Neuropsychological Rehabilitation最新文献

Purpose: This scoping review aimed to synthesize evidence on the psychometric properties of measurement instruments used to assess people with aphasia (PWA) after stroke. In constructing support for PWA, a comprehensive assessment is vital, yet evidence on measurement accuracy is limited.

Materials and methods: Six databases (PubMed, MEDLINE, EMBASE, PsycINFO, Web of Science, and Ichushi-Web) were searched for studies up to 2023. Four authors independently screened studies examining the psychometric properties of instruments for PWA. Data were classified according to the Research Outcome Measurement in Aphasia (ROMA) Core Outcome Set (COS), focusing on language, communication, emotional well-being, and quality of life (QOL), and on four key instruments: Western Aphasia Battery-Revised (WAB-R), Scenario Test, GHQ-12, and SAQOL-39. Psychometric properties were appraised using the COSMIN criteria.

Results: From 12,150 records, 34 studies covering 37 instruments were included; participants were mostly ≥60 years and >6 months post-stroke. Fewer tools assessed communication, well-being, and QOL than language. Responsiveness and measurement error were rarely evaluated; ROMA instruments WAB-R and GHQ-12 were absent. Sufficient properties supported 2 languages, 5 communication, 1 well-being, and 3 QOL instruments.

Conclusions: Major gaps persist-limited validation, scant responsiveness/measurement error evidence, and weak support even for COS instruments.

Interventions targeting social cognition following moderate-to-severe Traumatic Brain Injury (TBI) have shown some benefit, however, there remains a need to systematically review, statistically synthesize, and evaluate these interventions to inform the development of Clinical Practice Guidelines. Six databases were searched from inception to May 2024. Eligible studies targeted adults with a moderate-to-severe TBI (P); evaluated interventions targeting social cognition (I); compared to a control, baseline performance, or phase without treatment (C); based on objective social-cognitive ability/performance (O). Studies were screened by two independent reviewers. A random effects model estimated treatment effects for RCTs (Hedge's g) and observational (pre-post) studies (SMD) separately. Risk of bias was assessed. Certainty of evidence was evaluated using GRADE. Twenty-five studies were eligible, including 478 participants. RCTs targeting emotion perception and ToM produced a small effect (g = 0.38 (95%CI, 0.17, 0.59), p < .001). Observational studies targeting emotion perception and ToM produced a small-medium effect (SMD = 0.42 (95% CI 0.22, 0.61), p < .001). Interventions targeting empathy or alexithymia were limited. Our review provides initial evidence for the effectiveness of social-cognitive interventions targeting emotion perception and/or ToM. More research is needed to develop and evaluate interventions for other social-cognitive domains, including empathy and alexithymia.

Fifty percent of Acquired Brain Injury (ABI) survivors experience fatigue. Symptom management in post-acute rehabilitation, where rehabilitation adherence is essential, is lacking. Research suggests that music listening interventions could help by addressing related symptoms including pain, mood and arousal. Our objective was to explore how music listening has been used for post-ABI fatigue and whether findings, together with interview data from a post-acute ward, could inform on its use for this purpose. Synthesized data included: intervention characteristics, study design and outcomes. Joanna Briggs Institute guidelines and PRISMA checklist were applied. Nine-hundred and eighty-seven abstracts and 29 full texts were screened, with thirteen papers on nine studies included. Fatigue was reported only as a secondary outcome and not defined by type. Associated outcomes included: increased self-reported stamina, vitality, arousal, sleep and relaxation, better mood and pain management, verbal memory and attention. Interview data (patients: n = 6; staff: n = 4; caregivers: n = 2) suggest the need for time allocation for music listening, help with equipment setup, and trialling to determine duration and frequency. Future studies should screen for fatigue type and symptoms and establish with participants whether music interventions might be beneficial for energizing or relaxing, and if complimentary to cited strategies including exercise or meditation.

Experiences of loss and change following acquired brain injury (ABI) are frequent and multi-contextual, yet the long-term experiences of people with ABI are not well understood. This study explored the experiences of intrapersonal loss, grief and change in people with ABI, a decade after their injury. Twelve adults with ABI were interviewed 10-13 years post-injury. Using interpretative phenomenological analysis, we identified four overarching themes: a dawning realization of the impact of injury; loss of personhood; loss and liminality; and learning to live with loss and grief. Our findings indicate that in the decade following ABI, people continue to develop awareness of the impact of their injury and experience oscillating acceptance towards enforced changes. Participants reported a diminished sense of agency and autonomy in how they were perceived by and interacted with following injury. Additionally, identity may be lost, suspended, and renegotiated. Findings suggest dynamic, active, and flexible coping strategies that continue to be present over the long term. Considering the persistent nature of the injury and the evolving needs of the individual, a longer term view of rehabilitation outcomes may be required, contextualised by relational and intrapersonal challenges that may present over the longer term.

Stigma represents a major obstacle in rehabilitation and community reintegration after brain injury. However, appropriate tools to measure stigma in Spanish-speaking countries are lacking. This study examined the psychometric properties of the Spanish version of the Anticipated Stigma and Concealment Questionnaire (ASCQ). An observational cross-sectional study was conducted with 103 participants who completed the ASCQ and other measures. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed to assess the scale's structure. Associations between the ASCQ and other mental health measures were explored to establish its nomological validity. All ASCQ items loaded significantly onto a single factor, with factor loadings ranging from .7 to .84. While χ² (35) = 56.282, p < .05, some fit indices indicated excellent model fit (CFI = .997 and TLI = .996), while others suggested a good fit (RMSEA = .077, 90% CI [.036, .113], and SRMR = .060). Significant associations were found between the ASCQ and measures of loneliness, depressive symptoms, quality of life, and self-esteem. The ASCQ is a valid and reliable tool for assessing anticipated stigma and the motivation to conceal information after acquired brain injury. It can aid rehabilitation professionals in identifying individuals with interpersonal difficulties during community reintegration.

Mental health difficulties are common post-stroke and developing support for psychological adjustment is a research priority. Wellbeing After Stroke (WAterS) is a nine-week, online, group-based Acceptance and Commitment Therapy (ACT)-informed intervention, delivered by trained third-sector practitioners, supervised by a clinical neuropsychologist. This study aimed to explore the acceptability of WAterS from the stroke survivors' perspective.Semi-structured interviews were conducted with twelve stroke survivors who received WAterS. The interview schedule was informed by theorised components of acceptability, including understanding, burden and perception of effectiveness. The data were analysed inductively and deductively using Template Analysis.Six qualitative themes were generated. Results indicate the intervention was mostly understandable and participants were able to engage with ACT and apply it to life. Online delivery reduced burden in accessing the intervention, and was acceptable when supported by live facilitation and a physical handbook. Group cohesion and understanding was facilitated by practitioners. The social aspect of the group was beneficial. Attending WAterS supported some participants to seek further support; others were left feeling unsupported when the intervention ended.Stroke survivors valued attending an online, group ACT-informed intervention, delivered by practitioners. This is a promising avenue in increasing the reach of interventions to support wellbeing.

Objective: The purpose of this study was to examine correlations between injury- and child-factors and participation and quality of life (QoL) after childhood traumatic brain injury (TBI).

Method: Cross-sectional data was analysed on 59 children with TBI included in a larger survey study. These children experienced their TBI at 12.2 years old and were 2.1 years post-injury, on average.

Results: On average, children's executive functioning, family functioning, and psychosocial QoL were within typical limits based on parent-reported standardized measures, yet participation was within the limited/somewhat limited range and physical QoL below the average for the U.S.

Population: Bivariate analyses revealed significant correlations between age at injury, executive functioning summary and subscale scores, and family functioning with participation and psychosocial QoL.

Conclusions: The results of this study support the understanding of risk and protective factors and the interaction amongst these factors for children with TBI. These findings highlight the need for professionals to monitor and provide direct and indirect interventions, as needed, for all components of the ICF framework for children with TBI and their families.

The Strategy Use Measure (SUM) was developed as a systematic tool to assess cognitive, behavioural and emotional strategy use by clients and carers after acquired brain injury. Comprehensive content development was undertaken across four clinical service sites via expert clinician consultation and consensus, file review of strategies used in clinical practice, and consumer consultation. Statistical analysis was undertaken to evaluate items and assess reliability, validity and factor structure. Two final versions of the SUM were developed, for use with clients (SUM-ABI; 14 items) and carers (SUM-C; 24 items). Internal consistency for the total scales was sound (SUM-ABI = .90; SUM-C = .96) as was test-retest reliability (SUM-ABI = .87; SUM-C = .90). Meaningful factors were identified for both scales (SUM-ABI: Memory and Planning, Emotion and Mood, Cognitive Load; SUM-C: Executive Support, Emotion/Behaviour Support, Enhancing Task Performance, Motivation Support) with all subscales demonstrating strong internal consistency (≥.80). Construct validity for both scales was explored using validated measures. The SUM versions were evaluated against COSMIN instrument design standards and found overall to be reliable and valid, with promising utility in rehabilitation for clinicians and researchers.

Objectives: This single-blind, parallel groups, randomized controlled trial examined whether (1) mnemonic strategy training (MST) improved memory for face-name associations relative to vanishing cue training (VCT) and (2) the interventions modulated blood oxygen level dependent (BOLD) signal in a training-specific manner.

Methods: We randomized 30 cognitively intact older adults to either MST or VCT (1:1 basis). Memory for face-name associations (primary outcome) was evaluated at baseline and post-training using functional magnetic resonance imaging (fMRI) and again at 1-month follow-up (memory test only). During training sessions, MST participants applied a 3-step strategy while those receiving VCT recalled the targeted name across trials with letters subtracted (correct trials) or added (incorrect trials) as appropriate.

Results: There were no adverse events and excellent retention. The magnitude of memory test improvement was significantly greater after MST at both post-training and 1-month relative to VCT. The MST group also showed significantly greater BOLD signal changes in multiple brain regions as well as increased functional connectivity between networks relative to the VCT group.

Conclusions: MST is superior to VCT for enhancing long-term retention of face-name associations in cognitively intact older adults and appears to enhance use of lateral frontoparietal regions and networks involved in top-down processing.

Prosopagnosia is a neurological disorder; characterized by an impairment in facial recognition. It can occur from acquired prosopagnosia (occurring in approximately 5.6% of the population), or from developmental prosopagnosia (occurring in approximately 2% of the population). Despite the relatively high prevalence of prosopagnosia, there has been limited research into intervention for this condition. The current systematic review aimed to review the evidence base to aid the development of practice guidelines for clinicians working with impacted individuals. A systemic search identified 14 studies, 10 of which involved participants with developmental prosopagnosia, while the remaining studies involved participants with acquired prosopagnosia. Overall, the findings identified two strategies which produced significant improvement in face recognition in prosopagnosics. The first strategy involved a perceptual learning strategy (a restorative approach). While this strategy improved face processing abilities, the intervention was time-consuming and relied on specific software. The second strategy involved learned association of distinguishable facial features (a compensatory approach). This intervention produced improvements in face recognition and was quick to administer, however, the gains made were not generalisable to untrained faces. The current review identified a number of limitations in the existing literature, such as the lack of single-case experimental designs and randomized controlled trials, limited control for practice effects, and no consensus with regard to the assessment and diagnosis of prosopagnosia. This review highlighted the need for further research to inform practice guidelines.