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Cognitive rehabilitation of severe brain injury guidelines

Tatyana Mollayeva, Chen Xiong, Sara Hanafy, Vincy Chan, Zheng Jing Hu, Mitchell Sutton, Michael Escobar, Angela Colantonio
INTRODUCTION: Reports on the association between comorbidity and functional status and risk of death in patients with traumatic brain injury (TBI) have been inconsistent; it is currently unknown which additional clinical entities (comorbidities) have an adverse influence on the evolution of outcomes across the lifespan of men and women with TBI. The current protocol outlines a strategy for a systematic review of the current evidence examining the impact of comorbidity on functional status and early-term and late-term mortality, taking into account known risk factors of these adverse outcomes (ie, demographic (age and sex) and injury-related characteristics)...
October 13, 2017: BMJ Open
Stephen N Macciocchi, Ronald T Seel, Angela Yi, Sarah Small
Objective: This study examined performance on the Medical Symptom Validity test (MSVT) during acute rehabilitation for moderate-severe traumatic brain injury (TBI) stratified by Orientation Log (O-Log) scores. Method: Participants were 77 prospectively enrolled persons who sustained moderate-severe TBI and were acutely hospitalized secondary to the cognitive, medical and physical sequelae of their TBI. Participants were administered neuropsychological metrics, the O-Log and the MSVT a mean of 44 days post injury...
May 1, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
Thomas M Swanson, Brad M Isaacson, Cherina M Cyborski, Louis M French, Jack W Tsao, Paul F Pasquina
Exposure to explosive armaments during Operation Iraqi Freedom and Operation Enduring Freedom contributed to approximately 14% of the 352 612 traumatic brain injury (TBI) diagnoses in the US military between 2000 and 2016. The US Department of Defense issued guidelines in 2009 to (1) standardize TBI diagnostic criteria; (2) classify TBI according to mechanism and severity; (3) categorize TBI symptoms as somatic, psychological, or cognitive; and (4) systematize types of care given during the acute and rehabilitation stages of TBI treatment...
March 2017: Public Health Reports
C A M van Bennekom, H Wind, C T J Hulshof, M H W Frings-Dresen
Acquired brain injury may lead to cognitive, emotional and behavioural problems which often go unrecognised. Combined with the patient's lack of self-awareness this may impede social participation, in particular in returning to work. To stress the importance of diagnosing and treating such consequences, we present two patients. A 40-year-old man suffering from the invisible consequences of brain injury caused by several cerebral infarctions. He tried but failed several times to hold down a job before he was sent to a specialized vocational rehabilitation centre...
2016: Nederlands Tijdschrift Voor Geneeskunde
Jean Gagnon, Grahame Kenneth Simpson, Glenn Kelly, Denis Godbout, Michel Ouellette, Jacques Drolet
PURPOSE: To develop a French version of the Overt Behaviour Scale (OBS) and examine some of its psychometric properties. METHODS: The scale was adapted and validated according to standard guidelines for cross-cultural adaptation of questionnaires (Échelle des comportements observables; ÉCO). The reliability and construct validity of the ÉCO were studied among 29 inpatients and outpatients who sustained an acquired brain injury. The instruments were administered by 12 clinicians located at eight rehabilitation centres and the local brain injury association...
2016: Brain Injury: [BI]
Bridgette D Semple, Sangmi Lee, Raha Sadjadi, Nora Fritz, Jaclyn Carlson, Carrie Griep, Vanessa Ho, Patrice Jang, Annick Lamb, Beth Popolizio, Sonia Saini, Jeffrey J Bazarian, Mayumi L Prins, Donna M Ferriero, D Michele Basso, Linda J Noble-Haeusslein
Sports-related concussions are particularly common during adolescence, a time when even mild brain injuries may disrupt ongoing brain maturation and result in long-term complications. A recent focus on the consequences of repetitive concussions among professional athletes has prompted the development of several new experimental models in rodents, as well as the revision of guidelines for best management of sports concussions. Here, we consider the utility of rodent models to understand the functional consequences and pathobiology of concussions in the developing brain, identifying the unique behavioral and pathological signatures of concussive brain injuries...
2015: Frontiers in Neurology
Karen L McCulloch, Sarah Goldman, Lynn Lowe, Mary Vining Radomski, John Reynolds, Rita Shapiro, Therese A West
OBJECTIVE: Previously published mild traumatic brain injury (mTBI) management guidelines provide very general recommendations to return individuals with mTBI to activity. This lack of specific guidance creates variation in military rehabilitation. The Office of the Army Surgeon General in collaboration with the Defense and Veterans Brain Injury Center, a component center of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, convened an expert working group to review the existing literature and propose clinical recommendations that standardize rehabilitation activity progression following mTBI...
January 2015: Journal of Head Trauma Rehabilitation
Gerard A Gioia
BACKGROUND: Significant attention has been focused on concussions in children, but a dearth of research evidence exists supporting clinical evaluation and management. AIM: The primary objective of this review paper is to describe a multimodal, developmentally adapted, standardized concussion assessment and active rehabilitation approach for children as young as 5 years old. METHODS: This study reviews the CDC-funded research programme, including the development of tools for post-concussion symptom assessment involving the child and parent, measurement of specific neurocognitive functions and assessment of dynamic cognitive exertional effects...
2015: Brain Injury: [BI]
Nadia E Webb, Brittany Little, Stephanie Loupee-Wilson, Elizabeth M Power
INTRODUCTION: Traumatic Brain Injury (TBI) initiates a cascade of neuromodulatory damage that blurs the distinctions between physical and psychological medicine. Monitoring endocrine function through labs is not part of the medical care algorithm for treatment of TBI, but the clinical symptoms are easily misidentified as they include: depression, fatigue, poor concentration, irritability and a decline in overall cognitive functioning. The reciprocal flow of change between neuroendocrine health and psychosocial health is well established within the field of neuroscience, social psychology, endocrinology and behavioral neurology, but has not translated into patient care...
2014: NeuroRehabilitation
Kathy Aligene, Emerald Lin
OBJECTIVES: The purpose of this chapter is to provide an update on the clinical management of vestibular and balance dysfunction in a concussed athlete with a focus on diagnosis, initial work-up, and initial and continuing management. Although much is still unknown about the etiology of vestibular and balance dysfunction in a concussed athlete, we briefly review current theories about neural pathophysiology to help link proposed treatment methodologies. INTRODUCTION: The treatment and management of vestibular and balance dysfunction in concussed athletes requires a multidisciplinary approach and is based on continuous reassessment of the presenting symptoms...
2013: NeuroRehabilitation
Cady K Block, Sarah E West
UNLABELLED: Abstract Primary objective: To provide an overview of useful clinical information for healthcare providers involved in traumatic brain injury (TBI) rehabilitation, including current methods used with survivors of TBI, therapeutic considerations in light of this population's cognitive, emotional and social difficulties and issues regarding the therapeutic working alliance from both survivor and provider perspectives. RESEARCH DESIGN: Non-systematic clinical review...
2013: Brain Injury: [BI]
P Reuther, A Hendrich, W Kringler, E Vespo
In Germany a number of patients who are suffering from acquired brain injury and chronic neurological disability are either undersupplied or exposed to inappropriate care in their social environment. The number of these patients is increasing due to the changes in the procedures of care and due to demographic factors. While acute medical care and early rehabilitative treatment is accessible throughout the German health care system the necessary multimodal and competent care is rare or absent in the social participative sites such as life and occupational environments of the patients...
December 2012: Die Rehabilitation
Anna O'Callaghan, Lindy McAllister, Linda Wilson
INTRODUCTION: Adults sustain significant, often irreversible impairments following brain injury. The process they go through coming to terms with these impairments can seriously interfere with their readiness to engage in rehabilitation. AIM: This study aimed to look beyond the development of self-awareness and insight in order to explore the concept of readiness as it relates to clients' experiences of engaging with therapy. METHOD: Sixteen in-depth interviews were conducted with 14 adults with a moderate-severe traumatic brain injury (TBI) and nine of their significant others...
2012: Brain Injury: [BI]
Frederick P Rivara, Stephanie K Ennis, Rita Mangione-Smith, Ellen J MacKenzie, Kenneth M Jaffe
OBJECTIVE: To determine variations in care provided by 9 inpatient rehabilitation units for children with traumatic brain injury (TBI) using newly developed quality indicators. DESIGN: Retrospective cohort study. SETTING: Nine inpatient rehabilitation units. PARTICIPANTS: Children (N=174; age range, 0-17y) admitted for the inpatient rehabilitation of moderate to severe TBI. INTERVENTIONS: Not applicable...
August 2012: Archives of Physical Medicine and Rehabilitation
W Schupp
Stroke, Multiple Sclerosis (MS), traumatic brain injuries (TBI) and neuropathies are the most important diseases in neurological rehabilitation financed by the German Pension Insurance. The primary goal is vocational (re)integration. Driven by multiple findings of neuroscience research the traditional holistic approach with mainly empirically derived strategies was developed further and improved by new evidence-based interventions. This process had been, and continues to be, necessary to meet the health-economic pressures for ever shorter and more efficient rehab measures...
December 2011: Die Rehabilitation
William P Meehan
Clinicians who manage sport-related concussions have excellent guidelines by which most injuries can be managed. Because sport-related concussions typically resolve within a short time frame, most can be managed with physical and cognitive rest alone. However, clinicians who specialize in the assessment and management of this diagnosis encounter patients with prolonged recovery courses, persistent symptoms, and significant deficits in cognitive functioning. These patients require more involved therapy, which may include additional education, academic accommodations, physical therapy, cognitive rehabilitation, and medication...
January 2011: Clinics in Sports Medicine
Laurie A Ehlhardt, McKay Moore Sohlberg, Mary Kennedy, Carl Coelho, Mark Ylvisaker, Lyn Turkstra, Kathryn Yorkston
This article examines the instructional research literature pertinent to teaching procedures or information to individuals with acquired memory impairments due to brain injury or related conditions. The purpose is to evaluate the available evidence in order to generate practice guidelines for clinicians working in the field of cognitive rehabilitation. A systematic review of the instructional literature from 1986 to 2006 revealed 51 studies meeting search criteria. Studies were analysed and coded within the following four key domains: Population Sample, Intervention, Study Design, and Treatment Outcomes...
June 2008: Neuropsychological Rehabilitation
R Nakase-Richardson, S A Yablon, M Sherer, C C Evans, T G Nick
BACKGROUND: Published guidelines for defining the "minimally conscious state" (MCS) included behaviours that characterise emergence, specifically "reliable and consistent" functional interactive communication (accurate yes/no responding) and functional use of objects. Guidelines were developed by consensus because of the lack of empirical data to guide definitions. Criticism emerged that individuals with severely impaired cognition would have difficulty achieving the requisite threshold of accuracy and consistency proposed to demonstrate emergence from MCS...
February 2008: Journal of Neurology, Neurosurgery, and Psychiatry
Tina M Trudel, F Don Nidiffer, Jeffrey T Barth
Traumatic brain injury (TBI) is a major health problem in civilian, military, and veteran populations. Individuals experiencing moderate to severe TBI require a continuum of care involving acute hospitalization and postacute rehabilitation, including community reintegration and, one would hope, a return home to function as a productive member of the community. In the military, the goal is to help individuals with TBI return to active duty or make an optimal return to civilian life if the extent of their injuries necessitates a "medical board" discharge...
2007: Journal of Rehabilitation Research and Development
Barbara A Wilson
Neuropsychological rehabilitation (NR) is concerned with the amelioration of cognitive, emotional, psychosocial, and behavioral deficits caused by an insult to the brain. Major changes in NR have occurred over the past decade or so. NR is now mostly centered on a goal-planning approach in a partnership of survivors of brain injury, their families, and professional staff who negotiate and select goals to be achieved. There is widespread recognition that cognition, emotion, and psychosocial functioning are interlinked, and all should be targeted in rehabilitation...
2008: Annual Review of Clinical Psychology
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