As this goal-oriented rehabilitation program in MCI resulted in some improvements in cognition, occupational performance, and QoL, further randomized controlled studies are warranted.
Assessment of motor and process skills reflects brain-injured patients' ability to resume independent living better than neuropsychological tests.
Using everyday technology (ET) is a prerequisite for activities and participation at home and in the community. It is well known that persons with an acquired brain injury (ABI) can have limitations in activities of daily living but our knowledge of their difficulties using ET is not known. Thirty-six persons (27 men and 9 women, mean age 44 years, age range 26-60) with an ABI (2-10 years post injury) were interviewed, using the Everyday Technology Use Questionnaire (ETUQ), about their perceived difficulties using ET and how these difficulties influenced their everyday activities and their possibilities to participate at home and in the community. A majority (78%) of the persons reported difficulties using ET. The most common difficulties were related to the use of telecommunication and computers. Despite these difficulties, a majority still used most objects and services independently. Twenty-six participants (72%) perceived that their difficulties using ET influenced their everyday activities and their possibility to participate at home and in the community. The results indicate that rehabilitation following an ABI should consider whether clients' use of ET influences their activity and participation and adopt interventions accordingly. The results also indicate that difficulties using ET need to be considered in the design of community services to prevent societal barriers.
Purpose: To investigate how individualized occupation-based interventions with commonly available everyday technology (ET) can compensate for perceived difficulties with daily life tasks after an aquired brain injury (ABI) and improve satisfaction with occupational performance. Method: This intervention study was designed as a multiple case study according to Yin. Ten men and women with an ABI (traumatic or non-traumatic) participated. Data were collected through interviews, observations and field notes before and after the intervention and at follow-up (on average 11 weeks afterwards). The interventions focused on enabling each participant's prioritized goals related to task performance in daily life. Results: All participants achieved all their goals by learning to use both new functions in their own familiar ET and new ET. The participants perceived difficulties in occupational performance decreased and their satisfaction with occupational performance increased with the use of ET. Conclusions: An individualised intervention process, involving the use of own familiar ET or ET off-the-shelf, has the potential to compensate for perceived difficulties following an ABI and improve satisfaction with occupational performance in daily life.Key words: activities of daily living; assistive technology; brain injury; occupational therapy; rehabilitation INTRODUCTIONPeople with an acquired brain injury (ABI) can experience a wide range of difficulties with daily life tasks, such as self-care, productivity and leisure [1,2], as well as restrictions of participation and decreased quality of life [3][4][5][6][7]. A compensatory approach to reduce remaining disabilities are therefore commonly applied, in rehabilitation in general [4,8,9] as well in occupational therapy [10,11]. In occupational therapy [11], adapted methods of doing, adaptive equipment and assistive technology (AT) are used to compensate for ineffective actions to improve the performance of daily life tasks that people with an ABI need and want to do to enhance their roles and participation in society.AT comprises low-tech (mechanical) and high-tech (electro-mechanical or computerized) devices [12] and is defind as "any item, piece of equipment, or product system, (acquired commercially off-the-shelf, modified, or customized), that is used to increase, maintain, or improve functional capabilities of individuals with disabilities" [13]. However, it can be difficult to differentiate AT from everyday technology (ET) objects [14], such as mobile phones and computers, that already exist in peoples' lives and may be used to reduce difficulties in occupational performance.In reviewing the literature about the use and efficency of AT or ET in the form of electronic aids in people with ABI, it was found that a variety of AT, such as palmtop computer, paging system, voice organizer, can reduce memory problems [9,[15][16][17][18][19]. To the best of our knowledge, only one study has used unmodified handheld computers off-the-shelf to compensate for disabilities ...
Virtual Reality (VR) as a complementary tool for medical practitioners in the assessment and rehabilitation of people who have suffered a traumatic brain injury (TBI) is discussed. A pilot-study has been undertaken on a prototype VR assessment tool. The design involved nine occupational therapists with expertise in the care of traumatic brain injured patients and one (computer experienced) patient. The aim was to begin a dialogue and to ascertain the potential of a VR system. A common method for occupational therapists to assess function and ability is to ask a patient to brew coffee. From the performance of such a task, an individual's "functional signature" can be determined. The prototype was built using Superscape, a personal computer based VR system, to be close to the real coffee making task, including effects of making mistakes, realistic graphics and sound effects. The world was designed to be as easy to use and intuitive as possible, though problems of mental abstraction level, transfer of training and realistic interaction have yet to be resolved. The comments from the test participants have highlighted problem areas, given positive insight and pointed out other scenarios where VR may be of use in the rehabilitation of people with a traumatic brain injury.
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