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Brihmat N, Bayram MB, Bheemreddy A, Saleh S, Yue GH, Forrest GF. Insights into COVID-19 pathophysiology from a longitudinal multisystem report during acute infection. Exp Neurol 2024; 380:114917. [PMID: 39127120 DOI: 10.1016/j.expneurol.2024.114917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 08/06/2024] [Accepted: 08/07/2024] [Indexed: 08/12/2024]
Abstract
The Coronavirus disease 2019 (COVID-19), an illness caused by a SARS-CoV-2 viral infection, has been associated with neurological and neuropsychiatric disorders, revealing its impact beyond the respiratory system. Most related research involved individuals with post-acute or persistent symptoms of COVID-19, also referred to as long COVID or Post-Acute Sequelae of COVID-19 (PASC). In this longitudinal unique report, we aimed to describe the acute supraspinal and corticospinal changes and functional alterations induced by a COVID-19 infection using neuroimaging, neurophysiological and clinical assessment of a participant during acute infection, as compared to three other visits where the participant had no COVID-19. The results favor a multisystem impairment, impacting cortical activity, functional connectivity, and corticospinal excitability, as well as motor and cardiovascular function. The report suggests pathophysiological alteration and impairment already present at the acute stage, that if resolved tend to lead to a full clinical recovery. Such results could be also insightful into PASC symptomatology.
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Affiliation(s)
- Nabila Brihmat
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States; Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, United States.
| | - Mehmed B Bayram
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States; Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, United States
| | - Akhil Bheemreddy
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States
| | - Soha Saleh
- Department of Rehabilitation and Movement Sciences, Rutgers School of Health Professions, Newark, NJ, United States; Department of Neurology, Robert Wood Johnson Medical School (RWJMS), New Brunswick, NJ, United States
| | - Guang H Yue
- Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, United States; Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States
| | - Gail F Forrest
- Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West Orange, NJ, United States; Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, United States; Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, United States.
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2
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Mudge S, Smith G, Parry GJ. A personalised activity programme helps reduce fatigue in people after Guillain-Barré Syndrome in a replicated single system design. Disabil Rehabil 2024:1-13. [PMID: 39001796 DOI: 10.1080/09638288.2024.2374486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/13/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE We evaluated the effectiveness of an online activity-focussed programme to decrease fatigue in people with prior Guillain-Barré Syndrome and explored the perspectives of participants regarding the acceptability and feasibility of the programme. MATERIALS AND METHODS We recruited eight people diagnosed with Guillain-Barré Syndrome more than two years previously who still had fatigue limiting daily activity. We used mixed methods with a replicated single system design using repeated outcome measures across the three phases (baseline, intervention, follow-up) to evaluate the impact of the intervention on fatigue, activity, wellbeing and confidence to exercise. We used qualitative interviews to explore participants' perspectives of the programme. RESULTS All participants developed a personalized plan to manage fatigue using goals and feedback, which was effective in reducing fatigue for most participants. Participants were positive about what they had learnt about fatigue, themselves and strategies to manage fatigue. Some participants also experienced improvements in activity, exercise confidence and health and wellbeing. Not all changes were sustained past the follow-up period, which reflects participants' differing levels of confidence to continue with their plan. CONCLUSION Graduated physical activity in association with developing a personalised plan were key features effective in managing fatigue after Guillain-Barré Syndrome.
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Affiliation(s)
- Suzie Mudge
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Greta Smith
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Gareth J Parry
- Department of Neurology, University of MN, Minneapolis, MN, USA
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Leeson R, Collins M, Douglas J. Interventions that aim to increase social participation through recreation or leisure activity for adults with moderate to severe traumatic brain injury: a scoping review. Disabil Rehabil 2024; 46:3286-3302. [PMID: 37607065 DOI: 10.1080/09638288.2023.2246377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE Social isolation and reduced social participation are common after traumatic brain injury (TBI). Developing interventions that aim to increase social participation through recreation or leisure activities continues to be challenging. This scoping review was conducted to provide an overview of interventions used to increase social participation through in-person recreation or leisure activity for adults with moderate to severe TBI living in the community. METHODS Using the Arksey and O'Malley framework, a scoping review of the literature published from 2005 to 2023 was conducted across four databases: Medline, CINAHL, PsycINFO and Scopus. Quality appraisals were conducted for included studies. RESULTS Following the removal of duplicates, 10,056 studies were screened and 52 were retained for full-text screening. Seven papers were included in the final review. Studies varied with respect to the type of intervention and program outcomes. The interpretation was impeded by study quality, with only two studies providing higher levels of evidence. Barriers and facilitators to successful program outcomes were identified. CONCLUSIONS Few studies with interventions focused on increasing social participation in leisure or recreation activity were identified. Further research incorporating mixed methods and longitudinal design to evaluate effectiveness over time is needed to build the evidence base for increasing social participation through leisure activity.
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Affiliation(s)
- Rebecca Leeson
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Michelle Collins
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Jacinta Douglas
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Summer Foundation, Melbourne, Victoria, Australia
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Spaccavento S, Carraturo G, Brattico E, Matarrelli B, Rivolta D, Montenegro F, Picciola E, Haumann NT, Jespersen KV, Vuust P, Losavio E. Musical and electrical stimulation as intervention in disorder of consciousness (DOC) patients: A randomised cross-over trial. PLoS One 2024; 19:e0304642. [PMID: 38820520 PMCID: PMC11142721 DOI: 10.1371/journal.pone.0304642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 05/14/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Disorders of consciousness (DOC), i.e., unresponsive wakefulness syndrome (UWS) or vegetative state (VS) and minimally conscious state (MCS), are conditions that can arise from severe brain injury, inducing widespread functional changes. Given the damaging implications resulting from these conditions, there is an increasing need for rehabilitation treatments aimed at enhancing the level of consciousness, the quality of life, and creating new recovery perspectives for the patients. Music may represent an additional rehabilitative tool in contexts where cognition and language are severely compromised, such as among DOC patients. A further type of rehabilitation strategies for DOC patients consists of Non-Invasive Brain Stimulation techniques (NIBS), including transcranial electrical stimulation (tES), affecting neural excitability and promoting brain plasticity. OBJECTIVE We here propose a novel rehabilitation protocol for DOC patients that combines music-based intervention and NIBS in neurological patients. The main objectives are (i) to assess the residual neuroplastic processes in DOC patients exposed to music, (ii) to determine the putative neural modulation and the clinical outcome in DOC patients of non-pharmacological strategies, i.e., tES(control condition), and music stimulation, and (iii) to evaluate the putative positive impact of this intervention on caregiver's burden and psychological distress. METHODS This is a randomised cross-over trial in which a total of 30 participants will be randomly allocated to one of three different combinations of conditions: (i) Music only, (ii) tES only (control condition), (iii) Music + tES. The music intervention will consist of listening to an individually tailored playlist including familiar and self-relevant music together with fixed songs; concerning NIBS, tES will be applied for 20 minutes every day, 5 times a week, for two weeks. After these stimulations two weeks of placebo treatments will follow, with sham stimulation combined with noise for other two weeks. The primary outcomes will be clinical, i.e., based on the differences in the scores obtained on the neuropsychological tests, such as Coma Recovery Scale-Revised, and neurophysiological measures as EEG, collected pre-intervention, post-intervention and post-placebo. DISCUSSION This study proposes a novel rehabilitation protocol for patients with DOC including a combined intervention of music and NIBS. Considering the need for rigorous longitudinal randomised controlled trials for people with severe brain injury disease, the results of this study will be highly informative for highlighting and implementing the putative beneficial role of music and NIBS in rehabilitation treatments. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT05706831, registered on January 30, 2023.
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Affiliation(s)
- Simona Spaccavento
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
| | - Giulio Carraturo
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Elvira Brattico
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Benedetta Matarrelli
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Davide Rivolta
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Fabiana Montenegro
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
| | - Emilia Picciola
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
| | - Niels Trusbak Haumann
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Kira Vibe Jespersen
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Peter Vuust
- Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & Royal Academy of Aarhus/Aalborg, Aarhus, Denmark
| | - Ernesto Losavio
- Istituti Clinici Scientifici Maugeri IRCCS, Institute of Bari, Bari, Italy
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Baillot A, Asselin M, Bernard P, Lapointe J, Bond DS, Romain AJ, Garneau PY, Biertho L, Tchernof A, Blackburn P, Langlois MF, Brunet J. Acceptability and Feasibility of the Telehealth Bariatric Behavioral Intervention to Increase Physical Activity Before Bariatric Surgery: A Single-Case Experimental Study (Part I). Obes Surg 2024; 34:1639-1652. [PMID: 38483742 DOI: 10.1007/s11695-024-07161-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Physical activity (PA) can play an important role in optimizing metabolic/bariatric surgery (MBS) outcomes. However, many MBS patients have difficulty increasing PA, necessitating the development of theory-driven counseling interventions. This study aimed to (1) assess the feasibility and acceptability of the TELEhealth BARIatric behavioral intervention (TELE-BariACTIV) trial protocol/methods and intervention, which was designed to increase moderate-to-vigorous intensity physical activity (MVPA) in adults awaiting MBS and (2) estimate the effect of the intervention on MVPA. METHODS This trial used a repeated single-case experimental design. Twelve insufficiently active adults awaiting MBS received 6 weekly 45-min PA videoconferencing counseling sessions. Feasibility and acceptability data (i.e., refusal, recruitment, retention, attendance, and attrition rates) were tracked and collected via online surveys, and interviews. MVPA was assessed via accelerometry pre-, during, and post-intervention. RESULTS Among the 24 patients referred to the research team; five declined to participate (refusal rate = 20.8%) and seven were ineligible or unreachable. The recruitment rate was 1.2 participants per month between 2021-09 and 2022-07. One participant withdrew during the baseline phase, and one after the intervention (retention rate = 83.3%). No participant dropouts occurred during the intervention and 98.6% of sessions were completed. Participants' anticipated and retrospective acceptability of the intervention was 3.2/4 (IQR, 0.5) and 3.0/4 (IQR, 0.2), respectively. There was a statistically significant increase in MVPA [Tau-U = 0.32(0.11; 0.51)] from pre- to post-intervention. CONCLUSION Despite a low recruitment rate, which could be explained by circumstances (COVID-19 pandemic), results support feasibility, acceptability, and preliminary efficacy of the TELE-Bari-ACTIV intervention for increasing MVPA in patients awaiting MBS.
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Affiliation(s)
- Aurélie Baillot
- École Interdisciplinaire de Santé, Université du Québec en Outaouais, 283 Boul. Alexandre-Taché, Gatineau, Québec, J8X 3X7, Canada.
- Institut du Savoir Montfort, Ottawa, ON, Canada.
- Centre de Recherche en Médecine Psychosociale, Centre Intégré de Santé et Services, Sociaux de L'Outaouais, Gatineau, Québec, Canada.
| | | | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec À Montréal, Montréal, Québec, Canada
- Centre de Recherche, Institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada
| | - Josyanne Lapointe
- Department of Physical Activity Sciences, Université du Québec À Montréal, Montréal, Québec, Canada
- Centre de Recherche, Institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada
| | - Dale S Bond
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, USA
| | - Ahmed Jérôme Romain
- Centre de Recherche, Institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Pierre Y Garneau
- Department of Surgery, Université de Montréal, Montréal, Québec, Canada
| | - Laurent Biertho
- Institut Universitaire de Cardiologie et de Pneumologie de Québec et Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - André Tchernof
- Institut Universitaire de Cardiologie et de Pneumologie de Québec et École de Nutrition, Université Laval, Québec, Québec, Canada
| | - Patricia Blackburn
- Division of Kinesiology, Department of Health Sciences, Université du Québec À Chicoutimi, Chicoutimi, Québec, Canada
| | - Marie-France Langlois
- CHUS Research Center and Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Jennifer Brunet
- Institut du Savoir Montfort, Ottawa, ON, Canada
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Ubeda Matzilevich E, Daniel PL, Little S. Towards therapeutic electrophysiological neurofeedback in Parkinson's disease. Parkinsonism Relat Disord 2024; 121:106010. [PMID: 38245382 DOI: 10.1016/j.parkreldis.2024.106010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 01/22/2024]
Abstract
Neurofeedback (NF) techniques support individuals to self-regulate specific features of brain activity, which has been shown to impact behavior and potentially ameliorate clinical symptoms. Electrophysiological NF (epNF) may be particularly impactful for patients with Parkinson's disease (PD), as evidence mounts to suggest a central role of pathological neural oscillations underlying symptoms in PD. Exaggerated beta oscillations (12-30 Hz) in the basal ganglia-cortical network are linked to motor symptoms (e.g., bradykinesia, rigidity), and beta is reduced by successful therapy with dopaminergic medication and Deep Brain Stimulation (DBS). PD patients also experience non-motor symptoms related to sleep, mood, motivation, and cognitive control. Although less is known about the mechanisms of non-motor symptoms in PD and how to successfully treat them, low frequency neural oscillations (1-12 Hz) in the basal ganglia-cortical network are particularly implicated in non-motor symptoms. Here, we review how cortical and subcortical epNF could be used to target motor and non-motor specific oscillations, and potentially serve as an adjunct therapy that enables PD patients to endogenously control their own pathological neural activities. Recent studies have demonstrated that epNF protocols can successfully support volitional control of cortical and subcortical beta rhythms. Importantly, this endogenous control of beta has been linked to changes in motor behavior. epNF for PD, as a casual intervention on neural signals, has the potential to increase understanding of the neurophysiology of movement, mood, and cognition and to identify new therapeutic approaches for motor and non-motor symptoms.
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Affiliation(s)
- Elena Ubeda Matzilevich
- Movement Disorders and Neuromodulation Division, Department of Neurology, University of California San Francisco, CA, USA
| | - Pria Lauren Daniel
- Movement Disorders and Neuromodulation Division, Department of Neurology, University of California San Francisco, CA, USA; Department of Psychology, University of California San Diego, CA, USA.
| | - Simon Little
- Movement Disorders and Neuromodulation Division, Department of Neurology, University of California San Francisco, CA, USA
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Blause S, Tirelli E, Wauquiez G, Raffard S, Didone V, Willems S. What Information Do Neuropsychologists Use to Guide their Clinical Decisions? A Survey on Knowledge and Application of Evidence-Based Practice in a French-Speaking Population. Arch Clin Neuropsychol 2024; 39:140-156. [PMID: 37551122 DOI: 10.1093/arclin/acad057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/01/2023] [Accepted: 06/29/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVE Evidence-based practice (EBP) is an approach that encourages clinicians to base their practice on evidence to improve the quality of patient care and reduce uncertainty in their clinical decisions. However, the state of knowledge and practice of neuropsychologists in French-speaking countries is still unknown. This study aimed to find out what these neuropsychologists know about EBP and whether they use it. METHOD A questionnaire with 39 questions for French-speaking neuropsychologists was distributed. The questions focused on neuropsychologists' knowledge and use of EBP and information that guide their clinical decisions. RESULTS A total of 392 respondents started the survey. The data show that only 35% correctly defined EBP and there was confusion between this practice and the strict use of research data. In practice, their decisions are influenced by multiple factors, including the patient's difficulties and advice from peers. Regarding the research, a significant proportion of the sample stated that they did not search the scientific literature frequently. Barriers to accessing scientific information and ineffective article-reading behavior were highlighted. CONCLUSION A lack of knowledge of EBP among French-speaking neuropsychologists was observed. Furthermore, the factors influencing their decision-making do not clearly fit the definitions of EBP. Information-seeking behaviors show several weaknesses and barriers to the integration of scientific evidence into practice. These results are like those of other studies conducted among psychologists or in other health professions. We will discuss possible courses of action that could be implemented to improve the knowledge and use of EBP.
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Affiliation(s)
- Sacha Blause
- Department of Psychology, University of Liège, Liège, Belgium
| | - Ezio Tirelli
- Department of Psychology, University of Liège, Liège, Belgium
| | - Grégoire Wauquiez
- Rehabilitation Centre, University Hospital Centre Dijon, Dijon, France
| | - Stéphane Raffard
- Department of Psychology, University of Montpellier, Montpellier, France
| | - Vincent Didone
- Department of Psychology, University of Liège, Liège, Belgium
| | - Sylvie Willems
- Department of Psychology, University of Liège, Liège, Belgium
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Bontemps M, Servières-Bordes M, Moritz-Gasser S. Combining executive function training and anomia therapy in chronic post-stroke aphasia: A preliminary study of multidimensional effects. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-19. [PMID: 38356392 DOI: 10.1080/17549507.2023.2289351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
PURPOSE The influential relationship between executive functioning and aphasia rehabilitation outcomes has been addressed in a number of studies, but few have studied the effect of adding executive function training to linguistic therapies. The present study aimed to measure the effects of combining, within therapy sessions, executive function training and anomia therapy on naming and discourse abilities in people with chronic aphasia. METHOD A single-case experimental design with multiple baselines across participants was used. Four persons with chronic post-stroke aphasia received 12 sessions of a tailored treatment combining executive function training and semantic feature analysis (SFA) therapy. Naming accuracy of treated items was examined over the course of the treatment while control naming scores of untreated items and discourse measures were collected pre-treatment, immediately post-treatment, and 4 weeks post-treatment, in order to investigate the multidimensional effects of the treatment and their maintenance. RESULT Naming skills improved in all participants for treated and untreated items, were maintained over time, and were accompanied by improved discourse abilities. Visual and statistical analyses showed a significant treatment effect for naming skills in three out of the four participants. CONCLUSION A combination of executive function training and SFA treatment in people with chronic aphasia may improve both naming skills and discourse efficiency. Further studies are needed to substantiate these promising preliminary results.
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Affiliation(s)
- Mélanie Bontemps
- Department of Speech-Language Pathology, University of Montpellier, Montpellier, France
| | | | - Sylvie Moritz-Gasser
- Department of Speech-Language Pathology, University of Montpellier, Montpellier, France
- Departments of Neurology and Neurosurgery, University Hospital of Montpellier, Montpellier, France
- Institute of Functional Genomics INSERM U 1191, Montpellier, France
- Praxiling UMR 5267 CNRS, Montpellier, France
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Nakamura-Palacios EM, Falçoni Júnior AT, Tanese GL, Vogeley ACE, Namasivayam AK. Enhancing Speech Rehabilitation in a Young Adult with Trisomy 21: Integrating Transcranial Direct Current Stimulation (tDCS) with Rapid Syllable Transition Training for Apraxia of Speech. Brain Sci 2024; 14:58. [PMID: 38248273 PMCID: PMC10813810 DOI: 10.3390/brainsci14010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Apraxia of speech is a persistent speech motor disorder that affects speech intelligibility. Studies on speech motor disorders with transcranial Direct Current Stimulation (tDCS) have been mostly directed toward examining post-stroke aphasia. Only a few tDCS studies have focused on apraxia of speech or childhood apraxia of speech (CAS), and no study has investigated individuals with CAS and Trisomy 21 (T21, Down syndrome). This N-of-1 randomized trial examined the effects of tDCS combined with a motor learning task in developmental apraxia of speech co-existing with T21 (ReBEC RBR-5435x9). The accuracy of speech sound production of nonsense words (NSWs) during Rapid Syllable Transition Training (ReST) over 10 sessions of anodal tDCS (1.5 mA, 25 cm) over Broca's area with the cathode over the contralateral region was compared to 10 sessions of sham-tDCS and four control sessions in a 20-year-old male individual with T21 presenting moderate-severe childhood apraxia of speech (CAS). The accuracy for NSW production progressively improved (gain of 40%) under tDCS (sham-tDCS and control sessions showed < 20% gain). A decrease in speech severity from moderate-severe to mild-moderate indicated transfer effects in speech production. Speech accuracy under tDCS was correlated with Wernicke's area activation (P3 current source density), which in turn was correlated with the activation of the left supramarginal gyrus and the Sylvian parietal-temporal junction. Repetitive bihemispheric tDCS paired with ReST may have facilitated speech sound acquisition in a young adult with T21 and CAS, possibly through activating brain regions required for phonological working memory.
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Affiliation(s)
| | | | - Gabriela Lolli Tanese
- Clinic of Speech-Language Pathology, Eldorado Business Tower, Goiânia 74280-010, GO, Brazil;
| | - Ana Carla Estellita Vogeley
- Department of Speech and Language Pathology, Federal University of Paraíba, João Pessoa 58051-900, PB, Brazil;
| | - Aravind Kumar Namasivayam
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON M5G 1V7, Canada;
- Speech Research Centre Inc., Brampton, ON L7A 2T1, Canada
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10
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Becker A. The benefits of single-subject research designs and multi-methodological approaches for neuroscience research. Front Hum Neurosci 2023; 17:1190412. [PMID: 37954937 PMCID: PMC10634204 DOI: 10.3389/fnhum.2023.1190412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 09/27/2023] [Indexed: 11/14/2023] Open
Affiliation(s)
- April Becker
- Department of Behavior Analysis, College of Health and Public Service, University of North Texas, Denton, TX, United States
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11
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Dittli J, Goikoetxea-Sotelo G, Lieber J, Gassert R, Meyer-Heim A, Van Hedel HJA, Lambercy O. A Tailorable Robotic Hand Orthosis to Support Children with Neurological Hand Impairments: a Case Study in a Child's Home. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941220 DOI: 10.1109/icorr58425.2023.10304752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Neurological disorders such as traumatic brain injuries (TBI) can lead to hand impairments in children, negatively impacting their quality of life. Fully wearable robotic hand orthoses (RHO) have been proposed to actively support children and promote the use of the impaired limb in daily life. Here we report a case study on the feasibility of using the pediatric RHO PEXO for assistance at home in a 13- year-old child with hand impairment after TBI. The size and functionalities of the RHO were first fully tailored to the child's needs. We trained the child and their parent on independently using the RHO before taking it home for a period of two weeks. The use of the RHO improved hand ability. Additionally, the tailoring and training benefited the unimanual capacity (Box and Block Test score +2 after tailoring) and bimanual performance (Assisting Hand Assessment score +4) of the child with PEXO. Further, it increased device acceptance by the child and the parent. The child used PEXO at home for 76 minutes distributed over three days during eating and drinking tasks. Personal and environmental factors caused the moderate use. No adverse events or safety-related issues occurred. This study highlights the value of tailoring an assistive RHO and, for the first time, demonstrates the feasibility of home use of a pediatric RHO by children with neurological hand impairments.
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O’Neil J, Egan M, Marshall S, Bilodeau M, Pelletier L, Sveistrup H. The Impact of Two Telerehabilitation Supervision Schedules on Physical Activity, Mobility, and Balance Among People with Moderate to Severe Traumatic Brain Injury: A Mixed-Method Single-Subject Design. Physiother Can 2023; 75:118-131. [PMID: 37736373 PMCID: PMC10510551 DOI: 10.3138/ptc-2021-0040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/26/2021] [Accepted: 10/08/2021] [Indexed: 09/23/2023]
Abstract
Background Many individuals who experience a moderate or severe traumatic brain injury (TBI) have long-term deficits in physical activity, balance, and mobility requiring specialized care. New delivery models are being investigated for interventions to address challenges caused by living in remote communities, difficulties with transportation, and/or physical distancing requirements. Determining the effectiveness of telerehabilitation is critical given the current movement toward remote health care delivery. Objective We investigated the effectiveness of two teletherapy supervision schedules used to deliver a home-based, intensive exercise programme on 1) physical activity, mobility, balance, participation, and 2) concerns with falling, and satisfaction with life. Methods A mixed methods approach with alternating single subject design (SSD) and interviews was used. Five individuals who experienced a moderate or severe TBI completed two intensive home-based telerehabilitation programmes. Programmes differed only by supervision schedule - daily or weekly. Impacts on objective and patient-reported outcomes were measured. Results Four individuals demonstrated clinically significant improvements in physical activity level, balance, and mobility. One individual experienced less concerns with falling after both schedules, while two other individuals showed a trend in that direction after the weekly remote supervision. Important functional gains (i.e., improved balance and decreased fatigue) were also perceived and reported by family partners regardless of supervision schedule. Conclusion Although the study has limitations, the findings indicate that exercise programmes delivered via telerehabilitation can improve balance and mobility as well as positively affect concerns with falling and physical activity levels for this population. No clear differences were seen between the two telerehabilitation supervision schedules.
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Affiliation(s)
- Jennifer O’Neil
- From the:
Schools of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Mary Egan
- From the:
Schools of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Shawn Marshall
- Bruyère Research Institute, Ottawa, Ontario, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Martin Bilodeau
- From the:
Schools of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Luc Pelletier
- Physical Medicine and Rehabilitation, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Heidi Sveistrup
- From the:
Schools of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
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Santamaria V, Ai X, Agrawal SK. A motor learning-based postural intervention with a robotic trunk support trainer to improve functional sitting in spinal cord injury: case report. Spinal Cord Ser Cases 2022; 8:88. [PMID: 36433944 PMCID: PMC9700847 DOI: 10.1038/s41394-022-00554-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 11/08/2022] [Indexed: 11/26/2022] Open
Abstract
STUDY DESIGN Single-subject-research-design. OBJECTIVES To improve seated postural control in a participant with spinal cord injury (SCI) with a robotic Trunk-Support-Trainer (TruST). SETTING Laboratory. METHODS TruST delivered "assist-as-needed" forces on the participant's torso during a motor learning-and-control-based intervention (TruST-intervention). TruST-assistive forces were progressed and matched to the participant's postural trunk control gains across six intervention sessions. The T-shirt test was used to capture functional improvements while dressing the upper body. Kinematics were used to compute upper body excursions (cm) and velocity (cm2), and sitting workspace area (cm2). Functional trunk dynamometry was used to examine muscle force (Kg). Surface electromyography (sEMG) was applied to measure trunk muscle activity. The Borg Rating of Perceived Exertion (RPE) was used to monitor physical exertion during TruST-intervention. A two-standard-deviation bandwidth method was adopted for data interpretation. RESULTS After TruST-intervention, the participant halved the time needed to don and doff a T-shirt, increased muscle force of trunk muscles (mean = 3 kg), acquired a steadier postural sitting control without vision (mean excursion baseline: 76.0 ± 2 SD = 5.25 cm and post-intervention: 44.1 cm; and mean velocity baseline: 3.0 ± 2 SD = 0.2 cm/s and post-intervention: 1.8 cm/s), and expanded his sitting workspace area (mean baseline: 36.7 ± 2 SD = 36.6 cm2 and post-intervention: 419.2 cm2). The participant increased his tolerance to counteract greater TruST-force perturbations in lateral and posterior directions. Furthermore, abdominal muscle activity substantially augmented after completion of TruST-intervention across all perturbation directions. CONCLUSIONS Our data indicate a potential effectiveness of TruST-intervention to promote functional sitting in SCI.
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Affiliation(s)
- V Santamaria
- Department of Physical Therapy, New York Medical College, New York, NY, USA
| | - X Ai
- Department of Mechanical Engineering, Columbia University, New York, NY, USA
| | - S K Agrawal
- Department of Mechanical Engineering, Columbia University, New York, NY, USA.
- Department of Rehabilitation and Regenerative Medicine, Columbia University, New York, NY, USA.
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Kingsdorf S, Pančocha K, Troshanska J, Rasimi TR. Examining the perceptions of needs, services and abilities of Czech and North Macedonian caregivers of children with autism and trainers. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:479-492. [PMID: 38699490 PMCID: PMC11062262 DOI: 10.1080/20473869.2022.2111970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/04/2022] [Indexed: 05/05/2024]
Abstract
Effective practices for supporting families with autistic children ensure a match between their needs and the expectations and competencies of the clinician. Applied behavior analysis (ABA) services are a common provision for serving autistic individuals. However, in regions where ABA is in its infancy, like the Czech Republic and North Macedonia, culturally relevant resources, regulations for practice, and standardized coursework are missing. In their absence, it is necessary to investigate the degree to which practitioners in the regions are meeting the behavioral needs of families. Assessing this match can set the stage for establishing more stable and effective services in the areas, as well as neighboring countries with similar historical foundations. Therefore, a survey was conducted to examine the perceptions of caregivers and trainers (those who self-identified as providing support to families with autistic children). A total of 233 caregivers and 204 trainers participated. Analysis of the survey responses verified the lack of behavioral knowledge on the part of the trainers, the apparent lack of access to ABA services for families in both regions, a potential misalignment between family needs and training targets, and the disparities between the two countries. The information evaluated here can be used to guide preservice training, dissemination efforts, and regulations surrounding behavioral practices.
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Affiliation(s)
- Sheri Kingsdorf
- Institute for Research in Inclusive Education, Faculty of Education, Masaryk University, Brno, Czech Republic
| | - Karel Pančocha
- Institute for Research in Inclusive Education, Faculty of Education, Masaryk University, Brno, Czech Republic
| | - Jasmina Troshanska
- Department of Special Education and Rehabilitation, University of Tetovo, Tetovo, North Macedonia
| | - Teuta Ramadani Rasimi
- Department of Special Education and Rehabilitation, University of Tetovo, Tetovo, North Macedonia
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15
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Hughes DM, Vento-Wilson M, Boyd LE. Direct Speech-Language Intervention Effects on Augmentative and Alternative Communication System Use in Adults With Developmental Disabilities in a Naturalistic Environment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1621-1636. [PMID: 35442756 DOI: 10.1044/2022_ajslp-21-00242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Research involving the effects of augmentative and alternative communication (AAC) intervention in adults, especially in naturalistic settings, has been identified as a critical public health need. Despite rapid advances in high-tech AAC, many adults with developmental disabilities have experienced reduced access to assistive technology and AAC, which can function as a de facto environmental barrier to participation, for these individuals. As a means of decreasing barriers to participation, this study targeted skill increases in the operational, linguistic, social, and strategic use of AAC systems. METHOD This study used a preexperimental, single-case AB design to identify skill level changes in the operational, linguistic, social, and strategic use of their AAC system from baseline to the completion of intervention. The four adult participants with developmental disabilities and limited use of natural speech as a primary modality of communication were identified through a collaborative relationship between a communication sciences and disorder university program and a state-run adult day program for individuals who had aged out of the K-12 school system. Each participant received direct intervention in the four areas described across 7 weeks. RESULTS Visual analysis and percent of nonoverlap of all pairs were used to identify changes in performance occurring between baseline and the conclusion of the intervention period. Results revealed increases across the specific skills, with individuals' variation across participants and target area. Out of 22 total goals targeted, strong effect sizes were observed for 10 goals and moderate effect sizes were observed for seven. CONCLUSIONS Skill increases in the four areas of AAC system use can be achieved with direct intervention in adults with developmental disabilities and limited use of natural speech as a primary modality of communication. This approach also underscores the value of collaborations between university training programs, providers of adult services, and adult participants as a cost-effective strategy for service delivery.
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Affiliation(s)
- Deanna M Hughes
- Communication Sciences & Disorders, Crean College of Health & Behavioral Sciences, Chapman University, Irvine, CA
| | - Margaret Vento-Wilson
- Department of Speech-Language Pathology, College of Health and Human Services, California State University, Long Beach
| | - LouAnne E Boyd
- Computer Science, Fowler School of Engineering, Chapman University, Irvine, CA
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Personalized Research on Diet in Ulcerative Colitis and Crohn's Disease: A Series of N-of-1 Diet Trials. Am J Gastroenterol 2022; 117:902-917. [PMID: 35442220 DOI: 10.14309/ajg.0000000000001800] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/15/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Evidence about specific carbohydrate diet (SCD) for inflammatory bowel disease (IBD) is limited. We conducted 54 single-subject, double-crossover N-of-1 trials comparing SCD with a modified SCD (MSCD) and comparing each with the participant's baseline, usual diet (UD). METHODS Across 19 sites, we recruited patients aged 7-18 years with IBD and active inflammation. Following a 2-week baseline (UD), patients were randomized to 1 of 2 sequences of 4 alternating 8-week SCD and MSCD periods. Outcomes included fecal calprotectin and patient-reported symptoms. We report posterior probabilities from Bayesian models comparing diets. RESULTS Twenty-one (39%) participants completed the trial, 9 (17%) completed a single crossover, and 24 (44%) withdrew. Withdrawal or early completion occurred commonly (lack of response [n = 11], adverse events [n = 11], and not desiring to continue [n = 6]). SCD and MSCD performed similarly for most individuals. On average, there was <1% probability of a clinically meaningful difference in IBD symptoms between SCD and MSCD. The average treatment difference was -0.3 (95% credible interval -1.2, 0.75). There was no significant difference in the ratio of fecal calprotectin geometric means comparing SCD and MSCD (0.77, 95% credible interval 0.51, 1.10). Some individuals had improvement in symptoms and fecal calprotectin compared with their UD, whereas others did not. DISCUSSION SCD and MSCD did not consistently improve symptoms or inflammation, although some individuals may have benefited. However, there are inherent difficulties in examining dietary changes that complicate study design and ultimately conclusions regarding effectiveness.
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Baillot A, St-Pierre M, Lapointe J, Bernard P, Bond D, Romain AJ, Garneau PY, Biertho L, Tchernof A, Blackburn P, Langlois MF, Brunet J. Acceptability and feasibility of the TELEhealth BARIatric behavioural intervention to increase physical ACTIVity (TELE-BariACTIV): A single-case experimental study protocol (Preprint). JMIR Res Protoc 2022; 11:e39633. [PMID: 36173668 PMCID: PMC9562082 DOI: 10.2196/39633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background Regular physical activity (PA) is recommended to optimize weight and health outcomes in patients who have undergone metabolic and bariatric surgery (MBS). However, >70% of patients have low PA levels before MBS that persist after MBS. Although behavioral interventions delivered face-to-face have shown promise for increasing PA among patients who have undergone MBS, many may experience barriers, preventing enrollment into and adherence to such interventions. Delivering PA behavior change interventions via telehealth to patients who have undergone MBS may be an effective strategy to increase accessibility and reach, as well as adherence. Objective This paper reports the protocol for a study that aims to assess the feasibility and acceptability of the protocol or methods and the Telehealth Bariatric Behavioral Intervention (TELE-BariACTIV). The intervention is designed to increase moderate-to-vigorous intensity PA (MVPA) in patients awaiting bariatric surgery and is guided by a multitheory approach and a patient perspective. Another objective is to estimate the effect of the TELE-BariACTIV intervention on presurgical MVPA to determine the appropriate sample size for a multicenter trial. Methods This study is a multicenter trial using a repeated (ABAB’A) single-case experimental design. The A phases are observational phases without intervention (A1=pre-MBS phase; A2=length personalized according to the MBS date; A3=7 months post-MBS phase). The B phases are interventional phases with PA counseling (B1=6 weekly pre-MBS sessions; B2=3 monthly sessions starting 3 months after MBS). The target sample size is set to 12. Participants are inactive adults awaiting sleeve gastrectomy who have access to a computer with internet and an interface with a camera. The participants are randomly allocated to a 1- or 2-week baseline period (A1). Protocol and intervention feasibility and acceptability (primary outcomes) will be assessed by recording missing data, refusal, recruitment, retention, attendance, and attrition rates, as well as via web-based acceptability questionnaires and semistructured interviews. Data collected via accelerometry (7-14 days) on 8 occasions and via questionnaires on 10 occasions will be analyzed to estimate the effect of the intervention on MVPA. Generalization measures assessing the quality of life, anxiety and depressive symptoms, and theory-based constructs (ie, motivational regulations for PA, self-efficacy to overcome barriers to PA, basic psychological needs satisfaction and frustration, PA enjoyment, and social support for PA; secondary outcomes for a future large-scale trial) will be completed via web-based questionnaires on 6-10 occasions. The institutional review board provided ethics approval for the study in June 2021. Results Recruitment began in September 2021, and all the participants were enrolled (n=12). Data collection is expected to end in fall 2023, depending on the MBS date of the recruited participants. Conclusions The TELE-BariACTIV intervention has the potential for implementation across multiple settings owing to its collaborative construction that can be offered remotely. International Registered Report Identifier (IRRID) DERR1-10.2196/39633
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Affiliation(s)
- Aurélie Baillot
- Nursing Department, Université du Québec en Outaouais, Gatineau, QC, Canada
- Institut du savoir de l'hôpital Montfort-recherche, Ottawa, ON, Canada
- Centre de Recherche en Médecine Psychosociale, Centre Intégré de Santé et Services Sociaux de l'Outaouais, Gatineau, QC, Canada
| | - Maxime St-Pierre
- Basic Science Department, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Josyanne Lapointe
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Montreal Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Montreal Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - Dale Bond
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, United States
| | - Ahmed Jérôme Romain
- Montreal Mental Health University Institute Research Centre, Montreal, QC, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Pierre Y Garneau
- Department of Surgery, Université de Montréal, Montréal, QC, Canada
| | - Laurent Biertho
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada
| | - André Tchernof
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec, QC, Canada
| | - Patricia Blackburn
- Division of Kinesiology, Department of Health Sciences, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Marie-France Langlois
- CHUS Research Center and Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jennifer Brunet
- Institut du savoir de l'hôpital Montfort-recherche, Ottawa, ON, Canada
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Rauwenhoff JCC, Bol Y, Peeters F, van den Hout AJHC, Geusgens CAV, van Heugten CM. Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases. Neuropsychol Rehabil 2022:1-31. [PMID: 35332849 DOI: 10.1080/09602011.2022.2053169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Patients with acquired brain injury (ABI) often experience symptoms of anxiety and depression. Until now, evidence-based treatment is scarce. This study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) for patients with ABI. To evaluate the effect of ACT for people with ABI, a non-concurrent multiple baseline design across four cases was used. Participants were randomly assigned to a baseline period, followed by treatment and then follow-up phases. Anxiety and depressive symptoms were repeatedly measured. During six measurement moments over a year, participants filled in questionnaires measuring anxiety, depression, stress, participation, quality of life, and ACT-related processes. Randomization tests and NAP scores were used to calculate the level of change across phases. Clinically significant change was defined with the Reliable Change Index. Three out of four participants showed medium to large decreases in anxiety and depressive symptoms (NAP = 0.85 till 0.99). Furthermore, participants showed improvements regarding stress, cognitive fusion, and quality of life. There were no improvements regarding psychological flexibility, value-driven behaviour, or social participation. This study shows that ACT is possibly an effective treatment option for people experiencing ABI-related anxiety and depression symptoms. Replication with single case or large scale group studies is needed to confirm these findings.
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Affiliation(s)
- Johanne C C Rauwenhoff
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Centre, Maastricht, Netherlands
| | - Yvonne Bol
- Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, Netherlands
| | - Frenk Peeters
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Anja J H C van den Hout
- Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, Netherlands
| | - Chantal A V Geusgens
- Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, Netherlands
| | - Caroline M van Heugten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Centre, Maastricht, Netherlands.,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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Carignan M, Courchesne M, Cantin S, Moore V, Poncet F. Visual Rehabilitation After Retinal Prosthesis Implantation: An 18-month Case Report, From Candidate Selection to Follow-Up. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2022. [DOI: 10.1177/0145482x221092020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Various retinal implants are being developed and appear to be a promising option for improving the visual capacities of individuals with retinal dystrophy. A multidisciplinary approach to both assessment of a candidate’s factors and rehabilitation could contribute to improved activity and participation. The purpose of this study was (i) to document the approach taken by a multidisciplinary team in the candidate selection process and in training in the use of the Argus II retinal prosthesis system (RPS), and (ii) to examine the effects of the RPS on sensory and mental functions and on activity and participation. Methods: An A1-B1-A2-B2 experimental case report was used, with repeated measures pre- and post-rehabilitation program design. The A phases represent the periods with the system off, whereas the B phases represent the periods with the system on. A 65-year-old man with retinitis pigmentosa and total blindness was followed by a multidisciplinary team for over 18 months. After receiving the retinal implant, he benefited from a 10-week rehabilitation program (twice per week; B1 phase). Results: Globally, the RPS improved vision in the B phases when the system was on and visual acuity was stable at 2.3 logMAR (functional blindness). The participant’s mental and neuromusculoskeletal function scores were generally stable throughout the data collection periods. Lower performance on some measures at the end of phase B2 coincided with a negative mood. Discussion: Use of the RPS improved activity, but this did not transfer into greater participation in the living environment. Despite efforts made by the rehabilitation team to manage the user’s expectations concerning the RPS, the interventions reactivated his grieving over his vision loss. Implications for Practitioners: New technologies can make users dream of unrealistic possibilities, and managing their expectations requires problem solving supported by a multidisciplinary team.
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Affiliation(s)
- Mathieu Carignan
- Institut Nazareth et Louis Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, QC, Canada
| | - Marie Courchesne
- Institut Nazareth et Louis Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, QC, Canada
| | - Sylvie Cantin
- Institut Nazareth et Louis Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, QC, Canada
| | - Vincent Moore
- Institut Nazareth et Louis Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, QC, Canada
| | - Frédérique Poncet
- Institut Nazareth et Louis Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal, QC, Canada
- Lethbridge-Layton-Mackay Rehabilitation Center, Integrated Health and Social Services University Network for West-Central Montreal, Montreal, QC, Canada
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Lane H, Harding S, Wren Y. A systematic review of early speech interventions for children with cleft palate. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:226-245. [PMID: 34767284 DOI: 10.1111/1460-6984.12683] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 09/08/2021] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Children with cleft palate with or without cleft lip (CP±L) are at high risk of problems with early speech sound production, and these difficulties can persist into later childhood. Early intervention could help to reduce the number of children whose problems become persistent. However, much research in the field to date has focused on older children. There is a need to determine if providing intervention during the phase of early typical speech development leads to better outcomes. AIMS To review the evidence for the effectiveness of interventions targeting speech, delivered in the first 3 years of life for children with CP±L, and discuss factors such as intervention type, facilitator, dosage, outcome measures and the age of the child. METHODS & PROCEDURES The systematic review was registered with PROSPERO (CRD42019121964). Eight bibliographic databases including CINAHL and MEDLINE were searched in August 2018. Studies were included if participants received speech and language interventions before 37 months and if they reported outcomes for speech. Two reviewers independently completed inclusion reviews, quality analysis and data extraction. OUTCOME & RESULTS The review included seven papers: one pilot randomized controlled trial, one controlled trial, four cohort studies and one case series report. Interventions largely took a naturalistic approach, namely focused stimulation and milieu teaching. The findings provide preliminary support for naturalistic interventions and suggest that these interventions can be delivered by parents with suitable training. Studies included in the review provided low-strength evidence with variation in both the type of intervention, the manner of delivery and in the risk of bias in the designs used. CONCLUSIONS & IMPLICATIONS The papers included in this review suggest that early naturalistic interventions can have positive impacts on the speech development of children with CP±L. However, the reported methodological quality of the publications overall was weak, and the current evidence lacks clarity and specificity in terms of therapy technique, delivery and optimum age of delivery. Future research should use more robust methodological designs to determine whether early speech interventions are beneficial for children born with CP±L. WHAT THIS PAPER ADDS What is already known on the subject Children with CP±L show difficulties with early speech development and often have restricted speech sound inventories. They may reach the canonical babbling stage later than children without CP±L and studies have shown that 20% of children with CP±L have speech which is considered unintelligible or barely intelligible at age 5. It has been proposed that early intervention can lessen the impact of CP±L on speech development. However, currently, the evidence for early interventions for children with CP±L is limited, with the majority of studies focusing on children aged 3 years and older. What this paper adds to existing knowledge This paper reviews the evidence for different types of early interventions for speech provided to children born with CP±L and whether these interventions are effective in supporting speech sound development. In this review, early intervention is defined as intervention provided to children in the first 3 years of life. This review describes intervention approaches and how they are delivered for this population. What are the potential or actual clinical implications of this work? In the UK, children born with CP±L and their families are supported by National Health Service (NHS) services over a 20-year period and speech and language therapy sessions may take place over many weeks and months. If providing early intervention in the first 3 years of life is effective, there is the potential for improved speech outcomes in early childhood and a reduced burden of care on children, families and services. This review considers the evidence for early speech intervention for children with CP±L in the first 3 years of life and identifies areas for future research.
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Affiliation(s)
- Hannah Lane
- Speech and Language Therapy, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Sam Harding
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, University of Bristol, Bristol, UK
| | - Yvonne Wren
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, University of Bristol, Bristol, UK
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21
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Beaudoin AJ, Pedneault F, Houle M, Bilodeau C, Gauvin MP, Groleau D, Brochu P, Couture M. Case study assessing the feasibility of using a wearable haptic device or humanoid robot to facilitate transitions in occupational therapy sessions for children with autism spectrum disorder. J Rehabil Assist Technol Eng 2021; 8:20556683211049041. [PMID: 34671485 PMCID: PMC8521426 DOI: 10.1177/20556683211049041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/09/2019] [Indexed: 11/16/2022] Open
Abstract
Introduction Some children with autism spectrum disorder (ASD) have difficulties with transitions that may lead to problem behaviours. Although the use of technologies with children with ASD is receiving increasing attention, no study has looked at their effect on transitions in activities of daily living. This study aimed to document the feasibility of (1) using two intervention technologies (NAO humanoid robot or wearable haptic device) separately to facilitate transitions in occupational therapy sessions for children with ASD and (2) the method used to document changes. Methods Using a single case reversal (ABA) design, two children with ASD were randomly assigned to one of the intervention technologies (humanoid robot or haptic bracelet). Each technology was used as an antecedent to stimulate the start of transitions in eight intervention sessions at a private occupational therapy clinic. Data concerning the time required for transitions, child's behaviours during transitions at the clinic and mother's perception of the child's performance in transitions at home were analysed graphically. Results When using technology, both children's behaviours were appropriate, quick and relatively stable. Also, both mothers reported improved perceptions of their child's performance in transitions. Conclusions This exploratory study suggests no detrimental effect of using these technologies.
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Affiliation(s)
- Audrée Jeanne Beaudoin
- Institut Universitaire de Première Ligne en Santé et Services Sociaux, Centre Intégré Universitaire en Santé et Services Sociaux de L'Estrie - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.,School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | - Marina Houle
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Cynthia Bilodeau
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Pier Gauvin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | | | | | - Mélanie Couture
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
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22
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Feasibility and tolerance of a robotic postural training to improve standing in a person with ambulatory spinal cord injury. Spinal Cord Ser Cases 2021; 7:94. [PMID: 34620833 PMCID: PMC8497530 DOI: 10.1038/s41394-021-00454-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 09/18/2021] [Accepted: 09/19/2021] [Indexed: 11/08/2022] Open
Abstract
An ambulatory elder with SCI, AIS C, balance deficits, and right ankle-foot-orthosis participated. RobUST-intervention comprised six 90 min-sessions of postural tasks with pelvic assistance and trunk perturbations. We collected three baselines and two 1 week post-training assessments-after the first four sessions (PT1) and after the last two sessions (PT2). We measured Berg Balance Scale (BBS), four-stage balance test (4SBT)-including a 30 s-window with and without vision-standing workspace area, and reactive balance (measured as body weight%). Kinematics, center-of-pressure (COP), and electromyography (EMG) were analyzed to compute root-mean-square-COP (RMS-COP), the margin of stability (MoS), ankle range of motion, and integrated EMG (iEMG) normalized to baseline. The Borg Rating of Perceived Exertion (BRPE), and change in the Mean Arterial Pressure (MAP) and heart rate (HR) compared with baseline were collected to address training tolerance. A 2SD-bandwidth method was selected for data interpretation. The maximum BBS was achieved (1-point improvement). In the 4SBT, the participant completed 30 s (baseline = 20 s) with reduced balance variability during semi-tandem position without vision (RMS-COP baseline = 50.32 ± 2 SD = 19.64 mm; PT1 = 21.29 mm; PT2 = 19.34 mm). A trend toward increase was found in workspace area (baseline = 996 ± 359 cm2; PT1 = 1539 cm2; PT2 = 1138 cm2). The participant tolerated higher perturbation intensities (baseline mean = 25%body weight, PT2 mean = 44% body weight), and on average improved his MoS (3 cm), ankle range of motion (4°), and gluteus medius activity (iEMG = 10). RobuST-intervention was moderate-sort of hard (BRPE = 3-4). A substantial reduction in MAP (9%) and HR (30%) were observed. In conclusion, RobUST-intervention might be effective in ambulatory SCI.
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23
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Santamaria V, Khan M, Luna T, Kang J, Dutkowsky J, Gordon AM, Agrawal SK. Promoting Functional and Independent Sitting in Children With Cerebral Palsy Using the Robotic Trunk Support Trainer. IEEE Trans Neural Syst Rehabil Eng 2021; 28:2995-3004. [PMID: 33079652 DOI: 10.1109/tnsre.2020.3031580] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Seated postural abilities are critical to functional independence and participation in children with cerebral palsy, Gross Motor Functional Classification System (GMFCS) levels III-IV. In this proof-of-concept study, we investigated the feasibility of a motor learning-based seated postural training with a robotic Trunk-Support-Trainer (TruST) in a longitudinal single-subject-design (13y, GMFCS IV), and its potential effectiveness in a group of 3 children (6-14y, GMFCS III-IV). TruST is a motorized-cable driven belt placed on the child's trunk to exert active-assistive forces when the trunk moves beyond stability limits. TruST-intervention addresses postural-task progression by tailoring the assistive-force fields to the child's sitting balance to train trunk control during independent short-sitting posture. TruST-intervention consisted of 2 training blocks of six 2hour-sessions per block (3 sessions per week). Pelvic strapping was required in the 1st block to prevent falls. As primary outcomes, we used the modified functional reach test, gross motor function measure-item set (GMFM-IS), Box & Blocks, and postural kinematics. After TruST-intervention children did not require pelvic strapping to prevent a fall, improved trunk stability during reaching (baseline = 5.49cm, 1week post-training = 16.38cm, 3mos follow-up = 14.63cm, ) and increased their sitting workspace (baseline = 127.55cm2, 1week post-training, = 409.92cm2, 3mos follow-up = 270.03cm2, ). Three children also improved in the GMFM-IS. In summary, our novel robotic TruST-intervention is feasible and can effectively maximize functional independent sitting in children with CP GMFCS III-IV.
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24
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Spauwen P, Ter Mors B, van Harten P, Domensino AF, Ponds R, van Heugten C. Efficacy and safety of amantadine as a treatment for apathy after brain injury: Two single-case experimental design studies. Neuropsychol Rehabil 2020; 32:872-896. [PMID: 33975525 DOI: 10.1080/09602011.2020.1842214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Studies on the efficacy of amantadine as a treatment for apathy after brain injury are scarce and of low quality. We examined the efficacy and safety of amantadine for treatment of apathy in two individuals with brain injury.Two double-blind, randomized, single-case experimental (baseline-amantadine-placebo-withdrawal) design (SCED) studies. Apathy measures included a Visual Analogue Scale (VAS), the Neuropsychiatric Inventory (NPI) apathy subscale and the Behavior Rating Inventory of Executive Function for Adults "Initiate" subscale. Safety measures included a rating scale of possible side effects of amantadine and physical examinations.No difference in apathy symptoms (VAS) between baseline and amantadine phase was found in case 1 (NAP = 0.55). Surprisingly, in case 2, apathy symptoms deteriorated from baseline to amantadine phase (NAP = 0.28, 90% CI = -0.69 to -0.20) and improved from amantadine to placebo phase (NAP = 0.92, 90% CI = 0.60-1.00). This improvement was also found on the NPI apathy subscale. Side effects of amantadine were observed in case 2.In this SCED study, amantadine did not improve apathy symptoms in two individuals with brain injury. However, this study shows that side effects of amantadine can occur which lead to a significant decrease in well-being. More high quality studies are required.
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Affiliation(s)
- Peggy Spauwen
- Multidisciplinary Specialist Center for Brain Injury and Neuropsychiatry, GGZ Oost-Brabant, Boekel, The Netherlands.,Limburg Brain Injury Center, Maastricht, The Netherlands
| | - Bert Ter Mors
- Multidisciplinary Specialist Center for Brain Injury and Neuropsychiatry, GGZ Oost-Brabant, Boekel, The Netherlands.,Limburg Brain Injury Center, Maastricht, The Netherlands
| | - Peter van Harten
- Psychiatric Centre GGz Centraal, Amersfoort, The Netherlands.,Department of Psychiatry and Neuropsychology and School of Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Anne-Fleur Domensino
- Limburg Brain Injury Center, Maastricht, The Netherlands.,Department of Psychiatry and Neuropsychology and School of Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Rudolf Ponds
- Limburg Brain Injury Center, Maastricht, The Netherlands.,Department of Psychiatry and Neuropsychology and School of Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands.,Adelante Rehabilitation Center, Department of Brain Injury, Hoensbroek, The Netherlands
| | - Caroline van Heugten
- Limburg Brain Injury Center, Maastricht, The Netherlands.,Department of Psychiatry and Neuropsychology and School of Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands.,Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
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25
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Whiting DL, Deane FP, Simpson GK, Ciarrochi J, Mcleod HJ. Acceptance and Commitment Therapy delivered in a dyad after a severe traumatic brain injury: A feasibility study. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12118] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Diane L. Whiting
- Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia,
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia,
| | - Frank P. Deane
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia,
| | - Grahame K. Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia,
- John Walsh Centre for Rehabilitation Research, University of Sydney, Sydney, New South Wales, Australia,
| | - Joseph Ciarrochi
- Institute of Positive Psychology & Education, Australian Catholic University, Strathfield, New South Wales, Australia,
| | - Hamish J. Mcleod
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland,
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26
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Kucheria P, Moore Sohlberg M, Machalicek W, Seeley J, DeGarmo D. A single-case experimental design investigation of collaborative goal setting practices in hospital-based speech-language pathologists when provided supports to use motivational interviewing and goal attainment scaling. Neuropsychol Rehabil 2020; 32:579-610. [PMID: 33153386 DOI: 10.1080/09602011.2020.1838301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The study investigated the impact of the electronic Goal Attainment Scaling (eGAS) process on medical speech-language pathologists' (SLPs) interviewing and goal setting. The process was trained via the eGAS app, designed to facilitate motivational interviewing and goal attainment scaling. The study utilized a single-case, nonconcurrent, multiple-baseline design replicated across three clinicians and their 27 respective clients. We observed client-clinician dyads engaged in setting rehabilitation goals pre and post eGAS training. The clients had neurogenic conditions and were being treated for cognitive, communication and/or swallowing challenges in an outpatient setting. Two measures were used to collect data on the clinician's interviewing and goal-setting behaviors: (1) Assessment of Client-Centeredness when Interviewing and Goal Setting (ACIG) scale, and (2) a task analysis, i.e., the Clinician Interview Behavior scale (CIB). Training with eGAS had a strong effect on clinicians' collaborative interviewing behaviors, an inconsistent effect on their ability to adhere to a three-phase interview structure, and a strong effect on their ability to generate valid goal attainment scales. This study provides preliminary support that the eGAS process provides a feasible framework for training hospital-based SLPs engaged in neurorehabilitation to use collaborative interviewing behaviors and produce valid person-centered rehabilitation goals.
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Affiliation(s)
- Priya Kucheria
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - McKay Moore Sohlberg
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - John Seeley
- Department of Education Methodology, Policy and Leadership, University of Oregon, Eugene, OR, USA
| | - David DeGarmo
- Department of Education Methodology, Policy and Leadership, University of Oregon, Eugene, OR, USA
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27
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Chowdhury MSN, Dutta A, Robison MK, Blais C, Brewer GA, Bliss DW. Deep Neural Network for Visual Stimulus-Based Reaction Time Estimation Using the Periodogram of Single-Trial EEG. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6090. [PMID: 33120869 PMCID: PMC7662233 DOI: 10.3390/s20216090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 12/14/2022]
Abstract
Multiplexed deep neural networks (DNN) have engendered high-performance predictive models gaining popularity for decoding brain waves, extensively collected in the form of electroencephalogram (EEG) signals. In this paper, to the best of our knowledge, we introduce a first-ever DNN-based generalized approach to estimate reaction time (RT) using the periodogram representation of single-trial EEG in a visual stimulus-response experiment with 48 participants. We have designed a Fully Connected Neural Network (FCNN) and a Convolutional Neural Network (CNN) to predict and classify RTs for each trial. Though deep neural networks are widely known for classification applications, cascading FCNN/CNN with the Random Forest model, we designed a robust regression-based estimator to predict RT. With the FCNN model, the accuracies obtained for binary and 3-class classification were 93% and 76%, respectively, which further improved with the use of CNN (94% and 78%, respectively). The regression-based approach predicted RTs with correlation coefficients (CC) of 0.78 and 0.80 for FCNN and CNN, respectively. Investigating further, we found that the left central as well as parietal and occipital lobes were crucial for predicting RT, with significant activities in the theta and alpha frequency bands.
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Affiliation(s)
- Mohammad Samin Nur Chowdhury
- School of Electrical, Computer & Energy Engineering, Arizona State University, Tempe, AZ 85281, USA; (A.D.); (D.W.B.)
| | - Arindam Dutta
- School of Electrical, Computer & Energy Engineering, Arizona State University, Tempe, AZ 85281, USA; (A.D.); (D.W.B.)
| | - Matthew Kyle Robison
- Department of Psychology, The University of Texas at Arlington, Arlington, TX 76019, USA;
| | - Chris Blais
- Department of Psychology, Arizona State University, Tempe, AZ 85281, USA; (C.B.); (G.A.B.)
| | - Gene Arnold Brewer
- Department of Psychology, Arizona State University, Tempe, AZ 85281, USA; (C.B.); (G.A.B.)
| | - Daniel Wesley Bliss
- School of Electrical, Computer & Energy Engineering, Arizona State University, Tempe, AZ 85281, USA; (A.D.); (D.W.B.)
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28
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Hagopian LP. The consecutive controlled case series: Design, data-analytics, and reporting methods supporting the study of generality. J Appl Behav Anal 2020; 53:596-619. [PMID: 32125716 PMCID: PMC8805508 DOI: 10.1002/jaba.691] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/17/2020] [Accepted: 01/17/2020] [Indexed: 07/20/2023]
Abstract
Single-case experimental designs (SCEDs) have proven invaluable in research and practice because they are optimal for asking many experimental questions relevant to the analysis of behavior. The consecutive controlled case series (CCCS) is a type of study in which a SCED is employed in a series of consecutively encountered cases that undergo a common procedure or share a common characteristic. Additional design elements, data-analytic, and reporting methods enable researchers to ask experimental questions relevant to the study of generality of procedures and processes. The current paper discusses the CCCS methodologies, including the retrospective, prospective, and randomized CCCS. These methodologies can be applied to examine the generality of clinical procedures (including their general efficacy, the limits of their generality, and variables that may mediate generality); study the epidemiology and phenomenology of clinical problems; and compare the efficacy of 2 clinical procedures within a randomized controlled trial combining SCEDs with randomized group designs.
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Affiliation(s)
- Louis P Hagopian
- Kennedy Krieger Institute
- Johns Hopkins University School of Medicine
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29
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Barnard-Brak L, Watkins L, Richman D. Estimating effect size with respect to variance in baseline to treatment phases of single-case experimental designs: A Bayesian simulation study. ACTA ACUST UNITED AC 2020. [DOI: 10.1080/17489539.2020.1738625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Lucy Barnard-Brak
- Special Education and Multiple Abilities, The University of Alabama, Tuscaloosa, AL, USA
| | - Laci Watkins
- Special Education and Multiple Abilities, The University of Alabama, Tuscaloosa, AL, USA
| | - David Richman
- Educational Psychology and Leadership, Texas Tech University, Lubbock, TX, USA
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30
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Chavez-Arana C, Catroppa C, Carranza-Escárcega E, Godfrey C, Yáñez-Téllez G, Prieto-Corona B, de León MA, Anderson V. A Systematic Review of Interventions for Hot and Cold Executive Functions in Children and Adolescents With Acquired Brain Injury. J Pediatr Psychol 2019; 43:928-942. [PMID: 30124957 DOI: 10.1093/jpepsy/jsy013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/23/2018] [Indexed: 11/13/2022] Open
Abstract
Objective We investigated interventions, which aimed to improve cold and hot executive functions (EFs) in children and adolescents with a diagnosis of acquired brain injury (ABI). Methods The following electronic databases were searched: Medline, CINAHL, PsycINFO, and Pubmed. The database filters limited the search to articles published between 1990 and July 2017 in English or Spanish, including children and adolescents. Articles were read and classified according to the levels of evidence of the Australian National Health and Medical Research Council and the Downs and Black checklist was used for Measuring Study Quality. Results Thirty studies are reported in this systematic review. Level of evidence, quality of the studies, characteristics of the participants, interventions implemented, and outcomes are described. Conclusions The study of rehabilitation for executive dysfunction in children with ABI is emerging. Although few high-quality intervention studies exist in this area, which limits conclusions regarding intervention efficacy, results of existing studies suggest that education for parents may be an important component of intervention. Moreover, caregiver involvement may improve the effectiveness of hot EFs rehabilitation interventions, while high intervention session frequency may be important in improving cold EFs. Positive behavior supports and specific training based on a cognitive model provided some promising findings, which require further evaluation.
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Affiliation(s)
- Clara Chavez-Arana
- Child Neuropsychology, Murdoch Children's Research Institute.,University of Melbourne.,FES Iztacala, Universidad Nacional Autónoma de México
| | - Cathy Catroppa
- Child Neuropsychology, Murdoch Children's Research Institute.,University of Melbourne
| | | | - Celia Godfrey
- Child Neuropsychology, Murdoch Children's Research Institute
| | | | | | | | - Vicki Anderson
- Child Neuropsychology, Murdoch Children's Research Institute.,University of Melbourne
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31
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Tanious R, De TK, Onghena P. A multiple randomization testing procedure for level, trend, variability, overlap, immediacy, and consistency in single-case phase designs. Behav Res Ther 2019; 119:103414. [DOI: 10.1016/j.brat.2019.103414] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/16/2019] [Accepted: 05/28/2019] [Indexed: 11/15/2022]
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32
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Soldevila-Domenech N, Boronat A, Langohr K, de la Torre R. N-of-1 Clinical Trials in Nutritional Interventions Directed at Improving Cognitive Function. Front Nutr 2019; 6:110. [PMID: 31396517 PMCID: PMC6663977 DOI: 10.3389/fnut.2019.00110] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 07/08/2019] [Indexed: 12/30/2022] Open
Abstract
Longer life expectancy has led to an increase in the prevalence of age-related cognitive decline and dementia worldwide. Due to the current lack of effective treatment for these conditions, preventive strategies represent a research priority. A large body of evidence suggests that nutrition is involved in the pathogenesis of age-related cognitive decline, but also that it may play a critical role in slowing down its progression. At a population level, healthy dietary patterns interventions, such as the Mediterranean and the MIND diets, have been associated with improved cognitive performance and a decreased risk of neurodegenerative disease development. In the era of evidence-based medicine and patient-centered healthcare, personalized nutritional recommendations would offer a considerable opportunity in preventing cognitive decline progression. N-of-1 clinical trials have emerged as a fundamental design in evidence-based medicine. They consider each individual as the only unit of observation and intervention. The aggregation of series of N-of-1 clinical trials also enables population-level conclusions. This review provides a general view of the current scientific evidence regarding nutrition and cognitive decline, and critically states its limitations when translating results into the clinical practice. Furthermore, we suggest methodological strategies to develop N-of-1 clinical trials focused on nutrition and cognition in an older population. Finally, we evaluate the potential challenges that researchers may face when performing studies in precision nutrition and cognition.
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Affiliation(s)
- Natalia Soldevila-Domenech
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Experimental and Health Sciences, University Pompeu Fabra, Barcelona, Spain
| | - Anna Boronat
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Experimental and Health Sciences, University Pompeu Fabra, Barcelona, Spain
| | - Klaus Langohr
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Statistics and Operations Research, Universitat Politècnica de Barcelona/Barcelonatech, Barcelona, Spain
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Experimental and Health Sciences, University Pompeu Fabra, Barcelona, Spain
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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Ter Mors B, Backx A, Spauwen P, Ponds R, Van Harten P, Van Heugten C. Efficacy of amantadine on behavioural problems due to acquired brain injury: A systematic review. Brain Inj 2019; 33:1137-1150. [DOI: 10.1080/02699052.2019.1631482] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- B.J. Ter Mors
- GGZ Oost-Brabant, Brain Injury Department Huize Padua, Boekel, The Netherlands
| | - A.P.M. Backx
- Adelante Rehabilitation Centre, Hoensbroek, The Netherlands
| | - P. Spauwen
- GGZ Oost-Brabant, Brain Injury Department Huize Padua, Boekel, The Netherlands
| | - R.W.H.M. Ponds
- Adelante Rehabilitation Centre, Hoensbroek, The Netherlands
- Limburg Brain Injury Center, Maastricht, The Netherlands
| | - P.N. Van Harten
- School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- GGz Centraal, Amersfoort, The Netherlands
| | - C.M. Van Heugten
- Limburg Brain Injury Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
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34
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Best W, Ping Sze W, Edmundson A, Nickels L. What counts as evidence? Swimming against the tide: Valuing both clinically informed experimentally controlled case series and randomized controlled trials in intervention research. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/17489539.2019.1597444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Wendy Best
- Language and Cognition, Division of Psychology and Language Sciences, University College London, London, UK
| | - Wei Ping Sze
- Language and Cognition, Division of Psychology and Language Sciences, University College London, London, UK
| | - Anne Edmundson
- Language and Cognition, Division of Psychology and Language Sciences, University College London, London, UK
| | - Lyndsey Nickels
- Australian Research Council Centre of Excellence in Cognition and Its Disorders, Macquarie University, Sydney, Australia
- Department of Cognitive Science, Macquarie University, Sydney, Australia
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35
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Normes de présentation de recherche utilisant les protocoles à cas unique en interventions comportementales (SCRIBE-2016). PRAT PSYCHOL 2019. [DOI: 10.1016/j.prps.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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36
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Tate RL, Perdices M, Rosenkoetter U, McDonald S, Togher L, Shadish W, Horner R, Kratochwill T, Barlow DH, Kazdin A, Sampson M, Shamseer L, Vohra S. Reprint of “The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016: Explanation and Elaboration”. PRAT PSYCHOL 2019. [DOI: 10.1016/j.prps.2019.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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37
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Ricketts EJ, Wu MS, Leman T, Piacentini J. A Review of Tics Presenting Subsequent to Traumatic Brain Injury. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2019; 6:145-158. [PMID: 31984203 DOI: 10.1007/s40474-019-00167-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose of review This review summarizes case reports of patients with tics emerging subsequent to traumatic brain injury (TBI), with respect to demographics, post-TBI symptoms, tic onset latency and topography, clinical history, neuroimaging results and treatment outcome. Recent findings Patients were 22 adults and 3 youth. Trauma onset appeared to fall mostly in adulthood. Two-thirds of patients were male and head trauma was related to motor vehicle accidents in most cases. Loss of consciousness was reported in just below half (48.0%) of cases. Associated physical and cognitive symptoms (e.g., impaired memory, reduced sensory perception, poor balance, muscle weakness, attention problems, aggression/impulsivity, obsessions and compulsions, depression and anxiety) were commonly reported. The latency between head trauma and tic onset varied, but generally ranged from one day post-trauma to approximately one year post-trauma. Sole presentation of motor tics was common, with rostral to caudal development of motor tics in other cases. Simple and/or complex vocal tics were present in several cases, often emerging after motor tics. Post-trauma obsessive-compulsive symptoms were noted in five cases (20.0%). A personal or family history of tics was reported in four cases. Damage to the basal ganglia, ventricular system, and temporal region was observed across ten patients (40.0%). Pharmacological intervention varied, with tic symptoms deemed to have significantly or somewhat improved in 12 cases (48.0%). A comparison of post-TBI symptoms in youth with head trauma history relative to those with peripheral injury suggests tic symptoms are not a common post-TBI symptom in youth. Summary Ultimately, there has been limited study on the link between traumatic brain injury and tic expression, and methodological issues preclude the ability to draw definitive conclusions regarding this relationship. Nevertheless, findings do suggest there may be heterogeneity in brain dysfunction associated with tic expression. Future case reports should utilize more systematic and thorough assessment of TBI and tics using validated measures, evaluate medication effects using single-case designs, and perform more longitudinal follow-up of cases with repeated neuroimaging.
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Affiliation(s)
- Emily J Ricketts
- Division of Child and Adolescent Psychiatry, University of California, Los Angeles, Los Angeles, CA, 90024
| | - Monica S Wu
- Division of Child and Adolescent Psychiatry, University of California, Los Angeles, Los Angeles, CA, 90024
| | - Talia Leman
- Division of Child and Adolescent Psychiatry, University of California, Los Angeles, Los Angeles, CA, 90024
| | - John Piacentini
- Division of Child and Adolescent Psychiatry, University of California, Los Angeles, Los Angeles, CA, 90024
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Tanious R, De TK, Michiels B, Van den Noortgate W, Onghena P. Assessing Consistency in Single-Case A-B-A-B Phase Designs. Behav Modif 2019; 44:518-551. [PMID: 30931585 DOI: 10.1177/0145445519837726] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous research has introduced several effect size measures (ESMs) to quantify data aspects of single-case experimental designs (SCEDs): level, trend, variability, overlap, and immediacy. In the current article, we extend the existing literature by introducing two methods for quantifying consistency in single-case A-B-A-B phase designs. The first method assesses the consistency of data patterns across phases implementing the same condition, called CONsistency of DAta Patterns (CONDAP). The second measure assesses the consistency of the five other data aspects when changing from baseline to experimental phase, called CONsistency of the EFFects (CONEFF). We illustrate the calculation of both measures for four A-B-A-B phase designs from published literature and demonstrate how CONDAP and CONEFF can supplement visual analysis of SCED data. Finally, we discuss directions for future research.
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Douglas J. Loss of friendship following traumatic brain injury: A model grounded in the experience of adults with severe injury. Neuropsychol Rehabil 2019; 30:1277-1302. [PMID: 30755079 DOI: 10.1080/09602011.2019.1574589] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Relationships make important contributions to wellbeing and maintenance of self-worth. For those who sustain traumatic brain injury (TBI), life is frequently characterized by declining interpersonal relationships. The aim of this study was to understand the post-injury experience of friendship from the perspective of adults with severe TBI. Participants were 23 adults who had sustained severe TBI on average 10 years earlier; the majority was between 25 and 45 years old. The experience of friendship was explored using a convergent mixed methods design (quantitative self-report measures and in-depth interviews). Qualitative analysis of interview transcripts employed open and focussed coding to reveal themes and categories. Participants nominated on average 3.35 (SD 2.19) friends. When paid carers and family members were excluded, the mean dropped to 1.52 (SD 1.38). Exploratory correlations between number of friends and quality of life, depression and strong-tie support revealed significant associations of moderate to large effects. The post-injury experience of friendship was broadly conceptualized as "going downhill" with four overlapping phases: losing contact, being misunderstood, wanting to share and hanging on. Participants' stories illustrated how rehabilitation can focus on friendship by supporting established relationships and facilitating access to activities that afford interpersonal encounters and opportunities to share experiences.
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Affiliation(s)
- Jacinta Douglas
- Living with Disability Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.,Summer Foundation, Melbourne, Australia.,NHMRC Centre of Research Excellence in Traumatic Brain Injury Psychosocial Rehabilitation, Canberra, Australia
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Allen JL, Ting LH, Kesar TM. Gait Rehabilitation Using Functional Electrical Stimulation Induces Changes in Ankle Muscle Coordination in Stroke Survivors: A Preliminary Study. Front Neurol 2018; 9:1127. [PMID: 30619077 PMCID: PMC6306420 DOI: 10.3389/fneur.2018.01127] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 12/07/2018] [Indexed: 11/23/2022] Open
Abstract
Background: Previous studies have demonstrated that post-stroke gait rehabilitation combining functional electrical stimulation (FES) applied to the ankle muscles during fast treadmill walking (FastFES) improves gait biomechanics and clinical walking function. However, there is considerable inter-individual variability in response to FastFES. Although FastFES aims to sculpt ankle muscle coordination, whether changes in ankle muscle activity underlie observed gait improvements is unknown. The aim of this study was to investigate three cases illustrating how FastFES modulates ankle muscle recruitment during walking. Methods: We conducted a preliminary case series study on three individuals (53–70 y; 2 M; 35–60 months post-stroke; 19–22 lower extremity Fugl-Meyer) who participated in 18 sessions of FastFES (3 sessions/week; ClinicalTrials.gov: NCT01668602). Clinical walking function (speed, 6-min walk test, and Timed-Up-and-Go test), gait biomechanics (paretic propulsion and ankle angle at initial-contact), and plantarflexor (soleus)/dorsiflexor (tibialis anterior) muscle recruitment were assessed pre- and post-FastFES while walking without stimulation. Results:Two participants (R1, R2) were categorized as responders based on improvements in clinical walking function. Consistent with heterogeneity of clinical and biomechanical changes commonly observed following gait rehabilitation, how muscle activity was altered with FastFES differed between responders. R1 exhibited improved plantarflexor recruitment during stance accompanied by increased paretic propulsion. R2 exhibited improved dorsiflexor recruitment during swing accompanied by improved paretic ankle angle at initial-contact. In contrast, the third participant (NR1), classified as a non-responder, demonstrated increased ankle muscle activity during inappropriate phases of the gait cycle. Across all participants, there was a positive relationship between increased walking speeds after FastFES and reduced SOL/TA muscle coactivation. Conclusion:Our preliminary case series study is the first to demonstrate that improvements in ankle plantarflexor and dorsiflexor muscle recruitment (muscles targeted by FastFES) accompanied improvements in gait biomechanics and walking function following FastFES in individuals post-stroke. Our results also suggest that inducing more appropriate (i.e., reduced) ankle plantar/dorsi-flexor muscle coactivation may be an important neuromuscular mechanism underlying improvements in gait function after FastFES training, suggesting that pre-treatment ankle muscle status could be used for inclusion into FastFES. The findings of this case-series study, albeit preliminary, provide the rationale and foundations for larger-sample studies using similar methodology.
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Affiliation(s)
- Jessica L Allen
- Department of Chemical and Biomedical Engineering, West Virginia University, Morgantown, WV, United States
| | - Lena H Ting
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, United States.,Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, United States
| | - Trisha M Kesar
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, United States
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Giguère-Rancourt A, Plourde M, Doiron M, Langlois M, Dupré N, Simard M. Goal management training ® home-based approach for mild cognitive impairment in Parkinson's disease: a multiple baseline case report. Neurocase 2018; 24:276-286. [PMID: 30821637 DOI: 10.1080/13554794.2019.1583345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Approximately 30% of patients with Parkinson's disease experience mild cognitive impairment (PD-MCI), often affecting executive functions. Our objective was to assess tolerability, safety and preliminarily efficacy of Goal Management Training® (GMT) for PD-MCI. GMT was administered at home, for five weeks. Dysexecutive Questionnaire (DEX), Parkinson Disease Questionnaire (PDQ-39), Zoo Map Test and Dementia Rating Scale-II were administered before, one and four weeks after Adapted-GMT. Reliable Change Index (RCI) was calculated. One participant completed GMT with caregiver. Executive complaints decreased (DEX RCIs between -2.10 and -1.68), PDQ-39 was maintained (RCI = -0.18). Adapted-GMT seems safe for PD-MCI, but efficacy remains doubtful.
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Affiliation(s)
- Ariane Giguère-Rancourt
- a School of Psychology , Laval University , Quebec City , Canada.,b Centre de Recherche CERVO , Institut de Recherche en Santé Mentale de Québec , Quebec City , Canada
| | - Marika Plourde
- a School of Psychology , Laval University , Quebec City , Canada.,b Centre de Recherche CERVO , Institut de Recherche en Santé Mentale de Québec , Quebec City , Canada
| | - Maxime Doiron
- a School of Psychology , Laval University , Quebec City , Canada.,b Centre de Recherche CERVO , Institut de Recherche en Santé Mentale de Québec , Quebec City , Canada.,c Department of Medicine, Faculty of Medicine , Laval University , Québec , Canada.,d Axe Neurosciences du CHU de Québec , Université Laval , Québec , QC , Canada
| | - Mélanie Langlois
- c Department of Medicine, Faculty of Medicine , Laval University , Québec , Canada.,d Axe Neurosciences du CHU de Québec , Université Laval , Québec , QC , Canada
| | - Nicolas Dupré
- c Department of Medicine, Faculty of Medicine , Laval University , Québec , Canada.,d Axe Neurosciences du CHU de Québec , Université Laval , Québec , QC , Canada
| | - Martine Simard
- a School of Psychology , Laval University , Quebec City , Canada.,b Centre de Recherche CERVO , Institut de Recherche en Santé Mentale de Québec , Quebec City , Canada
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Ernst A, Delrue G, Willems S. Overcoming familiarity illusions in a single case with persistent déjà vu. Memory 2018; 29:869-883. [PMID: 30136891 DOI: 10.1080/09658211.2018.1510965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
While occasional déjà vu is benign in the general population, rare neuropsychological cases with persistent déjà vu have been described in the literature. We report the case of MN, a 25-year-old woman, who suffered a cerebral haemorrhage in the right thalamo-callosal region and experienced recurrent déjà vu episodes. Through clinical interviews and memory tasks related to déjà vu, we assumed that source memory errors and an inappropriate feeling of familiarity (measured by the number of false recognitions) were critically involved in MN's déjà vu. Based on this, we developed the first neuropsychological intervention dedicated to déjà vu. The rationale was to train MN to detect elements that could produce an inappropriate feeling of familiarity and to promote metacognitive awareness about déjà vu. This intervention was effective at reducing the frequency of déjà vu episodes in MN's daily life, as well as the number of false recognitions in memory tasks. In addition to its clinical contribution, this single-case study contributes to the limited literature on patients whose déjà vu is not related to epileptic abnormalities and medial temporal brain damage, and provide supportive evidence of the role of an erroneous feeling of familiarity and of metacognitive processes in déjà vu.
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Affiliation(s)
- Alexandra Ernst
- Department of Psychology, Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liege, Belgium
| | - Gaël Delrue
- Unité de revalidation neuropsychologique de l'Adulte - CHU de Liège, Liege, Belgium
| | - Sylvie Willems
- Psychological and Speech Therapy Consultation Centre (CPLU), University of Liège, Liege, Belgium
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Schrijnemaekers ACMC, Winkens I, Rasquin SMC, Verhaeg A, Ponds RWHM, van Heugten CM. Effectiveness and feasibility of Socratic feedback to increase awareness of deficits in patients with acquired brain injury: Four single-case experimental design (SCED) studies. Neuropsychol Rehabil 2018; 30:591-612. [PMID: 29956557 DOI: 10.1080/09602011.2018.1485110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To investigate the effectiveness and feasibility of a Socratic feedback programme to improve awareness of deficits in patients with acquired brain injury (ABI). SETTING Rehabilitation centre. PARTICIPANTS Four patients with ABI with awareness problems. DESIGN A series of single-case experimental design studies with random intervention starting points (A-B + maintenance design). MAIN MEASURES Rate of trainer-feedback and self-control behaviour on everyday tasks, patient competency rating scale (PCRS), self-regulating skills interview (SRSI), hospital anxiety and depression scale. RESULTS All patients needed less trainer feedback, the change was significant in 3 out of 4. One patient increased in overt self-corrective behaviour. SRSI performance increased in all patients (medium to strong effect size), and PCRS performance increased in two patients (medium and strong effect size). Mood and anxiety levels were elevated in one patient at the beginning of the training and decreased to normal levels at the end of the training. The feasibility of the programme was scored 9 out of 10. CONCLUSIONS The Socratic feedback method is a promising intervention for improving awareness of deficits in patients with ABI. Controlled studies with larger populations are needed to draw more solid conclusions about the effect of this method.
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Affiliation(s)
- Anne-Claire M C Schrijnemaekers
- Department of Brain Injury Rehabilitation, Adelante Rehabilitation Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Ieke Winkens
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Sascha M C Rasquin
- Department of Brain Injury Rehabilitation, Adelante Rehabilitation Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands.,Department of Rehabilitation Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Hoensbroek, Netherlands
| | - Annette Verhaeg
- Department of Brain Injury Rehabilitation, Adelante Rehabilitation Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Rudolf W H M Ponds
- Department of Brain Injury Rehabilitation, Adelante Rehabilitation Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands.,Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Hoensbroek, Netherlands.,Department of Medical Psychology, Maastricht University Medical Centre, Hoensbroek, Netherlands
| | - Caroline M van Heugten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Hoensbroek, Netherlands
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44
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Lee JB, Sohlberg MM, Harn B, Horner R, Cherney LR. Attention Process Training-3 to improve reading comprehension in mild aphasia: A single-case experimental design study. Neuropsychol Rehabil 2018; 30:430-461. [DOI: 10.1080/09602011.2018.1477683] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Jaime B. Lee
- Communication Sciences and Disorders, James Madison University, Harrisonburg, VA, USA
| | | | - Beth Harn
- Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - Robert Horner
- Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - Leora R. Cherney
- Shirley Ryan AbilityLab, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Manolov R, Solanas A. Quantifying differences between conditions in single-case designs: Possible analysis and meta-analysis. Dev Neurorehabil 2018; 21:238-252. [PMID: 26809851 DOI: 10.3109/17518423.2015.1100688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The current paper is a call for and illustration of a way of closing the gap between basic research and professional practice in the field of neurorehabilitation. Methodologically, single-case experimental designs and the guidelines created regarding their conduct are highlighted. Statistically, we review two data analytical options, namely (a) indices quantifying the difference between pairs of conditions in the same metric as the target behavior and (b) a formal statistical procedure offering a standardized overall quantification. The paper provides guidance in the analysis and suggests free software in order to illustrate, in the context of data from behavioral interventions with children with developmental disorders, that informative analyses are feasible. We also show how the results of individual studies can be made eligible for meta-analyses, which are useful for establishing the evidence basis of interventions. Nevertheless, we also point at decisions that need to be made during the process of data analysis.
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Affiliation(s)
- Rumen Manolov
- a Department of Behavioral Sciences Methods , University of Barcelona , Barcelona , Spain.,b Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona , Barcelona , Spain
| | - Antonio Solanas
- a Department of Behavioral Sciences Methods , University of Barcelona , Barcelona , Spain.,b Institute for Brain, Cognition and Behavior (IR3C), University of Barcelona , Barcelona , Spain
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46
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Wren Y, Harding S, Goldbart J, Roulstone S. A systematic review and classification of interventions for speech-sound disorder in preschool children. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:446-467. [PMID: 29341346 DOI: 10.1111/1460-6984.12371] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 12/06/2017] [Accepted: 12/08/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Multiple interventions have been developed to address speech sound disorder (SSD) in children. Many of these have been evaluated but the evidence for these has not been considered within a model which categorizes types of intervention. The opportunity to carry out a systematic review of interventions for SSD arose as part of a larger scale study of interventions for primary speech and language impairment in preschool children. AIMS To review systematically the evidence for interventions for SSD in preschool children and to categorize them within a classification of interventions for SSD. METHODS & PROCEDURES Relevant search terms were used to identify intervention studies published up to 2012, with the following inclusion criteria: participants were aged between 2 years and 5 years, 11 months; they exhibited speech, language and communication needs; and a primary outcome measure of speech was used. Studies that met inclusion criteria were quality appraised using the single case experimental design (SCED) or PEDro-P, depending on their methodology. Those judged to be high quality were classified according to the primary focus of intervention. OUTCOMES & RESULTS The final review included 26 studies. Case series was the most common research design. Categorization to the classification system for interventions showed that cognitive-linguistic and production approaches to intervention were the most frequently reported. The highest graded evidence was for three studies within the auditory-perceptual and integrated categories. CONCLUSIONS & IMPLICATIONS The evidence for intervention for preschool children with SSD is focused on seven out of 11 subcategories of interventions. Although all the studies included in the review were good quality as defined by quality appraisal checklists, they mostly represented lower-graded evidence. Higher-graded studies are needed to understand clearly the strength of evidence for different interventions.
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Affiliation(s)
- Yvonne Wren
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, UK
- Faculty of Health Sciences, University of Bristol, UK
| | - Sam Harding
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, UK
| | - Juliet Goldbart
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, UK
| | - Sue Roulstone
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, UK
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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Selanikyo E, Weintraub N, Yalon-Chamovitz S. Effectiveness of the Co-PID for Students With Moderate Intellectual Disability. Am J Occup Ther 2018; 72:7202205090p1-7202205090p10. [PMID: 29426387 DOI: 10.5014/ajot.2018.024109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We aimed to corroborate the effectiveness of the Collaborative Consultation for Participation of Students With Intellectual Disability (Co-PID), intended for enhancing participation in classroom-related activities. METHOD The study took place in two special education schools and included students with moderate intellectual and developmental disabilities ages 7-20 yr. The schools were randomly assigned to intervention (Co-PID; n = 28 students, n = 4 teachers) and control (In-Service [IS]; n = 32 students, n = 7 teachers) groups. Participation was evaluated at pre- and posttest of an 8-mo intervention. RESULTS The Co-PID improved students' ability to choose among provided options. Additionally, the Co-PID group achieved more goals (measured by goal attainment scaling) than the IS group in all participation areas, and their enhanced participation transferred to other school environments (as measured by the School Function Assessment). CONCLUSION The Co-PID was found to be an effective program for enhancing classroom and school participation.
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Affiliation(s)
- Efrat Selanikyo
- Efrat Selanikyo, PhD, is Lecturer, Department of Occupational Therapy, Faculty of Health Professions, Ono Academic College, Kiryat Ono, Israel
| | - Naomi Weintraub
- Naomi Weintraub, PhD, is Head, Neurodevelopmental and Writing Research Laboratory, Hadassah School of Occupational Therapy, Hebrew University, Jerusalem, Israel
| | - Shira Yalon-Chamovitz
- Shira Yalon-Chamovitz, PhD, OTR, is Dean of Students, Ono Academic College, Kiryat Ono, Israel;
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Krasny-Pacini A, Evans J. Single-case experimental designs to assess intervention effectiveness in rehabilitation: A practical guide. Ann Phys Rehabil Med 2017; 61:164-179. [PMID: 29253607 DOI: 10.1016/j.rehab.2017.12.002] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/29/2017] [Accepted: 12/10/2017] [Indexed: 11/15/2022]
Abstract
Single-case experimental designs (SCED) are experimental designs aiming at testing the effect of an intervention using a small number of patients (typically one to three), using repeated measurements, sequential (±randomized) introduction of an intervention and method-specific data analysis, including visual analysis and specific statistics. The aim of this paper is to familiarise professionals working in different fields of rehabilitation with SCEDs and provide practical advice on how to design and implement a SCED in clinical rehabilitation practice. Research questions suitable for SCEDs and the different types of SCEDs (e.g., alternating treatment designs, introduction/withdrawal designs and multiple baseline designs) are reviewed. Practical steps in preparing a SCED design are outlined. Examples from different rehabilitation domains are provided throughout the paper. Challenging issues such as the choice of the repeated measure, assessment of generalisation, randomization, procedural fidelity, replication and generalizability of findings are discussed. Simple rules and resources for data analysis are presented. The utility of SCEDs in physical and rehabilitation medicine (PRM) are discussed.
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Affiliation(s)
- Agata Krasny-Pacini
- Institut universitaire de réadaptation Clemenceau-Strasbourg, 45, boulevard Clemenceau, 67082 Strasbourg, France; Service de chirurgie orthopédique infantile, hôpital de Hautepierre, CHU de Strasbourg, avenue Molière, 67098 Strasbourg, France; GRC handicap cognitif et réadaptation (HanCRe), hôpitaux universitaires Pitié-Salpêtière, 75013 Paris, France.
| | - Jonathan Evans
- Institute of Health and Wellbeing, University of Glasgow, The Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, United Kingdom
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One by One: Accumulating Evidence by using Meta-Analytical Procedures for Single-Case Experiments. BRAIN IMPAIR 2017. [DOI: 10.1017/brimp.2017.25] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper presents a unilevel and multilevel approach for the analysis and meta-analysis of single-case experiments (SCEs). We propose a definition of SCEs and derive the specific features of SCEs’ data that have to be taken into account when analysing and meta-analysing SCEs. We discuss multilevel models of increasing complexity and propose alternative and complementary techniques based on probability combining and randomisation test wrapping. The proposed techniques are demonstrated with real-life data and corresponding R code.
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50
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Analytical Options for Single-Case Experimental Designs: Review and Application to Brain Impairment. BRAIN IMPAIR 2017. [DOI: 10.1017/brimp.2017.17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Single-case experimental designs meeting evidence standards are useful for identifying empirically-supported practices. Part of the research process entails data analysis, which can be performed both visually and numerically. In the current text, we discuss several statistical techniques focusing on the descriptive quantifications that they provide on aspects such as overlap, difference in level and in slope. In both cases, the numerical results are interpreted in light of the characteristics of the data as identified via visual inspection. Two previously published data sets from patients with traumatic brain injury are re-analysed, illustrating several analytical options and the data patterns for which each of these analytical techniques is especially useful, considering their assumptions and limitations. In order to make the current review maximally informative for applied researchers, we point to free user-friendly web applications of the analytical techniques. Moreover, we offer up-to-date references to the potentially useful analytical techniques not illustrated in the article. Finally, we point to some analytical challenges and offer tentative recommendations about how to deal with them.
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