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Gopi Y, Wilding E, Madan CR. Memory rehabilitation: restorative, specific knowledge acquisition, compensatory, and holistic approaches. Cogn Process 2022; 23:537-557. [PMID: 35790619 PMCID: PMC9553770 DOI: 10.1007/s10339-022-01099-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
Memory impairment following an acquired brain injury can negatively impact daily living and quality of life—but can be reduced by memory rehabilitation. Here, we review the literature on four approaches for memory rehabilitation and their associated strategies: (1) the restorative approach, aimed at a return to pre-morbid functioning, (2) the knowledge acquisition approach, involving training on specific information relevant to daily life, (3) the compensatory approach, targeted at improving daily functioning, and (4) the holistic approach, in which social, emotional, and behavioral deficits are addressed alongside cognitive consequences of acquired brain injury. Each memory rehabilitation approach includes specific strategies such as drill and practice (restorative), spaced retrieval (knowledge acquisition), memory aids (compensatory), or a combination of psychotherapy and cognitive strategies (holistic). Past research has demonstrated mixed support for the use of restorative strategies to improve memory function, whereas knowledge acquisition strategies show promising results on trained tasks but little generalization to untrained tasks and activities of daily living. Compensatory strategies remain widely used but require intensive training to be effectively employed. Finally, the holistic approach is becoming more widespread due to improvements in psychosocial wellbeing, yet there are considerable resource and cost requirements. Several factors can influence rehabilitation outcomes including metacognition and emotional disturbances. Considerations for future research to improve the applicability of strategies for memory rehabilitation include assessing memory impairment severity, examining memory needs in daily life, and exploring the long-term effects of memory rehabilitation.
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Affiliation(s)
- Yashoda Gopi
- School of Psychology, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - Edward Wilding
- School of Psychology, University of Birmingham, Birmingham, UK
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Baptista C, Afonso RM, Silva AR. Practitioners’ knowledge, acceptability and use of external memory aids with individuals with cognitive deficits: An exploratory study. Neuropsychol Rehabil 2022; 33:745-763. [DOI: 10.1080/09602011.2022.2044354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Catarina Baptista
- Department of Psychology and Education, University of Beira Interior, Covilhã, Portugal
| | - Rosa Marina Afonso
- Department of Psychology and Education, University of Beira Interior, Covilhã, Portugal
- Center for Health Technology and Services Research (CINTESIS, Faculty of Medicine University of Porto), Porto, Portugal
| | - Ana Rita Silva
- Center for Research in Neuropsychology and Cognitive Behavioral Interventions, CINEICC, Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra, Coimbra, Portugal
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Masterson Y, Brady E, Miller A. Informational Practices of Postacute Brain Injury Patients During Personal Recovery: Qualitative Study. J Particip Med 2019; 11:e15174. [PMID: 33055067 PMCID: PMC7434071 DOI: 10.2196/15174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 10/03/2019] [Accepted: 10/18/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The effects of brain injury, structural damage, or the physiological disruption of brain function last far beyond initial clinical treatment. Self-tracking and management technologies have the potential to help individuals experiencing brain injury in their personal recovery-helping them to function at their best despite ongoing symptoms of illness. However, current self-tracking technologies may be unsuited for measuring the interconnected, nonlinear ways in which brain injury manifests. OBJECTIVE This study aimed to investigate (1) the current informational practices and sensemaking processes used by postacute brain injury patients during personal recovery and (2) the potential role of quality-of-life instruments in improving patient awareness of brain injury recovery, advocacy, and involvement in care used outside the clinical context. Our objective was to explore the means of improving awareness through reflection that leads to compensatory strategies by anticipating or recognizing the occurrence of a problem caused by impairment. METHODS We conducted a qualitative study and used essentialist or realist thematic analysis to analyze the data collected through semistructured interviews and questionnaires, 2 weeks of structured data collection using brain injury-specific health-related quality of life instrument, quality of life after brain injury (QoLIBRI), and final interviews. RESULTS Informational practices of people with brain injury involve data collection, data synthesis, and obtaining and applying the insights to their lifestyles. Participants collected data through structured tools such as spreadsheets and wearable devices but switched to unstructured tools such as journals and blogs as changes in overall progress became more qualitative in nature. Although data collection helped participants summarize their progress better, the lack of conceptual understanding made it challenging to know what to monitor or communicate with clinicians. QoLIBRI served as an education tool in this scenario but was inadequate in facilitating reflection and sensemaking. CONCLUSIONS Individuals with postacute brain injury found the lack of conceptual understanding of recovery and tools for making sense of their health data as major impediments for tracking and being aware of their personal recovery. There is an urgent need for a better framework for recovery and a process model for choosing patient-generated health data tools that focus on the holistic nature of recovery and improve the understanding of brain injury for all stakeholders involved throughout recovery.
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Affiliation(s)
- Yamini Masterson
- Department of Human-Centered Computing, School of Informatics and Computing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Erin Brady
- Department of Human-Centered Computing, School of Informatics and Computing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Andrew Miller
- Department of Human-Centered Computing, School of Informatics and Computing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
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McGoldrick C, Crawford S, Evans JJ. MindMate: A single case experimental design study of a reminder system for people with dementia. Neuropsychol Rehabil 2019; 31:18-38. [PMID: 31429370 DOI: 10.1080/09602011.2019.1653936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Prospective memory difficulties are commonly reported in people with dementia. The evidence supporting the use of prospective memory devices among the dementia population remains limited. MindMate is a recently developed smart device application that aims to support individuals with a diagnosis of dementia, improving self-management skills and quality of life. This study investigated the effectiveness and usability of the reminder tool on the MindMate application as a memory aid. Three participants with a diagnosis of Alzheimer's disease were recruited to this multiple baseline single-case experimental design study. Partners of the participants recorded their performance on everyday tasks on weekly monitoring forms during a baseline phase (between five and seven weeks) and during the intervention phase (five weeks) whilst using MindMate. Two participants successfully used the app throughout the intervention weeks and gave positive usability ratings. Tau-U analysis showed a significant increase in memory performance between baseline and intervention phase (Tau-U = 1, 0.94, p < .01). A third participant withdrew from the intervention phase following difficulties turning off the reminders and frustrations with the reminder alert sound. For two of the three participants, use of MindMate was feasible and effective in supporting remembering of everyday tasks compared to practice as usual.
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Affiliation(s)
- Claire McGoldrick
- Mental Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
| | - Stephanie Crawford
- NHS Greater Glasgow & Clyde, Older People's Psychology Service, Greenock, UK
| | - Jonathan J Evans
- Mental Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
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Ferreira-Correia A, Barberis T, Msimanga L. Barriers to the implementation of a computer-based rehabilitation programme in two public psychiatric settings. S Afr J Psychiatr 2018. [DOI: 10.4102/sajpsychiatry.v24i0.1163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Ferreira-Correia A, Barberis T, Msimanga L. Barriers to the implementation of a computer-based rehabilitation programme in two public psychiatric settings. S Afr J Psychiatr 2018; 24:1163. [PMID: 30263222 PMCID: PMC6138119 DOI: 10.4102/sajpsychiatry.v24.i0.1163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 05/04/2018] [Indexed: 11/30/2022] Open
Abstract
Background Working memory (WM) deficits have a negative impact on treatment adherence and quality of life. Efficient and effective interventions are needed in order to improve the cognitive functioning of those affected, especially in low-resource communities. Computer-based rehabilitation programmes (CBRP) are low-cost therapeutic approaches for WM deficits. Perceptions and experiences of target users may influence whether CBRP constitute an effective therapeutic option for adults with cognitive impairment in under-resourced environments. Aim The goal of the study was to explore the experiences of a group of volunteers with WM deficits (associated with diagnoses of HIV and schizophrenia), in terms of the perceived barriers they encountered during their participation in a CBRP. Methods A qualitative, descriptive research design was implemented. Short interviews and field notes were used in order to investigate the experiences of nine participants in relation to the CBRP. The sample included four participants living with HIV and five with schizophrenia, all with WM deficits. Results Using a thematic analysis, eight barriers were identified: unawareness of the cognitive deficit, anticipation of negative results, stigma, difficulties accessing a computer and/or Internet connection, ill health, negative emotional experiences, daily routine challenges and non-conducive or sabotaging environments. A representational model of these barriers is proposed. Conclusion The implementation of a cognitive rehabilitation strategy should not only take into consideration issues of access to particular strategies and materials but should also be preceded by an exploration of how individual and contextual barriers are experienced by the potential users, as these contribute to the risk of dropout.
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Affiliation(s)
| | - Tyler Barberis
- Department of Psychology, University of the Witwatersrand, South Africa
| | - Lerato Msimanga
- Department of Psychology, University of the Witwatersrand, South Africa
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Bos HR, Babbage DR, Leathem JM. Efficacy of memory aids after traumatic brain injury: A single case series. NeuroRehabilitation 2018; 41:463-481. [PMID: 29036840 DOI: 10.3233/nre-151528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Individuals living with traumatic brain injury commonly have difficulties with prospective memory-the ability to remember a planned action at the intended time. Traditionally a memory notebook has been recommended as a compensatory memory aid. Electronic devices have the advantage of providing a cue at the appropriate time to remind participants to refer to the memory aid and complete tasks. Research suggests these have potential benefit in neurorehabilitation. OBJECTIVE This study aimed to investigate the efficacy of a memory notebook and specifically a smartphone as a compensatory memory aid. METHODS A single case series design was used to assess seven participants. A no-intervention baseline was followed by training and intervention with either the smartphone alone, or a memory notebook and later the smartphone. Memory was assessed with weekly assigned memory tasks. RESULTS Participants using a smartphone showed improvements in their ability to complete assigned memory tasks accurately and within the assigned time periods. Use of a smartphone provided additional benefits over and above those already seen for those who received a memory notebook first. CONCLUSIONS Smartphones have the potential to be a useful and cost effective tool in neurorehabilitation practice.
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Affiliation(s)
- Hannah R Bos
- School of Psychology, Massey University, Wellington, New Zealand
| | - Duncan R Babbage
- Centre for eHealth, Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Janet M Leathem
- School of Psychology, Massey University, Wellington, New Zealand
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Goodwin RA, Lincoln NB, das Nair R, Bateman A. Evaluation of NeuroPage as a memory aid for people with multiple sclerosis: A randomised controlled trial. Neuropsychol Rehabil 2018; 30:15-31. [PMID: 29557731 DOI: 10.1080/09602011.2018.1447973] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Memory problems are reported in 40%-60% of people with multiple sclerosis (MS). These problems affect independence and may limit the ability to benefit from rehabilitation. Our aim was to evaluate the effectiveness of NeuroPage for people with MS living in the community. A multicentre, single-blind, randomised controlled crossover trial was conducted. The intervention comprised the NeuroPage service, which sends reminder messages to mobile phones at pre-arranged times. In the control condition participants received "non-memory texts", that is, messages not aimed at providing a reminder; for example, supplying news headlines or sport updates. Outcome measures were completed using postal questionnaires after each condition. There were 38 participants aged 28 to 72 (mean 48, SD 11) and 10 (26%) were men. There were no significant differences between NeuroPage and control conditions on the Everyday Memory Questionnaire (p = 0.41, d = 0.02). The number of daily diary items forgotten in the NeuroPage condition was significantly less than in the control (9% vs. 31%, p = 0.01, d = -0.64). Psychological distress was less in the NeuroPage condition than control (p = 0.001, d = -0.84). Further evaluation of the effect on everyday memory is required.
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Affiliation(s)
- Rachel A Goodwin
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK.,The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Princess of Wales Hospital, Ely, UK
| | - Nadina B Lincoln
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Roshan das Nair
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK.,Division of Psychiatry & Applied Psychology, Institute of Mental Health, School of Medicine, University of Nottingham, UK
| | - Andrew Bateman
- The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Princess of Wales Hospital, Ely, UK
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Mangaoang MA, Lucey JV. Cognitive rehabilitation: assessment and treatment of persistent memory impairments following ECT. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.bp.106.002899] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Few tests address the types of memory problem commonly reported after electroconvulsive therapy (ECT). Here, we focus on the importance of neuropsychological assessment in ECT-treated patients and describe a number of tasks that may be useful in measuring the everyday memory problems of such patients with ongoing memory difficulties. At the time of writing, no attempts have been made to rehabilitate patients who experience persistent adverse cognitive effects, but clinicians should be aware of the potential beneficial role of cognitive rehabilitation in the treatment and management of these effects.
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Chow TE, Rissman J. Neurocognitive mechanisms of real‐world autobiographical memory retrieval: insights from studies using wearable camera technology. Ann N Y Acad Sci 2017; 1396:202-221. [DOI: 10.1111/nyas.13353] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 03/13/2017] [Accepted: 03/20/2017] [Indexed: 12/30/2022]
Affiliation(s)
| | - Jesse Rissman
- Department of Psychology
- Department of Psychiatry and Biobehavioral Sciences
- Brain Research Institute
- Integrative Center for Learning and Memory University of California Los Angeles Los Angeles California
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It is not only memory: effects of sensecam on improving well-being in patients with mild alzheimer disease. Int Psychogeriatr 2017; 29:741-754. [PMID: 28124633 DOI: 10.1017/s104161021600243x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Cognitive interventions (either restorative or compensatory) developed for mild Alzheimer's Disease (AD) have been tested widely with cognitive measures, but less is known about how the effects of such interventions are generalizable to daily functioning. In the present study, we looked at affective state and perceived functionality and quality of life indicators, for three different cognitive rehabilitation programs. METHODS Fifty-one AD patients in the mild stage of the disease were selected for the study and were randomly assigned to one of three cognitive training groups: (1) Memo+ (a paper and pencil memory training program); (2) SenseCam (wearable camera used as a passive external memory aid); (3) Written diary (a personal journal, used as control condition). All patients attended 11 sessions, twice a week, of 1-hour length. The three outcome indicators were examined with standardized instruments applied before the intervention, one week after and at six months follow-up. RESULTS After treatment, the SenseCam and Memo+ groups had significantly reduced depressive symptoms compared to the Diary control condition. The same was found for measures of perceived functional capacity. No intervention effects were found for quality of life measures. The immediate effects of the interventions were not maintained at follow-up. CONCLUSIONS Our results suggest that two types of memory rehabilitation can improve depressive symptomology and instrumental activities of daily living, suggesting that these interventions can stimulate not only cognition but also well-being, at least in the short term.
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Allé MC, Manning L, Potheegadoo J, Coutelle R, Danion JM, Berna F. Wearable Cameras Are Useful Tools to Investigate and Remediate Autobiographical Memory Impairment: A Systematic PRISMA Review. Neuropsychol Rev 2017; 27:81-99. [DOI: 10.1007/s11065-016-9337-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 11/29/2016] [Indexed: 10/20/2022]
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Obermeit LC, Morgan EE, Casaletto KB, Grant I, Woods SP. Antiretroviral Non-Adherence is Associated With a Retrieval Profile of Deficits in Verbal Episodic Memory. Clin Neuropsychol 2015; 29:197-213. [PMID: 25781903 DOI: 10.1080/13854046.2015.1018950] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
HIV-associated deficits in verbal episodic memory are commonly associated with antiretroviral non-adherence; however, the specific aspects of memory functioning (e.g., encoding, consolidation, or retrieval) that underlie this established relationship are not well understood. This study evaluated verbal memory profiles of 202 HIV+ participants who underwent a 30-day electronic monitoring of antiretroviral adherence. At the group level, non-adherence was significantly associated with lower scores on immediate and delayed passage recall and word list learning. Retention and recognition of passages and word lists were not related to adherence. Participants were then classified as having either a normal verbal memory profile, a "subcortical" retrieval profile (i.e., impaired free recall with relatively spared recognition), or a "cortical" encoding profile (e.g., cued recall intrusions) based on the Massman et al. ( 1990 ) algorithm for the California Verbal Learning Test. HIV+ participants with a classic retrieval deficit had significantly greater odds of being non-adherent than participants with a normal or encoding profile. These findings suggest that adherence to prescribed antiretroviral regimens may be particularly vulnerable to disruption in HIV+ individuals due to deficits in the complex process of efficiently accessing verbal episodic information with minimal cues. A stronger relationship between non-adherence and passage (vs. word list) recall was also found and may reflect the importance of contextual features in remembering to take medications. Targeted interventions for enhancing and supporting episodic memory retrieval processes may improve antiretroviral adherence and overall health outcomes among persons living with HIV.
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Affiliation(s)
- Lisa C Obermeit
- a The HIV Neurobehavioral Research Program , University of California , San Diego , CA 92103-8231 , USA
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Baldwin VN, Powell T. Google Calendar: A single case experimental design study of a man with severe memory problems. Neuropsychol Rehabil 2014; 25:617-36. [PMID: 25263266 PMCID: PMC4487547 DOI: 10.1080/09602011.2014.956764] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A single case experimental design across behaviours was utilised to explore the effectiveness of Google Calendar text alerts delivered to a mobile phone as a memory aid. The participant was a 43-year-old man (JA) with severe memory problems and executive difficulties caused by a traumatic brain injury (TBI). JA was initially very unwilling to use any memory aid and so a detailed assessment of his beliefs about memory aids, his cognitive difficulties and his social context was performed and a set of specifications for an aid was produced collaboratively. Six weeks of baseline data and six weeks of intervention data were collected for three target memory behaviours and three control memory behaviours. Results were analysed using nonoverlap of all pairs (NAP) analysis which showed a reduction in forgetting in the three target behaviours and no change in two of the three control behaviours. A subjective measure (the revised Everyday Memory Questionnaire) also suggested improvement. This study illustrates that Google Calendar is a highly effective memory aid and emphasises the importance of choosing a memory aid to suit the person's lifestyle and beliefs.
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Migo EM, Haynes BI, Harris L, Friedner K, Humphreys K, Kopelman MD. mHealth and memory aids: levels of smartphone ownership in patients. J Ment Health 2014; 24:266-70. [PMID: 25188922 DOI: 10.3109/09638237.2014.951479] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The use of mobile devices to deliver healthcare has not yet been exploited in neuropsychological rehabilitation. Smartphones have the potential to serve as multi-functional memory aids. AIMS To investigate whether patients attending a clinic for mixed memory problems own smartphones, to determine whether this could be a widely applicable medium to use as a memory aids device. METHODS A questionnaire on smartphone ownership was given to an opportunity sample of consecutive patients attending a neuropsychiatry and memory disorders outpatient clinic. Data were collected in 2012 and repeated 12 months later in 2013 to assess changes over time. RESULTS Ownership of mobile phones was stable between 2012 (81%) and 2013 (85%), but ownership of smartphones showed a significant increase (from 26% to 40%). Age negatively predicted smartphone ownership. CONCLUSION Despite cognitive or psychiatric problems, our patient group are as likely to own a mobile phone as a member of the general population. Ownership levels are at 40% and likely to increase in the future. Exploring how smartphones and their apps could function as memory aids is likely to be useful for a large enough number of patients to be clinically worthwhile.
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Affiliation(s)
- Ellen M Migo
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Becky I Haynes
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Lara Harris
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Kim Friedner
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Kate Humphreys
- b Neuropsychiatry and Memory Disorders Clinic, South London and Maudsley NHS Foundation Trust, St Thomas's Hospital , London , UK
| | - Michael D Kopelman
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and.,b Neuropsychiatry and Memory Disorders Clinic, South London and Maudsley NHS Foundation Trust, St Thomas's Hospital , London , UK
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Woodberry E, Browne G, Hodges S, Watson P, Kapur N, Woodberry K. The use of a wearable camera improves autobiographical memory in patients with Alzheimer's disease. Memory 2014; 23:340-9. [DOI: 10.1080/09658211.2014.886703] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chu Y, Brown P, Harniss M, Kautz H, Johnson K. Cognitive support technologies for people with TBI: current usage and challenges experienced. Disabil Rehabil Assist Technol 2013; 9:279-85. [PMID: 23919409 DOI: 10.3109/17483107.2013.823631] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE We investigated the current use of off-the-shelf cognitive support technologies (CSTs) by individuals with traumatic brain injury (TBI), the challenges they and their caregivers face when using these technologies, the functional areas where support is needed, and their current experience in learning new technologies. METHOD We conducted two focus groups with participants with TBI and their caregivers. Focus group interactions were captured using recordings and a court reporter. Transcripts were analyzed qualitatively. RESULTS We identified three core themes - consumer and caregiver self-reported needs for support, how support is used on a daily basis and consumer and caregiver attitudes towards the use of support by types of support. We also inferred implications for design of CSTs. CONCLUSIONS Individuals with TBI use consumer available technologies to support cognition. The design of most of these devices is not targeted to meet the needs of people with TBI, and they can be challenging to use independently, but individuals and their caregivers still benefit from their use by embedding technology as one type of support within a broader support network that includes personal assistance. IMPLICATIONS FOR REHABILITATION People with traumatic brain injury (TBI) are attempting to use a wide range of consumer available technologies to support cognition, although not always successfully. One important role for rehabilitation providers could be helping people with TBI use these technologies with more accuracy and success. People with TBI note that an important element in adopting new technology is good training in its use. Cognitive support technologies (CSTs) are one part of broader network of supports. People with TBI and their caregivers desire independence but do not want to lose the human element that can be provided by a caregiver. New technologies should be implemented with an understanding of an individual's broader support network. Psychosocial aspects of TBI need to be considered when designing and implementing CSTs. In particular, rehabilitation providers need to address the anxiety that many people with TBI experience, including fear about forgetting and their need for early, repeated reminders so they can prepare for upcoming events.
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Affiliation(s)
- Yi Chu
- Computer Science, University of Rochester , Rochester, NY , USA and
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Cole E. Patient-Centered Design of Cognitive Assistive Technology for Traumatic Brain Injury Telerehabilitation. ACTA ACUST UNITED AC 2013. [DOI: 10.2200/s00478ed1v01y201302arh003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Mason S, Craig D, O'Neill S, Donnelly M, Nugent C. Electronic reminding technology for cognitive impairment. ACTA ACUST UNITED AC 2013; 21:855-61. [PMID: 23252168 DOI: 10.12968/bjon.2012.21.14.855] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Demographic changes highlight the need to address disabilities associated with the costly morbidities of old age, such as dementia. Memory impairment associated with dementia represents a significant challenge for many older people. Difficulties occur in carrying out activities in their entirety or in commencing them at all. Technology has the potential to help individuals overcome the barriers created by cognitive disability in terms of performing activities of daily living and therefore help to maintain independence and enhance quality of life (Czaja, 2005). This literature review examines the current reported research, which employs electronic reminding technology to support individuals with cognitive impairment. These devices range from everyday technologies, such as phones, to sophisticated interactive devices with specifically designed software. A summary of the current evidence base is presented and recommendations for future practice are made.
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Abstract
This chapter begins with a discussion about the common characteristics of people with memory deficits resulting from brain injury followed by a description of a typical patient referred for memory rehabilitation. We then address some general principles to help people with memory deficits. These principles include ways of improving encoding, storage, and retrieval. The next section addresses more specific strategies to help people (a) cope without a memory through environmental modifications, (b) learn more efficiently (particularly through errorless learning strategies), and (c) compensate for their problems through external memory aids. A memory aids resource center is described. The impact of memory impairment on emotions is considered. A summary of the main components of a memory rehabilitation program is provided. The overall conclusion is that rehabilitation can help people to compensate for, bypass, or reduce their everyday problems and thus survive more efficiently in their own most appropriate environments.
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Affiliation(s)
- Barbara A Wilson
- The Oliver Zangwill Centre, Princess of Wales Hospital, Cambs, UK.
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Abstract
The relationship between assistive technology for cognition (ATC) and cognitive function was examined using a systematic review. A literature search identified 89 publications reporting 91 studies of an ATC intervention in a clinical population. The WHO International Classification of Functioning, Disability and Health (ICF) was used to categorize the cognitive domains being assisted and the tasks being performed. Results show that ATC have been used to effectively support cognitive functions relating to attention, calculation, emotion, experience of self, higher level cognitive functions (planning and time management) and memory. The review makes three contributions: (1) It reviews existing ATC in terms of cognitive function, thus providing a framework for ATC prescription on the basis of a profile of cognitive deficits, (2) it introduces a new classification of ATC based on cognitive function, and (3) it identifies areas for future ATC research and development.
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Seelye AM, Schmitter-Edgecombe M, Das B, Cook DJ. Application of cognitive rehabilitation theory to the development of smart prompting technologies. IEEE Rev Biomed Eng 2012; 5:29-44. [PMID: 23231987 PMCID: PMC8841061 DOI: 10.1109/rbme.2012.2196691] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Older adults with cognitive impairments often have difficulty performing instrumental activities of daily living (IADLs). Prompting technologies have gained popularity over the last decade and have the potential to assist these individuals with IADLs in order to live independently. Although prompting techniques are routinely used by caregivers and health care providers to aid individuals with cognitive impairment in maintaining their independence with everyday activities, there is no clear consensus or gold standard regarding prompt content, method of instruction, timing of delivery, or interface of prompt delivery in the gerontology or technology literatures. In this paper, we demonstrate how cognitive rehabilitation principles can inform and advance the development of more effective assistive prompting technologies that could be employed in smart environments. We first describe cognitive rehabilitation theory (CRT) and show how it provides a useful theoretical foundation for guiding the development of assistive technologies for IADL completion. We then use the CRT framework to critically review existing smart prompting technologies to answer questions that will be integral to advancing development of effective smart prompting technologies. Finally, we raise questions for future exploration as well as challenges and suggestions for future directions in this area of research.
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Affiliation(s)
- Adriana M Seelye
- Department of Psychology, Washington State University, Pullman, WA 99164, USA.
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23
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Pauly-Takacs K, Moulin CJA, Estlin EJ. SenseCam as a rehabilitation tool in a child with anterograde amnesia. Memory 2011; 19:705-12. [DOI: 10.1080/09658211.2010.494046] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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24
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Aadal L, Kirkevold M. Integrating situated learning theory and neuropsychological research to facilitate patient participation and learning in traumatic brain injury rehabilitation patients. Brain Inj 2011; 25:717-28. [PMID: 21604928 DOI: 10.3109/02699052.2011.580314] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Traumatic brain injury (TBI) constitutes a major health problem throughout the world. Despite interdisciplinary efforts, patients reach varying outcomes in terms of every-day life functioning and quality-of-life. This paper suggests that a situated learning perspective supplemented with evidence from neurophysiologic and neuropsychological research provides a perspective to get a grasp of problems typically encountered in rehabilitation. Applying such a perspective may help to facilitate patient participation and learning during the rehabilitation process by taking their altered abilities into consideration. METHOD Qualitative study. Theoretical analysis and synthesis of 'situated learning theory', neuropsychological theory and empirical studies of cognitive and emotional functioning following a TBI collected through interviews with 11 interdisciplinary rehabilitation experts and a field study of two patients at a rehabilitation hospital. The data were analysed from a hermeneutic perspective using N-VIVO 8. RESULTS/CONCLUSION Patients with severe TBI pose challenges in terms of being participants in the 'rehabilitation practice community'. Two levels of pedagogical challenges seem to exist: Helping the patient regain or compensate for changed learning abilities and supporting the patient in learning or compensating for lost abilities. This study highlighted six main categories of changed abilities that need to be considered in developing a practice which fosters re-learning: perception, attention, memory, language, physical competencies and emotion/model of behaviour.
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Affiliation(s)
- L Aadal
- Hammel Neurorehabilitation and Research Centre, Voldbyvej 15, Hammel, Denmark.
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25
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Boman IL, Bartfai A, Borell L, Tham K, Hemmingsson H. Support in everyday activities with a home-based electronic memory aid for persons with memory impairments. Disabil Rehabil Assist Technol 2010; 5:339-50. [DOI: 10.3109/17483100903131777] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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de Joode E, van Heugten C, Verhey F, van Boxtel M. Efficacy and usability of assistive technology for patients with cognitive deficits: a systematic review. Clin Rehabil 2010; 24:701-14. [DOI: 10.1177/0269215510367551] [Citation(s) in RCA: 130] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To determine the efficacy of portable electronic aids such as personal digital assistants (PDAs), pagers or mobile phones for patients with cognitive deficits by means of a systematic review. The usability of these aids is also briefly discussed. Data sources: PubMed, CINAHL, PsychINFO, EMBASE and MEDLINE were searched up to February 2009. The references of identified and relevant articles were scanned to find additional relevant titles. Review methods: Papers referring to ‘electronic aids’, ‘cognition’ and ‘brain injury’ were included. The population had to be adult and have cognitive impairments as a result of acquired brain injury. Outcome measures were change in cognitive or occupational performance or the level of participation in daily life. The criteria of Cicerone et al. were used to evaluate the quality of the retrieved studies. Results: Twenty-eight papers presenting 25 studies were reviewed. The total number of participants was 423. Most identified papers described case reports or non-randomized clinical trials. Only one randomized controlled trial was identified, in which the NeuroPage proved effective in supporting prospective memory. Other kinds of assistive technology such as PDAs and voice recorders showed positive results in supporting retrospective and prospective memory. Conclusion: The efficacy of assistive technology in general is not yet sufficiently studied in randomized controlled trials, although promising results has been reported. Furthermore, several survey studies established that both potential users and clinicians have optimistic expectations about the usability of assistive technology.
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Affiliation(s)
- Elsbeth de Joode
- School for Mental Health and Neuroscience, Division Cognitive Neuropsychiatry and Clinical Neuroscience, Maastricht University, The Netherlands,
| | - Caroline van Heugten
- School for Mental Health and Neuroscience, Division Cognitive Neuropsychiatry and Clinical Neuroscience, Maastricht University, The Netherlands
| | - Frans Verhey
- School for Mental Health and Neuroscience, Division Cognitive Neuropsychiatry and Clinical Neuroscience, Maastricht University, The Netherlands
| | - Martin van Boxtel
- School for Mental Health and Neuroscience, Division Cognitive Neuropsychiatry and Clinical Neuroscience, Maastricht University, The Netherlands
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Boman IL, Lindberg Stenvall C, Hemmingsson H, Bartfai A. A training apartment with a set of electronic memory aids for patients with cognitive problems. Scand J Occup Ther 2010; 17:140-8. [DOI: 10.3109/11038120902875144] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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28
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Fish J, Wilson BA, Manly T. The assessment and rehabilitation of prospective memory problems in people with neurological disorders: a review. Neuropsychol Rehabil 2010; 20:161-79. [PMID: 20146135 PMCID: PMC2840878 DOI: 10.1080/09602010903126029] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
People with neurological disorders often report difficulty with prospective memory (PM), that is, remembering to do things they had intended to do. This paper briefly reviews the literature regarding the neuropsychology of PM function, concluding that from the clinical perspective, PM is best considered in terms of its separable but interacting mnemonic and executive components. Next, the strengths and limitations in the current clinical assessment of PM, including the assessment of component processes, desktop analogues of PM tasks, and naturalistic PM tasks, are outlined. The evidence base for the rehabilitation of PM is then considered, focusing on retraining PM, using retrospective memory strategies, problem-solving training, and finally, electronic memory aids. It is proposed that further research should focus on establishing the predictive validity of PM assessment, and refining promising rehabilitation techniques.
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Affiliation(s)
- Jessica Fish
- MRC Cognition and Brain Sciences Unit, Cambridge, UK.
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29
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O'Neill B, Moran K, Gillespie A. Scaffolding rehabilitation behaviour using a voice-mediated assistive technology for cognition. Neuropsychol Rehabil 2010; 20:509-27. [PMID: 20182951 DOI: 10.1080/09602010903519652] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A variety of cognitive deficits can lead to difficulties performing complex behavioural sequences and thus, disability in the performance of routine and rehabilitation behaviours. Interventions to date involve increasing support or providing behavioural training. Assistive technologies for cognition have the potential to augment cognitive capacity thus enabling the performance of behavioural sequences. Guide is an assistive technology for cognition that scaffolds task performance by providing verbal prompts and responding to verbal feedback. Guide was used to provide verbal support and guidance for eight amputees (mean age 64), with cognitive impairment of vascular origin, putting on their prosthetic limbs. Participants were referred to the research due to problems learning the correct behavioural sequence. The research used repeated trials with random assignment to intervention and baseline conditions. The voice-mediated assistive technology for cognition resulted in a significant reduction of safety critical errors and omitted steps. Discussion focuses upon the relation between voice-mediated cognitive support for memory and executive function, and suggestions are made for future research.
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Affiliation(s)
- Brian O'Neill
- Department of Psychology, University of Stirling, Stirling, UK.
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30
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Pitel AL, Beaunieux H, Lebaron N, Joyeux F, Desgranges B, Eustache F. Two case studies in the application of errorless learning techniques in memory impaired patients with additional executive deficits. Brain Inj 2009; 20:1099-110. [PMID: 17060144 DOI: 10.1080/02699050600909961] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PRIMARY OBJECTIVE The purpose of the present study was to examine in what extent errorless learning can be applied to amnesic patients with additional executive dysfunction. RESEARCH DESIGN Two case studies were used in which two patients with severe closed head-injury were compared according to their different neuropsychological profiles. METHODS AND PROCEDURES Patients were taught complex semantic information about their therapists and cognitive procedures needed to programme an electronic organizer. MAIN OUTCOMES AND RESULTS Both semantic and procedural results suggest that the errorless method can be very helpful for teaching complex new knowledge to amnesic patients with mild executive impairment, whereas the presence of a dysexecutive syndrome may hamper the success of this form of memory rehabilitation. CONCLUSIONS The present study puts forward that executive deficits should be taken into account when neuropsychologists are planning to use errorless techniques.
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Affiliation(s)
- Anne Lise Pitel
- Inserm, EPHE, Université de Caen, Basse-Normadie, Unité EO219, 14033, Caen Cedex, and Centre Hospitalier, Service de Rééducation et de Réadaptation Neurologique, Aunay sur Odon, France
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31
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Boman IL, Tham K, Granqvist A, Bartfai A, Hemmingsson H. Using electronic aids to daily living after acquired brain injury: a study of the learning process and the usability. Disabil Rehabil Assist Technol 2009; 2:23-33. [PMID: 19263551 DOI: 10.1080/17483100600856213] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose was to study the ability of persons with memory impairments after acquired brain injury to learn how to and use electronic aids to daily living (EADL) and to describe changes in function and quality of life. METHOD Eight participants stayed in two apartments equipped with a set of basic and advanced EADL for either 4 or 6 months during an intervention time of 2 years. The teaching and learning method was influenced by certain principles of errorless learning. Ability to learn to use EADL was measured by structured observations. Function and quality of life were assessed with self-rating questionnaires. RESULTS Results indicate that the participants learned to use EADL in their everyday activities. They perceived that EADL were very useful and easy to learn. Occupational performance and satisfaction with occupational performance and quality of life was improved. CONCLUSION The results indicate that EADL may play an important role in facilitating everyday activities and improve satisfaction with occupational performance and quality of life for people with memory impairments. The study indicates the importance of adjusting technology to the user's needs and calls for more consideration for human-technology interaction factors.
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Affiliation(s)
- I L Boman
- Department of Rehabilitation Medicine Stockholm, Danderyd University Hospital, Stockholm, Sweden.
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O'Neill B, Gillespie A. Simulating naturalistic instruction: the case for a voice mediated interface for assistive technology for cognition. ACTA ACUST UNITED AC 2008. [DOI: 10.1108/17549450200800015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Long-term compensatory treatment of organizational deficits in a patient with bilateral frontal lobe damage. J Int Neuropsychol Soc 2008; 14:154-63. [PMID: 18078543 DOI: 10.1017/s1355617708080120] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2006] [Revised: 07/18/2007] [Accepted: 07/18/2007] [Indexed: 11/06/2022]
Abstract
Evans et al. (1998) described compensatory strategy use in R.P., a patient with executive dysfunction following bilateral frontal lobe damage who had difficulty acting upon her intentions. A pager was used to remind R.P. of regularly scheduled activities, along with a checklist that aimed to moderate a perseverative routine. Although successful, 10 years after the original intervention, the strategies were no longer used, and considerable everyday problems were evident. In the current study, we conducted a follow-up assessment to examine potential reasons for this deterioration. No change in neuropsychological functioning was evident. Whereas the previous study introduced the two strategies together, and examined effects upon separate goals, in the current study we reintroduced the two strategies separately, and examined effects on three common goals. In addition to prompting specific activities, we aimed to support completion of more general goals (those that could be enacted within a wider window of time). The paging intervention had a dramatic effect on all three measured behaviors, at a much more consistent level than the checklist. We suggest that, in addition to direct reminders, the pager can cue a process of goal monitoring that bridges the gap between intention and action.
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Schmitter-Edgecombe M. Implications of basic science research for brain injury rehabilitation: a focus on intact learning mechanisms. J Head Trauma Rehabil 2006; 21:131-41. [PMID: 16569987 DOI: 10.1097/00001199-200603000-00006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Within a theoretical framework for rehabilitation that distinguishes between automatic and controlled processes, this article reviews basic science research and addresses the following issues: What cognitive abilities remain relatively intact after severe traumatic brain injury, and how can we incorporate intact skills into rehabilitative techniques? The reviewed research indicates that individuals with severe traumatic brain injury (a) generally perform similar to controls on cognitive tasks (or task components) that require automatic and implicit processes as opposed to consciously controlled processes; (b) can learn through implicit learning mechanisms; and (c) can acquire and use automatic processes in complex, cognitive task performance.
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35
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Cappa SF, Benke T, Clarke S, Rossi B, Stemmer B, van Heugten CM. EFNS guidelines on cognitive rehabilitation: report of an EFNS task force. Eur J Neurol 2005; 12:665-80. [PMID: 16128867 DOI: 10.1111/j.1468-1331.2005.01330.x] [Citation(s) in RCA: 172] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Disorders of language, spatial perception, attention, memory, calculation and praxis are a frequent consequence of acquired brain damage [in particular, stroke and traumatic brain injury (TBI)] and a major determinant of disability. The rehabilitation of aphasia and, more recently, of other cognitive disorders is an important area of neurological rehabilitation. We report here a review of the available evidence about effectiveness of cognitive rehabilitation. Given the limited number and generally low quality of randomized clinical trials (RCTs) in this area of therapeutic intervention, the Task Force considered, besides the available Cochrane reviews, evidence of lower classes which was critically analysed until a consensus was reached. In particular, we considered evidence from small group or single cases studies including an appropriate statistical evaluation of effect sizes. The general conclusion is that there is evidence to award a grade A, B or C recommendation to some forms of cognitive rehabilitation in patients with neuropsychological deficits in the post-acute stage after a focal brain lesion (stroke, TBI). These include aphasia therapy, rehabilitation of unilateral spatial neglect (ULN), attentional training in the post-acute stage after TBI, the use of electronic memory aids in memory disorders, and the treatment of apraxia with compensatory strategies. There is clearly a need for adequately designed studies in this area, which should take into account specific problems such as patient heterogeneity and treatment standardization.
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Affiliation(s)
- S F Cappa
- Department of Psychology, Vita Salute San Raffaele S. Raffaele University, Milano, Italy.
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Abstract
PURPOSE OF REVIEW This review discusses recent studies investigating the cognitive and psychiatric outcome of posttraumatic brain injury. In addition, it aims to highlight key areas for future research. RECENT FINDINGS Detailed cognitive assessments have revealed particular deficits in processing speed in the visual domain and the detrimental impact of interference on attentional performance. A pilot functional imaging study revealed neural changes in survivors performing a response inhibition task, even when matched to controls on behavioural indices. Recent psychiatric studies highlight the incidence of these disorders in the survivors and attempt to characterize distinct psychiatric profiles. Adult and child survivors appear to show differential difficulties. Successful rehabilitation strategies addressing these psychiatric and cognitive deficits include holistic intensive neuropsychological interventions and the introduction of electronic devices. Systematic randomized trials are needed to provide an adequate evidence base for clinical practice. The potential for cognitive enhancement using psychopharmacological agents has yet to be exploited. These treatments may lead to improved quality of life for traumatic brain injury survivors and their families. SUMMARY Survivors of head injury show a diverse pattern of cognitive and psychiatric profiles. Recent research highlights the nature of some of these deficits and possible ways to enhance functioning. However, the area is well poised for rapid progress in the understanding of cognitive and emotional dysfunction following traumatic brain injury (TBI) and its rehabilitation through neuropsychological and psychopharmacological means.
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Affiliation(s)
- Claire Helen Salmond
- Wolfson Brain Imaging Centre, University of Cambridge, School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK.
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