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Dobryakova E, Tong TT, Iosipchuk O, Lequerica A, Schneider V, Chiaravalloti N, Sandry J. Bypassing Striatal Learning Mechanisms Using Delayed Feedback to Circumvent Learning Deficits in Traumatic Brain Injury. J Head Trauma Rehabil 2024:00001199-990000000-00147. [PMID: 39046329 DOI: 10.1097/htr.0000000000000947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
OBJECTIVE Feedback facilitates learning by guiding and modifying behaviors through an action-outcome contingency. As the majority of existing studies have focused on the immediate presentation of feedback, the impact of delayed feedback on learning is understudied. Prior work demonstrated that learning from immediate and delayed feedback employed distinct brain regions in healthy individuals, and compared to healthy individuals, individuals with traumatic brain injury (TBI) are impaired in learning from immediate feedback. The goal of the current investigation was to assess the effects of delayed vs immediate feedback on learning in individuals with TBI and examine brain networks associated with delayed and immediate feedback processing. SETTING Nonprofit research organization. PARTICIPANTS Twenty-eight individuals with moderate-to-severe TBI. DESIGN Participants completed a paired-associate word learning task while undergoing magnetic resonance imaging. During the task, feedback was presented either immediately, after a delay, or not at all (control condition). MAIN MEASURES Learning performance accuracy, confidence ratings, post-task questionnaire, and blood oxygen level-dependent signal. RESULTS Behavioral data showed that delayed feedback resulted in better learning performance than immediate feedback and no feedback. In addition, participants reported higher confidence in their performance during delayed feedback trials. During delayed vs immediate feedback processing, greater activation was observed in the superior parietal and angular gyrus. Activation in these areas has been previously associated with successful retrieval and greater memory confidence. CONCLUSION The observed results might be explained by delayed feedback processing circumventing the striatal dopaminergic regions responsible for learning from immediate feedback that are impaired in TBI. In addition, delayed feedback evokes less of an affective reaction than immediate feedback, which likely benefited memory performance. Indeed, compared to delayed feedback, positive or negative immediate feedback was more likely to be rated as rewarding or punishing, respectively. The findings have significant implications for TBI rehabilitation and suggest that delaying feedback during rehabilitation might recruit brain regions that lead to better functional outcomes.
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Affiliation(s)
- Ekaterina Dobryakova
- Author Affiliations: Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, (Dr Dobryakova, Dr Tong, Ms Iosipchuk, Dr Lequerica, Ms Schneider, and Dr Chiaravalloti); Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, (Drs Dobryakova, Lequerica, and Chiaravalloti); and Psychology Department, Montclair State University, Montclair, New Jersey (Dr Sandry)
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Salazar-Frías D, Rodríguez-Bailón M, Ricchetti G, Navarro-Egido A, de Los Santos M, Funes MJ. Training to deal with distractions and conflicting situations in activities of daily living after traumatic brain injury (TBI): Preliminary evidence from a single-case experimental design study. Neuropsychol Rehabil 2024:1-36. [PMID: 39010748 DOI: 10.1080/09602011.2024.2375495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 06/28/2024] [Indexed: 07/17/2024]
Abstract
TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03958487.
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Affiliation(s)
- Daniel Salazar-Frías
- Mind, Brain and Behaviour Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - María Rodríguez-Bailón
- Physiotherapy (Occupational Therapy) Department, Health Science School, University of Málaga, Málaga, Spain
| | - Giorgia Ricchetti
- Mind, Brain and Behaviour Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - Alba Navarro-Egido
- Mind, Brain and Behaviour Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - Macarena de Los Santos
- Mind, Brain and Behaviour Research Centre (CIMCYC), Methodology of Behavioural Sciences Department, School of Psychology, University of Granada, Granada, Spain
| | - María Jesús Funes
- Mind, Brain and Behaviour Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
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Sansonetti D, Fleming J, Patterson F, Lannin NA, Toglia J. Online awareness: a concept analysis and review of assessment approaches for adults with neurological conditions. Disabil Rehabil 2024:1-16. [PMID: 38596894 DOI: 10.1080/09638288.2024.2338876] [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: 10/05/2023] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE Self-awareness is a multifaceted phenomenon that comprises two main concepts: general awareness and online awareness. The latter is an emerging concept that requires further consensus on its definition. The aim of this paper is to define the key components of online awareness and identify approaches for measuring this concept for adults with neurological conditions. MATERIALS AND METHODS Concept analysis using Rodgers' evolutionary method was used to systematically review and summarise relevant literature. Papers were included if they provided a definition of online awareness or method for assessing online awareness for an adult neurological population. RESULTS Fifty-six papers were included in this review, with 21 online awareness assessment approaches identified. Online awareness was described to occur within the context of task performance, with the definition framework comprising four main aspects: 1/appraisal; 2/anticipation and prediction; 3/monitoring; and 4/self-evaluation. Self-regulation is a related concept that is considered to sit outside the conceptual boundaries of online awareness. CONCLUSIONS The findings of this analysis highlight the complexity of online awareness and its importance in rehabilitation. Psychometrically robust measures of online awareness that are inclusive of the essential elements of this concept are needed to advance practice in this area.
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Affiliation(s)
- Danielle Sansonetti
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Occupational Therapy Department, Alfred Health, Melbourne, Australia
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Freyr Patterson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Natasha A Lannin
- Occupational Therapy Department, Alfred Health, Melbourne, Australia
- Department of Neuroscience, Monash University, Clayton, Victoria, Australia
| | - Joan Toglia
- School of Health and Natural Sciences, Mercy University, Dobbs Ferry, New York, USA
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Hingst R, Alvarado DC, Bardin L, Farmer N. Occupational therapy and cooking: A scoping review and future directions. Scand J Occup Ther 2024; 31:2267081. [PMID: 38065686 DOI: 10.1080/11038128.2023.2267081] [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: 05/04/2023] [Accepted: 09/30/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Occupational therapy (OT) has historically used cooking as an intervention and assessment approach across settings. Current practices in OT and the emergence of the multidisciplinary field of culinary medicine highlight the relationship between cooking and health. AIMS/OBJECTIVES To map the current literature on OT and cooking and to identify key factors that may facilitate collaboration within culinary medicine. MATERIALS AND METHODS We conducted a scoping review using the Joanna Briggs Institute methodology to identify primary contexts and clinical settings. Publications were analysed using framework thematic analysis to identify OT themes and roles. RESULTS A total of 56 studies met the criteria for inclusion. The majority of studies (n = 29, 53%) represented home/community settings and brain injury was the largest clinical group (n = 15, 27%). Primary themes related to person (n = 47, 43%), occupation (n = 30 (28%), environment (n = 19, 17%), and psychosocial wellbeing (n = 13, 12%). The primary OT role identified was that of interventionist (n = 48, 86%). CONCLUSIONS/SIGNIFICANCE OT's holistic practice places cooking within a larger context that can help identify and overcome the barriers to participation. Findings support multiple pathways in which OT can contribute to cooking initiatives for health promotion and potentially expand OT practice in population health.
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Affiliation(s)
- R Hingst
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - D C Alvarado
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - L Bardin
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
| | - N Farmer
- Translational Biobehavioral and Health Disparities Branch, Office of the Director, National Institutes of Health Clinical Center, Bethesda, Maryland, USA
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INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part III: Executive Functions. J Head Trauma Rehabil 2023; 38:52-64. [PMID: 36594859 DOI: 10.1097/htr.0000000000000834] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Moderate-to-severe traumatic brain injury (MS-TBI) causes debilitating and enduring impairments of executive functioning and self-awareness, which clinicians often find challenging to address. Here, we provide an update to the INCOG 2014 guidelines for the clinical management of these impairments. METHODS An expert panel of clinicians/researchers (known as INCOG) reviewed evidence published from 2014 and developed updated recommendations for the management of executive functioning and self-awareness post-MS-TBI, as well as a decision-making algorithm, and an audit tool for review of clinical practice. RESULTS A total of 8 recommendations are provided regarding executive functioning and self-awareness. Since INCOG 2014, 4 new recommendations were made and 4 were modified and updated from previous recommendations. Six recommendations are based on level A evidence, and 2 are based on level C. Recommendations retained from the previous guidelines and updated, where new evidence was available, focus on enhancement of self-awareness (eg, feedback to increase self-monitoring; training with video-feedback), meta-cognitive strategy instruction (eg, goal management training), enhancement of reasoning skills, and group-based treatments. New recommendations addressing music therapy, virtual therapy, telerehabilitation-delivered metacognitive strategies, and caution regarding other group-based telerehabilitation (due to a lack of evidence) have been made. CONCLUSIONS Effective management of impairments in executive functioning can increase the success and well-being of individuals with MS-TBI in their day-to-day lives. These guidelines provide management recommendations based on the latest evidence, with support for their implementation, and encourage researchers to explore and validate additional factors such as predictors of treatment response.
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Wadams A, Suting L, Lindsey A, Mozeiko J. Metacognitive Treatment in Acquired Brain Injury and Its Applicability to Aphasia: A Systematic Review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:813416. [PMID: 36188940 PMCID: PMC9397955 DOI: 10.3389/fresc.2022.813416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/11/2022] [Indexed: 11/30/2022]
Abstract
Purpose The purpose of this systematic review is to identify the utility of metacognitive therapeutic intervention for persons with acquired brain injury (ABI), with a focus on persons with aphasia. Methods A search of six databases resulted in two hundred and sixty-six unique manuscripts relating to the explicit use of metacognitive treatment for people with ABI. Two independent reviewers rated abstracts for inclusion or exclusion of the study given predetermined criteria. Twenty-nine articles, five of which included people with aphasia, were selected for inclusion in this systematic review. SCED+ and PEDro+ rating scales were used to rate the methodological quality of each study. Results Methodological quality of the 29 studies that met inclusion criteria ranged from weak to high quality studies. Three -hundred and sixty-nine individuals with ABI took part in the 29 studies. Varying treatment methods were employed. Outcome measures were inconsistent. Metacognitive treatment has been applied to people with aphasia with positive results, but efficacy of the treatment cannot yet be determined. Conclusions Metacognitive therapeutic intervention tends to be effective for persons with acquired brain injury (ABI) despite variability between intervention designs and treatment outcomes across studies. Due to so few studies with participants with aphasia, we were unable to draw conclusions regarding the efficacy of metacognitive treatment for people with aphasia. Further research on the efficacy of metacognitive treatment for this population is warranted.
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Affiliation(s)
- Amanda Wadams
- Department of Speech, Language and Hearing Science, University of Connecticut, Mansfield, MA, United States
- *Correspondence: Amanda Wadams
| | - Louisa Suting
- Department of Speech, Language and Hearing Science, University of Connecticut, Mansfield, MA, United States
| | - André Lindsey
- School of Education, Speech Pathology, Nevada State College, Henderson, NV, United States
| | - Jennifer Mozeiko
- Department of Speech, Language and Hearing Science, University of Connecticut, Mansfield, MA, United States
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Mohapatra S, Kulnik ST. Kitchen-related tasks used in occupational therapy during rehabilitation of adults with acquired brain injury: A systematic review. Br J Occup Ther 2020. [DOI: 10.1177/0308022620950975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Kitchen-related tasks are widely used in occupational therapy for adults with acquired brain injury. This study aimed to investigate the effectiveness of kitchen-related, task-based occupational therapy interventions for improving clinical and functional outcomes in the rehabilitation of adults with acquired brain injury. Method A systematic review of the literature was conducted with narrative synthesis (PROSPERO registration CRD42019141898), by searching relevant electronic databases (BNI, CINAHL Plus, MEDLINE, DORIS, OT Seeker etc.), registries of ongoing studies (ISRCTN, PROSPERO, etc.), and grey literature (OpenGrey, etc.). English-language studies that evaluated kitchen-related tasks in the rehabilitation of adults with acquired brain injury were included and independently appraised for their methodological quality by two reviewers. Results Seventeen primary studies met the eligibility criteria. Studies were heterogeneous in methods, methodological quality, setting, sample size, purpose, and design of kitchen-related tasks. Fifteen studies evaluated kitchen-related, task-based treatments for improving function, and two studies examined kitchen-related task assessments for safety and task performance. This provides very limited evidence for the effectiveness of kitchen-related, task-based interventions compared to interventions not based on kitchen-related tasks. Conclusion While kitchen-related, task-based occupational therapy interventions in acquired brain injury rehabilitation are common practice, there is currently limited research evidence to support this. Further studies are warranted to strengthen the evidence base.
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Affiliation(s)
- Sushmita Mohapatra
- Division of Occupational Therapy, College of Health and Life Sciences, Brunel University London, UK
| | - Stefan Tino Kulnik
- Faculty of Health, Social Care and Education, Kingston University and St George’s University of London, London, UK
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Ranner M, Guidetti S, von Koch L, Tham K. Experiences of participating in a client-centred ADL intervention after stroke. Disabil Rehabil 2018; 41:3025-3033. [DOI: 10.1080/09638288.2018.1483434] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Maria Ranner
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Susanne Guidetti
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lena von Koch
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Kerstin Tham
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Faculty of Health and Society, Malmö University, Malmö, Sweden
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Engel L, Chui A, Goverover Y, Dawson DR. Optimising activity and participation outcomes for people with self-awareness impairments related to acquired brain injury: an interventions systematic review. Neuropsychol Rehabil 2017; 29:163-198. [DOI: 10.1080/09602011.2017.1292923] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Lisa Engel
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Adora Chui
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Yael Goverover
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA
| | - Deirdre R. Dawson
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
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Hendry K, Ownsworth T, Beadle E, Chevignard MP, Fleming J, Griffin J, Shum DHK. Cognitive Deficits Underlying Error Behavior on a Naturalistic Task after Severe Traumatic Brain Injury. Front Behav Neurosci 2016; 10:190. [PMID: 27790099 PMCID: PMC5063844 DOI: 10.3389/fnbeh.2016.00190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/26/2016] [Indexed: 11/19/2022] Open
Abstract
People with severe traumatic brain injury (TBI) often make errors on everyday tasks that compromise their safety and independence. Such errors potentially arise from the breakdown or failure of multiple cognitive processes. This study aimed to investigate cognitive deficits underlying error behavior on a home-based version of the Cooking Task (HBCT) following TBI. Participants included 45 adults (9 females, 36 males) with severe TBI aged 18–64 years (M = 37.91, SD = 13.43). Participants were administered the HBCT in their home kitchens, with audiovisual recordings taken to enable scoring of total errors and error subtypes (Omissions, Additions, Estimations, Substitutions, Commentary/Questions, Dangerous Behavior, Goal Achievement). Participants also completed a battery of neuropsychological tests, including the Trail Making Test, Hopkins Verbal Learning Test-Revised, Digit Span, Zoo Map test, Modified Stroop Test, and Hayling Sentence Completion Test. After controlling for cooking experience, greater Omissions and Estimation errors, lack of goal achievement, and longer completion time were significantly associated with poorer attention, memory, and executive functioning. These findings indicate that errors on naturalistic tasks arise from deficits in multiple cognitive domains. Assessment of error behavior in a real life setting provides insight into individuals' functional abilities which can guide rehabilitation planning and lifestyle support.
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Affiliation(s)
- Kathryn Hendry
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University Brisbane, QLD, Australia
| | - Tamara Ownsworth
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University Brisbane, QLD, Australia
| | - Elizabeth Beadle
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University Brisbane, QLD, Australia
| | - Mathilde P Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury, Centre National de la Recherche Scientifique, Institut National de la Santé et de la Recherche Médicale, Saint Maurice Hospitals, Saint Maurice, Sorbonne Universités, UPMC Université Paris 06, LIB, F-7013 ParisFrance; Groupe de Recherche Clinique Handicap Cognitif et Réadaptation-UPMC Paris 6France
| | - Jennifer Fleming
- Occupational Therapy Department, Princess Alexandra HospitalBrisbane, QLD, Australia; School of Health and Rehabilitation Sciences, The University of QueenslandBrisbane, QLD, Australia
| | - Janelle Griffin
- Occupational Therapy Department, Princess Alexandra Hospital Brisbane, QLD, Australia
| | - David H K Shum
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University Brisbane, QLD, Australia
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Abstract
Traumatic brain injury (TBI) can reduce people's ability to monitor their own actions and identify and correct errors on everyday tasks. This usually occurs because of damage to neural pathways that support ‘metacognition’ or the higher-order capacity to reflect upon and regulate one's own behaviour. This paper initially reviews the neuro-cognitive mechanisms underlying error self-regulation. An overview of assessment approaches is provided which emphasises how approaches to measuring error self-regulation following TBI have been extended from the laboratory to people's real life environments. Over the last few decades, the evidence base supporting the efficacy of error-based learning or metacognitive approaches in rehabilitation has advanced considerably. An overview of the theory underpinning rehabilitation approaches and evidence supporting the efficacy of error-based learning is provided. Finally, the paper briefly describes the protocol for a randomised controlled trial that aims to determine whether people with severe TBI benefit from making errors when they learn new complex tasks.
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