1
|
Lovette BC, Kanaya MR, Grunberg VA, McKinnon E, Vranceanu AM, Greenberg J. "Alone in the dark": A qualitative study of treatment experiences among young adults with a recent concussion and anxiety. Neuropsychol Rehabil 2024; 34:781-801. [PMID: 37497984 PMCID: PMC10818011 DOI: 10.1080/09602011.2023.2238950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Young adults with anxiety are vulnerable to developing persistent symptoms following concussions. In order to develop psychosocial interventions to prevent persistent post-concussion symptoms, we need to understand patients' 1) experiences with treatments offered by health care providers; 2) experiences with attempted concussion management strategies; and 3) needs after their injury. METHODS We conducted in-depth interviews with 17 young adults with recent (≤ 10 weeks) concussions who have at least mild anxiety (Generalized Anxiety Disorder Assessment-7 ≥ 5). We used a hybrid deductive-inductive approach to thematic analysis. RESULTS Findings provide insight into recommended treatments (e.g., active/avoidant strategies, accommodations, referrals), attempted strategies (e.g., lifestyle changes, pacing, relationships, acceptance-based coping skills), and patient needs (e.g., education, accommodations, referrals for cognitive and emotional skills). Participants frequently expressed that treatment recommendations were confusing and difficult to implement. They initiated non-prescribed strategies that helped promote recovery and expressed a desire for more interdisciplinary treatment and education on concussions. CONCLUSION Patients' perceptions of health care provider recommendations after concussions did not fully meet patients' perceived needs. Young adults with concussions and anxiety would benefit from more education, guidance, and psychosocial and rehabilitation services. Addressing these gaps may help align treatments with patients' needs and therefore help optimize their recovery.
Collapse
Affiliation(s)
- Brenda C. Lovette
- MGH Institute of Health Professions, Boston, MA, USA
- Center for Health Outcomes and Interdisciplinary Research
(CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA,
USA
- Dr. Robert C. Cantu Concussion Center, Emerson Hospital,
Concord, MA, USA
| | - Millan R. Kanaya
- Center for Health Outcomes and Interdisciplinary Research
(CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA,
USA
| | - Victoria A Grunberg
- Center for Health Outcomes and Interdisciplinary Research
(CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA,
USA
- Harvard Medical School, Boston, MA, USA
- Division of Newborn Medicine, MassGeneral Hospital for
Children, Boston, MA, USA
| | - Ellen McKinnon
- Dr. Robert C. Cantu Concussion Center, Emerson Hospital,
Concord, MA, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research
(CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA,
USA
- Harvard Medical School, Boston, MA, USA
| | - Jonathan Greenberg
- Center for Health Outcomes and Interdisciplinary Research
(CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA,
USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
2
|
Leeson R, Collins M, Douglas J. Interventions that aim to increase social participation through recreation or leisure activity for adults with moderate to severe traumatic brain injury: a scoping review. Disabil Rehabil 2024; 46:3286-3302. [PMID: 37607065 DOI: 10.1080/09638288.2023.2246377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE Social isolation and reduced social participation are common after traumatic brain injury (TBI). Developing interventions that aim to increase social participation through recreation or leisure activities continues to be challenging. This scoping review was conducted to provide an overview of interventions used to increase social participation through in-person recreation or leisure activity for adults with moderate to severe TBI living in the community. METHODS Using the Arksey and O'Malley framework, a scoping review of the literature published from 2005 to 2023 was conducted across four databases: Medline, CINAHL, PsycINFO and Scopus. Quality appraisals were conducted for included studies. RESULTS Following the removal of duplicates, 10,056 studies were screened and 52 were retained for full-text screening. Seven papers were included in the final review. Studies varied with respect to the type of intervention and program outcomes. The interpretation was impeded by study quality, with only two studies providing higher levels of evidence. Barriers and facilitators to successful program outcomes were identified. CONCLUSIONS Few studies with interventions focused on increasing social participation in leisure or recreation activity were identified. Further research incorporating mixed methods and longitudinal design to evaluate effectiveness over time is needed to build the evidence base for increasing social participation through leisure activity.
Collapse
Affiliation(s)
- Rebecca Leeson
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Michelle Collins
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Jacinta Douglas
- Living with Disability Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Summer Foundation, Melbourne, Victoria, Australia
| |
Collapse
|
3
|
Fraser EE, Downing MG, Haines K, Bennett L, Olver J, Ponsford JL. Experience of adapted cognitive behaviour therapy to address sexuality problems after traumatic brain injury: A qualitative study. Neuropsychol Rehabil 2024; 34:572-599. [PMID: 37306485 DOI: 10.1080/09602011.2023.2221858] [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: 07/21/2022] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
Although sexuality has been shown to be negatively impacted in up to half of individuals who sustain traumatic brain injury (TBI), few studies have sought to evaluate the efficacy of targeted interventions. Gaining insight into the participant experience of undergoing treatment for post-TBI sexuality changes is a crucial aspect of intervention evaluation. This study aimed to investigate participants with TBI experience of undergoing eight sessions of a novel CBT intervention designed to help both couples and singles improve sexual wellbeing after TBI. Eight participants (50% male) with moderate-severe TBI, and a mean age of 46.38-years (SD = 13.54), completed a qualitative interview. A six-phase reflexive thematic analysis approach was used. Despite variability in participant characteristics, the findings suggested that participants with TBI experience reflected that of a positive treatment journey characterized by high levels of enjoyment and satisfaction. Key themes identified included contextual factors that preceded treatment, factors that facilitated treatment engagement, outcomes derived from the treatment experience, and feedback provided on reflection. The results not only provide an enriched understanding of the client experience of the intervention but provide corroborating preliminary evidence of efficacy for this novel CBT intervention in addressing complex and persistent sexuality problems after TBI.
Collapse
Affiliation(s)
- Elinor E Fraser
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Epworth Healthcare, Monash-Epworth Rehabilitation Research Centre, Richmond, Australia
| | - Marina G Downing
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Epworth Healthcare, Monash-Epworth Rehabilitation Research Centre, Richmond, Australia
| | - Kerrie Haines
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Linda Bennett
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - John Olver
- Epworth HealthCare, Rehabilitation Medicine, Richmond, Australia
| | - Jennie L Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Epworth Healthcare, Monash-Epworth Rehabilitation Research Centre, Richmond, Australia
| |
Collapse
|
4
|
Weaver JA, Richard AK, Press D, Gupta K, Schmid AA, Stephens JA. Participants With Acquired Brain Injury Realized They "Could Still Do Things" After a Yoga Intervention: A Qualitative Descriptive Study. Am J Occup Ther 2024; 78:7802180150. [PMID: 38345946 PMCID: PMC11017735 DOI: 10.5014/ajot.2024.050409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
IMPORTANCE Occupational therapy practitioners use yoga in practice to achieve holistic care, and the American Occupational Therapy Association has provided guidance on the use of yoga in occupational therapy. For people with acquired brain injury (ABI), however, it is unknown whether yoga affects occupational performance. OBJECTIVE To explore the perceived impact of an adapted yoga intervention on occupational performance using the Occupational Therapy Practice Framework: Domain and Process (4th ed.; OTPF-4) for participants with ABI. DESIGN Qualitative descriptive study using virtual, semistructured interviews. An inductive, holistic, open-coding process, followed by a deductive process to map open codes to the OTPF-4. PARTICIPANTS Nine individuals with ABI were recruited from a yoga intervention study. RESULTS The theme generated from the data-"Yoga participants with ABI realized that they could still do quite a bit"-was supported by two major categories from the OTPF-4: Occupations and Performance Skills. Participants described improvements in their functional performance (i.e., motor skills, process skills) and how these factors were synergistically connected to their occupational performance (i.e., self-care, leisure). CONCLUSIONS AND RELEVANCE This study provides novel insight into how functional performance improved so participants could "still do things," such as engaging in occupations. When participants described improved performance skills, they simultaneously described re-engagement with their meaningful occupations. Participants also perceived an improvement in their mind-body connection, which should be further explored in future studies. This study generated original findings about participants' perceptions of an adapted yoga intervention as they relate to the OTPF-4. Plain-Language Summary: This study reports individuals' perceptions of their re-engagement with occupations and changes in occupational performance skills after participating in an adaptive yoga intervention. We highlight the distinct contribution that adaptive yoga-an intervention modality that can be used by occupational therapy practitioners-may have, using the OTPF-4 to connect the participants' perceptions about their improvements in occupational performance.
Collapse
Affiliation(s)
- Jennifer A Weaver
- Jennifer A. Weaver, PhD, OTR/L, is Assistant Professor, Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins;
| | - Abby K Richard
- Abby K. Richard, BS, is Student, Department of Molecular, Cellular, and Integrative Neurosciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins
| | - Denny Press
- Denny Press, BS, is Student, Department of Molecular, Cellular, and Integrative Neurosciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins
| | - Kalpana Gupta
- Kalpana Gupta, EdD, is Professional Development Lead, Center for Teaching and Learning, University of Colorado Boulder, Boulder
| | - Arlene A Schmid
- Arlene A. Schmid, PhD, OTR, FAOTA, is Professor, Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins
| | - Jaclyn A Stephens
- Jaclyn A. Stephens, PhD, OTR, is Associate Professor, Department of Health and Exercise Science, College of Health and Human Sciences, Colorado State University, Fort Collins
| |
Collapse
|
5
|
de Araujo EL, Rodrigues MR, Kozasa EH, Lacerda SS. Psychoeducation versus psychoeducation integrated with yoga for family caregivers of people with Alzheimer's disease: a randomized clinical trial. Eur J Ageing 2023; 20:46. [PMID: 38006405 PMCID: PMC10676341 DOI: 10.1007/s10433-023-00792-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 11/27/2023] Open
Abstract
We evaluate and compare the effectiveness of two psychoeducation programs on the burden and quality of life of family caregivers of people with Alzheimer's disease: one of psychoeducation alone and the other integrated with yoga. Forty-nine participants were randomly allocated to two groups, 25 to the psychoeducation integrated with yoga group (G1) and 24 to the psychoeducation group (G2). The programs took place online through Google Meet and consisted of eight weekly meetings, lasting 30 min for psychoeducation and 30 min for yoga. Participants were evaluated by the Burden Interview Scale (BI-Zarit), Quality of Life Scale in Alzheimer's Disease-Caregiver Version (CQOL-AD), Depression, Anxiety and Stress Scale (DASS-21), Mindfulness and Awareness Scale (MAAS) and a satisfaction survey. Both groups showed reduced overload according to the BI-Zarit scale (F(1) = 4.435, p = 0.041, η2p = 0.086) and improvement in the domains of physical health (F(1) = 4.881, p = 0.032, η2p = 0.094), memory (F(1) = 4.192, p = 0.046, η2p = 0.082) and money (F(1) = 4.862, p = 0.032, η2p = 0.094) in the CQOL-AD. We detected a significantly higher improvement of G1 in memory (F(1) = 4.192, p = 0.046 η2p = 0.082), money (F(1) = 7.147, p = 0.010, η2p = 0.132) and friends (F(1) = 4.828, p = 0.033, η2p = 0.093). The G1 when compared to the G2 did not demonstrate significant effects of the BI-Zarit, in the total scores CQOL-AD, MAAS and DASS-21. The study showed that both psychoeducation alone and integrated with yoga reduced the burden of family caregivers of people with Alzheimer's disease, and that the integration of online yoga practice with psychoeducation potentiated the improvement only in some aspects of the quality of life and subjective perception of burden reduction.Clinical trial registration https://ensaiosclinicos.gov.br/ , identifier RBR-794593r, retrospectively registered.
Collapse
Affiliation(s)
- Edivaldo Lima de Araujo
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil.
| | | | | | - Shirley Silva Lacerda
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil.
- Hospital Israelita Albert Einstein, São Paulo, Brazil.
| |
Collapse
|
6
|
Kotzur C, Patterson F, Harrington R, Went S, Froude E. Therapeutic groups run for community-dwelling people with acquired brain injury: a scoping review. Disabil Rehabil 2023:1-17. [PMID: 37975242 DOI: 10.1080/09638288.2023.2283099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Therapeutic group interventions are commonly provided in acquired brain injury (ABI) inpatient rehabilitation settings, but little is known about the extent of therapeutic groups run for community-dwellers with ABI. This paper seeks to review current literature concerning the nature of therapeutic groups run for community-dwellers with ABI and the involvement of occupational therapists. MATERIALS & METHODS A scoping review was conducted with systematic searching of relevant databases guided by Arksey and O'Malley's framework. Studies were included if they reported on therapeutic groups for community-dwellers with ABI. Articles were collated and summarised with key findings presented in narrative form with accompanying tables. RESULTS Seventy articles met inclusion. Groups are used as therapeutic change agents for community-dwellers with ABI and target a diverse range of participation barriers. Participants valued group programs that established safe environments, a sense of belonging, growth opportunities and social connections. Group accessibility needs to be improved, with better funding avenues available for service providers, as well as greater consumer involvement in group design and facilitation. CONCLUSIONS Groups are a valuable therapeutic modality supporting community-dwellers with ABI. Further research is warranted into the use of groups by occupational therapists working with community-dwellers with ABI.IMPLICATIONS FOR REHABILITATIONTherapeutic groups can support the development of social connections, community participation and help community-dwellers with ABI re-establish a positive self-identity.Conducting groups in community settings and involving consumers in group design and facilitation may enhance the group experience for participants.Occupational Therapists should be involved in the design and delivery of occupation-based and participation focused group-based programs.
Collapse
Affiliation(s)
- Cheryl Kotzur
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - Freyr Patterson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Rosamund Harrington
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - Samantha Went
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - Elspeth Froude
- School of Allied Health, Australian Catholic University, Sydney, Australia
| |
Collapse
|
7
|
Stephens JA, Press D, Atkins J, Duffy JR, Thomas ML, Weaver JA, Schmid AA. Feasibility of Acquiring Neuroimaging Data from Adults with Acquired Brain Injuries before and after a Yoga Intervention. Brain Sci 2023; 13:1413. [PMID: 37891782 PMCID: PMC10605412 DOI: 10.3390/brainsci13101413] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND To date, no one has prospectively evaluated yoga intervention-induced changes in brain structure or function in adults with acquired brain injuries (ABI). Thus, this study was conducted to test the feasibility of acquiring neuroimaging data from adults with ABI before and after a yoga intervention. METHODS This was a single-arm intervention feasibility study that included 12 adults with chronic (i.e., greater than 6 months post-injury) ABI and self-reported limitations in balance. Neuroimaging data were acquired before and after yoga. The yoga intervention was completed once per week for eight weeks. Feasibility objectives and benchmarks were established a priori. RESULTS Most feasibility objectives and benchmarks were achieved. The goal of recruiting 12 participants was successfully achieved, and 75% of participants were retained throughout the study (goal of 80%). All imaging feasibility benchmarks were met; rs-fMRI and fNIRS data were acquired safely, data were of acceptable quality, and data pre-processing procedures were successful. Additionally, improvements were detected in balance after yoga, as group-level balance was significantly better post-yoga compared to pre-yoga, p = 0.043. CONCLUSIONS These findings indicate it is feasible to acquire neuroimaging data from adults with ABI before and after a yoga intervention. Thus, future prospective studies are warranted.
Collapse
Affiliation(s)
- Jaclyn A. Stephens
- Department of Occupational Therapy, Colorado State University, Fort Collins, CO 80524, USA; (J.A.W.); (A.A.S.)
- Molecular, Cellular and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO 80521, USA (M.L.T.)
| | - Denny Press
- Molecular, Cellular and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO 80521, USA (M.L.T.)
| | | | - John R. Duffy
- Psychology Department, Colorado State University, Fort Collins, CO 80523, USA;
| | - Michael L. Thomas
- Molecular, Cellular and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO 80521, USA (M.L.T.)
- Psychology Department, Colorado State University, Fort Collins, CO 80523, USA;
| | - Jennifer A. Weaver
- Department of Occupational Therapy, Colorado State University, Fort Collins, CO 80524, USA; (J.A.W.); (A.A.S.)
| | - Arlene A. Schmid
- Department of Occupational Therapy, Colorado State University, Fort Collins, CO 80524, USA; (J.A.W.); (A.A.S.)
| |
Collapse
|
8
|
Schafer KM, Wilson E, Joiner T. Traumatic brain injury and suicidality among military veterans: The mediating role of social integration. J Affect Disord 2023; 338:414-421. [PMID: 37364657 DOI: 10.1016/j.jad.2023.06.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/01/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
Suicide is a widespread public health concern, including among military Veterans. Traumatic brain injuries (TBIs) and lack of social integration have both been shown to increase risk for suicidality, an outcome that includes, among other suicide-related variables, suicidal ideation, suicide attempts, and suicide death. Interestingly, TBIs have also been identified as a risk factor for social integration problems. In this cross-sectional study we investigated associations between TBI, social integration, and suicidality. Additionally, mediation analysis was used to test whether social integration mediated the association between TBI and suicidality. A sample of 1469 military Veterans (male, n = 1004, 67.2 %; female, n = 457, 32.3 %; transgender/non-binary/prefer not to say, n = 8, 0.5 %) completed an online survey as part of the Military Health and Well-Being Project. TBI was negatively associated with social integration (r = -0.084, p < .001) and positively with suicidality (r = 0.205, p < .001). Social integration was negatively associated with suicidality (r = -0.161, p < .001). Finally, social integration partially mediated the relationship between TBI and social integration (B = 0.121, 95 % CI [0.031-0.23]). This work shows that in the context of TBI, lack of social integration may promote suicidality. It provides support for many theories of suicide which propose social problems as a risk factor of suicide-related outcomes. It further highlights social integration as potential fodder for novel interventions for suicidality, an approach that would have transtheoretical support.
Collapse
Affiliation(s)
| | - Emma Wilson
- Kings College London, United States; Florida State University, United States
| | | |
Collapse
|
9
|
Naisby J, Wilson-Menzfeld G, Baker K, Morris R, Robinson J, Barry G. Yoga and Multiple Sclerosis: Maintaining engagement in physical activity. PLoS One 2023; 18:e0288319. [PMID: 37467234 DOI: 10.1371/journal.pone.0288319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/25/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Physical activity is encouraged for people with Multiple Sclerosis. Yoga is a popular form of physical activity and is chosen by some people with Multiple Sclerosis. However, little is known about the impact of yoga for this population, alongside what influences ongoing engagement. AIM The aim of this study is to qualitatively explore the impact of online home-based yoga on people with Multiple Sclerosis and to explore factors that influence engagement. METHODS A qualitative study using semi-structured interviews and focus groups with people with Multiple Sclerosis and a yoga teacher. Thematic analysis was used to analyse the data. Ethical Approval was gained from Northumbria University. FINDINGS Three overarching themes emerged from the analysis. 'Yoga as engagement in physical activity' captured the reasoning for participating in yoga and how this method of physical activity was an alternative to physical activity done prior to diagnosis. Frustration was apparent within this theme that some individuals were unable to engage in the range of physical activity that they wished to. 'Yoga is a personalised approach' demonstrated the flexibility and inclusivity of yoga, for individuals with varying symptoms to be able to engage with. Finally, 'yoga impacts individuals both physically and psychologically' captured the focus on the psychological impact of yoga, improving wellbeing and control. CONCLUSIONS Yoga gives people with Multiple Sclerosis the feeling of control over their symptoms and a means to engage with meaningful physical activity. Prior involvement in physical activity influenced engagement in yoga and wanting to push themselves. There was reluctance among this group to engage with aerobic activity, which warrants future investigation and support from health and exercise professionals.
Collapse
Affiliation(s)
- Jenni Naisby
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Gemma Wilson-Menzfeld
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Katherine Baker
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Rosie Morris
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jonathan Robinson
- School of Health and Social Care, Teesside University, Middlesbrough, United Kingdom
| | - Gill Barry
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
10
|
Moore A, Bertotti M, Hanafiah A, Hayes D. Factors affecting the sustainability of community mental health assets: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3369-e3383. [PMID: 35900123 PMCID: PMC10087471 DOI: 10.1111/hsc.13929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/21/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
Resources and activities offered by Voluntary, Community and Social Enterprise (VCSE) organisations could play a key role in supporting communities with their mental health. Whilst policy makers have become increasingly interested in using such asset-based approaches to improve mental health and well-being, the sustainability of these approaches remains underresearched. In this review, we explored the factors affecting the sustainability of community mental health assets. We conducted a systematic review of the literature using keywords based on three key terms: 'sustainability', 'mental health issues' and 'service provision'. Our search strategy was deployed in four electronic databases (MEDLINE, Web of Science, ASSIA and IBSS) and relevant websites were also searched. The literature search was conducted in November and December 2020 and yielded 2486 results. After title and abstract screening, 544 articles were subjected to full-text review. A total of 16 studies were included in a narrative synthesis. Studies included a broad range of community interventions and 30 factors affecting sustainability were identified across three sustainability levels: micro (individual), meso (organisational) and macro (local/national/global). Factors were discussed as barriers or facilitators to sustainability. A key barrier across all sustainability levels was funding (cost to individual participants, lack of available funding for VCSEs, economic uncertainty) whilst a key facilitator was connectedness (social connections, partnering with other organisations, linking with national public health systems). Nearly all articles included no definition of sustainability and the majority of factors identified here were at the meso/organisational level. As funding was found to be such a prevalent barrier, more research into macro level factors (e.g. government policies) is required.
Collapse
Affiliation(s)
- Anna Moore
- Evidence Based Practice Unit (EBPU)University College London and Anna Freud National Centre for Children and Families (AFNCCF)LondonUK
| | - Marcello Bertotti
- Institute for Connected Communities (ICC)University of East LondonLondonUK
| | - Ainul Hanafiah
- Institute for Connected Communities (ICC)University of East LondonLondonUK
| | - Daniel Hayes
- Evidence Based Practice Unit (EBPU)University College London and Anna Freud National Centre for Children and Families (AFNCCF)LondonUK
- Research Department of Behavioural Science and HealthInstitute of Epidemiology & Health Care, University College LondonLondonUK
| |
Collapse
|
11
|
Lovette BC, Kanaya MR, Bannon SM, Vranceanu AM, Greenberg J. "Hidden gains"? Measuring the impact of mindfulness-based interventions for people with mild traumatic brain injury: a scoping review. Brain Inj 2022; 36:1059-1070. [PMID: 36003005 PMCID: PMC9481709 DOI: 10.1080/02699052.2022.2109745] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 08/01/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Mindfulness-based interventions can support recovery from mild traumatic brain injury (mTBI). Although measurement is a key determinant of outcomes, there is no comprehensive assessment of measurement approaches used to capture outcomes of these programs. Here, we review the domains targeted, measurement techniques used, and domains and techniques most affected by mindfulness-based interventions for mTBI. METHODS We conducted a scoping review. After screening and full-text review, we included 29 articles and extracted data related to measurement domains, techniques, and results. RESULTS We identified 8 outcome domains, each with multiple subdomains. The most common domains were cognitive symptoms and general health/quality of life. No quantitative studies directly assessed sleep, physical-function, or pain-catastrophizing. Self-report was the most common measurement technique, followed by performance-based methods. Coping, somatic symptoms, emotional symptoms, stress response, and domains of cognition (particularly attention) were the most frequently improved domains. Qualitative results described benefits across all domains and suggested novel areas of benefit. Biomarkers did not reflect significant change. CONCLUSIONS Mindfulness-based interventions for mTBI impact a range of clinical domains and are best captured with a combination of measurement approaches. Using qualitative methods and expanding the breadth of outcomes may help capture underexplored effects of mindfulness-based interventions for mTBI.
Collapse
Affiliation(s)
- Brenda C. Lovette
- MGH Institute of Health Professions, Boston, MA, USA
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Millan R. Kanaya
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah M. Bannon
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jonathan Greenberg
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
12
|
Krese KA, Donnelly KZ, Etingen B, Bender Pape TL, Chaudhuri S, Aaronson AL, Shah RP, Bhaumik DK, Billups A, Bedo S, Wanicek-Squeo MT, Bobra S, Herrold AA. Feasibility of a Combined Neuromodulation and Yoga Intervention for Mild Traumatic Brain Injury and Chronic Pain: Protocol for an Open-label Pilot Trial. JMIR Res Protoc 2022; 11:e37836. [PMID: 35704372 PMCID: PMC9244651 DOI: 10.2196/37836] [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: 03/08/2022] [Accepted: 03/16/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Mild traumatic brain injury (mTBI) and chronic pain often co-occur and worsen rehabilitation outcomes. There is a need for improved multimodal nonpharmacologic treatments that could improve outcomes for both conditions. Yoga is a promising activity-based intervention for mTBI and chronic pain, and neuromodulation through transcranial magnetic stimulation is a promising noninvasive, nonpharmacological treatment for mTBI and chronic pain. Intermittent theta burst stimulation (iTBS) is a type of patterned, excitatory transcranial magnetic stimulation. iTBS can induce a window of neuroplasticity, making it ideally suited to boost the effects of treatments provided after it. Thus, iTBS may magnify the impacts of subsequently delivered interventions as compared to delivering those interventions alone and accordingly boost their impact on outcomes. OBJECTIVE The aim of this study is to (1) develop a combined iTBS+yoga intervention for mTBI and chronic pain, (2) assess the intervention's feasibility and acceptability, and (3) gather preliminary clinical outcome data on quality of life, function, and pain that will guide future studies. METHODS This is a mixed methods, pilot, open-labeled, within-subject intervention study. We will enroll 20 US military veteran participants. The combined iTBS+yoga intervention will be provided in small group settings once a week for 6 weeks. The yoga intervention will follow the LoveYourBrain yoga protocol-specifically developed for individuals with TBI. iTBS will be administered immediately prior to the LoveYourBrain yoga session. We will collect preliminary quantitative outcome data before and after the intervention related to quality of life (TBI-quality of life), function (Mayo-Portland Adaptability Index), and pain (Brief Pain Inventory) to inform larger studies. We will collect qualitative data via semistructured interviews focused on intervention acceptability after completion of the intervention. RESULTS This study protocol was approved by Edward Hines Jr Veterans Administration Hospital Institutional Review Board (Hines IRB 1573116-4) and was prospectively registered on ClinicalTrials.gov (NCT04517604). This study includes a Food and Drug Administration Investigational Device Exemption (IDE: G200195). A 2-year research plan timeline was developed. As of March 2022, a total of 6 veterans have enrolled in the study. Data collection is ongoing and will be completed by November 2022. We expect the results of this study to be available by October 2024. CONCLUSIONS We will be able to provide preliminary evidence of safety, feasibility, and acceptability of a novel combined iTBS and yoga intervention for mTBI and chronic pain-conditions with unmet treatment needs. TRIAL REGISTRATION ClinicalTrials.gov NCT04517604; https://www.clinicaltrials.gov/ct2/show/NCT04517604. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/37836.
Collapse
Affiliation(s)
- Kelly A Krese
- Brain Innovation Center, Shirley Ryan AbilityLab, Chicago, IL, United States
- Research and Development Service, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
| | | | - Bella Etingen
- Center for Innovation in Complex Chronic Healthcare & Research Service, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
| | - Theresa L Bender Pape
- Research and Development Service, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
- Center for Innovation in Complex Chronic Healthcare & Research Service, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Sarmistha Chaudhuri
- Department of Physical Medicine and Rehabilitation, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
| | - Alexandra L Aaronson
- Mental Health Service Line, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
- Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Hines, IL, United States
| | - Rachana P Shah
- Department of Physical Medicine and Rehabilitation, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
| | - Dulal K Bhaumik
- Research and Development Service, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
- Department of Psychiatry, University of Illinois Chicago, Chicago, IL, United States
| | - Andrea Billups
- Research and Development Service, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
| | - Sabrina Bedo
- Department of Physical Medicine and Rehabilitation, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
- Recreation Therapy, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
| | - Mary Terese Wanicek-Squeo
- Recreation Therapy, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
- Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
| | - Sonia Bobra
- Department of Radiology, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
- Department of Radiology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL, United States
| | - Amy A Herrold
- Research and Development Service, Edward Hines Jr Veterans Administration Hospital, Hines, IL, United States
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| |
Collapse
|
13
|
Quilico EL, Alarie C, Swaine BR, Colantonio A. Characteristics, Outcomes, Sex and Gender Considerations of Community-Based Physical Activity Interventions after Moderate-to-Severe Traumatic Brain Injury: Scoping Review. Brain Inj 2022; 36:295-305. [PMID: 35394859 DOI: 10.1080/02699052.2022.2059815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This scoping review mapped the current evidence about community-based physical activity (PA) interventions for individuals with moderate-to-severe traumatic brain injury (TBI) and identified the reported health-related outcomes, measurement tools used, and considerations given to sex and gender. METHODS Searches were conducted in six academic databases for peer-reviewed articles (MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL, SPORTDiscus, and PEDro). PRISMA Scoping Review guidelines were followed. Two reviewers independently screened articles for inclusion and extracted data for the analysis with a modified Consensus on Exercise Reporting Template (CERT). Health-related outcomes were classified with domains of the International Classification of Function, Disability and Health (ICF). RESULTS 19 studies were identified. Seven PA intervention types were included. CERT scores varied (M = 12.74, SD = 3.51 items), with limited details for replication. ICF outcomes focused on improving body functions (74%), activities and participation (14%), environmental factors (1%), and other: not covered (11%). Only four studies (21%) stratified their results by sex or gender. CONCLUSIONS Identified PA interventions from this review revealed common characteristics that led to improved outcomes. Proposed recommendations aim to improve future research and community practice. There is a pressing need for more sex and gender considerations in PA research after moderate-to-severe TBI.
Collapse
Affiliation(s)
- Enrico L Quilico
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | | | - Bonnie R Swaine
- École de réadaptation, Université de Montréal, Montréal, QC, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
14
|
Bracho-Ponce MJ, Grasso-Cladera A, Salas C, Lassaletta A. ‘I am not who you think I am’: public stigma and invisible brain injury (‘No soy quien creen que soy’: estigma público y daño cerebral invisible). STUDIES IN PSYCHOLOGY 2022. [DOI: 10.1080/02109395.2021.2006947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
| | | | - Christian Salas
- Universidad Diego Portales
- Centro de Estudios en Neurociencia Humana y Unidad de Neuropsicología Clínica
| | | |
Collapse
|
15
|
Schulze T, Hahn E, Hahne I, Bergmann N, Fuchs LM, Mähler F, Zierhut MM, Ta TMT, Pijnenborg GHM, Böge K. Yoga-Based Group Intervention for In-patients With Schizophrenia Spectrum Disorders-A Qualitative Approach. Front Psychiatry 2021; 12:715670. [PMID: 34484004 PMCID: PMC8414901 DOI: 10.3389/fpsyt.2021.715670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Yoga may pose a promising complementary therapy in the multimodal treatment of in-patients with schizophrenia spectrum disorders (SSD). However, to date, no studies have qualitatively examined in-patients' with SSD experiences of Yoga as well as their perceptions of its limitations and benefits as a treatment component. This qualitative study aimed to explore for the first time the mechanisms and processes of Yoga-based Group Intervention (YoGI) for in-patients with SSD in Germany by asking for their subjective experiences. Findings could serve as a preliminary basis for developing an effective and evidence-based YoGI manual tailored to this patient group. Materials and Methods: In total, 25 semi-structured interviews were conducted directly after YoGI, for which responses were either noted down by hand or audio-recorded. The interview guide was pilot-tested and consisted of 14 questions to explore the personal articulated experiences of participation in YoGI from in-patients with SSD. Positive, negative, depressive, and anxiety symptoms were assessed during a diagnostic interview and through questionnaires. The interview data was transcribed, coded by two independent researchers, and analysed using an inductive thematic approach. The research team collaboratively discussed emerging categories to reduce redundancy and form meaningful themes and subthemes. Results: The analysis revealed seven main themes. YoGI was perceived as feasible and focusing on individual adaptation, captured by the theme inclusivity. Nevertheless, participants encountered challenges; thus, physical limitations need to be considered. While practising together, participants experienced interconnectedness and developed a mindful stance as they accepted their limitations and adapted exercises with self-compassion. Patients described that following the flow of the asanas required physical persistence, which ultimately led many participants to experience confidence and relaxation. YoGI affected symptom representation as heightened awareness led participants to notice impeding as well as improved symptoms. Conclusion: YoGI showed various promising effects on in-patients with SSD. Future research should examine to what extent these effects can be sustained and how the mindful approach during YoGI can be transferred to areas outside the Yoga class. Furthermore, a randomised controlled trial could investigate the effectiveness of a manualised YoGI.
Collapse
Affiliation(s)
- Theresa Schulze
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department Clinical Psychology and Experimental Psychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Inge Hahne
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Niklas Bergmann
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | - Franziska Mähler
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Marco Matthäus Zierhut
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Thi Minh Tam Ta
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gerdina Hendrika Maria Pijnenborg
- Department Clinical Psychology and Experimental Psychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Kerem Böge
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, A Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| |
Collapse
|
16
|
Driver S, Douglas M, Reynolds M, McShan E, Swank C, Dubiel R. A narrative review of biopsychosocial factors which impact overweight and obesity for individuals with acquired brain injury. Brain Inj 2021; 35:1075-1085. [PMID: 34324396 DOI: 10.1080/02699052.2021.1953596] [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: 10/20/2022]
Abstract
Primary Objective: To discuss the biopsychosocial factors that affect being overweight or obese after acquired brain injury (ABI)Research Design: Narrative reviewMethods and Procedures: Based on the biopsychosocial model, we discuss the unique injury-specific factors that can affect bring overweight or obese among individuals with ABI including: (1) biological, (2) psychological and (3) social/ecological factors.Main Outcomes and Results: Injury-specific factors that impact being overweight or obese following ABI include endocrine dysfunction, pain, bowel and bladder incontinence, balance problems and motor impairment, medications, sleep quality and fatigue, alcohol and tobacco use, psychological disorders and symptoms, cognitive changes, social support, isolation, participation, transportation, independence, and knowledge. These factors may also compound general factors impacting weight management, making it difficult for individuals with ABI to maintain a healthy lifestyle.Conclusions: It is important to recognize the biopsychosocial factors that impact weight-loss and lifestyle change after ABI so that interventions can be tailored to meet individuals' unique needs. Empirical research is needed to better understand how biopsychosocial factors interact and impact overweight/ obesity after ABI.
Collapse
Affiliation(s)
- Simon Driver
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, United States of America
| | - Megan Douglas
- Rehabilitation Research Department, Baylor Scott and White Research Institute, Dallas, Texas
| | - Megan Reynolds
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, United States of America
| | - Evan McShan
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, United States of America
| | - Chad Swank
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, United States of America
| | - Randi Dubiel
- Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas, United States of America
| |
Collapse
|
17
|
Yoga for Healthy Aging: Science or Hype? ACTA ACUST UNITED AC 2021; 3. [PMID: 34368806 PMCID: PMC8341166 DOI: 10.20900/agmr20210016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Yoga, one of the world’s oldest health systems is receiving new attention for claims that it can contribute to healthy aging. Until recently, scientific evidence for its efficacy has relied heavily on small and poorly-designed research, but this is changing. Multiple, well-designed studies provide data showing that yoga practice has positive effects on cellular aging, mobility, balance, mental health, and prevention of cognitive decline—all areas of concern for older adults. Since the cost of implementing yoga-based community and home-based interventions is low—policymakers are also eyeing yoga practice as a cost-effective way to reduce medical costs and improve outcomes among a growing aging population. This commentary reviews the evidence for both physical and mental health benefits from yoga, as well as concerns about injuries that have been associated with certain types of yoga practice. It reveals a surprising range of yoga programs and difficulty levels that provide opportunities for almost anyone to participate and gain health benefits with practice.
Collapse
|
18
|
Short MR, Hernandez-Pavon JC, Jones A, Pons JL. EEG hyperscanning in motor rehabilitation: a position paper. J Neuroeng Rehabil 2021; 18:98. [PMID: 34112208 PMCID: PMC8194127 DOI: 10.1186/s12984-021-00892-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/31/2021] [Indexed: 11/10/2022] Open
Abstract
Studying the human brain during interpersonal interaction allows us to answer many questions related to motor control and cognition. For instance, what happens in the brain when two people walking side by side begin to change their gait and match cadences? Adapted from the neuroimaging techniques used in single-brain measurements, hyperscanning (HS) is a technique used to measure brain activity from two or more individuals simultaneously. Thus far, HS has primarily focused on healthy participants during social interactions in order to characterize inter-brain dynamics. Here, we advocate for expanding the use of this electroencephalography hyperscanning (EEG-HS) technique to rehabilitation paradigms in individuals with neurological diagnoses, namely stroke, spinal cord injury (SCI), Parkinson's disease (PD), and traumatic brain injury (TBI). We claim that EEG-HS in patient populations with impaired motor function is particularly relevant and could provide additional insight on neural dynamics, optimizing rehabilitation strategies for each individual patient. In addition, we discuss future technologies related to EEG-HS that could be developed for use in the clinic as well as technical limitations to be considered in these proposed settings.
Collapse
Affiliation(s)
- Matthew R Short
- Legs + Walking Lab, Shirley Ryan AbilityLab, Floor 24, 355 E Erie St, Chicago, IL, 60611, USA.,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA
| | - Julio C Hernandez-Pavon
- Legs + Walking Lab, Shirley Ryan AbilityLab, Floor 24, 355 E Erie St, Chicago, IL, 60611, USA.,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Alyssa Jones
- Legs + Walking Lab, Shirley Ryan AbilityLab, Floor 24, 355 E Erie St, Chicago, IL, 60611, USA
| | - Jose L Pons
- Legs + Walking Lab, Shirley Ryan AbilityLab, Floor 24, 355 E Erie St, Chicago, IL, 60611, USA. .,Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA. .,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| |
Collapse
|
19
|
Tucker J, Beitscher I, Koc Jr. TA, Fama G, Patel J, Friedman H. Creative therapeutic interventions for clinicians to promote physical activity in older adults with a history of brain injury: a viewpoint. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2020.1850164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
20
|
Acabchuk RL, Brisson JM, Park CL, Babbott-Bryan N, Parmelee OA, Johnson BT. Therapeutic Effects of Meditation, Yoga, and Mindfulness-Based Interventions for Chronic Symptoms of Mild Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Appl Psychol Health Well Being 2020; 13:34-62. [PMID: 33136346 DOI: 10.1111/aphw.12244] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic symptoms of mild traumatic brain injury (mTBI) vary greatly and are difficult to treat; we investigate the impact of meditation, yoga, and mindfulness-based interventions on this treatment group. METHOD Search included four databases, allowing studies of any design containing pre/post outcomes for meditation, yoga, or mindfulness-based interventions in people suffering from brain injury acquired by mechanical force. Analyses used robust variance estimation to assess overall effects and random-effects models for selected outcomes; we evaluated both between- and within-group changes. RESULTS Twenty studies (N = 539) were included. Results revealed significant improvement of overall symptoms compared to controls (d = 0.41; 95% CI [0.04, 0.77]; τ2 = 0.06), with significant within-group improvements in mental health (d = 0.39), physical health (d = 0.39), cognitive performance (d = 0.24), quality of life (d = 0.39), and self-related processing (d = 0.38). Symptoms showing greatest improvement were fatigue (d = 0.96) and depression (d = 0.40). Findings were homogeneous across studies. Study quality concerns include lack of randomisation, blinding, and recording of adverse events. CONCLUSIONS This first-ever meta-analysis on meditation, yoga, and mindfulness-based interventions for chronic symptoms of mTBI offers hope but highlights the need for rigorous new trials to advance clinical applications and to explore mechanistic pathways.
Collapse
|
21
|
Stephens JA, Van Puymbroeck M, Sample PL, Schmid AA. Yoga improves balance, mobility, and perceived occupational performance in adults with chronic brain injury: A preliminary investigation. Complement Ther Clin Pract 2020; 40:101172. [PMID: 32347208 DOI: 10.1016/j.ctcp.2020.101172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/31/2020] [Accepted: 04/03/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND PURPOSE This was a preliminary investigation to investigate potential benefits of group yoga, as past work has indicated that one-on-one yoga can improve functional deficits in adults with brain injury. MATERIALS AND METHODS Participants served as their own controls. Nine participants with chronic brain injury were recruited, and seven (four female) completed the study. Performance measures of balance and mobility and self-reported measures of balance confidence, pain, and occupational performance and satisfaction were used. Data were collected 3 times: baseline (study onset), pre-yoga (after an 8-week no-contact period), and post-yoga (after 8 weeks of yoga). Group yoga was led by a yoga instructor/occupational therapist, and sessions lasted 1 h and occurred twice a week. RESULTS No participants withdrew due to adverse effects from yoga. There were no significant changes between baseline and pre-yoga. Significant improvement was observed post-yoga in balance (p = 0.05), mobility (p = 0.03), and self-reported occupational performance (p = 0.04). CONCLUSION We observed significant improvements in balance, mobility, and self-reported occupational performance in adults with chronic brain injury.
Collapse
Affiliation(s)
- J A Stephens
- Colorado State University, Department of Occupational Therapy, USA.
| | | | - P L Sample
- Colorado State University, Department of Occupational Therapy, USA.
| | - A A Schmid
- Colorado State University, Department of Occupational Therapy, USA.
| |
Collapse
|
22
|
Donnelly KZ, Baker K, Pierce R, St Ivany AR, Barr PJ, Bruce ML. A retrospective study on the acceptability, feasibility, and effectiveness of LoveYourBrain Yoga for people with traumatic brain injury and caregivers. Disabil Rehabil 2019; 43:1764-1775. [PMID: 31577456 DOI: 10.1080/09638288.2019.1672109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To conduct a mixed methods, pre-post, retrospective study on the feasibility, acceptability, and effectiveness of the LoveYourBrain Yoga program. MATERIALS AND METHODS People were eligible if they were a traumatic brain injury survivor or caregiver, age 15-70, ambulatory, and capable of gentle exercise and group discussion. We analyzed attendance, satisfaction, and mean differences in scores on Quality of Life After Brain Injury Overall scale (QOLIBRI-OS) and four TBI-QOL/Neuro-QOL scales. Content analysis explored perceptions of benefits and areas of improvement. RESULTS 1563 people (82.0%) participated ≥1 class in 156 programs across 18 states and 3 Canadian provinces. Mean satisfaction was 9.3 out of 10 (SD 1.0). Mixed effects linear regression found significant improvements in QOLIBRI-OS (B 9.70, 95% CI: 8.51, 10.90), Resilience (B 1.30, 95% CI: 0.60, 2.06), Positive Affect and Well-being (B 1.49, 95% CI: 1.14, 1.84), and Cognition (B 1.48, 95% CI: 0.78, 2.18) among traumatic brain injury survivors (n = 705). No improvement was found in Emotional and Behavioral Dysregulation, however, content analysis revealed better ability to regulate anxiety, anger, stress, and impulsivity. Caregivers perceived improvements in physical and psychological health. CONCLUSIONS LoveYourBrain Yoga is feasible and acceptable and may be an effective mode of community-based rehabilitation.IMPLICATIONS FOR REHABILITATIONPeople with traumatic brain injury and their caregivers often experience poor quality of life and difficulty accessing community-based rehabilitation services.Yoga is a holistic, mind-body therapy with many benefits to quality of life, yet is largely inaccessible to people affected by traumatic brain injury in community settings.Participants in LoveYourBrain Yoga, a six-session, community-based yoga with psychoeducation program in 18 states and 3 Canadian provinces, experienced significant improvements in quality of life, resilience, cognition, and positive affect.LoveYourBrain Yoga is feasible and acceptable when implemented on a large scale and may be an effective mode of, or adjunct to, community-based rehabilitation.
Collapse
Affiliation(s)
- Kyla Z Donnelly
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA.,The LoveYourBrain Foundation, Windsor, VT, USA
| | - Kim Baker
- The LoveYourBrain Foundation, Windsor, VT, USA
| | | | - Amanda R St Ivany
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | - Paul J Barr
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| | - Martha L Bruce
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Lebanon, NH, USA
| |
Collapse
|