Assessment of Users' Needs and Expectations Toward Clinical Practice Guidelines to Support the Rehabilitation of Adults With Moderate to Severe Traumatic Brain Injury

Lamontagne, Marie-Ève; Bayley, Mark; Kua, Ailene; Marier-Deschênes, Pascale; Allaire, Anne-Sophie; Schmouth, Marie-Ève; Kagan, Corinne; Truchon, Catherine; Swaine, Bonnie

doi:10.1097/htr.0000000000000429

Cited by 9 publications

(10 citation statements)

References 13 publications

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“…Patients with the disorder of consciousness (DOC) should be placed on regular neurological assessments and serial monitoring (Canadian Clinical Practice Guideline for Rehabilitation of Adults with Moderate to Severe TBI [INESSS-ONF], level of evidence C). 21) The JFK Coma Recovery Scale-Revised is the gold standard diagnostic tool for assessing patients with DOC and differentiating between the minimally conscious state and vegetative state/unresponsive wakefulness syndrome after severe acquired brain injury. 2 23) The recent practice guidelines of the American Academy of Neurology (AAN), American Congress of Rehabilitation Medicine (ACRM), and National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) present recommendations on the essential rehabilitation program required for effective recovery of awareness and attention.…”

Section: Rehabilitation Of Attention In the Acute Phase After Tbimentioning

confidence: 99%

Rehabilitation for Impaired Attention in the Acute and Post-Acute Phase After Traumatic Brain Injury: A Narrative Review

Lee

Hyun

2023

Korean J Neurotrauma

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Impaired attention is the most common and debilitating cognitive deficit following a traumatic brain injury (TBI). Attention is a fundamental function that profoundly influences the performance of other cognitive components such as memory and execution. Intriguingly, attention can be improved through cognitive rehabilitation. This narrative review summarizes the essential elements of rehabilitation for attention problems in acute and post-acute TBI. In the acute phase of mild TBI, investigations into the medical history and daily life performance, neurological examination, screening and management of concomitant sleep-wake disorders or neuropsychiatric disorders, and support and education on the natural course of concussion are covered. Rehabilitation for patients with moderate-to-severe TBI consists of serial assessment for patients with disorders of consciousness and a post-traumatic confusion state. In the post-acute phase after TBI, components of rehabilitation include investigating medical history; neurological, imaging, and electrophysiological tests; evaluation and treatment of factors that may impact attention, including sleep-wake, emotional, and behavioral disorders; evaluation of attention function; and cognitive rehabilitation as a matter of course. We summarized metacognitive strategy, direct attention training, computer-based cognitive interventions, medication, and environmental control as interventions to enhance attention.

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Section: Rehabilitation Of Attention In the Acute Phase After Tbimentioning

confidence: 99%

Rehabilitation for Impaired Attention in the Acute and Post-Acute Phase After Traumatic Brain Injury: A Narrative Review

Lee

Hyun

2023

Korean J Neurotrauma

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“…Persistent UL impairments and limitations in performance of daily life activities impact functional independence in this population. 11 Motor improvements post-TBI are attributable in part to motor learning and adaptive neuroplasticity. 12 Provision of rehabilitation benefits motor recovery by focusing on performing accurate repetitions of desired movement, 13 is an integral part of motor learning and promotes adaptive neuroplasticity.…”

Section: Tables:mentioning

confidence: 99%

“…Persistent UL impairments and difficulties in ADL performance can impact functional and social independence in this population. 11 Rehabilitation can help in motor improvement, promote independence in the performance of ADLs and community reintegration after a TBI. 9,12 Motor improvement after a TBI is attributable in part to motor learning and adaptive neuroplasticity.…”

Section: Introductionmentioning

confidence: 99%

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Upper Limb Motor Improvement after TBI: Systematic Review of Interventions

Subramanian

Fountain

Hood

et al. 2020

Preprint

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Traumatic Brain Injury (TBI) is a leading cause of adult morbidity and mortality. Individuals sustaining a TBI have impairments in both cognitive and motor domains. Motor improvements post-TBI are attributable to adaptive neuroplasticity and motor learning. Majority of the studies focus on remediation of balance and mobility impairments. There is limited understanding on the use of interventions for upper limb (UL) motor improvements in this population. We examined the evidence regarding the effectiveness of different interventions to augment UL motor improvement after a TBI. We systematically reviewed the literature published in English from 1990-2020. The modified Down’s and Black checklist helped assess study quality (total score:28). Studies were classified as excellent:24-28, good:19-23, fair:14-18 and poor:≤13 in quality. Effect sizes helped quantify intervention effectiveness. Twenty-three studies were retrieved. Study quality was excellent (n=1), good (n=4) or fair (n=19). Interventions used included strategies to decrease spasticity [Botulinum toxin provision (n=2), serial casting, soft splinting, tizanidine and acupuncture (n=1 each)], constraint induced movement therapy (n=4), virtual reality gaming (n=5), noninvasive stimulation (n=3), arm motor ability training (n=1), stem-cell transplant (n=1); task-oriented training (n=2) and augmented feedback (n=1). Motor impairment outcomes included Fugl-Meyer Assessment, Modified Ashworth Scale and kinematic outcomes (error and movement straightness). Activity limitation outcomes included Wolf Motor Function Test and Motor Activity Log. Effect sizes for majority of the interventions ranged from medium (0.5-0.79) to large (≥0.8). Only ten studies included retention testing. Results suggest that using these interventions can reduce UL motor impairment and improve activity performance after a TBI.

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“…Persistent UL impairments and limitations in ADL performance impact functional independence in this population. 11 Motor improvements post-TBI are attributable in part to motor learning and adaptive neuroplasticity. 12 Provision of rehabilitation, benefits motor recovery by focusing on performing accurate repetitions of desired movement, 13 is an integral part of motor learning and promotes adaptive neuroplasticity.…”

Section: Introductionmentioning

confidence: 99%

Upper Limb Motor Improvement after Traumatic Brain Injury: Systematic Review of Interventions

Subramanian

Fountain

Hood

et al. 2021

Neurorehabil Neural Repair

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Background Traumatic brain injury (TBI) is a leading cause of adult morbidity and mortality. Individuals with TBI have impairments in both cognitive and motor domains. Motor improvements post-TBI are attributable to adaptive neuroplasticity and motor learning. Majority of the studies focus on remediation of balance and mobility issues. There is limited understanding on the use of interventions for upper limb (UL) motor improvements in this population. Objective We examined the evidence regarding the effectiveness of different interventions to augment UL motor improvement after a TBI. Methods We systematically examined the evidence published in English from 1990–2020. The modified Downs and Black checklist helped assess study quality (total score: 28). Studies were classified as excellent: 24–28, good: 19–23, fair: 14–18, and poor: ≤13 in quality. Effect sizes helped quantify intervention effectiveness. Results Twenty-three studies were retrieved. Study quality was excellent (n = 1), good (n = 5) or fair (n = 17). Interventions used included strategies to decrease muscle tone (n = 6), constraint induced movement therapy (n = 4), virtual reality gaming (n = 5), non-invasive stimulation (n = 3), arm motor ability training (n = 1), stem cell transplant (n = 1), task-oriented training (n = 2), and feedback provision (n = 1). Motor impairment outcomes included Fugl-Meyer Assessment, Modified Ashworth Scale, and kinematic outcomes (error and movement straightness). Activity limitation outcomes included Wolf Motor Function Test and Motor Activity Log (MAL). Effect sizes for majority of the interventions ranged from medium (.5-.79) to large (≥.8). Only ten studies included retention testing. Conclusion There is preliminary evidence that using some interventions may enhance UL motor improvement after a TBI. Answers to emergent questions can help select the most appropriate interventions in this population.

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Assessment of Users' Needs and Expectations Toward Clinical Practice Guidelines to Support the Rehabilitation of Adults With Moderate to Severe Traumatic Brain Injury

Abstract: Respondents have important expectations toward a CPG. We anticipate that early and meaningful engagement of end users could facilitate CPG implementation.

Cited by 9 publications

References 13 publications

Rehabilitation for Impaired Attention in the Acute and Post-Acute Phase After Traumatic Brain Injury: A Narrative Review

Rehabilitation for Impaired Attention in the Acute and Post-Acute Phase After Traumatic Brain Injury: A Narrative Review

Upper Limb Motor Improvement after TBI: Systematic Review of Interventions

Upper Limb Motor Improvement after Traumatic Brain Injury: Systematic Review of Interventions

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