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Bassingthwaighte L, Gustafsson L, Molineux M. On-road driving remediation following acquired brain injury: a scoping review. Brain Inj 2022; 36:239-250. [DOI: 10.1080/02699052.2022.2033837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Louise Bassingthwaighte
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Queensland, Australia
| | - Louise Gustafsson
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- Menzies Health Institute Queensland, The Hopkins Centre, Australia
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
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Perumparaichallai RK, Lewin RK, Klonoff PS. Community reintegration following holistic milieu-oriented neurorehabilitation up to 30 years post-discharge. NeuroRehabilitation 2020; 46:243-253. [PMID: 32083599 DOI: 10.3233/nre-192968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The primary goal of neurorehabilitation for individuals with acquired brain injury (ABI) is successful community reintegration, which commonly focuses on home independence, productivity, and social engagement. Previous research has demonstrated that holistic treatment approaches have better long-term outcomes than other treatment approaches. Holistic approaches go beyond the fundamental components of neurorehabilitation and address metacognition and self-awareness, as well as interpersonal and functional skills. OBJECTIVES The present study aimed to examine community reintegration of individuals with ABI who completed holistic milieu-oriented neurorehabilitation at the Center for Transitional Neuro-Rehabilitation (CTN), Barrow Neurological Institute (BNI) at up to 30-years post-discharge. We evaluated (a) functional independence, (b) productivity and driving status, and (c) psychosocial profiles of the brain injury survivors. METHOD Participants included 107 individuals with ABI with heterogeneous etiologies who attended holistic milieu-oriented neurorehabilitation between 1986 and 2016. These participants completed the Mayo-Portland Adaptability Inventory-4 (MPAI-4) and a long-term outcome questionnaire (LOQ) specifically developed for this study. RESULTS The results demonstrate that 89% of participants were productive at up to 30 years post-discharge (73% engaged in competitive work and/or school) after excluding the retired participants. Almost all of the participants who were engaged in work and/or school reported using compensatory strategies on a long-term basis. Furthermore, only 14% out of 102 study participants were driving at the time of program admission; whereas 58% out of 96 were driving at the time of discharge; and impressively, 70% out of 107 participants were driving at the time of follow-up. Regression analyses revealed that older age at the time of injury, shorter duration between injury and treatment, and better functionality indicated by lower MPAI-4 Ability Index scores significantly predicted a return to driving status at the time of study participation. Psychosocial data from the LOQ revealed positive findings with respect to patients' marital status, living situation, income, and quality of social life. CONCLUSION The findings from this study suggest that functional gains made during holistic neurorehabilitation have enduring effects and that patients can benefit highly from holistic milieu therapy beyond the early post-acute phases of their recovery. Additionally, they provide evidence that there is potential to return to driving, years after treatment completion.Our holistic milieu treatment approach addressing metacognition, self-awareness, social and coping skills training, and actively transitioning to community settings, is thought to have contributed to the exceptional and long-lasting outcomes in this study.
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Affiliation(s)
| | - Rivian K Lewin
- Center for Transitional Neuro-Rehabilitation, Barrow Neurological Institute/St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.,Department of Psychology, University of Memphis, Memphis, TN, USA
| | - Pamela S Klonoff
- Center for Transitional Neuro-Rehabilitation, Barrow Neurological Institute/St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
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Loetscher T, Potter K, Wong D, das Nair R. Cognitive rehabilitation for attention deficits following stroke. Cochrane Database Syst Rev 2019; 2019:CD002842. [PMID: 31706263 PMCID: PMC6953353 DOI: 10.1002/14651858.cd002842.pub3] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Many survivors of stroke report attentional impairments, such as diminished concentration and distractibility. However, the effectiveness of cognitive rehabilitation for improving these impairments is uncertain.This is an update of the Cochrane Review first published in 2000 and previously updated in 2013. OBJECTIVES To determine whether people receiving cognitive rehabilitation for attention problems 1. show better outcomes in their attentional functions than those given no treatment or treatment as usual, and 2. have a better functional recovery, in terms of independence in activities of daily living, mood, and quality of life, than those given no treatment or treatment as usual. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, PsycBITE, REHABDATA and ongoing trials registers up to February 2019. We screened reference lists and tracked citations using Scopus. SELECTION CRITERIA We included controlled clinical trials (CCTs) and randomised controlled trials (RCTs) of cognitive rehabilitation for impairments of attention for people with stroke. We did not consider listening to music, meditation, yoga, or mindfulness to be a form of cognitive rehabilitation. We only considered trials that selected people with demonstrable or self-reported attentional deficits. The primary outcomes were measures of global attentional functions, and secondary outcomes were measures of attentional domains (i.e. alertness, selective attention, sustained attention, divided attention), functional abilities, mood, and quality of life. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials, extracted data, and assessed the risk of bias. We used the GRADE approach to assess the certainty of evidence for each outcome. MAIN RESULTS We included no new trials in this update. The results are unchanged from the previous review and are based on the data of six RCTs with 223 participants. All six RCTs compared cognitive rehabilitation with a usual care control. Meta-analyses demonstrated no convincing effect of cognitive rehabilitation on subjective measures of attention either immediately after treatment (standardised mean difference (SMD) 0.53, 95% confidence interval (CI) -0.03 to 1.08; P = 0.06; 2 studies, 53 participants; very low-quality evidence) or at follow-up (SMD 0.16, 95% CI -0.23 to 0.56; P = 0.41; 2 studies, 99 participants; very low-quality evidence). People receiving cognitive rehabilitation (when compared with control) showed that measures of divided attention recorded immediately after treatment may improve (SMD 0.67, 95% CI 0.35 to 0.98; P < 0.0001; 4 studies, 165 participants; low-quality evidence), but it is uncertain that these effects persisted (SMD 0.36, 95% CI -0.04 to 0.76; P = 0.08; 2 studies, 99 participants; very low-quality evidence). There was no evidence for immediate or persistent effects of cognitive rehabilitation on alertness, selective attention, and sustained attention. There was no convincing evidence for immediate or long-term effects of cognitive rehabilitation for attentional problems on functional abilities, mood, and quality of life after stroke. AUTHORS' CONCLUSIONS The effectiveness of cognitive rehabilitation for attention deficits following stroke remains unconfirmed. The results suggest there may be an immediate effect after treatment on attentional abilities, but future studies need to assess what helps this effect persist and generalise to attentional skills in daily life. Trials also need to have higher methodological quality and better reporting.
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Affiliation(s)
- Tobias Loetscher
- University of South AustraliaSchool of PsychologyGPO Box 2471AdelaideSAAustralia5001
| | - Kristy‐Jane Potter
- University of NottinghamDivision of Psychiatry & Applied PsychologyNottinghamNottinghamshireUKNG7 2UH
| | - Dana Wong
- La Trobe UniversitySchool of Psychology and Public HealthMelbourneAustralia
| | - Roshan das Nair
- University of NottinghamDivision of Psychiatry & Applied PsychologyNottinghamNottinghamshireUKNG7 2UH
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Independent outdoor mobility of persons with multiple sclerosis - A systematic review. Mult Scler Relat Disord 2019; 37:101463. [PMID: 31678858 DOI: 10.1016/j.msard.2019.101463] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 10/20/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) can manifest itself in many ways, all of which can affect the independent outdoor mobility of persons with MS (pwMS). In most studies, mobility of pwMS is defined by the ability to walk. However, mobility comprises more than walking alone. This systematic review provides an overview of the literature on several types of independent outdoor mobility of pwMS. We aimed to identify which specific factors may influence outdoor mobility and how the lives of pwMS may be affected by a reduced mobility. METHODS A systematic literature search was performed, using three databases (PubMed, PsychInfo and Web of Science). Studies had to describe a group of pwMS sclerosis and had to concern some type of mobility other than walking. RESULTS The 57 studies that fulfilled the criteria included in total 10,394 pwMS and in addition, 95,300 pwMS in separate prevalence study. These studies showed that pwMS as a group have a decreased fitness to drive, make use of a wheelchair or mobility scooter more often and have difficulties making use of public transport. Mobility problems especially occur in patients with cognitive problems, secondary progressive MS or high disability scores. CONCLUSIONS The reduced mobility may prevent pwMS participating in society. However, few studies investigating interventions or rehabilitation options to improve mobility were found in the existing literature, highlighting an until now under recognised unmet need.
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Bishop M, Kayes N, McPherson K. Understanding the therapeutic alliance in stroke rehabilitation. Disabil Rehabil 2019; 43:1074-1083. [PMID: 31433673 DOI: 10.1080/09638288.2019.1651909] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The quality of the therapeutic alliance between a client and their clinician is thought to play an important role in healthcare but there is limited research about this concept in stroke rehabilitation. This study explored the core components of a therapeutic alliance and the factors perceived to impact on its development in a stroke rehabilitation unit. METHODS Interpretive description methodology was used to gather and synthesise participants' experiences of their therapeutic relationships. Ten individual client interviews and one clinician focus group were conducted. Data was were analysed using conventional content analysis. RESULTS A therapeutic alliance appeared to consist of three overlapping core components: a personal connection, a professional collaboration, and family collaboration. Clients valued these components to different degrees and priorities could change over time. Alliance breakdowns were perceived to stem from a clinician's incorrect assumptions about their client's relationship preferences or lack of responsiveness to their needs. Recovery of the alliance seemed to depend on the strength of the pre-existing relationship and steps taken to repair it. CONCLUSIONS Establishing and maintaining a therapeutic alliance appears to be an individualised and complex process. A clinician's ability to use their personal attributes therapeutically, and professional skills flexibly, appeared integral to relationship quality.IMPLICATIONS FOR REHABILITATIONDeveloping therapeutic relationships requires a person-centred and sometimes family/whānau-centred approach.The judicious use of self-disclosure may achieve emotional proximity and yet maintain professional boundaries.Maintaining relationship health requires a proactive approach to detect and manage relationship disruptions.
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Affiliation(s)
- Megan Bishop
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand.,School of Physiotherapy, University of Otago, Wellington, New Zealand
| | - Nicola Kayes
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Kathryn McPherson
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand.,Health Research Council of New Zealand, Auckland, New Zealand
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Cicerone KD, Goldin Y, Ganci K, Rosenbaum A, Wethe JV, Langenbahn DM, Malec JF, Bergquist TF, Kingsley K, Nagele D, Trexler L, Fraas M, Bogdanova Y, Harley JP. Evidence-Based Cognitive Rehabilitation: Systematic Review of the Literature From 2009 Through 2014. Arch Phys Med Rehabil 2019; 100:1515-1533. [DOI: 10.1016/j.apmr.2019.02.011] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 10/27/2022]
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Stagg K, Douglas J, Iacono T. A scoping review of the working alliance in acquired brain injury rehabilitation. Disabil Rehabil 2017; 41:489-497. [DOI: 10.1080/09638288.2017.1396366] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kellie Stagg
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Jacinta Douglas
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
- Summer Foundation, Melbourne, Australia
| | - Teresa Iacono
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne, Australia
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Stephens JA, Williamson KNC, Berryhill ME. Cognitive Rehabilitation After Traumatic Brain Injury: A Reference for Occupational Therapists. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2015; 35:5-22. [PMID: 26623474 DOI: 10.1177/1539449214561765] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nearly 1.7 million Americans sustain a traumatic brain injury (TBI) each year. These injuries can result in physical, emotional, and cognitive consequences. While many individuals receive cognitive rehabilitation from occupational therapists (OTs), the interdisciplinary nature of TBI research makes it difficult to remain up-to-date on relevant findings. We conducted a literature review to identify and summarize interdisciplinary evidence-based practice targeting cognitive rehabilitation for civilian adults with TBI. Our review summarizes TBI background, and our cognitive remediation section focuses on the findings from 37 recent (since 2006) empirical articles directly related to cognitive rehabilitation for individuals (i.e., excluding special populations such as veterans or athletes). This manuscript is offered as a tool for OTs engaged in cognitive rehabilitation and as a means to highlight arenas where more empirical, interdisciplinary research is needed.
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Unsworth CA, Baker A. Driver rehabilitation: a systematic review of the types and effectiveness of interventions used by occupational therapists to improve on-road fitness-to-drive. ACCIDENT; ANALYSIS AND PREVENTION 2014; 71:106-114. [PMID: 24906164 DOI: 10.1016/j.aap.2014.04.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 03/31/2014] [Accepted: 04/23/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Driver rehabilitation has the potential to improve on-road safety and is commonly recommended to clients. The aim of this systematic review was to identify what intervention approaches are used by occupational therapists as part of driver rehabilitation programmes, and to determine the effectiveness of these interventions. METHOD Six electronic databases (MEDLINE, CINAHL, PsycInfo, Embase, The Cochrane Library, and OTDBase) were searched. Two authors independently reviewed studies reporting all types of research designs and for all patient populations, provided the interventions could be administered by occupational therapists. The methodological quality of studies was assessed using the 'Downs and Black Instrument', and the level of evidence for each intervention approach was established using 'Centre for Evidence Based Medicine' criteria. RESULTS Sixteen studies were included in the review. The most common type of intervention approach used was computer-based driving simulator training (n=8), followed by off-road skill-specific training (n=4), and off-road education programmes (n=3). Car adaptations/modifications were used in one of the included studies. There was significant variability between studies with regards to frequency, duration, and total number of intervention sessions, and the diagnoses of the participants. Of the four intervention approaches, there is evidence to support the effectiveness of off-road skill-specific training (with older clients), and computer-based driving simulator training (with both older clients and participants with acquired brain injury). CONCLUSION Three types of intervention approaches are commonly reported, however, there is limited evidence to determine to effectiveness of these in improving fitness-to-drive. Further research is required, with clients from a range of diagnostic groups to establish evidence-based interventions and determine their effectiveness in improving these clients' on-road fitness-to-drive.
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Affiliation(s)
- Carolyn A Unsworth
- Faculty of Health Sciences, La Trobe University, Melbourne 3086, VIC, Australia; Department of Rehabilitation, School of Health Sciences, Jönköping University, Jönköping, Sweden.
| | - Anne Baker
- Faculty of Health Sciences, La Trobe University, Melbourne 3086, VIC, Australia
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Perumparaichallai RK, Husk KL, Myles SM, Klonoff PS. The relationship of neuropsychological variables to driving status following holistic neurorehabilitation. Front Neurol 2014; 5:56. [PMID: 24795693 PMCID: PMC4005955 DOI: 10.3389/fneur.2014.00056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 04/07/2014] [Indexed: 12/02/2022] Open
Abstract
Objective: The main objectives of the present study were to evaluate the cognitive and driving outcomes of a holistic neurorehabilitation program and to examine the relationship between the neuropsychological variables of attention, speed of information processing, and visuospatial functioning and driving outcomes. Methods: One hundred and twenty-eight individuals with heterogeneous neurological etiologies who participated in a holistic neurorehabilitation program. Holistic neurorehabilitation consisted of therapies focusing on physical, cognitive, language, emotional, and interpersonal functioning, including training in compensatory strategies. Neuropsychological testing was administered at admission and prior to starting driving or program discharge. Subtests of processing speed, working memory, and perceptual reasoning from the Wechsler Adult Intelligence Scale-III and Trail Making Test were included. Results: At the time of discharge, 54% of the individuals returned to driving. Statistical analyses revealed that at the time of discharge: the sample as a group made significant improvements on cognitive measures included in the study; the driving and non-driving groups differed significantly on aspects of processing speed, attention, abstract reasoning, working memory, and visuospatial functions. Further, at the time of admission, the driving group performed significantly better than the non-driving group on several neuropsychological measures. Conclusion: Cognitive functions of attention, working memory, visual-motor coordination, motor and mental speed, and visual scanning significantly contribute to predicting driving status of individuals after neurorehabilitation. Holistic neurorehabilitation facilitates recovery and helps individuals to gain functional independence after brain injury.
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Affiliation(s)
| | - Kristi L Husk
- Center for Transitional NeuroRehabilitation, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center , Phoenix, AZ , USA
| | - Stephen M Myles
- Center for Transitional NeuroRehabilitation, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center , Phoenix, AZ , USA
| | - Pamela S Klonoff
- Center for Transitional NeuroRehabilitation, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center , Phoenix, AZ , USA
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Ee LC, Lloyd O, Beale K, Fawcett J, Cleghorn GJ. Academic potential and cognitive functioning of long-term survivors after childhood liver transplantation. Pediatr Transplant 2014; 18:272-9. [PMID: 24646364 DOI: 10.1111/petr.12246] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2014] [Indexed: 11/30/2022]
Abstract
This cross-sectional study assessed intellect, cognition, academic function, behaviour, and emotional health of long-term survivors after childhood liver transplantation. Eligible children were >5 yr post-transplant, still attending school, and resident in Queensland. Hearing and neurocognitive testing were performed on 13 transplanted children and six siblings including two twin pairs where one was transplanted and the other not. Median age at testing was 13.08 (range 6.52-16.99) yr; time elapsed after transplant 10.89 (range 5.16-16.37) yr; and age at transplant 1.15 (range 0.38-10.00) yr. Mean full-scale IQ was 97 (81-117) for transplanted children and 105 (87-130) for siblings. No difficulties were identified in intellect, cognition, academic function, and memory and learning in transplanted children or their siblings, although both groups had reduced mathematical ability compared with normal. Transplanted patients had difficulties in executive functioning, particularly in self-regulation, planning and organization, problem-solving, and visual scanning. Thirty-one percent (4/13) of transplanted patients, and no siblings, scored in the clinical range for ADHD. Emotional difficulties were noted in transplanted patients but were not different from their siblings. Long-term liver transplant survivors exhibit difficulties in executive function and are more likely to have ADHD despite relatively intact intellect and cognition.
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Affiliation(s)
- L C Ee
- Queensland Liver Transplant Service, Brisbane, Australia; The University of Queensland, School of Medicine, Brisbane, QLD, Australia
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Rosti-Otajärvi E, Mäntynen A, Koivisto K, Huhtala H, Hämäläinen P. Predictors and impact of the working alliance in the neuropsychological rehabilitation of patients with multiple sclerosis. J Neurol Sci 2014; 338:156-61. [DOI: 10.1016/j.jns.2013.12.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 11/22/2013] [Accepted: 12/24/2013] [Indexed: 01/28/2023]
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Abstract
BACKGROUND Many survivors of stroke complain about attentional impairments, such as diminished concentration and mental slowness. However, the effectiveness of cognitive rehabilitation for improving these impairments is uncertain. OBJECTIVES To determine whether (1) people receiving attentional treatment show better outcomes in their attentional functions than those given no treatment or treatment as usual, and (2) people receiving attentional treatment techniques have a better functional recovery, in terms of independence in activities of daily living, mood and quality of life, than those given no treatment or treatment as usual. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (October 2012), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library October 2012), MEDLINE (1948 to October 2012), EMBASE (1947 to October 2012), CINAHL (1981 to October 2012), PsycINFO (1806 to October 2012), PsycBITE and REHABDATA (searched October 2012) and ongoing trials registers. We screened reference lists and tracked citations using Scopus. SELECTION CRITERIA We included randomised controlled trials (RCTs) of cognitive rehabilitation for impairments of attention for people with stroke. The primary outcome was measures of global attentional functions, and secondary outcomes were measures of attention domains, functional abilities, mood and quality of life. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials, extracted data and assessed trial quality. MAIN RESULTS We included six RCTs with 223 participants. All six RCTs compared cognitive rehabilitation with a usual care control. Meta-analyses demonstrated no statistically significant effect of cognitive rehabilitation for persisting effects on global measures of attention (two studies, 99 participants; standardised mean difference (SMD) 0.16, 95% confidence interval (CI) -0.23 to 0.56; P value = 0.41), standardised attention assessments (two studies, 99 participants; P value ≥ 0.08) or functional outcomes (two studies, 99 participants; P value ≥ 0.15). In contrast, a statistically significant effect was found in favour of cognitive rehabilitation when compared with control for immediate effects on measures of divided attention (four studies, 165 participants; SMD 0.67, 95% CI 0.35 to 0.98; P value < 0.0001) but no significant effects on global attention (two studies, 53 participants; P value = 0.06), other attentional domains (six studies, 223 participants; P value ≥ 0.16) or functional outcomes (three studies, 109 participants; P value ≥ 0.21).Thus there was limited evidence that cognitive rehabilitation may improve some aspects of attention in the short term, but there was insufficient evidence to support or refute the persisting effects of cognitive rehabilitation on attention, or on functional outcomes in either the short or long term. AUTHORS' CONCLUSIONS The effectiveness of cognitive rehabilitation remains unconfirmed. The results suggest there may be a short-term effect on attentional abilities, but future studies need to assess the persisting effects and measure attentional skills in daily life. Trials also need to have higher methodological quality and better reporting.
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Devos H, Akinwuntan AE, Gélinas I, George S, Nieuwboer A, Verheyden G. Shifting up a Gear: Considerations on Assessment and Rehabilitation of Driving in People with Neurological Conditions. An Extended Editorial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2012; 17:125-31. [DOI: 10.1002/pri.1535] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hannes Devos
- Department of Rehabilitation Sciences; Katholieke Universiteit Leuven - University of Leuven; Belgium
| | | | - Isabelle Gélinas
- Department of Physical and Occupational Therapy; McGill University; Montréal Canada
| | - Stacey George
- Department of Aged Care and Rehabilitation; Repatriation General Hospital; Adelaide Australia
| | - Alice Nieuwboer
- Department of Rehabilitation Sciences; Katholieke Universiteit Leuven - University of Leuven; Belgium
| | - Geert Verheyden
- Department of Rehabilitation Sciences; Katholieke Universiteit Leuven - University of Leuven; Belgium
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Lundqvist A, Alinder J, Modig-Arding I, Samuelsson K. Driving after Brain Injury: A Clinical Model Based on a Quality Improvement Project. ACTA ACUST UNITED AC 2011. [DOI: 10.4236/psych.2011.26094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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