Effects of Neurofeedback on Cognitive Function, Productive Activity, and Quality of Life in Patients With Traumatic Brain Injury: A Randomized Controlled Trial

BACKGROUND

Cognitive impairment is common in patients with traumatic brain injury (TBI). Studies that have examined the effectiveness of neurofeedback (NFB) on cognitive function following TBI have had poor study designs and small sample sizes.

OBJECTIVES

This randomized controlled trial assessed the effects of low-resolution tomography Z-score NFB (LZNFB) and theta/beta NFB on cognitive impairment, return to productive activity, and quality of life in patients with TBI.

METHODS

We randomly assigned 87 patients with TBI with cognitive impairment to LZNFB, theta/beta NFB, or usual care (UC) groups. Patients in both NFB groups received weekly 60-minute treatment for 10 weeks, and those in the control group received UC and telephone interviews for 10 weeks. The primary outcome was cognitive function as measured by performance on cognitive tasks; the secondary outcomes included productive activity and quality of life based on the Community Integration Questionnaire-revised (CIQ-R) and the Quality of Life after Brain Injury (QOLIBRI), respectively, at baseline and immediately after the last intervention.

RESULTS

The LZNFB group exhibited significantly greater improvements in immediate recall, delayed recall, recognition memory, and selective attention compared with the UC group; the theta/beta NFB group exhibited improvements in only immediate memory and selective attention (P < .05). The total CIQ-R scores of the LZNFB group after treatment were significantly improved than those of the UC group were.

CONCLUSION

Consecutive LZNFB achieved therapeutic effects in memory, attention, and productive activity, whereas theta/beta NFB improved memory and attention in patients with TBI.This trial was prospectively registered at ClinicalTrial.gov (registration number: NCT03515317; https://clinicaltrials.gov/ct2/show/NCT03515317).

The importance of work or productive activity in life care planning and case management

INTRODUCTION: The importance of work or productive activity for the well-being, community integration, and quality of life of people living with disabilities is addressed, with implications for life care planning and case management.

BACKGROUND: The role of work or productive activity in our society, and consequences of deprivation if rehabilitation services do not address vocational effects of disabilities, is explored. A continuum of productivity options is introduced; types of vocational rehabilitation assessment processes and interventions are described.

PURPOSE: The role of vocational rehabilitation services in life care planning and case management is discussed, focusing on quality of life for people living with disabilities.

CONCLUSION: Rehabilitation and health care professionals should understand the importance of work or other productive activity, and support the development of appropriate plans to address those needs among people who have disabilities.

Participation in productive activities and depression among older Europeans: survey of Health, Ageing and Retirement in Europe (SHARE)

OBJECTIVE

Although engagement in productive activities is associated with favourable outcomes with respect to the health and well-being of older individuals, the association between such activities and depression in older populations remains relatively unexplored. The purpose of this study was to evaluate the association among five productive activities (paid work, formal volunteering, caregiving, informal helping and caring for grandchildren) with depression in older adults in 14 European countries.

METHODS

This cross-sectional study used the first two waves of data collected by the Survey of Health, Ageing and Retirement in Europe and analysed a total sample of 7238 relatively healthy community residents aged 60 years and older from 14 European countries. The Survey of Health, Ageing and Retirement in Europe excluded potential participants with a past history of depression, cognitive impairment and physical limitations. Depression was categorised using the EURO-D instrument, and associations with participating in productive activities were investigated.

RESULTS

Depression was less prevalent among those individuals who were employed or self-employed and those who participated in formal volunteering or informal helping, whereas caregiving was associated with a higher risk of depression. Caring for grandchildren was not associated positively or negatively with depression. Formal volunteering and caregiving remained associated with depression after adjustment for age, sex, marital status, education, economic status, country and presence of long-term illness.

CONCLUSIONS

Availability of formal volunteering may be important in reducing depression risk, whereas caregiving is associated with a higher risk of depression in older European adults. Further research is required to clarify the direction of causation and evaluate interventions.

Dynamics of Constructs in Successful Aging of Korean Elderly: Modified Rowe and Kahn's Model

Objectives

This study examined components in Rowe and Kahn’s successful aging model to investigate their hierarchical order and led to a modification of the previous hierarchical order.

Methods

To examine the hierarchical order of components, we constructed a structural equation model and verified those paths that have discrepancies in studies and/or potential inclusion or omission errors in the model. For this purpose, we analyzed 556 cases out of stratified and purposively sampled 600 elderly people living in the city of Jeonju during the study period (2011).

Results

The paths with inclusion errors such as H3 [self-reported health → productive activity (SRH → PA)]: the effect of SRH on PA, and H6 [social network (SN) → PA]: the effect of SN on PA, were not directly but indirectly supported. The path with discrepancy, H4 [SN → physical–cognitive function (PCF)]: the effect of SN on PCFs, was statistically significant. The path with inclusion error and discrepancy, H8 (PCF → PA): the effect of PCF on PA, was not directly but indirectly supported. Also the path with the omission error, H2 [SRH → psychological trait (PT)]: the effect of SRH on PT, was statistically significant. The other paths in the hierarchical order of the model reported in previous studies were statistically significant.

Conclusion

We verified new dynamics of constructs involved in successful aging, which would provide better understanding of Rowe and Kahn’s successful aging model for Korean elderly people living in a medium-sized city.