Factors affecting participation after traumatic brain injury

Larsson, Jerry; Björkdahl, Ann; Esbjörnsson, Eva; Sunnerhagen, Katharina Stibrant

doi:10.2340/16501977-1184

Cited by 45 publications

(23 citation statements)

References 28 publications

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“…Erste Studien zeigen hier vielversprechende Ansätze. So konnten Larsson und Kollegen (2013) zeigen, dass vier Jahre nach einer Hirnverletzung bis zu 70 % der Teilhabevarianz durch emotionale und soziale Faktoren aufgeklärt werden konnte [32]. Und in einer Regressionsanalyse von Marino (2012) erwies sich die dort als personenbezogen erfasste Variable "Neurotizismus-Depressivität" als signifikanter Prädiktor der Teilhabe am Ende einer ambulanten neurologischen Rehabilitation [33].…”

Section: Diskussionunclassified

Teilhabebezogene Verlaufstypen in der Schlaganfallrehabilitation – Subgruppenanalyse der Daten einer multizentrischen Beobachtungsstudie zur ambulanten Rehabilitation nach Schlaganfall

Marheineke¹,

Deck

Reuther³

et al. 2017

Fortschr Neurol Psychiatr

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We used a trajectory analysis to evaluate the course of participation in a sample of stroke patients in German neurological outpatient rehabilitation centres. Among other benefits, the method of trajectory analysis enables exploration of variables that influence the course of rehabilitation. In a multicentric observational study, patients at 17 outpatientneurorehabilitation centres were asked to fill in a questionnaire four times: at the time of admission to the rehabilitation center, on discharge and on month 4 and 12 post rehab. Additionally, clinical experts were asked to rate the patients' status at admission and discharge. We obtained data on 364 stroke patients. There was deterioration in the social participation of 36 (9.9 %) patients, no change was observed in the participation of 173 (47.5 %) patients, and there was improvement in the participation of 155 (42.6 %) patients. 99 patients among the 173 patients that did not show changes in participation had already started with good participation scores. This questions the need for rehabilitation for this group. According to the sociodemographic variables, we could show that only sex and income are important for the course of rehabilitation. Further research is necessary about context factors that influence trajectories.

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Section: Diskussionunclassified

Teilhabebezogene Verlaufstypen in der Schlaganfallrehabilitation – Subgruppenanalyse der Daten einer multizentrischen Beobachtungsstudie zur ambulanten Rehabilitation nach Schlaganfall

Marheineke¹,

Deck

Reuther³

et al. 2017

Fortschr Neurol Psychiatr

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“…Furthermore, a core component of BA is problem solving barriers related to activity engagement, which is well suited to addressing the considerable cognitive, physical, motivational and societal challenges that are common in ABI. Reduced activity engagement is an important factor contributing to the elevated rates of depression and low mood in ABI [28][29][30][31][32] and thus interventions aimed at improving activity engagement are well-suited toward this population. Promising work examining BA in the speci c context of stroke is already underway [33,34].…”

Section: Introductionmentioning

confidence: 99%

Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): A randomised controlled pilot feasibility trial for low mood in acquired brain injury

Kusec

Murphy

Peers

et al. 2020

Preprint

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Abstract Background: Acquired brain injury (ABI) affects approximately 79.3 million individuals annually and is linked with elevated rates of depression and low mood. Existing methods for treating depression in ABI have shown mixed efficacy. Behavioural Activation (BA) is a potentially promising intervention. Its premise is that individuals with low mood avoid planning and engaging in activities due to low expectations of a positive outcome. Consequently, their exposure to positive reinforcement is reduced, exacerbating low mood. BA aims to break this cycle by encouraging activity planning and engagement. It is unknown whether cognitive demands of traditional BA may undermine efficacy in ABI. Here we assess the feasibility and acceptability of two groups designed to increase activity engagement. In the Activity Planning Group (traditional BA) the importance of meaningful and positive activity will be discussed and participants encouraged to plan/engage in activities in everyday life. The Activity Engagement Group (experiential BA) instead focuses on engagement in positive experiences (crafts, games, discussion) within the group. The primary aims are to evaluate the feasibility and acceptability of the two groups in ABI. A secondary aim is to explore relative efficacy of the groups compared to an equivalent period of waitlist controls. Method: This study outlines a parallel-arm pilot feasibility trial for individuals with low mood and ABI that compares a traditional vs experiential BA group vs. waitlist controls. Adults (≥18 years) will be recruited from local ABI services and randomised to condition. Feasibility and acceptability will be assessed via recruitment, retention, attendance, and participant feedback. Groups will be compared (pre- and post-intervention and 1 month follow-up) by assessing self-reported activity engagement. Secondary outcomes include self-report measures of depression, anxiety, post-traumatic distress related to the ABI, motivation, participation, and sense of control over one’s life. Ethics and Dissemination: The trial has been approved by the Health Research Authority of the NHS in the UK (East of England – Cambridge Central, REF: 18/EE/0305). Results will inform future research on interventions for mood in ABI and be disseminated broadly via peer-reviewed journals, conference presentations, and social media.

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“…However, less is known about whether these individuals eventually participate in social and productive activities. In fact, many studies of participation after TBI exclude persons with the most severe impairments and lower levels of function for logistical reasons (e.g., inability to complete self-report questionnaires or primary residence in a non-community setting) (7,8). Alternatively, patients with severe TBI and prolonged impairments may be grouped with less severe patient populations (e.g., moderate TBI) (9), thus potentially masking cohort-specific effects (10,11).…”

Section: Introductionmentioning

confidence: 99%

Participation Following Inpatient Rehabilitation for Traumatic Disorders of Consciousness: A TBI Model Systems Study

et al. 2019

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Severe traumatic brain injury (TBI) may result in a disorder of consciousness (DoC) and lead to substantial long-term disability. While level of independence with activities of daily living, especially for persons who recover consciousness during inpatient rehabilitation, generally improves over time, the degree of change in participation remains unknown. We determined level of participation among persons with TBI between 2005 and 2017 who were admitted to inpatient rehabilitation unable to follow commands and subsequently enrolled in the TBI Model Systems National Database. Participation on the Participation Assessment with Recombined Tools-Objective (PART-O) Productivity, Social Relations, and Out and About subscales was evaluated at 1-5 years post-injury. We used a mixed-effects model to longitudinally compare participation between persons who did and did not regain command-following during inpatient rehabilitation. We further explored the level of participation associated with increasing levels of functional independence (FIM). The analysis included 333 persons (229 recovered command-following during rehabilitation, mean age = 35.46 years, 74.9% male). Participation across groups, at all follow-up time points, on all PART-O subscales, was remarkably low (mean range = 0.021-1.91, maximum possible score = 5). Performance was highest on the Social Relations subscale and lowest on the Productivity subscale. Longitudinal analyses revealed no difference in level of participation or change in participation across time for persons who regained command-following during rehabilitation compared to those who did not. While productivity increased over time, social participation did not and participation outside the home increased more for younger than for older persons. Across Malone et al. Participation After Severe Brain Injury all three PART-O subscales, FIM Motor scores positively predicted participation. FIM Cognitive scores positively predicted level of participation on the Productivity and Social Relations subscales. Exploratory analyses revealed that even persons who achieved independence on the FIM Motor and Cognitive subscales had low levels of participation across domains and follow-up years. In summary, persons with severe TBI who were admitted to inpatient rehabilitation unable to follow commands were found to be unlikely to participate in productive tasks, social endeavors, or activities outside of the home up to 5 years post-injury, even if functional independence was recovered.

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Factors affecting participation after traumatic brain injury

Cited by 45 publications

References 28 publications

Teilhabebezogene Verlaufstypen in der Schlaganfallrehabilitation – Subgruppenanalyse der Daten einer multizentrischen Beobachtungsstudie zur ambulanten Rehabilitation nach Schlaganfall

Teilhabebezogene Verlaufstypen in der Schlaganfallrehabilitation – Subgruppenanalyse der Daten einer multizentrischen Beobachtungsstudie zur ambulanten Rehabilitation nach Schlaganfall

Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): A randomised controlled pilot feasibility trial for low mood in acquired brain injury

Participation Following Inpatient Rehabilitation for Traumatic Disorders of Consciousness: A TBI Model Systems Study

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