Multiple somatic complaints, tremor, and abnormalities in motor skills and executive functions are common long-term problems among patients who have had West Nile virus infection. Patients with milder illness are just as likely as patients with more-severe illness to experience adverse outcomes.
Patients with traumatic brain injuries often show impaired awareness of their impairments. This impaired awareness can decrease motivation for treatment and limit eventual functional outcome. The importance of this phenomenon has led to the development of multiple techniques and scales for measuring impaired awareness. The present paper briefly reviews the various methods of operationalizing impaired awareness and describes a new scale (the Awareness Questionnaire) designed to incorporate all these methods. Findings of previous studies supporting the validity of the Awareness Questionnaire are presented. The present investigation examined the factor structure and internal consistency of the Awareness Questionnaire with samples of 126 traumatic brain injury survivors and 75 family members/significant others. Principal components factor analysis with varimax rotation indicated three factors: cognitive, behavioural/affective, and motor/sensory. Investigation of internal consistency (Cronbach Coefficient Alpha) in both the patient and family sample yielded satisfactory results. These findings are supportive of continued use and investigation of the Awareness Questionnaire.
shown that such patients generally have a progressive decline in functioning from diagnosis to death. Consequently, PMBT patients have not been considered good 1 Department of Neuropsychology, The Institute candidates for rehabilitation services. The current study is a preliminary, retrospecfor Rehabilitation and Research, Houston, Texas.tive investigation of the effectiveness of postacute brain injury rehabilitation methods, originally developed for traumatic brain injury survivors, in a sample of pa-2 Department of Physical Medicine and Rehabiltients with PMBT. itation, Baylor College of Medicine, Houston, Texas.
METHODS.The subjects were 13 patients with a history of surgical resection of PMBT and subsequent radiation and chemotherapy. There were 8 males and 5 3 Department of Neuro-Oncology, The Univerfemales with a mean age of 34.3 { 10.0 years and a mean educational level of 15.1 sity of Texas M. D. Anderson Cancer Center, { 1.7 years. Mean time from tumor diagnosis to the commencement of rehabilitaHouston, Texas.tion was 75.4 { 87.9 months. All patients had cognitive deficits documented with neuropsychologic tests. Patients received an average of 2.6 { 1.9 months of postacute brain injury rehabilitation.
RESULTS.Six patients had increased independence during the time from the start of rehabilitation to discharge, six were unchanged, and one patient had decreased independence. Eight patients had increased productivity during the same time period, four were unchanged, and one had decreased productivity. Treatment gains were maintained at follow-up 8.0 { 7.6 months after discharge.
CONCLUSIONS.The results of the current study offer preliminary support for the effectiveness of postacute brain injury rehabilitation in the management of PMBT patients. Although additional investigation is needed, such treatment appears to be an attractive, relatively low cost option for these patients.
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