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Saxena R, Gilbert C, Kiran S, Cordella C. Measuring Impairment-Specific Gains in Individual Cognitive Rehabilitation Through a Systematic Therapy Protocol. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-13. [PMID: 39353063 DOI: 10.1044/2024_ajslp-23-00421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
PURPOSE This study investigated treatment-induced performance gains in memory function following therapy through the Intensive Cognitive Communication Rehabilitation (ICCR) program for young adults with acquired brain injury (ABI). We aimed to determine the utility of a novel approach to measuring memory performance improvement across semesters of therapy using (a) systematic treatment tasks called Individualized Quantitative Protocols (IQPs) as compared to (b) standardized measures of memory function. METHOD Retrospective IQP data spanning five consecutive ICCR semesters were collected from patients (N = 13) with ABI. Raw task-accuracy data were scaled to account for task difficulty gradation. Linear mixed-effects models (LMMs) were used to evaluate the degree of memory improvement-measured by scaled IQP scores-as a function of therapy duration, age, time postinjury, and aphasia; pre- to posttreatment effect sizes were also calculated. For comparison, similar LMMs were run using standardized metrics of memory abilities as the outcome measure. RESULTS Results showed significant treatment-induced improvements, with gains at the session level (β = 2.76; t = 2.23; p = .047), when improvement was measured using IQP scaled scores. Standardized metrics did not show significant improvement as a function of therapy. Effect size analysis mirrored LMM results, with a large (d = 0.92, 95% confidence interval [0.35, 1.49]) pre- to posttreatment effect when change was measured using IQP scaled scores and a small effect for standardized measures. CONCLUSIONS This preliminary study demonstrates the utility of a granular, individualized metric to index significant impairment-based performance gains following ICCR treatment. These results introduce promise for future analysis of complex treatment data. Additionally, they provide another lens with which to assess treatment progress and its significance. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.27045937.
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Affiliation(s)
- Riya Saxena
- College of Arts & Sciences, Boston University, MA
| | - Christianna Gilbert
- Program for Patient Safety and Quality, Boston Children's Hospital, MA
- Center for Brain Recovery, Boston University, MA
| | - Swathi Kiran
- Center for Brain Recovery, Boston University, MA
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Hernandez-Sarabia JA, Schmid AA, Sharp JL, Stephens JA. Intervention-Induced Changes in Balance and Task-Dependent Neural Activity in Adults with Acquired Brain Injury: A Pilot Randomized Control Trial. SENSORS (BASEL, SWITZERLAND) 2024; 24:4047. [PMID: 39000826 PMCID: PMC11244558 DOI: 10.3390/s24134047] [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: 05/02/2024] [Revised: 05/30/2024] [Accepted: 06/19/2024] [Indexed: 07/16/2024]
Abstract
Advances in neuroimaging technology, like functional near-infrared spectroscopy (fNIRS), support the evaluation of task-dependent brain activity during functional tasks, like balance, in healthy and clinical populations. To date, there have been no studies examining how interventions, like yoga, impact task-dependent brain activity in adults with chronic acquired brain injury (ABI). This pilot study compared eight weeks of group yoga (active) to group exercise (control) on balance and task-dependent neural activity outcomes. Twenty-three participants were randomized to yoga (n = 13) or exercise groups (n = 10). Neuroimaging and balance performance data were collected simultaneously using a force plate and mobile fNIRS device before and after interventions. Linear mixed-effects models were used to evaluate the effect of time, time x group interactions, and simple (i.e., within-group) effects. Regardless of group, all participants had significant balance improvements after the interventions. Additionally, regardless of group, there were significant changes in task-dependent neural activity, as well as distinct changes in neural activity within each group. In summary, using advances in sensor technology, we were able to demonstrate preliminary evidence of intervention-induced changes in balance and neural activity in adults with ABI. These preliminary results may provide an important foundation for future neurorehabilitation studies that leverage neuroimaging methods, like fNIRS.
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Affiliation(s)
| | - Arlene A. Schmid
- Department of Occupational Therapy, Colorado State University, Fort Collins, CO 80523, USA;
- Columbine Health Systems Center for Healthy Aging, Colorado State University, Fort Collins, CO 80523, USA
| | | | - Jaclyn A. Stephens
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA
- Molecular Cellular, and Integrative Neuroscience Program, Colorado State University, Fort Collins, CO 80523, USA
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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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Quang H, Le Heron C, Balleine B, Nguyen TV, Nguyen TQ, Nguyen MN, Kumfor F, McDonald S. Reduced Sensitivity to Background Reward Underlies Apathy After Traumatic Brain Injury: Insights From an Ecological Foraging Framework. Neuroscience 2023; 528:26-36. [PMID: 37536610 DOI: 10.1016/j.neuroscience.2023.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Altered reward processing is increasingly recognised as a crucial mechanism underpinning apathy in many brain disorders. However despite its clinical relevance, little is known about the mechanisms of apathy following moderate-to-severe traumatic brain injury (TBI). In real-life situations, reward representations encompass both foreground (gains from current activity) and background (potential gains from the broader environment) elements. This latter variable provides a crucial set-point for switching behaviour in many naturalistic settings. We hypothesised apathy post-TBI would be associated with disrupted background reward sensitivity. METHODS We administered a computer-based foraging task to 45 people with moderate-to-severe TBI (20 with apathy, 39 males) and 37 matched controls. Participants decided when to leave locations (patches) where foreground reward rates depleted at differing rates, to pursue greater rewards from other patches in the environment, which had either a high or low background reward rate. Primary analysis was performed using linear mixed effects models, with patch leaving time the dependent variable. RESULTS Findings showed a significant interaction between apathy and background reward sensitivity, driven by apathetic TBI participants not altering patch-leaving decisions as environmental reward rate changed. In contrast, although TBI was associated with reduced sensitivity to changing foreground rewards, this did not vary as a function of apathy. CONCLUSIONS These results provide the first evidence directly linking disrupted background reward processing to apathy in any brain disorder. They identify a novel mechanism for apathy following moderate-to-severe TBI, and point towards novel interventions to improve this debilitating complication of head injury.
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Affiliation(s)
- Halle Quang
- University of New South Wales, School of Psychology, Sydney, NSW 2052, Australia.
| | - Campbell Le Heron
- University of Otago, Department of Medicine, Christchurch 8011, New Zealand; New Zealand Brain Research Institute, Christchurch 8011, New Zealand; Department of Neurology, Canterbury District Health Board, 8011, New Zealand
| | - Bernard Balleine
- University of New South Wales, School of Psychology, Sydney, NSW 2052, Australia
| | - Tuong-Vu Nguyen
- Cho Ray Hospital, Department of Neurosurgery, Ho Chi Minh City 70000, Vietnam
| | - Truc-Quynh Nguyen
- Ho Chi Minh City University of Education, School of Psychology, Ho Chi Minh City 70000, Vietnam
| | - My-Ngan Nguyen
- Ho Chi Minh City University of Education, School of Psychology, Ho Chi Minh City 70000, Vietnam
| | - Fiona Kumfor
- University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, NSW 2050, Australia
| | - Skye McDonald
- University of New South Wales, School of Psychology, Sydney, NSW 2052, Australia
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Verrienti G, Raccagni C, Lombardozzi G, De Bartolo D, Iosa M. Motivation as a Measurable Outcome in Stroke Rehabilitation: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4187. [PMID: 36901206 PMCID: PMC10001639 DOI: 10.3390/ijerph20054187] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
Motivated behaviours are thought to lead to enhanced performances. In the neurorehabilitation field, motivation has been demonstrated to be a link between cognition and motor performance, therefore playing an important role upon rehabilitation outcome determining factors. While motivation-enhancing interventions have been frequently investigated, a common and reliable motivation assessment strategy has not been established yet. This review aims to systematically explore and provide a comparison among the existing motivation assessment tools concerning stroke rehabilitation. For this purpose, a literature search (PubMed and Google Scholar) was performed, using the following Medical Subject Headings terms: "assessment" OR "scale" AND "motivation" AND "stroke" AND "rehabilitation". In all, 31 randomized clinical trials and 15 clinical trials were examined. The existing assessment tools can be grouped into two categories: the first mirroring the trade-off between patients and rehabilitation, the latter reflecting the link between patients and interventions. Furthermore, we presented assessment tools which reflect participation level or apathy, as an indirect index of motivation. In conclusion, we are left to put forth a possible common motivation assessment strategy, which might provide valuable incentive to investigate in future research.
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Affiliation(s)
- Giulio Verrienti
- Department of Neurorehabilitation, Casa di Cura Villa Verde, 73100 Lecce, Italy
| | - Cecilia Raccagni
- Department of Neurology, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, 39100 Bolzano, Italy
- Department of Neurology, Innsbruck Medical University, 6030 Innsbruck, Austria
| | | | | | - Marco Iosa
- Smart Lab, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
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Psychosocial functioning mediates change in motor and cognitive function throughout neurorehabilitation for adults with acquired brain injury (ABI-RESTaRT). Neurol Sci 2023:10.1007/s10072-023-06645-8. [PMID: 36780031 DOI: 10.1007/s10072-023-06645-8] [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: 10/10/2022] [Accepted: 01/24/2023] [Indexed: 02/14/2023]
Abstract
OBJECTIVES This study aimed to evaluate the mediational role of change in psychosocial abilities, adjustment and participation on change in motor and cognitive function from admission to discharge from a staged community-based brain injury rehabilitation (SCBIR) service in Western Australia, 2011-2020. METHODS A retrospective cohort study of n = 324 adults with ABI enrolled in SCBIR using routinely collected rehabilitation outcome measures data. Motor and cognitive function were assessed with the UK Functional Independence and Assessment Measure and psychosocial function with the Mayo-Portland Adaptability Inventory-4. Six multilevel mediation regression analyses were conducted to determine whether change in psychosocial function (abilities, adjustment and participation) mediated change in motor and cognitive function from admission to discharge. RESULTS Participants demonstrated clinically significant improvements in both motor (+ 11.8, p < 0.001) and cognitive (+ 9.5, p < 0.001) functioning from admission to discharge. Statistically significant improvements in psychosocial abilities (- 4.8, p < 0.001), adjustment (- 2.9, p = 0.001) and participation (- 2.5, p < 0.001) were also seen but were not clinically significant. Mediation analyses showed that participation accounted for 81% of improvements in motor function at discharge and 71% of cognitive function improvements. Adjustment accounted for 26% and 32% of change in motor and cognitive function, respectively. Abilities accounted for 60% of change in cognitive function but did not significantly influence change in motor function. Changes in psychosocial participation fully mediated change in motor function during neurorehabilitation. CONCLUSIONS Psychosocial function, particularly participation, is an important driver of motor and cognitive recovery throughout neurorehabilitation. Functional rehabilitation programs should target psychosocial improvement as an important mechanism of change.
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Bray MJC, Bryant BR, Esagoff AI, Richey LN, Rodriguez C, Krieg A, McCullough G, Tsai J, Tobolowsky W, Jahed S, Cullum CM, LoBue C, Ismail Z, Yan H, Lyketsos CG, Peters ME. Effect of traumatic brain injury on mild behavioral impairment domains prior to all-cause dementia diagnosis and throughout disease progression. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12364. [PMID: 36514440 PMCID: PMC9735270 DOI: 10.1002/trc2.12364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 09/09/2022] [Accepted: 10/28/2022] [Indexed: 12/14/2022]
Abstract
Introduction Traumatic brain injury (TBI) may alter dementia progression, although co-occurring neuropsychiatric symptoms (NPS) have received less attention. Originally designed to evaluate behavioral disruption prior to dementia diagnosis, the mild behavioral impairment (MBI) construct relates NPS to underlying neural circuit disruptions, with probable relevance across the progression of neurodegenerative disease. Therefore, the MBI construct may represent a valuable tool to identify and evaluate related NPS both preceding diagnosis of all-cause dementia throughout the progression of disease, representing an important area of inquiry regarding TBI and dementia. This investigation sought to evaluate the effect of TBI on NPS related by the MBI construct in participants progressing from normal cognitive status to all-cause dementia. Methods Using National Alzheimer's Coordinating Center data, individuals progressing from normal cognition to all-cause dementia (clinician diagnosed) over 7.6 ± 3.0 years were studied to estimate prevalence of MBI domains in 124 participants with prior TBI history (57 with loss of consciousness [LOC] <5 minutes, 22 with LOC >5 min, 45 unknown severity) compared to 822 without. MBI domain prevalence was evaluated (1) prior to dementia onset (including only time points preceding time at dementia diagnosis, as per MBI's original definition) and (2) throughout dementia progression (evaluating all available time points, including both before and after dementia diagnosis). Results More severe TBI (LOC >5 minutes) was associated with the social inappropriateness MBI domain (adjusted odds ratio = 4.034; P = 0.024) prior to dementia onset, and the abnormal perception/thought content domain looking across dementia progression (adjusted hazard ratio [HRadj] = 3.703; P = 0.005). TBI (all severities) was associated with the decreased motivation domain looking throughout dementia progression (HRadj. = 1.546; P = 0.014). Discussion TBI history is associated with particular MBI profiles prior to onset and throughout progression of dementia. Understanding TBI's impact on inter-related NPS may help elucidate underlying neuropathology with implications for surveillance, detection, and treatment of behavioral concerns in aging TBI survivors. Highlights The mild behavioral impairment (MBI) construct links related neuropsychiatric symptoms (NPS) by probable underlying neural network dysfunction.Traumatic brain injury (TBI) with loss of consciousness (LOC) > 5 minutes was associated with pre-dementia social inappropriateness.TBI was associated with decreased motivation looking across dementia progression.TBI with LOC > 5 minutes was associated with abnormal perception/thought content.The MBI construct may be useful for examining related NPS across dementia progression.
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Affiliation(s)
- Michael J. C. Bray
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Barry R. Bryant
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Aaron I. Esagoff
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Lisa N. Richey
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Carla Rodriguez
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Akshay Krieg
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Gardner McCullough
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Jerry Tsai
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - William Tobolowsky
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Sahar Jahed
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Psychiatry and Behavioral MedicineMedical College of WisconsinMilwaukeeWisconsinUSA
| | - C. Munro Cullum
- Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Christian LoBue
- Department of PsychiatryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Zahinoor Ismail
- Department of Psychiatry, Cumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Haijuan Yan
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Constantine G. Lyketsos
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Matthew E. Peters
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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Raya-Ruiz MA, Rodríguez-Bailón M, Castaño-Monsalve B, Vidaña-Moya L, Fernández-Solano AJ, Merchán-Baeza JA. Study protocol for a non-randomised controlled trial: Community-based occupational therapy intervention on mental health for people with acquired brain injury (COT-MHABI). PLoS One 2022; 17:e0274193. [PMID: 36206208 PMCID: PMC9543977 DOI: 10.1371/journal.pone.0274193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 08/18/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The sequelae of moderate-severe acquired brain injury (ABI) encompass motor, cognitive, sensory, emotional and behavioural areas that affect meaningful occupational participation and quality of life, with a high prevalence of associated mental disorders. When the patient returns to community life after discharge from the hospital, specialised care is generally insufficient due to the lack of consideration of the dual condition of mental disorder and ABI. Since there is a negative impact on competence and thus on occupational participation, occupational therapy represents a convenient way of intervention. On these assumptions, a community-based occupational therapy protocol on mental health for people with moderate/severe acquired brain injury (COT-MHABI) is presented. It is focused on meaningful occupational participation and looks for improvement in the quality of life. METHODS AND ANALYSIS This study aims: (i) to design a protocol to evaluate the effectiveness of a community occupational therapy intervention based on MOHO for patients with a dual (mental health/ABI) for improving quality of life and self-perceived occupational performance; (ii) to analyse the outcomes of occupational and social variables (occupational balance, participation level, satisfaction with occupation and performed roles and community integration) after the COT-MHABI process; (iii) to analyse the impact of quality of life on satisfaction with occupations performed by this population. A non-randomised controlled clinical trial will be performed. Patients assigned to the experimental group will receive over one year of on-site and telematic occupational therapy sessions, 16 sessions on average. Variables such as quality of life, community integration or satisfaction with occupational performance will be collected at baseline, 6, and 12 months. DISCUSSION The needs for the dual mental/ABI population in their reintegration into the community are related to the associated deficits and to the absence of specialised services for the complexity of this patient profile. Few studies consider the coexistence of mental health and ABI issues. The COT-MHABI protocol is proposed to provide continuity to the community needs of this population, conceptualised from occupational participation, person-centred and focused on meaningful activities. CLINICAL TRIAL REGISTRATION Trial identifier and registry name ClinicalTrials.gov ID: NCT04586842 https://clinicaltrials.gov/ct2/show/NCT04586842?term=252136&draw=2&rank=1; Pre-results; Community-based Occupational Therapy Intervention on Mental Health for People With Acquired Brain Injury (COT-MHABI).
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Affiliation(s)
- Marco Antonio Raya-Ruiz
- Faculty of Health Science and Welfare, Social Sciences and Community Health Department, Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain
- Specialised Support and Assessment Team (EASE), Institut Guttmann, Badalona, Spain
| | | | | | - Laura Vidaña-Moya
- Research Group GrEUIT., Escola Universitària d’Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona, Terrassa, Spain
| | | | - José Antonio Merchán-Baeza
- Faculty of Health Science and Welfare, Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain
- * E-mail:
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Yoshida K. Botulinum Toxin Therapy for Oromandibular Dystonia and Other Movement Disorders in the Stomatognathic System. Toxins (Basel) 2022; 14:282. [PMID: 35448891 PMCID: PMC9026473 DOI: 10.3390/toxins14040282] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/01/2022] [Accepted: 04/11/2022] [Indexed: 01/02/2023] Open
Abstract
Various movement disorders, such as oromandibular dystonia, oral dyskinesia, bruxism, functional (psychogenic) movement disorder, and tremors, exist in the stomatognathic system. Most patients experiencing involuntary movements due to these disorders visit dentists or oral surgeons, who may be the first healthcare providers. However, differential diagnoses require neurological and dental knowledge. This study aimed to review scientific advances in botulinum toxin therapy for these conditions. The results indicated that botulinum toxin injection is effective and safe, with few side effects in most cases when properly administered by an experienced clinician. The diagnosis and treatment of movement disorders in the stomatognathic system require both neurological and dental or oral surgical knowledge and skills, and well-designed multicenter trials with a multidisciplinary team approach must be necessary to ensure accurate diagnosis and proper treatment.
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Affiliation(s)
- Kazuya Yoshida
- Department of Oral and Maxillofacial Surgery, National Hospital Organization, Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan
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Navarro-Pardo E, Suay F, Murphy M. Ageing: Not only an age-related issue. Mech Ageing Dev 2021; 199:111568. [PMID: 34536447 DOI: 10.1016/j.mad.2021.111568] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/31/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
Developments in the last century have led to an unprecedented increase in life expectancy. These changes open opportunities for humans to grow and develop in healthy and adaptive ways, adding life to years as well as years to life. There are also challenges, however - as we live longer, a greater number of people will experience chronic illness and disability, often linked to lifestyle factors. The current paper advances an argument that there are fundamental biological sex differences which, sometimes directly and sometime mediated by lifestyle factors, underpin the marked differences in morbidity and mortality that we find between the sexes. Furthermore, we argue that it is necessary to consider sex as a key factor in research on healthy ageing, allowing for the possibility that different patterns exist between males and females, and that therefore different approaches and interventions are required to optimise healthy ageing in both sexes.
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Affiliation(s)
- Esperanza Navarro-Pardo
- Department of Developmental and Educational Psychology, Universitat de València, Av. Blasco Ibañez, 21, 46008, València, Spain
| | - Ferran Suay
- Department of Biopsychology, Universitat de València, Av. Blasco Ibañez, 21, 46008, València, Spain
| | - Mike Murphy
- School of Applied Psychology, University College Cork, North Mall Campus, Cork, Ireland.
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Zolotareva A. Theoretical Analysis of the Apathy Diagnostical Measurement. КЛИНИЧЕСКАЯ И СПЕЦИАЛЬНАЯ ПСИХОЛОГИЯ 2021. [DOI: 10.17759/cpse.2021100302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The article lays out a theoretical analysis of the problem with diagnosing apathy in today's research. Apathy is a state characterized by a simultaneous decrease in the behavioral, cognitive and emotional concomitants of goal-directed behavior due to loss of motivation [15]. Behavioral changes lie in a declining everyday problem-solving effectiveness at home or work. Cognitive changes result in reduced cognitive functioning and a lack of plans and life strategies. Emotional changes manifest in a decrease in affective response to events that previously elicited either a positive or negative emotional response. Diagnostic criteria, or the 'gold standard' for apathy, identify behavioral, cognitive, emotional, and social symptoms of apathy that cause clinically significant disorders in personal, social, professional, or other important areas of life. The differential diagnosis of apathy involves its clinical distinction from syndromes such as delirium, dementia, depression, abulia, akinesia, and demoralization. The review can be useful for psychiatrists, psychologists, social workers and all practitioners who interact with people at risk of developing apathetic states.
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Oyake K, Suzuki M, Otaka Y, Momose K, Tanaka S. Motivational Strategies for Stroke Rehabilitation: A Delphi Study. Arch Phys Med Rehabil 2020; 101:1929-1936. [PMID: 32753111 DOI: 10.1016/j.apmr.2020.06.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/17/2020] [Accepted: 06/27/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The primary objective was to provide a list of effective motivational strategies based on consensus among rehabilitation experts, generated using the Delphi technique. The secondary objective was to identify the types of information that are important when selecting motivational strategies. DESIGN Delphi study. SETTING On-site survey at academic conferences and web-based survey. PARTICIPANTS Rehabilitation experts (N=198) including physicians, physical therapists, occupational therapists, and speech-language-hearing therapists who had worked in stroke rehabilitation for at least 5 years. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Panelists were asked to rate the effectiveness of motivational strategies and to rate the importance of different types of information using a 5-point Likert scale. Consensus was defined as having been reached for items with an interquartile range of 1 or less. RESULTS A total of 116 experts (58.6%) completed the third round of the Delphi survey. Consensus was reached on all of the 26 presented strategies. Seven strategies, such as control of task difficulty and goal setting, were considered to be very effective in increasing patient motivation. In addition, all 11 of the presented types of information regarding patient health status, environmental factors, and personal factors were deemed very important or important in determining which motivational strategies to use. CONCLUSIONS We generated a list of effective motivational strategies for stroke rehabilitation based on expert consensus. Our results suggest that experts consider a comprehensive range of patient information when choosing motivational strategies. These findings represent a group of consensus-based recommendations for increasing patient adherence to stroke rehabilitation programs, which may be beneficial to many medical professionals working in stroke rehabilitation.
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Affiliation(s)
- Kazuaki Oyake
- Department of Physical Therapy, School of Health Sciences, Shinshu University, Nagano
| | - Makoto Suzuki
- Faculty of Health Sciences, Tokyo Kasei University, Saitama
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi
| | - Kimito Momose
- Department of Physical Therapy, School of Health Sciences, Shinshu University, Nagano
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, Shizuoka, Japan.
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