Community-integrated brain injury rehabilitation: Treatment models and challenges for civilian, military, and veteran populations

Trudel, Tina M.; Nidiffer, F. Don; Barth, Jeffrey T.

doi:10.1682/jrrd.2006.12.0167

Cited by 30 publications

(26 citation statements)

References 54 publications

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“…One Level I systematic review [19] highlighted the role of cognitive interventions in improving neurobehavioral symptoms and successful RTW. Four Level IV descriptive reviews [8,[42][43][44] recommended cognitive interventions, with increased emphasis on compensatory strategies, to facilitate RTW.…”

Section: Cognitive Rehabilitation Facilitate Return To Work Post Traumentioning

confidence: 99%

Cognition and return to work after mild/moderate traumatic brain injury: A systematic review

Mani¹,

Cater

Hudlikar

2017

WOR

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Abstract. BACKGROUND:Approximately two percent of the United States population are traumatic brain injury (TBI) survivors. The unemployment rate among them is substantial. Cognitive skills are essential to perform any job. OBJECTIVE: We analyzed the literature on cognitive rehabilitation (CR) related to mild/moderate TBI to learn the influence of cognition on return to work (RTW) post TBI. METHODS:We conducted a systematic review of the studies on CR related to RTW post TBI that were published between 2000 and 2015. RESULTS: We critically reviewed 30 studies that met the inclusion criteria. Ten studies highlighted cognition as a predictor variable, seven studies demonstrated support for cognitive testing in RTW assessments, and 13 studies showed the efficacy of CR in facilitating RTW post TBI. CONCLUSION: Cognition plays a significant role in predicting and facilitating RTW in patients with TBI.

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Section: Cognitive Rehabilitation Facilitate Return To Work Post Traumentioning

confidence: 99%

Cognition and return to work after mild/moderate traumatic brain injury: A systematic review

Mani¹,

Cater

Hudlikar

2017

WOR

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“…Some strengths of our study include our use of objective measures of social/family functioning in conjunction with subjective measures of satisfaction, as well as our focus on a Veteran sample for whom social satisfaction and community reintegration may be problematic [49][50]. Furthermore, this study is one of the first to examine global mental health (e.g., mood, PTSD, and postconcussive symptoms) and specific areas of neurocognitive functioning that may be associated with measures of social satisfaction and reintegration.…”

Section: Discussionmentioning

confidence: 99%

Multivariate assessment of subjective and objective measures of social and family satisfaction in Veterans with history of traumatic brain injury

2016

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Abstract-Approximately 20% of current-era Veterans have sustained a traumatic brain injury (TBI), which can result in persistent postconcussive symptoms. These symptoms may disrupt family and social functioning. We explored psychiatric, postconcussive, and cognitive factors as correlates of objective functioning and subjective satisfaction in family and social relationships. At entry into a supported employment study, 50 unemployed Veterans with a history of mild to moderate TBI and current cognitive impairment were administered baseline assessments. Multivariate stepwise regressions determined that higher levels of depressive symptomatology were strongly associated with less frequent social contact, as well as lower subjective satisfaction with family and social relationships. Worse verbal fluency predicted less frequent social contact, whereas worse processing speed and switching predicted higher levels of subjective satisfaction with family relationships. The pattern of results remained similar when examining those Veterans with only mild TBI. Depressive symptoms and cognitive functioning may affect Veterans' social contact and satisfaction with family and social relationships. Evidencebased interventions addressing depression and cognition may therefore aid in improving community reintegration and satisfaction with social and family relationships.

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“…Participants as members of a community who have decision-making rights; key features promote community participation Ability to take responsibility for building own capacity Source: Malec et al, 2012;Trudel et al;Volpe, 2012 For persons affected by TBI, vocational rehabilitation (VR) is a treatment option that offers assistance with career planning and achievement of career goals. VR rehabilitation can include assessment, counseling, guidance, training and education, and on-the-job training.…”

Section: Club Housementioning

confidence: 99%

Prospective study of myelin water fraction changes after mild traumatic brain injury in collegiate contact sports

Spader

Dean

LaFrance

et al. 2019

Journal of Neurosurgery

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OBJECTIVEMild traumatic brain injury (mTBI) in athletes, including concussion, is increasingly being found to have long-term sequelae. Current imaging techniques have not been able to identify early damage caused by mTBI that is predictive of long-term symptoms or chronic traumatic encephalopathy. In this preliminary feasibility study, the authors investigated the use of an emerging magnetic resonance imaging (MRI) technique, multicomponent driven equilibrium single pulse observation of T1 and T2 (mcDESPOT), in visualizing acute and chronic white matter changes after mTBI in collegiate football and rugby players.METHODSThis study was a nonrandomized, nonblinded prospective trial designed to quantify changes in the myelin water fraction (MWF), used as a surrogate MRI measure of myelin content, in a group of male collegiate football and rugby players, classified here as a contact sport player (CSP) cohort, at the time of mTBI diagnosis and 3 months after injury when the acute symptoms of the injury had resolved. In addition, differences in the MWF between the CSP cohort and a control cohort of noncontact sport players (NCSPs) were quantified. T-tests and a threshold-free cluster enhancement (TFCE) statistical analysis technique were used to identify brain structures with significant changes in the MWF between the CSP and NCSP cohorts and between immediately postinjury and follow-up images obtained in the CSP cohort.RESULTSBrain MR images of 12 right-handed male CSPs were analyzed and compared with brain images of 10 right-handed male NCSPs from the same institution. A comparison of CSP and NCSP baseline images using TFCE showed significantly higher MWFs in the bilateral basal ganglia, anterior and posterior corpora callosa, left corticospinal tract, and left anterior and superior temporal lobe (p < 0.05). At the 3-month follow-up examination, images from the CSP cohort still showed significantly higher MWFs than those identified on baseline images from the NCSP cohort in the bilateral basal ganglia, anterior and posterior corpora callosa, and left anterior temporal lobe, and also in the bilateral corticospinal tracts, parahippocampal gyrus, and bilateral juxtapositional (previously known as supplemental motor) areas (p < 0.05). In the CSP cohort, a t-test comparing the MWF at the time of injury and 3 months later showed a significant increase in the overall MWF at follow-up (p < 0.005). These increases were greatest in the bilateral basal ganglia and deep white matter. MWF decreases were seen in more superficial white matter (p < 0.005).CONCLUSIONSIn this preliminary study, MWF was found to be increased in the brains of CSPs compared with the brains of controls, suggesting acute/chronic MWF alterations in CSPs from previous injuries. Increases in the MWF were also demonstrated in the brains of CSPs 3 months after the players sustained an mTBI. The full clinical significance of an increased MWF and whether this reflects axon neuropathology or disorderly remyelination leading to hypermyelination has yet to be determined.

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Community-integrated brain injury rehabilitation: Treatment models and challenges for civilian, military, and veteran populations

Cited by 30 publications

References 54 publications

Cognition and return to work after mild/moderate traumatic brain injury: A systematic review

Cognition and return to work after mild/moderate traumatic brain injury: A systematic review

Multivariate assessment of subjective and objective measures of social and family satisfaction in Veterans with history of traumatic brain injury

Prospective study of myelin water fraction changes after mild traumatic brain injury in collegiate contact sports

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