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Nukari JM, Laasonen MR, Arkkila EP, Haapanen ML, Poutiainen ET. Goal attainment in individual and group-based neuropsychological interventions for young adults with dyslexia in a randomized controlled trial. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:1424-1434. [PMID: 36476247 DOI: 10.1080/23279095.2022.2137025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In this study, we investigated the outcome of goal attainment in individual and group-based neuropsychological intervention for young adults with dyslexia. Participants (N = 120) were randomly assigned to individual intervention, group intervention, or wait-list control group. Attainment of goals set personally before the intervention was evaluated after the intervention using Goal Attainment Scaling. The participants were asked to report the number of concrete changes made in their study or working habits at five months (after intervention or wait-list control time), at ten months, and 15 months post-interventions. Potential predictive factors for predicting goal attainment were evaluated including background and cognitive variables, self-reported psychological variables (mood, cognitive and behavioral strategies, self-esteem, quality of life), and self-reported behavioral variables (concrete changes made, time used to work on intervention matters). Based on the results, personal goals were, on average, met especially in individual intervention. Nearly 50% of goal attainment was explained by intervention type, behavioral and cognitive strategies, concrete changes made, cognitive capacity, and used time. Concrete changes, e.g., adopting new strategies and methods in study or working habits, were reported in both interventions and more than during the wait-list control period. The changes seemed long-lasting as fifteen months post-intervention, 76.4% reported still using the learned strategies. A structured and relatively short neuropsychological intervention for dyslexia in either individual or group format can lead to attaining pre-set personal goals and positive behavioral changes that can last up to over a year post-intervention.
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Affiliation(s)
- Johanna M Nukari
- Rehabilitation Foundation, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marja R Laasonen
- Department of Logopedics, Philosophical Faculty, School of Humanities, University of Eastern Finland, Joensuu, Finland
| | - Eva P Arkkila
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Marja-Leena Haapanen
- Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Erja T Poutiainen
- Rehabilitation Foundation, Helsinki, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Goikoetxea-Sotelo G, van Hedel HJA. Reporting Completeness of Intensity-, Dose-, and Dosage-Related Items in Active Pediatric Upper Limb Neurorehabilitation Trials: A Systematic Review. Arch Phys Med Rehabil 2024; 105:1784-1792. [PMID: 38160897 DOI: 10.1016/j.apmr.2023.12.007] [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: 06/29/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To analyze the reporting completeness of the TIDieR items 8-12, in particular intensity, dose, and dosage, in active pediatric upper limb neurorehabilitation trials. DATA SOURCES We searched PubMed Central, Scopus, CINAHL, OTseeker, and Web of Science for eligible publications. STUDY SELECTION We included publications analyzing active pediatric upper limb neurorehabilitation interventions and assessed the reporting completeness of 11 items for each intervention and control group. DATA EXTRACTION Two raters independently screened titles and abstracts and selected the publications using the RYYAN platform. We unblinded the results after the raters had completed their selection and resolved the disagreements by discussion. We used the same procedures to review the full texts. DATA SYNTHESIS We included 52 randomized controlled trials with 65 intervention and 48 control groups. Authors did not report all 11 items in any of the study groups. The overall reporting completeness varied between 1% (intensity) to 95% (length of the intervention). The reporting completeness of the TIDieR items ranged from 2% (modifications) to 64% (when and how much). We found no significant differences in the reporting completeness between the intervention and control groups. CONCLUSIONS Information essential for dose-response calculations is often missing in randomized controlled trials of pediatric upper limb neurorehabilitation interventions. Reporting completeness should be improved, and new measures to accurately quantify intensity should be discussed and developed.
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Affiliation(s)
- Gaizka Goikoetxea-Sotelo
- Swiss Children's Rehab, University Children's Hospital Zurich, University of Zurich, Affoltern am Albis, Switzerland; Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Hubertus J A van Hedel
- Swiss Children's Rehab, University Children's Hospital Zurich, University of Zurich, Affoltern am Albis, Switzerland; Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.
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de Geus EQJ, Milders MV, van Horn JE, Jonker FA, Fassaert T, Hutten JC, Kuipers F, Grimbergen C, Noordermeer SDS. A literature review of outcome and treatment options after acquired brain injury: Suggestions for adult offenders using knowledge from the general population. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2024; 34:311-338. [PMID: 38527155 DOI: 10.1002/cbm.2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 03/05/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Acquired brain injury (ABI) is a major health problem, often with negative effects on behaviour and mental health as well as cognition. Prevalence of ABI is exceptionally high among offenders and increases their re-offending risk. Information on risk factors for ABI and its outcomes among offenders that could guide effective treatment for them is, nevertheless, scarce and dispersed. However, there is a more substantial literature about the general population that could inform work with brain-injured offenders, especially when selecting for samples or subgroups with similar relevant characteristics, such as lower socio-economic status (SES), pre-injury lower tested intelligence score (<85) and pre-injury mental health problems. AIMS To explore brain injury data from non-offender samples of otherwise similar socio-economic and mental health and ability characteristics to offenders then, first, to describe their untreated outcomes and, secondly, outcomes after frequently used interventions in these circumstances, noting factors associated with their effectiveness. METHOD Three databases were systematically searched for the years 2010-2022; first, using terms for brain injury or damage and cognitive (dys)function, mental health or quality of life. Second, in a separate search, we used these terms and terms for interventions and rehabilitation. In the second review, studies were selected for clear, distinguishable data on age, sex, SES and lifestyle factors to facilitate inferences for offenders. A narrative analytical approach was adopted for both reviews. RESULTS Samples with characteristics that are typical in offender groups, including lower SES, lower pre-injury intelligence quotient (<85), prior cognitive impairments and prior mental health problems, had poorer cognitive and behavioural outcomes following ABI than those without such additional problems, together with lower treatment adherence. With respect to treatment, adequate motivation and self-awareness were associated with better cognitive and behavioural outcomes than when these were low or absent, regardless of the outcome measured. CONCLUSIONS More complex pre-injury mental health problems and social disadvantages typical of offenders are associated with poorer post-brain injury recovery. This paper adds to practical knowledge by bringing together work that follows specific outcome trajectories. Overall, succesful ABI-interventions in the general population that aim at pre-injury difficulties comparable to those seen among offenders, show that personalising injury-specific treatments and taking account of these difficulties, maximised positive outcomes.
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Affiliation(s)
- Esther Q J de Geus
- Faculty of Behavioural Sciences, Department of Clinical Neuro- and Development Psychology, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maarten V Milders
- Faculty of Behavioural Sciences, Department of Clinical Neuro- and Development Psychology, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Frank A Jonker
- Faculty of Behavioural Sciences, Department of Clinical Neuro- and Development Psychology, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Altrecht, Vesalius, Amsterdam, The Netherlands
| | | | | | | | | | - Siri D S Noordermeer
- Faculty of Behavioural Sciences, Department of Clinical Neuro- and Development Psychology, Section of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Faria AL, Almeida Y, Branco D, Câmara J, Cameirão M, Ferreira L, Moreira A, Paulino T, Rodrigues P, Spinola M, Vilar M, Bermúdez i Badia S, Simões M, Fermé E. NeuroAIreh@b: an artificial intelligence-based methodology for personalized and adaptive neurorehabilitation. Front Neurol 2024; 14:1258323. [PMID: 38322797 PMCID: PMC10846403 DOI: 10.3389/fneur.2023.1258323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/21/2023] [Indexed: 02/08/2024] Open
Abstract
Cognitive impairments are a prevalent consequence of acquired brain injury, dementia, and age-related cognitive decline, hampering individuals' daily functioning and independence, with significant societal and economic implications. While neurorehabilitation represents a promising avenue for addressing these deficits, traditional rehabilitation approaches face notable limitations. First, they lack adaptability, offering one-size-fits-all solutions that may not effectively meet each patient's unique needs. Furthermore, the resource-intensive nature of these interventions, often confined to clinical settings, poses barriers to widespread, cost-effective, and sustained implementation, resulting in suboptimal outcomes in terms of intervention adaptability, intensity, and duration. In response to these challenges, this paper introduces NeuroAIreh@b, an innovative cognitive profiling and training methodology that uses an AI-driven framework to optimize neurorehabilitation prescription. NeuroAIreh@b effectively bridges the gap between neuropsychological assessment and computational modeling, thereby affording highly personalized and adaptive neurorehabilitation sessions. This approach also leverages virtual reality-based simulations of daily living activities to enhance ecological validity and efficacy. The feasibility of NeuroAIreh@b has already been demonstrated through a clinical study with stroke patients employing a tablet-based intervention. The NeuroAIreh@b methodology holds the potential for efficacy studies in large randomized controlled trials in the future.
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Affiliation(s)
- Ana Lúcia Faria
- Department of Psychology, Faculty of Arts and Humanities, University of Madeira, Funchal, Portugal
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
| | - Yuri Almeida
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Diogo Branco
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Joana Câmara
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Mónica Cameirão
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Luis Ferreira
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - André Moreira
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Teresa Paulino
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Pedro Rodrigues
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Mónica Spinola
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
| | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Sergi Bermúdez i Badia
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Mario Simões
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Eduardo Fermé
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
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Vuori O, Kallio EL, Wikström A, Jokinen H, Hietanen M. Web-based psychoeducational interventions for managing cognitive impairment-a systematic review. Front Neurol 2023; 14:1249995. [PMID: 37780726 PMCID: PMC10535106 DOI: 10.3389/fneur.2023.1249995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Objective Web-based rehabilitation, a branch of telerehabilitation, is carried out over the internet, unrestricted by time or place. Even though web-based interventions have been reported as feasible and effective in cases of mood disorders, for example, such evidence on the effectiveness of web-based cognitive rehabilitation remains unclear. This systematic review summarizes current knowledge on web-based psychoeducational programs aiming to manage cognitive deficits in patients with diseases that affect cognition. Methods Using the Ovid database and the Web of Science, we systematically searched the Cochrane Database of Systematic Reviews, Medline, and PsycINFO to identify eligible studies. The review protocol (CRD42021257315) was pre-registered with the PROSPERO International Prospective Register of Systematic Reviews. The search was performed 10/13/2022. Two reviewers independently screened titles, abstracts, and full-texts, and extracted data for the selected studies. Two independent reviewers assessed the methodological quality. Results The search retrieved 6,487 articles. Four studies with different patient groups (stroke, traumatic brain injury, brain tumor, and cancer) met the inclusion criteria of this systematic review. The studies examined systematic cognition-focused psychoeducational rehabilitation programs in which the patient worked independently. Three studies found positive effects on subjective cognitive functions, executive functions, and self-reported memory. No effects were found on objective cognitive functions. However, the studies had methodological weaknesses (non-randomized designs, small sample sizes, vaguely described interventions). Overall, adherence and patient satisfaction were good/excellent. Conclusion Web-based cognitive intervention programs are a new approach to rehabilitation and patient education. The evidence, although scarce, shows that web-based interventions are feasible and support subjective cognitive functioning. However, the literature to date is extremely limited and the quality of the studies is weak. More research with high-quality study designs is needed. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=257315, identifier: CRD42021257315.
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Affiliation(s)
- Outi Vuori
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Division of Neuropsychology, HUS Neurocenter, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Eeva-Liisa Kallio
- Division of Neuropsychology, HUS Neurocenter, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Annamaria Wikström
- Division of Neuropsychology, HUS Neurocenter, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Jokinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Division of Neuropsychology, HUS Neurocenter, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Marja Hietanen
- Division of Neuropsychology, HUS Neurocenter, Helsinki University and Helsinki University Hospital, Helsinki, Finland
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Gibson E, Koh CL, Eames S, Bennett S, Scott AM, Hoffmann TC. Occupational therapy for cognitive impairment in stroke patients. Cochrane Database Syst Rev 2022; 3:CD006430. [PMID: 35349186 PMCID: PMC8962963 DOI: 10.1002/14651858.cd006430.pub3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Cognitive impairment is a frequent consequence of stroke and can impact on a person's ability to perform everyday activities. Occupational therapists use a range of interventions when working with people who have cognitive impairment poststroke. This is an update of a Cochrane Review published in 2010. OBJECTIVES To assess the impact of occupational therapy on activities of daily living (ADL), both basic and instrumental, global cognitive function, and specific cognitive abilities in people who have cognitive impairment following a stroke. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, four other databases (all last searched September 2020), trial registries, and reference lists. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials that evaluated an intervention for adults with clinically defined stroke and confirmed cognitive impairment. The intervention needed either to be provided by an occupational therapist or considered within the scope of occupational therapy practice as defined in the review. We excluded studies focusing on apraxia or perceptual impairments or virtual reality interventions as these are covered by other Cochrane Reviews. The primary outcome was basic activities of daily living (BADL) such as dressing, feeding, and bathing. Secondary outcomes were instrumental ADL (IADL) (e.g. shopping and meal preparation), community integration and participation, global cognitive function and specific cognitive abilities (including attention, memory, executive function, or a combination of these), and subdomains of these abilities. We included both observed and self-reported outcome measures. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies that met the inclusion criteria, extracted data, and assessed the certainty of the evidence. A third review author moderated disagreements if consensus was not reached. We contacted trial authors for additional information and data, where available. We assessed the certainty of key outcomes using GRADE. MAIN RESULTS: We included 24 trials from 11 countries involving 1142 (analysed) participants (two weeks to eight years since stroke onset). This update includes 23 new trials in addition to the one study included in the previous version. Most were parallel randomised controlled trials except for one cross-over trial and one with a two-by-two factorial design. Most studies had sample sizes under 50 participants. Twenty studies involved a remediation approach to cognitive rehabilitation, particularly using computer-based interventions. The other four involved a compensatory and adaptive approach. The length of interventions ranged from 10 days to 18 weeks, with a mean total length of 19 hours. Control groups mostly received usual rehabilitation or occupational therapy care, with a few receiving an attention control that was comparable to usual care; two had no intervention (i.e. a waiting list). Apart from high risk of performance bias for all but one of the studies, the risk of bias for other aspects was mostly low or unclear. For the primary outcome of BADL, meta-analysis found a small effect on completion of the intervention with a mean difference (MD) of 2.26 on the Functional Independence Measure (FIM) (95% confidence interval (CI) 0.17 to 4.22; P = 0.03, I2 = 0%; 6 studies, 336 participants; low-certainty evidence). Therefore, on average, BADL improved by 2.26 points on the FIM that ranges from 18 (total assist) to 126 (complete independence). On follow-up, there was insufficient evidence of an effect at three months (MD 10.00, 95% CI -0.54 to 20.55; P = 0.06, I2 = 53%; 2 studies, 73 participants; low-certainty evidence), but evidence of an effect at six months (MD 11.38, 95% CI 1.62 to 21.14, I2 = 12%; 2 studies, 73 participants; low-certainty evidence). These differences are below 22 points which is the established minimal clinically important difference (MCID) for the FIM for people with stroke. For IADL, the evidence is very uncertain about an effect (standardised mean difference (SMD) 0.94, 95% CI 0.41 to 1.47; P = 0.0005, I2 = 98%; 2 studies, 88 participants). For community integration, we found insufficient evidence of an effect (SMD 0.09, 95% CI -0.35 to 0.54; P = 0.68, I2 = 0%; 2 studies, 78 participants). There was an improvement of clinical importance in global cognitive functional performance after the intervention (SMD 0.35, 95% CI 0.16 to 0.54; P = 0.0004, I2 = 0%; 9 studies, 432 participants; low-certainty evidence), equating to 1.63 points on the Montreal Cognitive Assessment (MoCA) (95% CI 0.75 to 2.52), which exceeds the anchor-based MCID of the MoCA for stroke rehabilitation patients of 1.22. We found some effect for attention overall (SMD -0.31, 95% CI -0.47 to -0.15; P = 0.0002, I2 = 20%; 13 studies, 620 participants; low-certainty evidence), equating to a difference of 17.31 seconds (95% CI 8.38 to 26.24), and for executive functional performance overall (SMD 0.49, 95% CI 0.31 to 0.66; P < 0.00001, I2 = 74%; 11 studies, 550 participants; very low-certainty evidence), equating to 1.41 points on the Frontal Assessment Battery (range: 0-18). Of the cognitive subdomains, we found evidence of effect of possible clinical importance, immediately after intervention, for sustained visual attention (moderate certainty) equating to 15.63 seconds, for working memory (low certainty) equating to 59.9 seconds, and thinking flexibly (low certainty), compared to control. AUTHORS' CONCLUSIONS The effectiveness of occupational therapy for cognitive impairment poststroke remains unclear. Occupational therapy may result in little to no clinical difference in BADL immediately after intervention and at three and six months' follow-up. Occupational therapy may slightly improve global cognitive performance of a clinically important difference immediately after intervention, likely improves sustained visual attention slightly, and may slightly increase working memory and flexible thinking after intervention. There is evidence of low or very low certainty or insufficient evidence for effect on other cognitive domains, IADL, and community integration and participation. Given the low certainty of much of the evidence in our review, more research is needed to support or refute the effectiveness of occupational therapy for cognitive impairment after stroke. Future trials need improved methodology to address issues including risk of bias and to better report the outcome measures and interventions used.
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Affiliation(s)
- Elizabeth Gibson
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Chia-Lin Koh
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Sally Eames
- Community and Oral Health Innovation and Research Centre, Metro North Hospital and Health Service, Brisbane, Australia
| | - Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
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Small R, Wilson PH, Wong D, Rogers JM. Who, what, when, where, why, and how: a systematic review of the quality of post-stroke cognitive rehabilitation protocols. Ann Phys Rehabil Med 2021; 65:101623. [PMID: 34933125 DOI: 10.1016/j.rehab.2021.101623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 11/01/2021] [Accepted: 11/28/2021] [Indexed: 10/18/2022]
Abstract
BACKGROUND . Rehabilitation research findings are not routinely incorporated into clinical practice. A key barrier is the quality of reporting in the original study, including who provided the intervention, what it entailed, when and where it occurred, how patient outcomes were monitored, and why the intervention was efficacious. OBJECTIVES . To facilitate clinical implementation of post-stroke cognitive rehabilitation research, we undertook a review to examine the quality of intervention reporting in this literature. METHODS . Four databases were systematically searched, identifying 27 randomised controlled trials of post-stroke cognitive rehabilitation. The quality of intervention protocol descriptions in each study was independently rated by 2 of the authors using the 12-item Template for Intervention Description and Replication (TIDieR) checklist. RESULTS .Why, when, and where items were reported in more than 70% of interventions, what materials and procedures used was described in 50% to 70%, how items were described in approximately half of the interventions, and who provided interventions was reported in 22% of studies. No study addressed all 12 TIDieR items. "Active ingredients" that may further characterise an intervention and the potential mechanisms of action included restorative training, massed practice, feedback, and tailoring demands (present in approximately 50% of studies). CONCLUSIONS . Descriptions of intervention protocols are variable and frequently insufficient, thereby restricting the ability to understand, replicate, and implement evidence-based cognitive rehabilitation. Use of reporting checklists to address this barrier to research translation is a readily achievable and effective means to advance post-stroke care.
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Affiliation(s)
- Rebecca Small
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Peter H Wilson
- Centre for Disability and Development Research, Australian Catholic University, Australia
| | - Dana Wong
- School of Psychology & Public Health, La Trobe University, Bundoora, Australia
| | - Jeffrey M Rogers
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; neuroCare Group, Sydney, Australia.
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Adamit T, Shames J, Rand D. Effectiveness of the Functional and Cognitive Occupational Therapy (FaC oT) Intervention for Improving Daily Functioning and Participation of Individuals with Mild Stroke: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7988. [PMID: 34360299 PMCID: PMC8345490 DOI: 10.3390/ijerph18157988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Mild stroke can cause subtle cognitive-behavioral symptoms, which although might be hidden, can restrict community reintegration and participation. Cognitive rehabilitation programs exist for stroke but not specifically for mild stroke and the research evidence varies. The Functional and Cognitive Occupational Therapy (FaCoT) intervention was developed specifically for this population. OBJECTIVE To examine the effectiveness of FaCoT intervention for improving daily functioning and participation compared with standard care. METHOD A single blind randomized controlled trial with assessments pre (T1), post (T2) and 3-month follow-up (T3). Individuals in the FaCoT group received 10 weekly sessions practicing cognitive and behavioral strategies. The Canadian Occupational Performance Measure (COPM) was the primary outcome measure, IADL-questionnaire, Reintegration to Normal Living questionnaire (RNL) were secondary measures. RESULTS In total, 66 community-dwelling individuals with mild stroke were randomly allocated to FaCoT (n = 33, mean (SD) age 64.6 (8.2), 33% women), or control group (n = 33, mean (SD) age 64.4 (10.8), 45% women). Time X Group interaction effects were found for the COPM performance (F(1.4,90.3) = 11.75, p < 0.000) and satisfaction (F(1.5,96.8) = 15.70, p < 0.000), with large effect size values. Significant between-group effects were found for RNL (F = 10.02, p < 0.002, ɳP2 = 0.13). Most participants in FaCoT achieved a clinically important difference in COPM between T1-T2, T1-T3, and in RNL between T1 to T3 compared with the control group. CONCLUSIONS FaCoT intervention is effective to improve daily functioning, participation and satisfaction of individuals with mild stroke compared with standard care, therefore FaCoT should be implemented in community rehabilitation settings.
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Affiliation(s)
- Tal Adamit
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel
- Maccabi Health-Care Services, Tel-Aviv 6812509, Israel;
| | | | - Debbie Rand
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv 6997801, Israel
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Banerjee M, Hegde S, Thippeswamy H, Kulkarni GB, Rao N. In search of the 'self': Holistic rehabilitation in restoring cognition and recovering the 'self' following traumatic brain injury: A case report. NeuroRehabilitation 2021; 48:231-242. [PMID: 33664160 DOI: 10.3233/nre-208017] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Following mild-moderate traumatic brain injury (TBI), an individual experiences a range of emotional changes. It is often difficult for the patient to reconcile with their post-injury persona, and the memory of pre-injury personhood is particularly painful. Insight into one's cognitive deficits subsequent to injury can lead to an existential crisis and a sense of loss, including loss of self. OBJECTIVE Restoration of cognitive functions and reconciliation with loss of pre-traumatic personhood employing a holistic method of neuropsychological rehabilitation in a patient suffering from TBI. METHODS Ms. K.S, a 25-year-old female, presented with emotional disturbances following TBI. She reported both retrograde and anterograde amnesia. A multidimensional holistic rehabilitation was planned. Treatment addressed cognitive deficits through the basic functions approach. Cognitive behavioural methods for emotional regulation like diary writing helped reduce irritability and anger outbursts. Use of social media created new modes of memory activation and interactions. Compensatory strategies were used to recover lost skills, music-based attention training helped foster an individualised approach to the sense of one's body and self. RESULTS As a result of these differing strategies, changes were reflected in neuro-psychological tests, depression score and the patient's self-evaluation. This helped generate a coherent self-narrative. CONCLUSION Treatment challenges in such cases are increased due to patient's actual deficits caused by neuronal/biochemical changes. Innovative and multi-pronged rehabilitation strategies which involve everyday activities provided an answer to some of these problems. This method of rehabilitation may provide an optimistic context for future research.
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Affiliation(s)
- Meenakshi Banerjee
- Neuropsychology and Cognitive Neuroscience Centre, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Shantala Hegde
- Neuropsychology and Cognitive Neuroscience Centre, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India.,Associate Professor and Wellcome DBT India Alliance Intermediate Fellow, Clinical Neuropsychology and Cognitive Neuro Sciences Center, Music Cognition Laboratory, Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India.,Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Harish Thippeswamy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Girish B Kulkarni
- Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - Narasinga Rao
- Department of Surgery, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
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10
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Exner C, Doering BK, Conrad N, Künemund A, Zwick S, Kühl K, Nestler S, Rief W. Integrated neuropsychological and cognitive behavioural therapy after acquired brain injury: A pragmatic randomized clinical trial. Neuropsychol Rehabil 2021; 32:1495-1529. [PMID: 33818305 DOI: 10.1080/09602011.2021.1908902] [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: 10/21/2022]
Abstract
After acquired brain injury (ABI) many patients suffer from persistent cognitive and emotional disturbances. The aim of this study was to investigate the treatment outcome of an integrated intervention, combining neuropsychological and cognitive behavioural therapy (nCBT), against waitlist (WL) in outpatients with ABI. Individuals seeking outpatient treatment for cognitive and emotional problems after ABI were randomly allocated to nCBT (n = 27) or WL (n = 29) and completed assessments at baseline, post-treatment/WL and at six-month follow-up. The primary outcome measures were general psychopathology and functional activity in daily life. The nCBT group showed significant improvement for general psychopathology post-treatment when compared to WL. nCBT was also superior to WL regarding the secondary outcomes, i.e., the reduction of negative affect and the improvement of quality of life. No significant differences for functional activity and community integration were observed. Significant pre-post effect sizes ranged between small for functional activity and medium for quality of life. The positive effects were maintained at follow-up. The majority of patients with cognitive and emotional problems after ABI benefit from an integrated approach that offers cognitive remediation and psychotherapy. However, the heterogeneous sequelae of ABI and the moderate sample sizes in clinical trials present a methodological challenge to ABI research.
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Affiliation(s)
- Cornelia Exner
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany.,Department of Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Bettina K Doering
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany.,Department of Clinical and Biological Psychology, University of Eichstaett-Ingolstadt, Ingolstadt, Germany
| | - Nico Conrad
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Anna Künemund
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Sarah Zwick
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Kerstin Kühl
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Steffen Nestler
- Department of Statistics and Psychological Methods, University of Muenster, Muenster, Germany
| | - Winfried Rief
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
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11
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Mitchell E, Philips N, Ahern E, McGettrick G, Mockler D, Fitzpatrick K, Trepel D. The effectiveness of community neurorehabilitation for persons with an acquired brain injury: protocol for a systematic review. HRB Open Res 2021. [DOI: 10.12688/hrbopenres.13196.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Acquired brain injury (ABI) refers to any type of brain damage after birth. ABI from either traumatic or non-traumatic origin is a leading cause of death and long-term disability globally. The impact of an ABI can be cognitive and/ or physical, greatly affecting their ability to function independently. With a lack of specialist inpatient rehabilitation facilities and services many of these survivors reside within the community either alone, with family or in residential facilities. Up-to-date evidence is required to indicate which forms of community rehabilitation are most effective in improving cognitive and physical outcomes for survivors. This systematic review aims to explore the clinical effectiveness of community neuro-rehabilitation services for persons living with an ABI. Methods: A systematic review of relevant electronic databases will be undertaken to identify eligible published randomised controlled trials. The PRISMA statement will be used to guide the systematic review. From running the initial search, we aim to submit the paper for publishing within 6 months. This process will be completed using Covidence software. Two reviewers will independently screen the search results and select studies using pre-defined selection criteria, extract data from and assess risk of bias for selected studies. Discussion: This systematic review will aim to explore the clinical effectiveness of community neuro-rehabilitation services for persons with an ABI. It plans to review and synthesize the current best available evidence base. A goal of this study is to positively inform ongoing service development within a quality framework. Systematic review registration: PROSPERO CRD42020148604 (26/02/2020)
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12
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Behn N, Francis J, Togher L, Hatch E, Moss B, Hilari K. Description and Effectiveness of Communication Partner Training in TBI: A Systematic Review. J Head Trauma Rehabil 2021; 36:56-71. [PMID: 32472837 DOI: 10.1097/htr.0000000000000580] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the current evidence on communication partner training and its effectiveness on outcomes for people with traumatic brain injury (TBI) and/or their communication partners. METHODS Information sources: Systematic searches of 9 databases (AMED, CINAHL, EMBASE, Medline/EBSCOHOST, PsycINFO, PsycBITE, PsycARTICLES, PubMed, and Scopus) from database inception to February 2019. Eligibility criteria: Empirical studies on interventions for adult communication partners where the primary focus of the program (>50%) was on improving communication skills of people with TBI and/or communication partners. Data: Participants, characteristics of the training, outcome measures, and findings. Risk of bias: Standard checklists were used for methodological quality (PEDro, ROBiN-T) and intervention description (TIDieR). Synthesis: Narrative synthesis and effect sizes (Cohen's d) for group-level studies. OUTCOMES Ten articles (describing 8 studies) met eligibility criteria: 3 randomized controlled trials, 2 nonrandomized controlled trials, and 3 single-case experimental designs. Studies included a total of 258 people with TBI and 328 communication partners; however, all but one study had fewer than 65 participants. Methodological quality varied and intervention description was poor. Three studies in the final synthesis (n = 41 communication partners, n = 36 people with TBI) reported positive intervention effects. Effect sizes in group studies were d = 0.80 to 1.13 for TBI and d = 1.16 to 2.09 for communication partners. CONCLUSIONS The articles provided encouraging, though limited, evidence for training communication partners. Greater methodological rigor, more clearly described interventions, and consistent use of outcome measures and follow-up after treatment are needed. Further research on this topic is warranted.
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Affiliation(s)
- Nicholas Behn
- Divisions of Language and Communication Science (Drs Behn, Moss, and Hilari and Ms Hatch) and Health Services Research and Management (Dr Francis), School of Health Sciences, City, University of London, England; and Speech Pathology, Faculty of Medicine and Health, The University of Sydney, Australia (Dr Togher)
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13
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Quality Appraisal of Systematic Reviews for Behavioral Treatments of Attention Disorders in Traumatic Brain Injury. J Head Trauma Rehabil 2020; 34:E42-E50. [PMID: 30499927 DOI: 10.1097/htr.0000000000000444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This review appraised the quality of systematic reviews (SRs) and meta-analyses (MAs) to summarize research on behavioral interventions for attention disorders in persons with traumatic brain injury. METHODS A search of 7 databases revealed 15 MAs/SRs reporting outcomes for attention treatments in traumatic brain injury. Two examiners independently coded the quality of reviews with the Critical Appraisal of Systematic Review or Meta-Analysis and the Evidence in Augmentative and Alternative Communication Systematic Review Scale. RESULTS The findings of both scales were highly correlated. Four reviews were conducted with high methodologic rigor indicated by a score of 60% or greater on both scales. No other study scored above 45%. Among the well-conducted SRs/MAs, evidence for direct attention training effects was limited to basic attention exercises, with little generalization to functional activities. Strategy training for activities and tasks requiring attentional abilities had a stronger evidence base in 1 rigorous MA. CONCLUSIONS This appraisal provides valuable practice information. The conclusions of 4 rigorous reviews suggest that there is only limited positive scientific support for the effects of attention treatments for traumatic brain injury. Future SRs/MAs would benefit from adherence to review guidelines.
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14
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Hokkanen L, Barbosa F, Ponchel A, Constantinou M, Kosmidis MH, Varako N, Kasten E, Mondini S, Lettner S, Baker G, Persson BA, Hessen E. Clinical Neuropsychology as a Specialist Profession in European Health Care: Developing a Benchmark for Training Standards and Competencies Using the Europsy Model? Front Psychol 2020; 11:559134. [PMID: 33123042 PMCID: PMC7573555 DOI: 10.3389/fpsyg.2020.559134] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/08/2020] [Indexed: 12/21/2022] Open
Abstract
The prevalence and negative impact of brain disorders are increasing. Clinical Neuropsychology is a specialty dedicated to understanding brain-behavior relationships, applying such knowledge to the assessment of cognitive, affective, and behavioral functioning associated with brain disorders, and designing and implementing effective treatments. The need for services goes beyond neurological diseases and has increased in areas of neurodevelopmental and psychiatric conditions, among others. In Europe, a great deal of variability exists in the education and training of Clinical Neuropsychologists. Training models include master’s programs, continuing education courses, doctoral programs, and/or post-doctoral specialization depending on the country, with no common framework of requirements, although patients’ needs demand equal competencies across Europe. In the past 5 years, the Standing Committee on Clinical Neuropsychology of the European Federation of Psychologists’ Association has conducted a series of surveys and interviews with experts in the field representing 30 European countries. The information, along with information from the existing literature, is used in presenting an overview of current and relevant topics related to policy and guidelines in the training and competencies in Clinical Neuropsychology. An option for the way forward is the EuroPsy Specialist Certificate, which is currently offered in Work and Organizational Psychology, and in psychotherapy. It builds upon the basic certificate and complements national standards without overriding them. General principles can be found that can set the basis for a common, solid, and comprehensive specialty education/training, sharpening the Neuropsychologists’ competencies across Europe. The requirements in Clinical Neuropsychology should be comparable to those for the existing specialty areas in the EuroPsy model. Despite the perceived challenges, developing a specialist certificate appears a step forward for the development of Clinical Neuropsychology. Recommendations are proposed toward a shared framework of competencies by the means of a common level of education/training for the professionals in Europe. Benchmarking training standards and competencies across Europe has the potential of providing protection against unqualified and ethically questionable practice, creating transparency, raising the general European standard, and promoting mobility of both Clinical Neuropsychologists and patients in Europe, for the benefit of the professional field and the population.
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Affiliation(s)
- Laura Hokkanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | | | | | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nataliya Varako
- Research Center of Neurology, Lomonosov Moscow State University, Moscow, Russia
| | - Erich Kasten
- Department of Psychology - Neurosciences, MSH University of Applied Sciences & Medical University, Hamburg, Germany
| | - Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Sandra Lettner
- Clinical Neuropsychology Unit, Hospital of the Sisters of Charity, Ried, Austria
| | - Gus Baker
- Division of Neurosciences, University of Liverpool, Liverpool, United Kingdom
| | - Bengt A Persson
- Department of Psychology, Linnaeus University, Växjö, Sweden
| | - Erik Hessen
- Department of Psychology, University of Oslo, Oslo, Norway.,Department of Neurology, Akershus University Hospital, Lørenskog, Norway
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Wagner MK, Berg SK, Hassager C, Armand S, Møller JE, Ekholm O, Rasmussen TB, Fisher PM, Knudsen GM, Stenbæk DS. Cognitive impairment and psychopathology in out-of-hospital cardiac arrest survivors in Denmark: The REVIVAL cohort study protocol. BMJ Open 2020; 10:e038633. [PMID: 32994252 PMCID: PMC7526293 DOI: 10.1136/bmjopen-2020-038633] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Cognitive impairment and psychopathology caused by brain hypoxia and the traumatic impact of critical illness are common in cardiac arrest survivors and can lead to negative consequences of everyday life functioning, and further impact mental health in relatives. Most studies have dealt with the mere survival rate after cardiac arrest and not with long-term consequences to mental health in cardiac arrest survivors. Importantly, we face a gap in our knowledge about suitable screening tools in the early post-arrest phase for long-term risk prediction of mental health problems. This study aims to evaluate the efficacy of a novel screening procedure to predict risk of disabling cognitive impairment and psychopathology 3 months after cardiac arrest. Furthermore, the study aims to evaluate long-term prevalence of psychopathology in relatives. METHODS AND ANALYSES In this multicentre prospective cohort study, out-of-hospital cardiac arrest survivors and their relatives will be recruited. The post-arrest screening includes the Montreal Cognitive Assessment (MoCA), the Hospital Anxiety and Depression Scale (HADS), the Impact of Event Scale-Revised (IES-R) and the Acute Stress Disorder Interview (ASDI) and is conducted during hospitalisation. In a subsample of the patients, functional MRI is done, and cortisol determination collected. At 3-month follow-up, the primary study outcomes for 200 survivors include the Danish Affective Verbal Learning Test-26 (VAMT-26), Delis-Kaplan Executive Function System tests (trail making, colour-word interference, word and design fluency), Rey's Complex Figure and Letter-number sequencing subtest of Wechsler Adult Intelligence Scale-IV, HADS and IES-R. For the relatives, they include HADS and IES-R. ETHICS AND DISSEMINATION The study is approved by the local regional Research Ethics Committee (H-18046155) and the Danish Data Protection Agency (RH-2017-325, j.no.05961) and follows the latest version of the Declaration of Helsinki. The results will be published in peer-reviewed journals and may impact the follow-up of cardiac arrest survivors.
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Affiliation(s)
- Mette Kirstine Wagner
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Selina Kikkenborg Berg
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Hassager
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sophia Armand
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Syddanmark, Denmark
| | | | - Patrick MacDonald Fisher
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Center for Integrated Molecular Brain Imaging, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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16
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Faria AL, Pinho MS, Bermúdez I Badia S. A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients. J Neuroeng Rehabil 2020; 17:78. [PMID: 32546251 PMCID: PMC7298954 DOI: 10.1186/s12984-020-00691-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 05/05/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Paper-and-pencil tasks are still widely used for cognitive rehabilitation despite the proliferation of new computer-based methods, like VR-based simulations of ADL's. Studies have established construct validity of VR assessment tools with their paper-and-pencil version by demonstrating significant associations with their traditional construct-driven measures. However, VR rehabilitation intervention tools are mostly developed to include mechanisms such as personalization and adaptation, elements that are disregarded in their paper-and-pencil counterparts, which is a strong limitation of comparison studies. Here we compare the clinical impact of a personalized and adapted paper-and-pencil training and a content equivalent and more ecologically valid VR-based ADL's simulation. METHODS We have performed a trial with 36 stroke patients comparing Reh@City v2.0 (adaptive cognitive training through everyday tasks VR simulations) with Task Generator (TG: content equivalent and adaptive paper-and-pencil training). The intervention comprised 12 sessions, with a neuropsychological assessment pre, post-intervention and follow-up, having as primary outcomes: general cognitive functioning (assessed by the Montreal Cognitive Assessment - MoCA), attention, memory, executive functions and language specific domains. RESULTS A within-group analysis revealed that the Reh@City v2.0 improved general cognitive functioning, attention, visuospatial ability and executive functions. These improvements generalized to verbal memory, processing speed and self-perceived cognitive deficits specific assessments. TG only improved in orientation domain on the MoCA, and specific processing speed and verbal memory outcomes. However, at follow-up, processing speed and verbal memory improvements were maintained, and a new one was revealed in language. A between-groups analysis revealed Reh@City v2.0 superiority in general cognitive functioning, visuospatial ability, and executive functions on the MoCA. CONCLUSIONS The Reh@City v2.0 intervention with higher ecological validity revealed higher effectiveness with improvements in different cognitive domains and self-perceived cognitive deficits in everyday life, and the TG intervention retained fewer cognitive gains for longer. TRIAL REGISTRATION The trial is registered at ClinicalTrials.gov, number NCT02857803. Registered 5 August 2016, .
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Affiliation(s)
- Ana Lúcia Faria
- Madeira Interactive Technologies Institute, Universidade da Madeira, Funchal, Portugal.
- Faculdade de Psicologia e de Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal.
- NOVA-LINCS, Universidade NOVA de Lisboa, Lisbon, Portugal.
| | - Maria Salomé Pinho
- Faculdade de Psicologia e de Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal
- Laboratório de Memória, Linguagem e Funções Executivas, Coimbra, Portugal
| | - Sergi Bermúdez I Badia
- Madeira Interactive Technologies Institute, Universidade da Madeira, Funchal, Portugal
- NOVA-LINCS, Universidade NOVA de Lisboa, Lisbon, Portugal
- Centro de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
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17
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Nott MT, Barden HLH, Chapparo C, Ranka JL. Evidence based practice and knowledge translation: A survey of Australian occupational therapy practice with clients experiencing neurocognitive impairments. Aust Occup Ther J 2019; 67:74-82. [PMID: 31758581 DOI: 10.1111/1440-1630.12625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 10/24/2019] [Accepted: 11/04/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The clinical practice patterns and use of research evidence by Australian occupational therapists working with clients experiencing neurocognitive impairments has not been surveyed for nearly 10 years. This survey aimed to evaluate the current status of occupational therapy practice and evidence use and provide recommendations for ongoing evidence translation. METHODS An online survey of occupational therapists working in Australia was conducted over four months targeting registered clinicians working with adults experiencing neurocognitive impairments. RESULTS 191 occupational therapists from a wide range of clinical practice areas, with a significant level of experience completed the survey. Functional retraining (n = 180, 94%), compensatory training (n = 173, 91%) and task/environmental modifications (n = 161, 84%) were the most commonly reported intervention techniques, while more targeted interventions such as context-sensitive training (n = 54, 28%), positive behaviour supports (n = 42, 22%) and metacognitive strategy training (n = 37, 19%) were used less frequently. Half the respondents were aware of current research evidence and suggested a wide range of strategies supporting evidence translation. Traditional barriers of limited time, access and skills to interpret research were also reported. CONCLUSION Consistent with earlier surveys most occupational therapists continue to use a functional/compensatory approach to cognitive rehabilitation, with an increasing number of therapists using specialist cognitive interventions. The current challenge for occupational therapists is embedding specialist techniques into occupation-based intervention. Knowledge translation and implementation strategies will be a critical component to achieving this.
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Affiliation(s)
- Melissa T Nott
- School of Community Health, Charles Sturt University, Albury, NSW, Australia
| | - Hannah L H Barden
- Brain Injury Rehabilitation Service, Westmead Hospital, Sydney, NSW, Australia
| | - Chris Chapparo
- Discipline of Occupational Therapy, The University of Sydney, Sydney, NSW, Australia
| | - Judy L Ranka
- The Occupational Performance Network, Sydney, NSW, Australia
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18
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Hamzah N, Narayanan V, Ramli N, Mustapha NA, Mohammad Tahir NA, Tan LK, Danaee M, Muhamad NA, Drummond A, das Nair R, Goh SY, Mazlan M. Randomised controlled clinical trial of a structured cognitive rehabilitation in patients with attention deficit following mild traumatic brain injury: study protocol. BMJ Open 2019; 9:e028711. [PMID: 31537559 PMCID: PMC6756424 DOI: 10.1136/bmjopen-2018-028711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To measure the clinical, structural and functional changes of an individualised structured cognitive rehabilitation in mild traumatic brain injury (mTBI) population. SETTING A single centre study, Malaysia. PARTICIPANTS Adults aged between 18 and 60 years with mTBI as a result of road traffic accident, with no previous history of head trauma, minimum of 9 years education and abnormal cognition at 3 months will be included. The exclusion criteria include pre-existing chronic illness or neurological/psychiatric condition, long-term medication that affects cognitive/psychological status, clinical evidence of substance intoxication at the time of injury and major polytrauma. Based on multiple estimated calculations, the minimum intended sample size is 50 participants (Cohen's d effect size=0.35; alpha level of 0.05; 85% power to detect statistical significance; 40% attrition rate). INTERVENTIONS Intervention group will receive individualised structured cognitive rehabilitation. Control group will receive the best patient-centred care for attention disorders. Therapy frequency for both groups will be 1 hour per week for 12 weeks. OUTCOME MEASURES Primary: Neuropsychological Assessment Battery-Screening Module (S-NAB) scores. Secondary: Diffusion Tensor Imaging (DTI) parameters and Goal Attainment Scaling score (GAS). RESULTS Results will include descriptive statistics of population demographics, CogniPlus cognitive program and metacognitive strategies. The effect of intervention will be the effect size of S-NAB scores and mean GAS T scores. DTI parameters will be compared between groups via repeated measure analysis. Correlation analysis of outcome measures will be calculated using Pearson's correlation coefficient. CONCLUSION This is a complex clinical intervention with multiple outcome measures to provide a comprehensive evidence-based treatment model. ETHICS AND DISSEMINATION The study protocol was approved by the Medical Research Ethics Committee UMMC (MREC ID NO: 2016928-4293). The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT03237676.
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Affiliation(s)
- Norhamizan Hamzah
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vairavan Narayanan
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norlisah Ramli
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nor Atikah Mustapha
- Department of Rehabilitation Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | - Li Kuo Tan
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nor Asiah Muhamad
- Institute for Public Health, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Avril Drummond
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Roshan das Nair
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Institute of Mental Health, Nottinghamshire Healthcare Trust, Nottingham, United Kingdom
| | - Sing Yau Goh
- Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Sungai Long Campus, Malaysia
| | - Mazlina Mazlan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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19
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Behn N, Marshall J, Togher L, Cruice M. Reporting on novel complex intervention development for adults with social communication impairments after acquired brain injury. Disabil Rehabil 2019; 43:805-814. [PMID: 31361164 DOI: 10.1080/09638288.2019.1642964] [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: 10/26/2022]
Abstract
PURPOSE Interventions are often poorly described in published controlled trials, with relatively little information regarding intervention development, content and fidelity. This makes it difficult to conduct replication studies, interpret and compare findings across studies and for therapists to deliver the intervention in clinical practice. Complete reporting of interventions (including fidelity) is now recommended for treatment studies, and this standardized approach is achieved using the Template for Intervention Description and Replication (TIDieR). The aim of this article is to describe the multi-phase process of developing a novel intervention for adults with acquired brain injury (ABI) and report on the findings from involving practicing therapists in this process. METHODS Phase 1 involved a review of relevant literature and specifying the intervention as a prototype intervention manual. Phase 2 comprised a focus group with eight practicing therapists exploring their experiences and perceptions of the intervention, potential active components, and essential elements; it also included a review of the prototype manual. Data from the focus group discussion was transcribed and analyzed thematically. Phase 3 investigated actual fidelity of the intervention undertaken, achieved by observers viewing videoed sessions and appraising against the fidelity checklist, which was then analyzed using Cohen's kappa. RESULTS Project-based intervention was defined as having six essential elements: a project or tangible end product focus; group-based intervention; individualized communication-based goals; communication partner involvement; acknowledgement and support of participants' cognitive ability; and consideration and plan to address impaired awareness. Analysis of focus group data revealed four themes of essential elements; group context; therapeutic skills; and manual core components and informed the development of a fidelity checklist with 13 essential and 6 desirable criteria. Fidelity assessed using percent agreement was acceptable for almost all rater pairs; where significant, Kappa coefficients had values ranging from poor to excellent (k = 0.34-1.0) depending on rater pair and session. DISCUSSION The TIDieR framework provided a clear systematic approach for the complete description and reporting of a complex communication intervention for people with ABI. This article comprehensively described the development and manualisation of intervention in collaboration with practicing therapists which can be used for future testing. In addition, the process undertaken has the potential to inform rehabilitation researchers in other fields on the development of complex interventions.Implications for rehabilitationThe results of this study detail the steps needed to describe an intervention, from the identification of the essential elements through to the creation of a manual and checklist to show fidelity. The process provides a starting point for other rehabilitation researchers developing complex interventions.This article provides a clear and comprehensive description of a novel intervention containing six essential elements for people with acquired brain injury presenting with communication impairments.Project-based intervention is one intervention, which intends to help improve communication skills and quality of life in people with acquired brain injury.This study highlights the important role practicing therapists can play in the creation of an intervention manual and fidelity checklist and in ensuring that sufficient detail is provided to help therapists implement the intervention into clinical practice.
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Affiliation(s)
- Nicholas Behn
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Jane Marshall
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Madeline Cruice
- Division of Language and Communication Science, School of Health Sciences, City, University of London, London, UK
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Gorgoraptis N, Zaw-Linn J, Feeney C, Tenorio-Jimenez C, Niemi M, Malik A, Ham T, Goldstone AP, Sharp DJ. Cognitive impairment and health-related quality of life following traumatic brain injury. NeuroRehabilitation 2019; 44:321-331. [DOI: 10.3233/nre-182618] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Nikos Gorgoraptis
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Joanna Zaw-Linn
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Claire Feeney
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
- Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, Charing Cross and St. Mary’s Hospitals, London, UK
| | - Carmen Tenorio-Jimenez
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Mari Niemi
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Aysha Malik
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Timothy Ham
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
| | - Anthony P. Goldstone
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
- Imperial Centre for Endocrinology, Imperial College Healthcare NHS Trust, Charing Cross and St. Mary’s Hospitals, London, UK
| | - David J. Sharp
- Department of Neurology, Imperial College Healthcare NHS Trust, London, UK
- Department of Medicine, Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, Hammersmith Hospital, London, UK
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21
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Küçükdeveci AA, Stibrant Sunnerhagen K, Golyk V, Delarque A, Ivanova G, Zampolini M, Kiekens C, Varela Donoso E, Christodoulou N. Evidence-based position paper on Physical and Rehabilitation Medicine professional practice for persons with stroke. The European PRM position (UEMS PRM Section). Eur J Phys Rehabil Med 2019; 54:957-970. [DOI: 10.23736/s1973-9087.18.05501-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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22
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Raymer AM, Roitsch J, Redman R, Michalek AMP, Johnson RK. Critical appraisal of systematic reviews of executive function treatments in TBI. Brain Inj 2018; 32:1601-1611. [PMID: 30240277 DOI: 10.1080/02699052.2018.1522671] [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 appraise the quality of systematic reviews (SRs) and meta-analyses (MAs) that summarize the treatment literature for executive function (EF) impairments following traumatic brain injury (TBI). METHODS We used five data sources (PubMed; PsycINFO; ANCDS.org; Cochrane Collaboration; American Speech-Language-Hearing Association Compendium; Psychological Database for Brain Impairment Treatment Efficacy) and identified 19 reviews that met eligibility criteria (adults with TBI; behavioural treatments for EF impairments; no pharmacologic treatments). Two reviewers independently and reliably rated each paper using two appraisal tools (Critical Appraisal of Systematic Review or Meta-Analysis and Evidence in Augmentative and Alternative Communication systematic review scale). RESULTS Five MAs received highest ratings. Four SRs also addressed the majority of SR criteria. Reviews were better at addressing SR criteria as outcome measures across studies varied considerably, posing a challenge to quantitatively synthesize TBI outcomes. The strongest research evidence favours compensatory treatments that train individuals with TBI to use strategies to circumvent EF impairments in daily activities. Smaller effects are reported for direct training approaches. CONCLUSIONS Researchers need to identify core outcome measures to facilitate future rigorous MAs of the EF rehabilitation literature. SRs/MAs need to be conducted with thorough methods that are reported with detail.
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Affiliation(s)
- Anastasia M Raymer
- a Department of Communication Disorders & Special Education , Old Dominion University , Norfolk , VA , USA
| | - Jane Roitsch
- a Department of Communication Disorders & Special Education , Old Dominion University , Norfolk , VA , USA
| | - Rachael Redman
- a Department of Communication Disorders & Special Education , Old Dominion University , Norfolk , VA , USA
| | - Anne M P Michalek
- a Department of Communication Disorders & Special Education , Old Dominion University , Norfolk , VA , USA
| | - Rachel K Johnson
- a Department of Communication Disorders & Special Education , Old Dominion University , Norfolk , VA , USA
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23
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Boyce LW, Goossens PH, Volker G, van Exel HJ, Vliet Vlieland TPM, van Bodegom-Vos L. Attention needed for cognitive problems in patients after out-of-hospital cardiac arrest: an inventory about daily rehabilitation care. Neth Heart J 2018; 26:493-499. [PMID: 30215169 PMCID: PMC6150874 DOI: 10.1007/s12471-018-1151-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim Recent literature and Dutch guidelines for patients with out-of-hospital cardiac arrest (OHCA) recommend screening for cognitive impairments and referral to cognitive rehabilitation when needed. The aim of this study is to assess the uptake of these recommendations for OHCA patients. Method An internet-based questionnaire was sent to 74 cardiologists and 143 rehabilitation specialists involved in rehabilitation of OHCA patients in the Netherlands. The questionnaire covered: background characteristics, availability and content of cognitive screening and rehabilitation, organisation of care, experienced need for an integrated care pathway including physical and cognitive rehabilitation, barriers and facilitators for an integrated care pathway. Results Forty-five questionnaires were returned (16 cardiologists and 29 rehabilitation doctors). Thirty-nine percent (n = 17) prescribed cognitive screening. Eighty-nine percent underscores an added value of an integrated care pathway. Barriers for an integrated care pathway included lack of knowledge, logistic obstacles, and poor cooperation between medical specialties. Conclusions In the Netherlands, only a minority of cardiologists and rehabilitation specialists routinely prescribe some form of cognitive screening in OHCA patients, although the majority underscores the value of cognitive screening in OHCA patients in an integrated care pathway. The uptake of such a care pathway seems hindered by lack of knowledge and organisational barriers.
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Affiliation(s)
- L W Boyce
- Rijnlands Rehabilitation Centre, Leiden, The Netherlands.
| | - P H Goossens
- Rijnlands Rehabilitation Centre, Leiden, The Netherlands.,Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - G Volker
- Rijnlands Rehabilitation Centre, Leiden, The Netherlands
| | - H J van Exel
- Rijnlands Rehabilitation Centre, Leiden, The Netherlands.,Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - T P M Vliet Vlieland
- Rijnlands Rehabilitation Centre, Leiden, The Netherlands.,Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - L van Bodegom-Vos
- Department of Biomedical Data Sciences, section Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
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24
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General and Domain-Specific Effectiveness of Cognitive Remediation after Stroke: Systematic Literature Review and Meta-Analysis. Neuropsychol Rev 2018; 28:285-309. [DOI: 10.1007/s11065-018-9378-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 06/21/2018] [Indexed: 12/26/2022]
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25
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Geraldo A, Dores AR, Coelho B, Ramião E, Castro-Caldas A, Barbosa F. Efficacy of ICT-Based Neurocognitive Rehabilitation Programs for Acquired Brain Injury. EUROPEAN PSYCHOLOGIST 2018. [DOI: 10.1027/1016-9040/a000319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Abstract. This systematic review aims to analyze the methods used in the assessment of the efficacy of Neurocognitive Rehabilitation Programs (NRP) based on Information and Communication Technologies in patients with Acquired Brain Injury, namely platforms and online rehabilitation programs. Studies with the main purpose of evaluating the efficacy of those programs were retrieved from multiple literature databases, accordingly to inclusion and exclusion criteria. The inclusion and analysis of the studies followed preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) and Cochrane Collaboration Guidelines. Thirty-one studies were included in this review. Results showed that most studies used a pre-post methodological design, with few studies performing assessment moments during intervention or follow-up. Attention, memory, and executive functions were the cognitive variables considered by a larger number of studies at the assessment of NRP efficacy. Despite that, there is a growing evidence on the inclusion of variables related to everyday functioning in this process, increasing its ecological validity. Concerning the instruments used, the studies presented a large heterogeneity of the instruments and methods used, even for the same assessment purpose, highlighting a lack of consensus regarding assessment protocol. Psychophysiological and neuroimaging techniques are seldom used on this field. This review identifies the main characteristics of the methodology used at the assessment of NRP and potential limitations, providing useful information to guide the practice of the health care professionals in rehabilitation of Acquired Brain Injury. It also suggests new directions for future studies.
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Affiliation(s)
- Andreia Geraldo
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Artemisa R. Dores
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | | | - Eduarda Ramião
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | | | - Fernando Barbosa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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26
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Physiotherapeutic interventions in multiple sclerosis across Europe: Regions and other factors that matter. Mult Scler Relat Disord 2018; 22:59-67. [DOI: 10.1016/j.msard.2018.03.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 01/30/2018] [Accepted: 03/04/2018] [Indexed: 11/19/2022]
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27
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Thomas RE, Alves J, Vaska Mlis MM, Magalhaes R. Therapy and rehabilitation of mild brain injury/concussion: Systematic review. Restor Neurol Neurosci 2017; 35:643-666. [DOI: 10.3233/rnn-170761] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Roger E. Thomas
- Department of Family Medicine, Faculty of Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada
| | - Jorge Alves
- CEREBRO – Brain Health Center, Braga, Portugal
| | | | - Rosana Magalhaes
- Instituto de Psicologia e Ciências da Educação, Universidade Lusíada – Norte (Porto), Porto, Portugal
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28
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Cognitive impairments and subjective cognitive complaints after survival of cardiac arrest: A prospective longitudinal cohort study. Resuscitation 2017; 120:132-137. [DOI: 10.1016/j.resuscitation.2017.08.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 07/16/2017] [Accepted: 08/05/2017] [Indexed: 11/19/2022]
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29
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Bahar-Fuchs A, Webb S, Bartsch L, Clare L, Rebok G, Cherbuin N, Anstey KJ. Tailored and Adaptive Computerized Cognitive Training in Older Adults at Risk for Dementia: A Randomized Controlled Trial. J Alzheimers Dis 2017; 60:889-911. [DOI: 10.3233/jad-170404] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Alex Bahar-Fuchs
- Centre for Research on Ageing, Health, and Wellbeing, Acton, The Australian National University, Australian Capital Territory, Australia
- Academic Unit for Psychiatry of Old Age, Parkville, The University of Melbourne, VIC, Australia
| | - Shannon Webb
- School of Psychology, Griffith Taylor Building, The University of Sydney, New South Wales, Australia
| | - Lauren Bartsch
- Centre for Research on Ageing, Health, and Wellbeing, Acton, The Australian National University, Australian Capital Territory, Australia
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, Washington Singer Laboratories, The University of Exeter, UK
| | - George Rebok
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health, and Wellbeing, Acton, The Australian National University, Australian Capital Territory, Australia
| | - Kaarin J. Anstey
- Centre for Research on Ageing, Health, and Wellbeing, Acton, The Australian National University, Australian Capital Territory, Australia
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30
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Dwyer A, Heary C, Ward M, MacNeela P. Adding insult to brain injury: young adults' experiences of residing in nursing homes following acquired brain injury. Disabil Rehabil 2017; 41:33-43. [PMID: 28845724 DOI: 10.1080/09638288.2017.1370732] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE There is general consensus that adults under age 65 with acquired brain injury residing in nursing homes is inappropriate, however there is a limited evidence base on the issue. Previous research has relied heavily on third-party informants and qualitative studies have been of questionable methodological quality, with no known study adopting a phenomenological approach. This study explored the lived experiences of young adults with brain injury residing in aged care facilities. METHODS Interpretative phenomenological analysis was employed to collect and analyze data from six semi-structured interviews with participants regarding their experiences of living in nursing homes. RESULTS Two themes were identified, including "Corporeal prison of acquired brain injury: broken selves" and "Existential prison of the nursing home: stagnated lives". Results illustrated that young adults with acquired brain injury can experience aged care as an existential prison in which their lives feel at a standstill. This experience was characterized by feelings of not belonging in a terminal environment, confinement, disempowerment, emptiness and hope for greater autonomy through rehabilitation. CONCLUSION It is hoped that this study will provide relevant professionals, services and policy-makers with insight into the challenges and needs of young adults with brain injury facing these circumstances. Implications for rehabilitation This study supports the contention that more home-like and age-appropriate residential rehabilitation services for young adults with acquired brain injury are needed. As development of alternative accommodation is a lengthy process, the study findings suggest that the interim implementation of rehabilitative care in nursing homes should be considered. Taken together with existing research, it is proposed that nursing home staff may require training to deliver evidence-based rehabilitative interventions to those with brain injury. The present findings add support to the call for systemic change in Ireland, to clarify the acquired brain injury care pathway and establish integrated rehabilitation services.
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Affiliation(s)
- Aoife Dwyer
- a School of Psychology , National University of Ireland Galway (NUIG) , Galway , Ireland
| | - Caroline Heary
- a School of Psychology , National University of Ireland Galway (NUIG) , Galway , Ireland
| | - Marcia Ward
- b Department of Psychology , Headway , Cork , Ireland
| | - Pádraig MacNeela
- a School of Psychology , National University of Ireland Galway (NUIG) , Galway , Ireland
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31
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Mhizha-Murira JR, Drummond A, Klein OA, dasNair R. Reporting interventions in trials evaluating cognitive rehabilitation in people with multiple sclerosis: a systematic review. Clin Rehabil 2017; 32:243-254. [PMID: 28828902 DOI: 10.1177/0269215517722583] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the quantity and quality of description of cognitive rehabilitation for cognitive deficits in people with multiple sclerosis, using a variety of published checklists, and suggest ways of improving the reporting of these interventions. DATA SOURCES A total of 10 electronic databases were searched, including MEDLINE, EMBASE, CINAHL and PsycINFO, from inception to May 2017. Grey literature databases, trial registers, reference lists and author citations were also searched. REVIEW METHODS Papers were included if participants were people with multiple sclerosis aged 18 years and over and if the effectiveness of cognitive rehabilitation in improving functional ability for memory, attention or executive dysfunction, with or without a control group, was being evaluated. RESULTS A total of 54 studies were included in this review. The reporting of a number of key aspects of cognitive rehabilitation was poor. This was particularly in relation to content of interventions (reported completely in 26 of the 54 studies), intervention procedures (reported completely in 16 of the 54 studies), delivery mode (reported completely in 24 of the 54 studies) and intervention mechanism of action (reported completely in 21 of the 54 studies). CONCLUSION The quality of reporting of cognitive rehabilitation for memory, attention and executive function for multiple sclerosis, across a range of study designs, is poor. Existing reporting checklists do not adequately cover aspects relevant to cognitive rehabilitation, such as the approaches used to address cognitive deficits. Future checklists could consider these aspects we have identified in this review.
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Affiliation(s)
| | - Avril Drummond
- 1 School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Olga A Klein
- 1 School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roshan dasNair
- 2 Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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32
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Rabin LA, Smart CM, Amariglio RE. Subjective Cognitive Decline in Preclinical Alzheimer's Disease. Annu Rev Clin Psychol 2017; 13:369-396. [DOI: 10.1146/annurev-clinpsy-032816-045136] [Citation(s) in RCA: 248] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Laura A. Rabin
- Department of Psychology, Brooklyn College and The Graduate Center of the City University of New York, Brooklyn, New York 11210
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York 10461
| | - Colette M. Smart
- Department of Psychology, University of Victoria, Victoria, British Columbia V8W 2Y2, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, British Columbia V8P 2Y2, Canada
| | - Rebecca E. Amariglio
- Department of Neurology and Center for Alzheimer Research and Treatment, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
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33
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Brunner M, Hemsley B, Togher L, Palmer S. Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI). Brain Inj 2017; 31:1028-1043. [DOI: 10.1080/02699052.2017.1292429] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Melissa Brunner
- Speech Pathology, Faculty of Education and Arts, University of Newcastle, Newcastle, Australia
| | - Bronwyn Hemsley
- Speech Pathology, Faculty of Education and Arts, University of Newcastle, Newcastle, Australia
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
| | - Stuart Palmer
- Faculty of Science, Engineering & Built Environment, Deakin University, Geelong, Australia
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34
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Martínez-Pernía D, González-Castán Ó, Huepe D. From ancient Greece to the cognitive revolution: A comprehensive view of physical rehabilitation sciences. Physiother Theory Pract 2017; 33:89-102. [DOI: 10.1080/09593985.2016.1266720] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- David Martínez-Pernía
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive and Translational Neuroscience, INECO Foundation, Favaloro University, Buenos Aires, Argentina
- Experiential Neurorehabilitation Research Department, Fundación Polibea, Madrid, Spain
| | | | - David Huepe
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
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35
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Faria AL, Andrade A, Soares L, i Badia SB. Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients. J Neuroeng Rehabil 2016; 13:96. [PMID: 27806718 PMCID: PMC5094135 DOI: 10.1186/s12984-016-0204-z] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 10/25/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Stroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patients' capability to live independently. There is substancial evidence on post-stroke cognitive rehabilitation benefits, but its implementation is generally limited by the use of paper-and-pencil methods, insufficient personalization, and suboptimal intensity. Virtual reality tools have shown potential for improving cognitive rehabilitation by supporting carefully personalized, ecologically valid tasks through accessible technologies. Notwithstanding important progress in VR-based cognitive rehabilitation systems, specially with Activities of Daily Living (ADL's) simulations, there is still a need of more clinical trials for its validation. In this work we present a one-month randomized controlled trial with 18 stroke in and outpatients from two rehabilitation units: 9 performing a VR-based intervention and 9 performing conventional rehabilitation. METHODS The VR-based intervention involved a virtual simulation of a city - Reh@City - where memory, attention, visuo-spatial abilities and executive functions tasks are integrated in the performance of several daily routines. The intervention had levels of difficulty progression through a method of fading cues. There was a pre and post-intervention assessment in both groups with the Addenbrooke Cognitive Examination (primary outcome) and the Trail Making Test A and B, Picture Arrangement from WAIS III and Stroke Impact Scale 3.0 (secondary outcomes). RESULTS A within groups analysis revealed significant improvements in global cognitive functioning, attention, memory, visuo-spatial abilities, executive functions, emotion and overall recovery in the VR group. The control group only improved in self-reported memory and social participation. A between groups analysis, showed significantly greater improvements in global cognitive functioning, attention and executive functions when comparing VR to conventional therapy. CONCLUSIONS Our results suggest that cognitive rehabilitation through the Reh@City, an ecologically valid VR system for the training of ADL's, has more impact than conventional methods. TRIAL REGISTRATION This trial was not registered because it is a small sample study that evaluates the clinical validity of a prototype virtual reality system.
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Affiliation(s)
- Ana Lúcia Faria
- Madeira Interactive Technologies Institute, Funchal, Madeira Portugal
- Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra, Coimbra, Portugal
| | | | - Luísa Soares
- Madeira Interactive Technologies Institute, Funchal, Madeira Portugal
- Universidade da Madeira, Funchal, Madeira Portugal
| | - Sergi Bermúdez i Badia
- Madeira Interactive Technologies Institute, Funchal, Madeira Portugal
- Universidade da Madeira, Funchal, Madeira Portugal
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36
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Cognitive reserve and preinjury educational attainment: effects on outcome of community-based rehabilitation for longer-term individuals with acquired brain injury. Int J Rehabil Res 2016; 39:234-9. [DOI: 10.1097/mrr.0000000000000175] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
OBJECTIVES To review publications in Clinical Rehabilitation over the last 30 years, discerning the original goals and whether they were met, and describing major trends over the 30 years. METHODS Personal review, backed up by data from 'most read' articles and 'most cited' articles, from yearly lists of all controlled trials published in the journal and other sources. RESULTS The original goals included making rehabilitation better understood both within and outside the speciality, and more scientific. The first goal is probably not achieved, but the scientific standard of publication is much higher and it routinely recommends the use of guidelines appropriate to the publication. The journal has established a pre-eminent position in publishing randomized controlled trials, systematic reviews and articles on goal-setting. It has developed a series describing rehabilitation interventions. It aims to increase consideration of the theoretical basis of rehabilitation practices. We would like to think its impact has increased - but we cannot prove that! CONCLUSION The journal has established some credentials as being a source of clinically relevant evidence and guidance across the whole field of rehabilitation and across most disabling conditions.
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Dewar BK, Kapur N, Kopelman M. Do memory aids help everyday memory? A controlled trial of a Memory Aids Service. Neuropsychol Rehabil 2016; 28:614-632. [PMID: 27267491 DOI: 10.1080/09602011.2016.1189342] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
There is a growing body of knowledge about the use of compensatory memory aids in memory rehabilitation, but relatively few controlled trials on how to train the use of such aids. This study investigated the effects of systematic training in the use of compensatory memory aids on everyday memory functioning within a Memory Aids Service. In a controlled clinical trial, a comparison was made between treatment participants and waiting list controls. Participants had everyday memory problems secondary to progressive or non-progressive neurological conditions. Following baseline assessment and goal setting, treatment participants underwent three training sessions, in which memory aids were matched to goals, across a six week period, with a follow-up assessment 12 weeks later. Outcome was measured by a goal attainment diary, neuropsychological test performance, psychosocial questionnaires and a problem solving inventory. There was a significant treatment effect of training on the goal attainment diary but only at 12 weeks follow-up. A post-hoc analysis indicated that treatment was effective for participants with a non-progressive condition but not for participants with a progressive condition. We conclude that a Memory Aids Service can be beneficial for patients with a non-progressive neurological condition, and make suggestions that might inform future applications of memory aids with those who have a progressive neurological disorder.
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Affiliation(s)
- Bonnie-Kate Dewar
- a Academic Neuropsychiatry, Psychological Medicine CAG, Kings College London (Institute of Psychiatry, Psychology and Neuroscience) , London , UK
| | - Narinder Kapur
- b Research Department of Clinical, Educational and Health Psychology , University College London , London , UK
| | - Michael Kopelman
- a Academic Neuropsychiatry, Psychological Medicine CAG, Kings College London (Institute of Psychiatry, Psychology and Neuroscience) , London , UK
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Gates NJ, March EG. A Neuropsychologist's Guide To Undertaking a Systematic Review for Publication: Making the most of PRISMA Guidelines. Neuropsychol Rev 2016; 26:109-20. [PMID: 27193864 DOI: 10.1007/s11065-016-9318-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 05/02/2016] [Indexed: 02/07/2023]
Abstract
There is increasing impetus to improve the quality of research and scientific writing. Systematic reviews provide Class 1 research evidence, are based upon an established rigor and communicate results in a comprehensive manner, and are therefore particularly relevant to clinicians and researchers. Clinician requirements for quality systematic reviews are twofold: to keep up to date with research and to make informed decisions including those required for diagnoses, disease or risk assessment, and treatment. Researchers rely upon quality systematic reviews to compete for diminishing research funds, prove efficacy for intervention trials, and to meet increasing demand for evidence based intervention. However, insufficient systematic reviews are undertaken, and the methodological rigor and quality are often variable. The aim of this article is to guide researchers through the iterative systematic review process in order to improve quality and thereby increase publication rates. The step by step guide provides a road map through the EQUATOR network and practical suggestions in order to meet the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (Moher et al. 2009) as well as encouraging high standards through the use of quality rating scales. Lastly, information is provided to encourage quantitative analysis to improve the synthesis of results and qualitative interpretation, such as calculating effect sizes or conducting a meta-analyses as the ultimate goal of a systematic review.
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Affiliation(s)
- Nicola J Gates
- Centre for Healthy Brain Aging (CHeBA), Medicine, University of New South Wales, NSW, Randwick, 2031, Australia.
| | - Evrim G March
- St Vincent's Mental Health, Fitzroy, VIC, 3065, Australia
- School of Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
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Stephens JA, Williamson KNC, Berryhill ME. Cognitive Rehabilitation After Traumatic Brain Injury: A Reference for Occupational Therapists. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2015; 35:5-22. [PMID: 26623474 DOI: 10.1177/1539449214561765] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nearly 1.7 million Americans sustain a traumatic brain injury (TBI) each year. These injuries can result in physical, emotional, and cognitive consequences. While many individuals receive cognitive rehabilitation from occupational therapists (OTs), the interdisciplinary nature of TBI research makes it difficult to remain up-to-date on relevant findings. We conducted a literature review to identify and summarize interdisciplinary evidence-based practice targeting cognitive rehabilitation for civilian adults with TBI. Our review summarizes TBI background, and our cognitive remediation section focuses on the findings from 37 recent (since 2006) empirical articles directly related to cognitive rehabilitation for individuals (i.e., excluding special populations such as veterans or athletes). This manuscript is offered as a tool for OTs engaged in cognitive rehabilitation and as a means to highlight arenas where more empirical, interdisciplinary research is needed.
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Paiva S, Magalhães R, Alves J, Sampaio A. Efficacy of cognitive intervention in stroke: A long road ahead. Restor Neurol Neurosci 2015; 34:139-52. [PMID: 26684266 DOI: 10.3233/rnn-150590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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das Nair R. Evaluating cognitive rehabilitation in multiple sclerosis: on the bumpy road to establishing evidence. Neurodegener Dis Manag 2015; 5:473-8. [PMID: 26618280 DOI: 10.2217/nmt.15.44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Roshan das Nair
- Division of Rehabilitation & Ageing, Medical School, University of Nottingham, QMC, Nottingham, NG7 2UH, UK.,Department of Clinical Psychology & Neuropsychology, Nottingham University Hospitals NHS Trust, QMC, Nottingham, NG7 2UH, UK
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Fortune DG, Walsh RS, Waldron B, McGrath C, Harte M, Casey S, McClean B. Changes in aspects of social functioning depend upon prior changes in neurodisability in people with acquired brain injury undergoing post-acute neurorehabilitation. Front Psychol 2015; 6:1368. [PMID: 26441744 PMCID: PMC4561758 DOI: 10.3389/fpsyg.2015.01368] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/25/2015] [Indexed: 11/30/2022] Open
Abstract
Post-acute community-based rehabilitation is effective in reducing disability. However, while social participation and quality of life are valued as distal outcomes of neurorehabilitation, it is often not possible to observe improvements on these outcomes within the limited time-frames used in most investigations of rehabilitation. The aim of the current study was to examine differences in the sequence of attainments for people with acquired brain injury (ABI) undergoing longer term post-acute neurorehabilitation. Participants with ABI who were referred to comprehensive home and community-based neurorehabilitation were assessed at induction to service, at 6 months and again at 1.5 years while still in service on the Mayo-Portland Adaptability Index (MPAI-4), Community Integration Questionnaire, Hospital Anxiety and Depression Scale, and World Health Organisation Quality of Life measure. At 6 months post-induction to service, significant differences were evident in MPAI abilities, adjustment, and total neurodisability; and in anxiety and depression. By contrast, there was no significant effect at 6 months on more socially oriented features of experience namely quality of life (QoL), Community Integration and Participation. Eighteen month follow-up showed continuation of the significant positive effects with the addition of QoL-related to physical health, Psychological health, Social aspects of QoL and Participation at this later time point. Regression analyses demonstrated that change in QoL and Participation were dependent upon prior changes in aspects of neurodisability. Age, severity or type of brain injury did not significantly affect outcome. Results suggest that different constructs may respond to neurorehabilitation at different time points in a dose effect manner, and that change in social aspects of experience may be dependent upon the specific nature of prior neurorehabilitation attainments.
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Affiliation(s)
- Dónal G Fortune
- Centre for Social Issues, Department of Psychology, University of Limerick Limerick, Ireland ; Acquired Brain Injury Ireland Dun Laoghaire, Ireland
| | - R Stephen Walsh
- Centre for Social Issues, Department of Psychology, University of Limerick Limerick, Ireland ; Acquired Brain Injury Ireland Dun Laoghaire, Ireland
| | - Brian Waldron
- Acquired Brain Injury Ireland Dun Laoghaire, Ireland
| | | | - Maurice Harte
- Acquired Brain Injury Ireland Dun Laoghaire, Ireland
| | - Sarah Casey
- Acquired Brain Injury Ireland Dun Laoghaire, Ireland
| | - Brian McClean
- Acquired Brain Injury Ireland Dun Laoghaire, Ireland
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Prevalence of perceived cognitive dysfunction in survivors of a wide range of cancers: results from the 2010 LIVESTRONG survey. J Cancer Surviv 2015; 10:302-11. [PMID: 26238504 DOI: 10.1007/s11764-015-0476-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 07/15/2015] [Indexed: 02/06/2023]
Abstract
PURPOSE With cancer survivors now numbering over 13 million in the United States, and expected to continue to increase, it is important to consider the needs of this growing population. In the literature, one of the most common complaints by cancer survivors is perceived cognitive dysfunction. Since the preponderance of the research has focused on breast cancer survivors, the purpose of the present study was to explore the prevalence and correlates of perceived cognitive dysfunction in a large sample of cancer survivors with representation across a wide range of different types of cancer. METHODS A sample of 3108 post-treatment cancer survivors completed the 2010 LIVESTRONG survey as part of a larger study of cancer survivorship. Respondents completed standardized questions regarding current and past perceived cognitive dysfunction, as well as depressive symptoms, and demographic and medical variables. RESULTS Current perceived cognitive dysfunction was reported by nearly half of respondents (45.7%), across a wide range of cancer types, with the highest prevalence among survivors of central nervous system cancers. Receiving chemotherapy and current report of depressive symptoms were both strongly associated with current perceived cognitive dysfunction. CONCLUSION These findings contribute to a growing appreciation of the high prevalence of perceived cognitive dysfunction in survivors of a wide range of cancer types and the potential interactive effect of concurrent symptoms of depression. These findings highlight a need to develop more effective means of preventing or reducing cognitive dysfunction in cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Perceived cognitive dysfunction was reported in a wide range of cancer survivors. The potential interactive effect of symptoms of depression suggests the need to develop interventions targeting both cognitive dysfunction and depression to achieve improvements in cognitive functioning.
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Cognitive problems in patients in a cardiac rehabilitation program after an out-of-hospital cardiac arrest. Resuscitation 2015; 93:63-8. [DOI: 10.1016/j.resuscitation.2015.05.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/29/2015] [Accepted: 05/26/2015] [Indexed: 11/19/2022]
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Martin KJ, Sinclair EJ, dasNair R. Descriptions of memory rehabilitation group interventions for neurological conditions: a systematic review. Clin Rehabil 2015; 30:705-13. [DOI: 10.1177/0269215515595273] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/13/2015] [Indexed: 11/15/2022]
Abstract
Objective: To establish what aspects of group-based cognitive rehabilitation for memory problems are reported, and to develop a checklist for authors, which may to improve reporting of these interventions in future studies. Data sources: A systematic search was conducted on Web of Knowledge, CINAHL, MEDLINE, AMED, EMBASE and PsycINFO electronic databases (last search: 01/05/2015). Review methods: Articles were included if the sample were adults with a neurological disorder, the intervention was group-based cognitive rehabilitation for memory problems, and if the study was a randomised controlled trial. Articles were independently screened for inclusion and data extracted by two researchers, with the third researcher arbitrating any disputes. Results: Fourteen studies were included in this review. The reporting of certain aspects of an intervention was found to be poor, particularly in relation to: duration of the programme (6 of 14 studies did not report), the development of the intervention (7 of 14 studies did not discuss), and the content and structure of intervention (7 of the 14 studies did not provide details). Conclusion: This review found that the overall reporting of memory rehabilitation content and format is poor. Refinement and adaption of pre-existing checklists to capture aspects of cognitive rehabilitation programmes may help authors when reporting complex interventions. A draft checklist is provided that could be refined and validated in further research.
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Affiliation(s)
- Kristy-Jane Martin
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Emma J Sinclair
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Roshan dasNair
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
- Department of Clinical Psychology & Neuropsychology, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Dijkers MP. Reporting on interventions: issues and guidelines for rehabilitation researchers. Arch Phys Med Rehabil 2015; 96:1170-80. [PMID: 25660003 DOI: 10.1016/j.apmr.2015.01.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/23/2014] [Accepted: 01/18/2015] [Indexed: 11/16/2022]
Abstract
Observers commonly note the poor reporting of research, including rehabilitation research. The Consolidated Standards of Reporting Trials (CONSORT) checklist (supplemented by the CONSORT extension for nonpharmacologic interventions) has been published for improving the reporting of intervention research. However, the items on these checklists are considered to be inadequate to guide authors as to which information to include when reporting on the intervention(s) studied, and the Template for Intervention Description and Replication, Journal Article Reporting Standards, and the checklist of the Western Journal of Nursing Research are recommended to rehabilitation researchers. The Rehabilitation Treatment Taxonomy framework is recommended as a conceptual scheme to assist authors in thinking through the linkages between intervention ingredients, targets of treatment, and the mechanisms of action linking these 2 areas. Recommendations are made for prospective authors and journal editors who desire to see improved reporting of rehabilitation interventions.
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Affiliation(s)
- Marcel P Dijkers
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
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Harris JE, Hebert A. Utilization of motor imagery in upper limb rehabilitation: a systematic scoping review. Clin Rehabil 2015; 29:1092-107. [DOI: 10.1177/0269215514566248] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 12/06/2014] [Indexed: 11/15/2022]
Abstract
Objective: To determine how motor imagery is being delivered in upper limb rehabilitation to guide practice and research. Data source: MEDLINE, PubMed, CINAHL, EMBASE, PsychINFO databases were searched from 1987 to November 2014 Study selection: English, adults, any clinical population or diagnosis, intervention for upper limb with an outcome measure used. All types of studies were included. Two authors independently selected studies for review using consensus. Data extraction: Seven motor imagery elements were extracted using a model implemented in sport research: PETTLEP model (Physical, Environment, Task, Timing, Learning, Emotion, and Perspective). Results: The search yielded 1107 articles with 1059 excluded leaving 48 articles for full review. A total of 38 articles involved individuals with stroke, five articles involved individuals with complex regional pain syndrome, and five articles for other conditions. Motor imagery elements most commonly described were physical, environment, task, and perspective. Elements less commonly described were timing, learning, and emotional aspects. There were significant differences between study populations (e.g. stroke and complex regional pain syndrome) and within populations on how motor imagery was delivered. Conclusion: Many of the imagery elements reviewed are not being considered or reported on in the selected studies. How motor imagery is being delivered within and between populations is inconsistent, which may lead to difficulties in determining key elements of effectiveness.
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Affiliation(s)
- JE Harris
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - A Hebert
- Hotel Dieu Shaver Rehabilitation Center, St. Catherines, Ontario, Canada
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Cognitive impairments after cardiac arrest: Implications for clinical daily practice. Resuscitation 2014; 85:A3-4. [DOI: 10.1016/j.resuscitation.2014.09.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 09/29/2014] [Indexed: 11/22/2022]
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Peña J, Ibarretxe-Bilbao N, García-Gorostiaga I, Gomez-Beldarrain MA, Díez-Cirarda M, Ojeda N. Improving functional disability and cognition in Parkinson disease: randomized controlled trial. Neurology 2014; 83:2167-74. [PMID: 25361785 PMCID: PMC4276404 DOI: 10.1212/wnl.0000000000001043] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objectives: To examine the efficacy of an integrative cognitive training program (REHACOP) to improve cognition, clinical symptoms, and functional disability of patients with Parkinson disease (PD). Methods: Forty-two patients diagnosed with PD in Hoehn & Yahr stages 1 to 3 were randomly assigned to either the cognitive training group (REHACOP) or the control group (occupational activities) for 3 months (3 sessions, 60 min/wk). Primary outcomes were change on processing speed, verbal memory, visual memory, executive functioning, and theory of mind. Secondary outcomes included changes on neuropsychiatric symptoms, depression, apathy, and functional disability. The trial was registered with clinicaltrials.gov (NCT02118480). Results: No baseline group differences were found. Bootstrapped analysis of variance results showed significant differences in the mean change scores between the REHACOP group and control group in processing speed (0.13 [SE = 0.07] vs −0.15 [SE = 0.09], p = 0.025), visual memory (0.10 [SE = 0.10] vs −0.24 [SE = 0.09], p = 0.011), theory of mind (1.00 [SE = 0.37] vs −0.27 [SE = 0.29], p = 0.013), and functional disability (−5.15 [SE = 1.35] vs 0.53 [SE = 1.49], p = 0.012). Conclusions: Patients with PD receiving cognitive training with REHACOP demonstrated statistically significant and clinically meaningful changes in processing speed, visual memory, theory of mind, and functional disability. Future studies should consider the long-term effect of this type of intervention. These findings support the integration of cognitive training into the standard of care for patients with PD. Classification of evidence: This study provides Class II evidence that for patients with PD, an integrative cognitive training program improves processing speed, visual memory, theory of mind, and functional disability.
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Affiliation(s)
- Javier Peña
- From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain
| | - Naroa Ibarretxe-Bilbao
- From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain.
| | - Inés García-Gorostiaga
- From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain
| | - Maria Angeles Gomez-Beldarrain
- From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain
| | - María Díez-Cirarda
- From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain
| | - Natalia Ojeda
- From the Department of Methods and Experimental Psychology (J.P., N.I.-B., M.D.-C., N.O.), Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country; and Department of Neurology (I.G.-G., M.A.G.-B.), Galdakao Hospital, Basque Country, Spain
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