Acquired Brain Injury (acquired + brain_injury)

Distribution by Scientific Domains


Selected Abstracts


Goal attainment for spasticity management using botulinum toxin

PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2006
Stephen Ashford
Abstract Background and Purpose. To determine whether goal attainment scaling (GAS) can demonstrate functional gains following injection of botulinum toxin (BTX) for spasticity in severely disabled patients. Method. Subjects were categorized as ,responder' (positive clinical outcome) and ,non-responder' (non-significant clinical outcome) on the basis of their overall clinical response. GAS scores for functional goals were calculated retrospectively and compared with standard outcome assessments undertaken at the time of intervention. Integrated care pathway (ICP) proformas were interrogated for 18 patients with acquired brain injuries. Mean age was 44.4 (SD 13.4) years. Results. Baseline GAS and Barthel scores were similar for the responder and non-responder groups. The outcome GAS score was significantly greater in the responder than in the non-responder group (Mann,Whitney U = 11.0; p = 0.011) as was the change in GAS score (Mann,Whitney U = 8.0; p = 0.004). GAS scores reflected change recorded in focal outcome measures. However, the Barthel Index measured change in only one case. Conclusions. This exploratory retrospective study provides preliminary support for the hypothesis that GAS provides a useful measure of functional gains in response to treatment with BTX, and is more sensitive than global measures such as the Barthel Index. Copyright © 2006 John Wiley & Sons, Ltd. [source]


Exploring the utility of functional analysis methodology to assess and treat problematic verbal behavior in persons with acquired brain injury

BEHAVIORAL INTERVENTIONS, Issue 2 2004
Mark R. Dixon
Functional analyses were conducted on four adults with acquired brain injuries who regularly displayed instances of inappropriate verbal behavior including depressive, aggressive, suicidal, profane, and sexually inappropriate utterances. After the functional analysis yielded a maintaining variable for each participant, a function-based intervention consisting of differential reinforcement of alternative verbal behavior was implemented. Results of the behavioral interventions show that instances of vocal behavior can be assessed and subsequently treated using the functional analysis methodology often reserved for nonverbal forms of behavior. The utility of functional analysis for assessing complex human behavior is discussed. Copyright © 2004 John Wiley & Sons, Ltd. [source]


Effectiveness of a community-based 3-year advisory program after acquired brain injury

EUROPEAN JOURNAL OF NEUROLOGY, Issue 11 2007
E. Grill
Objective of this study was to examine the effectiveness of a coordinated, community based 3-year advisory program in 1534 patients with acquired brain injury. Patients and caregivers were offered a coordinated advisory program after discharge from rehabilitation. Patients in the historical control group received standard aftercare. The main outcomes were functional status [Functional Independence Measure (FIM)], and days spent in the acute hospital. The secondary outcome was survival. Patients were comparable for sex (intervention: 41.3% female, control: 38.0%), and younger in the control group (mean age intervention: 55.3, control: 49.6). Functional status at discharge was lower in the intervention group (mean FIM intervention: 66.2, control: 80.3). Patients in the intervention group experienced a moderate gain in FIM. Rate of days in hospital was 15.4 per 1000 person days (intervention) and 15.5 per 1000 person days (control). Patients of the intervention group had an increased rate of days in hospital. A total of 16.0% of patients in the intervention group and 19.3% in the control group died during follow-up. Patients in the intervention had a significant lower mortality risk depending on follow-up period and discharge FIM. The advisory program may be effective for all patients with acquired brain injury. [source]


Practitioner Review: Cognitive rehabilitation for children with acquired brain injury

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 4 2005
Jenny Limond
Background:, The need to address acquired cognitive impairments is increasing in child populations seen across a range of settings. However, current clinical practice following brain injury in children does not necessarily incorporate the use of cognitive rehabilitation models or techniques. The aim of this paper is to review the literature in this area. Methods:, All published interventions targeting the cognitive domains of attention, memory and/or executive function that could be identified were reviewed. Different cognitive rehabilitation techniques are briefly described and the clinical and research implications of the findings are discussed. Results:, Eleven papers, involving 54 children and adolescents receiving intervention, were identified. This literature describes generalised cognitive rehabilitation programmes as well as more specific strategies targeting focal deficits. Conclusions:, There is an absence of randomised controlled trials and a very limited number of studies using other methodological approaches, providing at this time no conclusive evidence for the efficacy of cognitive rehabilitation for children with acquired brain injury, but a clear need to address a range of methodological difficulties in this field of enquiry. [source]


A review of paroxysmal sympathetic hyperactivity after acquired brain injury

ANNALS OF NEUROLOGY, Issue 2 2010
Iain Perkes BMedSc
Severe excessive autonomic overactivity occurs in a subgroup of people surviving acquired brain injury, the majority of whom show paroxysmal sympathetic and motor overactivity. Delayed recognition of paroxysmal sympathetic hyperactivity (PSH) after brain injury may increase morbidity and long-term disability. Despite its significant clinical impact, the scientific literature on this syndrome is confusing; there is no consensus on nomenclature, etiological information for diagnoses preceding the condition is poorly understood, and the evidence base underpinning our knowledge of the pathophysiology and management strategies is largely anecdotal. This systematic literature review identified 2 separate categories of paroxysmal autonomic overactivity, 1 characterized by relatively pure sympathetic overactivity and another group of disorders with mixed parasympathetic/sympathetic features. The PSH group comprised 349 reported cases, with 79.4% resulting from traumatic brain injury (TBI), 9.7% from hypoxia, and 5.4% from cerebrovascular accident. Although TBI is the dominant causative etiology, there was some suggestion that the true incidence of the condition is highest following cerebral hypoxia. In total, 31 different terms were identified for the condition. Although the most common term in the literature was dysautonomia, the consistency of sympathetic clinical features suggests that a more specific term should be used. The findings of this review suggest that PSH be adopted as a more clinically relevant and appropriate term. The review highlights major problems regarding conceptual definitions, diagnostic criteria, and nomenclature. Consensus on these issues is recommended as an essential basis for further research in the area. ANN NEUROL 2010;68:126,135 [source]


Children's participation in home, school and community life after acquired brain injury

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 2 2010
Jane Galvin
Aims:,This study aimed to describe participation at home, school and in the community of Australian children who had sustained an acquired brain injury (ABI). Parent ratings regarding the impact of cognitive, motor and behavioural impairments on participation were obtained. In addition, the influence of environmental factors on participation was investigated. Methodology:,This study used a cross-sectional design with convenience sampling to recruit 20 children who attended a rehabilitation review clinic between September 2006 and September 2007. Participants completed the Child and Family Follow-up Survey (Bedell, 2004) to describe the participation of their children in home, school and community settings. The CFFS was developed based on the International Classification of Function, and uses parent report to measure the impact of impairments and environmental factors on children's participation in home, school and community life. Results:,The children were reported to have the greatest participation restrictions for structured events in the community, and social, play or leisure activities with peers either at school or in the community. Children were least restricted moving about in and around their own homes. Conclusions:,This research describes difficulties encountered by Australian children with ABI in participating in community-based activities with their same aged peers. This study adds to the current literature describing patterns of participation of United States children who have sustained brain injuries, and provides useful information for Australian therapists to consider when addressing children's return to school and engagement with their peers following brain injury. [source]


Splinting the hand in the functional position after acquired brain injury did not influence muscle length, hand function or pain

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 4 2003
Marion Walker
No abstract is available for this article. [source]


Sexual behaviors among children and adolescents with acquired brain injury: an incidence survey at a community-based neurorehabilitation center

BEHAVIORAL INTERVENTIONS, Issue 1 2005
James K. Luiselli
We conducted a survey to identify the incidence of sexual behaviors among a community sample of children and adolescents with acquired brain injury (ABI). The survey was completed by professional staff at a residential pediatric neurorehabilitation setting and included behaviors observed directly during their employment tenure (1,6 years). The five highest ranked categories of sexual behaviors from a sample of 24 students were (1) masturbation, (2) sex talk, (3) attempted or actual ,petting/fondling';, (4) attempt to solicit sex, and (5) verbal sexual threat. Staff identified relatively few students who exhibited sexually coercive or aggressive behaviors. Clinical implications of the findings are discussed. Copyright © 2005 John Wiley & Sons, Ltd. [source]


Exploring the utility of functional analysis methodology to assess and treat problematic verbal behavior in persons with acquired brain injury

BEHAVIORAL INTERVENTIONS, Issue 2 2004
Mark R. Dixon
Functional analyses were conducted on four adults with acquired brain injuries who regularly displayed instances of inappropriate verbal behavior including depressive, aggressive, suicidal, profane, and sexually inappropriate utterances. After the functional analysis yielded a maintaining variable for each participant, a function-based intervention consisting of differential reinforcement of alternative verbal behavior was implemented. Results of the behavioral interventions show that instances of vocal behavior can be assessed and subsequently treated using the functional analysis methodology often reserved for nonverbal forms of behavior. The utility of functional analysis for assessing complex human behavior is discussed. Copyright © 2004 John Wiley & Sons, Ltd. [source]


Training of attention and memory deficits in children with acquired brain injury

ACTA PAEDIATRICA, Issue 2 2010
N Madsen Sjö
Abstract This pilot study concerns cognitive rehabilitation of children with acquired brain injury (ABI). Aim:, The aim is threefold; to determine (1) whether the Amsterdam Memory and Attention Training for Children (AMAT-C) programme for children with ABI can be integrated in the child's school, (2) whether supervision in the school-setting maintains the child's motivation throughout the training programme and (3) whether positive changes in memory, attention and executive functions are found with this implementation of the training method. Methods:, Seven children with memory and/or attention deficits after ABI were trained with AMAT-C. Measures used were programme evaluation questions, neuropsychological tests and a questionnaire concerning executive functions. Results:, Overall, children, parents and trainers were satisfied with the programme and the children were motivated throughout the programme. The children showed significant improvements in neuropsychological subtests, primarily in tests of learning and memory. No overall change in executive functions was noted. Conclusion:, Provision of AMAT-C training and supervision at the child's school appears to ensure (1) satisfaction with the programme, (2) sustaining of motivation and (3) improvements in learning and memory. [source]