The interrelationship of functional skills in individuals living in the community, following moderate to severe traumatic brain injury

Abstract

Objective: The Adaptive Behaviour and Community Competency Scale was used to investigate the interrelationship of 22 basic and instrumental activities of daily living (ADL/IADL) in individuals with moderate to severe traumatic brain injury (TBI). The relationship of self-awareness to task performance was also investigated. Research design: Prospective descriptive study. Method: The profiles of 100 community dwelling individuals were used to compare the degree to which independence in each ADL/IADL was associated with independence in every other ADL/IADL. The interrelationship of these skills was further explored in a factor analysis, and comparisons made between the degree of self-awareness of those who could and could not complete IADL independently. Results: We found evidence of a hierarchy of skills: individuals who were independent in IADL were more able to perform ADL, than vice versa. Factor analysis supported a two-factor solution distinguishing ADL and IADL. Self-awareness was more strongly associated with IADL than with ADL independence. Conclusions: A subset of individuals with moderate to severe TBI are able to perform a range of IADL. This group appears to have higher levels of self-awareness than those who are limited to performing only ADL skills. Implications for the applications of functional retraining interventions are discussed.

Playing Mahjong for 12 Weeks Improved Executive Function in Elderly People With Mild Cognitive Impairment: A Study of Implications for TBI-Induced Cognitive Deficits

“…Because executive function is projected in the prefrontal cortex, which is sensitive to aging-related brain atrophy and traumatic brain injury (TBI), it would be interesting to know if the present findings can be applied to prevent or reverse the decline in prefrontal cortex functional activity and the ability of daily living of TBI patients (41). It is tempting to speculate that playing mahjong could stimulate activity and restore some of the lost functions of prefrontal cortex and thus improve the executive function and instrumental activities of daily living in TBI patients because improved social interactions are important for restoring executive function and instrumental activities of daily living in subjects with TBI (42).…”

Whose Outcome is it Anyway? Outcome and Brain Injury Case Management

“…(P1) Participants commented that their role included the coordination, implementation, and maintenance of an appropriate support system tailored to each client's needs. Individuals post ABI who often struggle with impairments to their executive skills are identified as more able to perform regular and unvarying activities of daily living than instrumental activities of daily living that require "online" thinking, idea generation, problem solving, decision making, and planning (Giles et al, 2019). The concept of the support an individual requires is therefore considerably broader than in some other standard care services and, as noted above, is sometimes referred to as "scaffolding" around an individual; supporting that person to act rather than acting on their behalf (Vygotsky, 1978).…”

Neuropsychological Assessments of Patients With Acquired Brain Injury: A Cluster Analysis Approach to Address Heterogeneity in Web-Based Cognitive Rehabilitation

“…We included external variables found in previous related research ( 15 ) such as gender, age, age intervals, educational level or time since injury. Furthermore, ABI is a major cause of long-term ADL disability ( 47 ) therefore we included a standard measure of functional independence extensively used in population after ABI, the FIM (Functional Independence Measure). The FIM is typically reported as a total score or subdivided into a motor and a cognitive sub-score ( 48 ).…”