 27.
Individuals with acquired brain injury (ABI) often struggle planning and executing tasks outside daily routines. Given the pervasive effects executive functioning challenges have on independent living, professionals need methods of assessing these skills.This study's purpose was to evaluate an ecologically-valid procedure to assess novel task planning and execution by adults with ABI.The researchers implemented a single group design across two phases. Participants included nine adults with severe ABI. In the first experimental phase, participants created a plan for executing tasks that required adherence to pre-determined rules; in the second phase, participants executed the tasks. The researchers tallied information units recorded during the planning phase, performed momentary time-sampling to document observations about participant behaviors, and collected speed, accuracy, and rule violation data about task completion.Planning strategies implemented by most participants were limited to word-for-word copying of some or all of the specified tasks. On average, participants attempted and accurately performed less than half the required tasks and exhibited high rule violation rates.Given further development and refinement, the implemented procedures may serve as a basis for developing an ecologically-valid tool for evaluating executive functioning in adults with ABI.
- The impact of the neurodevelopmental traction technique on activation of lateral abdominal muscles in children aged 11-13 years. [JOURNAL ARTICLE]
- NeuroRehabilitation 2016 Jun 27.
The aim of the study was to evaluate the activation of lateral abdominal muscles (LAM) in response to neurodevelopmental traction technique as assessed by ultrasounds as well as to compare the effects of different traction forces.An experiment with repeated measurements of the dependent variables was conducted. Thirty-seven children (22 girls) participated.Measurements of LAM thickness (indicating LAM activation) were performed bilaterally during traction of 5% body weight: 1) in neutral position, 2) in 20° posterior trunk inclination; during traction of 15% body weight: 3) in neutral position, 4) in 20° posterior trunk inclination. The ultrasound technology was employed.When applying the lighter traction the superficial LAM (external and internal oblique muscles) showed significant changes. The mean thickness of both muscles during traction increased (both p < 0.001). The deepest transversus abdominis showed no response (p > 0.05). Stronger traction elicited smaller changes. External and internal oblique muscles showed significant increases (p < 0.001, p < 0.01, respectively). Transversus abdominis became less thick during stronger traction (p < 0.01).The neurodevelopmental traction technique elicits the changes in LAM thickness in children with typical development. The superficial LAM show more distinct responses than the profound LAM. Stronger traction induces smaller LAM thickness changes than lighter traction.
- Life satisfaction and associated factors in persons with mild to moderate Parkinson's disease. [JOURNAL ARTICLE]
- NeuroRehabilitation 2016 Jun 23.
Life satisfaction (LS) is an overall goal in the long-term management and rehabilitation of persons with Parkinson's disease (PD). However, very little is known about LS in persons with PD and no study has examined factors associated with their LS.To describe LS in persons with mild to moderate PD and to evaluate the association with gender, age, years since diagnosis, and sense of coherence, perceived participation, and mental and emotional status.Eighty persons with mild to moderate PD (46 men and 34 women, mean age 70.1 years, mean time since diagnosis 7.4 years) responded to a postal survey with the Swedish versions of the Satisfaction With Life Scale (SWLS), the Sense of Coherence scale (SOC-13), the Reintegration to Normal Living Index (RNLI) and the Geriatric Depression Scale (GDS-20). Hierarchical multiple regression analyses were used to evaluate the association with LS.The mean SWLS total score was 21.8 points, and 45% rated themselves as satisfied to highly satisfied with their lives. SOC and years since diagnosis explained 36% of the variance, where a strong SOC, indicating a person's capacity to adapt to the overall strains of the disease, showed the strongest association with a high LS.Persons with mild to moderate PD seem to be generally satisfied with their lives but LS may decrease as the disease progresses. The strong association with SOC implies that LS may increase through rehabilitation that support persons with PD to understand and confront the nature of problems arising in their lives as a result of their PD.
- Effect of supporting 3D-garment on gait postural stability in children with bilateral spastic cerebral palsy. [JOURNAL ARTICLE]
- NeuroRehabilitation 2016 Jun 23.
Children with cerebral palsy show dysfunctional postural control which interferes with their functional performance and daily-life activities.The aim of the study was to identify the effect of a 3D supporting garment on trunk postural control and interjoint coordination during gait in children with bilateral cerebral palsy.We analyzed tridimensional trunk motion, trunk-thigh and interjoint coordination in 15 4-10 year-old children with bilateral spastic cerebral palsy (GMFCS I or II) and 16 4-10 year-old typically developing children while walking with or without a supporting garment.We found significantly changes in the coordination between trunk and lower limbs in children with cerebral palsy. Step velocity and cadence both increased significantly in children with cerebral palsy but in controls, the cadence remained unaltered. Interjoint coordination between hip-knee and knee-ankle was altered during the stance phase only in the subgroup of children with cerebral palsy without any limitations in ankle joint passive range of motion.3D supporting garments improve trunk-thigh and lower limb interjoint coordination in walking in children with bilateral cerebral palsy.
- Perspective training to treat anger problems after brain injury: Two case studies. [Journal Article]
- NeuroRehabilitation 2016 Jun 18; 39(1):153-62.
People with acquired brain injury (ABI) often show increased anger and aggression. Anger has been linked to attributions of hostile intent. The more intentional and hostile the judgments of other's behaviours are, the angrier the responses tend to be. Some people with ABI tend to make harsher attributions than healthy controls (negative attribution bias). Poor perspective-taking may distort assessment of others' intentions, thereby contributing to this bias and subsequent anger responses.Examine changes in anger and perspective-taking after a Perspectives Group in two participants with ABI.This study is a case report exploring observational changes in anger, hostility, verbal and physical aggression and perspective-taking in two males with ABI and severe emotion dysregulation. Participants and their spouses also provided qualitative feedback through a semi-structured interview following perspectives training. The six-week "Perspectives Group" used hypothetical and real-life situations to teach participants to consider the perspectives of others when determining their intentions.Both participants showed post-treatment declines in aggression. Although only minimal changes occurred on the perspective-taking measure, spouses described important behavioural changes in their partners that indicated both decreased aggression and better perspective taking.These preliminary findings support further investigation of perspectives training for reducing anger after ABI.
- Effectiveness of Animal Assisted Therapy after brain injury: A bridge to improved outcomes in CRT. [Journal Article]
- NeuroRehabilitation 2016 Jun 18; 39(1):135-40.
Animal Assisted Therapy (AAT) has been widely used as a complementary therapy in mental health treatment especially to remediate social skill deficits. The goal of AAT is to improve social, emotional, and cognitive functioning.The purpose of this article is to draw upon the literature on AAT and explore specific applications to cognitive rehabilitation therapy (CRT) and social skills training.This study provides a systematic review of most of the available literature on ATT and assesses that potential uses of ATT for brain injury rehabilitation.Although the efficacy of AAT is not currently well documented by rigorous research, (Kazin, 2010) anecdotal evidence suggests that brain injury survivors may benefit from the combination of AAT and cognitive rehabilitation techniques.Acquired Brain Injury (ABI) survivors with cognitive impairments can benefit from AAT as part of a comprehensive and holistic rehabilitation treatment plan.
- Efficacy of legal judgments for defendants with traumatic brain injury. [Journal Article]
- NeuroRehabilitation 2016 Jun 23; 39(1):125-34.
Literature has compared the frequency of aggressive behaviors of the TBI population and the non-TBI population, suggesting that the TBI population is predisposed to aggressive tendencies because the injury enables impulsivity, loss of self-control, and the inability to modify behaviors. These behavior changes have consequently, been found to lead to criminal involvement. In fact, the majority of the prison population has sustained at least one TBI in their lifetime compared to the prevalence of brain injuries in the general population. However, there is little research investigating the perceptions of criminality and guilt of these individuals.Two experiments were conducted that investigated the perceptions of morality, level of guilt, and appropriate sentencing of crimes committed by defendants with different severities of TBI (i.e., mild, severe, and no TBI). Participants were asked to read scenarios about crimes being committed by the defendant. Experiment 1 used a 1-between (crime), 1-within (TBI) mixed design ANOVA testing three dependent variables (morality, guilt, and sentencing). Using a more in vivo jury approach, Experiment 2 used a 3 (TBI)×2 (crime) independent groups factorial design testing the three dependent measures.Overall, defendants with TBI were found less guilty of their crime, perceived as behaving morally to the crime, and receiving a milder punishment relative to the no-TBI defendants.In the courtroom, the defense attorney should educate the judge and/or the jury on the effects brain injuries have on the cognition, behavior, and emotions of an individual. Thus, this education will ensure the best verdict is being reached.
- A systematic review of pediatric cognitive rehabilitation in the elementary and middle school systems. [Journal Article]
- NeuroRehabilitation 2016 Jun 18; 39(1):119-23.
Cognitive Rehabilitation Therapy (CRT) is efficacious in remediating cognitive deficits, and has been demonstrated to be effective in a school setting.The purpose of this paper is to review the literature on pediatric CRT as it relates to successful re-integration of TBI survivors into the school system and community.This systematic review of the literature suggests that social re-integration strategies which incorporate problem-solving, reasoning, self-awareness, and positive social skills within a developmental framework are the most effective techniques for Pediatric CRT.Children and adolescents with cognitive impairments benefit from a holistic approach to rehabilitation which incorporates developmental, social, and emotional considerations, as well as, cognitive rehabilitation techniques.This systematic review identifies several avenues for effective therapeutic interventions for school aged TBI survivors. Many are supported by laboratory based efficacy studies. Future research should investigate optimal ages for particular treatments, as well as, the effectiveness of treatments across different social settings.