Neuropsychological Rehabilitation最新文献

ABSTRACTThe benefits of assistive technology (AT) have been well established to positively support participation within disability. Clinicians have an important role in guiding clients to choose goal-centred AT. This study aims to explore (i) the frequency and types of AT prescribed by clinicians and (ii) real-world implementation of AT by clinicians, employing the ISO 9999 framework, and the challenges involved with AT prescription. An online survey was circulated to brain injury clinicians within New South Wales (NSW). Data were exported into IBM SPSS Statistics v.27 for analysis. Free text responses were analysed using a mixed-methods content analysis. A total of 31 AT products were reported 131 times by clinicians. The most frequently reported AT category was mainstream technology (n = 81), used amongst all professions. Using the ISO 9999 framework, the most reported class use of AT was "communication and information management" (n = 77/131). Challenges around AT implementation were funding acquisition, customizability of AT and time constraints with training. NSW clinicians have demonstrated varied use of AT to support cognitive, physical and communication functions. However, with the rapidly advancing nature of AT, there needs to be quicker approaches to generate high-quality evidence to support its use.

Trial registration: ACTRN12619001243101.

A pilot randomised controlled trial examined the feasibility (i.e., intervention demand, acceptability and initial efficacy) of a single-session (T1) and two-week follow-up (T2) values-based versus standard goal-setting intervention for ABI community dwellers. Twenty four participants (12 in each group) with ABI were recruited, 14 of whom were male (age: M = 61, SD = 9.3). Retention rate was at 92%, and both interventions were rated as acceptable (mean ratings ≥ 80%). Improvements in the primary outcome of wellbeing were greater in the values group (d_ppc2 = 0.30), while no differences between groups were found for goal attainment or memory of goals. Regarding attitudes towards goals measured at T1, motivation was higher for the values group with a small-to-medium effect size (d = -0.31), whereas confidence and anticipated pleasure from working on the goal were higher for the standard goal-setting group with small-to-medium (d = 0.28) and small (d = 0.17) effect sizes, respectively. The study found a modest improvement for the wellbeing of ABI community dwellers when their goals were embedded in values, while memory of goals and goal achievement was similar across both groups. Study limitations and future recommendations are discussed, and replication is required.

This psychometric study aimed to evaluate the psychometric properties of the Dysexecutive Questionnaire (DEX) following a cardiac event, and to examine the relationship between self- and informant-ratings. Approximately 7 months post-cardiac event, 196 participants and their informants (N = 179) completed the DEX. Reliability was assessed by confirmatory factor analysis and internal consistency estimates. Construct validity was evaluated using two performance-based neuropsychological tests, the Colour-Word Interference Test and the Trail Making Test (TMT), along with the Hospital Anxiety and Depression Scale (HADS). A one-factor model showed acceptable fit for the self-assessed DEX (RMSEA = 0.062) with excellent internal consistency (ω > 0.90). Slight positive associations were found between the DEX and the performance-based executive function measures, while strong positive associations emerged between the self-assessed DEX and the HADS. Overall, self-assessed and informant-reported scores did not differ significantly (self-assessed DEX median = 11, Q₁-Q₃ = 5.75-20; informant-reported DEX median = 11, Q₁-Q₃ = 4-19, p = 0.924). However, participants with severe executive dysfunction (TMT-B z-scores ≤-2) rated their own symptoms as less severe than informants (p = .001), indicating impaired self-awareness in a subgroup of participants. In conclusion, the DEX provides a useful perspective into general executive dysfunction in daily life but should be complemented with performance-based measures.Trial registration: ClinicalTrials.gov identifier: NCT03543371.

Everyday life demands handling multiple tasks that need attention simultaneously, which may be challenging for children with ADHD. In this study we tested dual-tasks in a cognitive-motor and motor-motor condition in children with and without ADHD. Sixty-six children (42 children with ADHD; 24 typically developing) participated and were tested on a primary Wii Fit balance task, and two secondary tasks: a cognitive task (counting specific sounds) and a motor task (crossing fingers (CF)), performed in single-task and dual-task conditions. In addition, attentional and motor abilities were measured independently. Children with ADHD presented poorer motor performance (Wii-Fit game, finger crossings) in the single task with large effect sizes, but performed equally on cognitive performance compared with their peers. Dual-task interference was not present in the primary Wii-Fit scores, but clearly and similarly present in the cognitive and CF tasks in both groups. The impact of divided attention on Wii Fit dual-task performance was 6-11%, and on dual-task CF performance 28.8% when combined with motor abilities. Children with ADHD are disproportionately impaired in dual-task situations where they must perform two motor tasks, but not when they perform a motor and a cognitive task.

Acquired brain injury (ABI) often limits daily activities and participation. Comprehensive neuropsychological rehabilitation (CNR) aims to address these issues. This review examines research on predictors and moderators of improved activity, participation, and quality of life (QoL) after CNR, and updates its effectiveness. A comprehensive search of five databases (PubMed, MEDLINE, CINAHL, PsycINFO, CENTRAL) from 2002 to 2025 identified 12,174 studies. Ninety-five were screened, and 25 met the inclusion criteria. The included studies evaluated CNR for adults with ABI in outpatient or community settings, incorporating cognitive and psychological interventions with repeated assessments of activity, participation, and QoL. We found no clinical trials reporting predictors or moderators of CNR outcomes. However, four observational studies suggested that earlier admission to CNR may serve as a potential predictor of improved outcomes. Most controlled studies demonstrated that CNR significantly improved activity, participation, or QoL compared to control groups. These effects were substantiated by 13 observational studies, with improvements sustained in 89% of studies with follow-up beyond three months. Overall, while CNR improves levels of activity, participation, and QoL post-ABI, research on predictors and moderators of CNR effectiveness is still lacking. Future research should focus on identifying these factors to optimize CNR effectiveness for individual patients.

Executive Functions (EF) are particularly vulnerable among the cognitive functions affected by paediatric stroke. However, to date, only one study investigated EF rehabilitation for primary and secondary school children. The present study aims to investigate the feasibility of a home-based computerized cognitive EF training, with a sample of children aged 6-12 with a history of perinatal or childhood stroke referred to the Giannina Gaslini Children hospital in Italy. In addition, the feasibility of the recruitment and assessment process was also investigated, and the descriptive data for the pre- and post-training evaluation are presented. Twelve children with stroke were recruited. Ten indicators were used to assess the feasibility of the training and of the recruitment and assessment procedures. Results demonstrated high compliance and no relevant technical issues, demonstrating the feasibility of the computerized training at home. In addition, parents and children reported positive satisfaction with the training. The recruitment and assessment procedures were found to be feasible, as well. Results shed light on the potential of telerehabilitation for children with stroke, suggesting its utility to facilitate the rehabilitation of paediatric patients. Further efficacy and larger-scale studies are needed.

Cognitive challenges are common and often impede performing everyday tasks after acquired brain injury. Occupational therapists working with client groups with cognitive impairments seek evidence-based, occupation-based interventions to help individuals achieve independence in everyday activities. The aim of the study was to evaluate the effectiveness of the Perceive, Recall, Plan and Perform (PRPP) Intervention in increasing task mastery for individuals with cognitive challenges post-brain injury. This study is part of a systematic replication series and employed a multiple baseline design with intersubject replication across four participants with brain injury in a local inpatient rehabilitation context. Occupational therapists conducted nine PRPP Intervention sessions over three weeks during everyday tasks and collected data using the PRPP Assessment during baseline, intervention, post-intervention, and follow-up phases. Results were analyzed using systematic visual inspection, Tau-U, and descriptive methods. Different analytical methods yielded divergent results, with limited evidence of an immediate change. However, all four participants demonstrated improved task mastery after the intervention was completed, three with clinically significant improvements. The PRPP Intervention provides occupational therapists with a standardized and occupation-based approach to cognitive rehabilitation for individuals following brain injury. This study contributes to the existing knowledge base on the PRPP Intervention.Trial registration: NCT05148247.

There is considerable variability in return-to-work (RTW) outcomes for individuals with major traumatic injuries, including traumatic brain injury (TBI), spinal cord injury (SCI) and multi-trauma orthopaedic (MTO) injury. This study aimed to understand how injury-related, demographic and psychosocial factors and access to vocational rehabilitation interact to determine likelihood and time to RTW at one and two years post-injury. Participants were 170 adults employed pre-injury, enrolled in a trial of early vocational rehabilitation and followed up one- and/or two years post-injury. Of the 143 and 128 participants followed up, 53.8% and 59.4% were employed at one and two years post-injury. Employment was lowest for those with SCI. Factors associated with being employed at one and/or two years post-injury included being female, having more education, higher work skill level, no pre-injury psychological issues, and lower post-injury anxiety, depression, fatigue and pain. Mean time to RTW was 189 days for the one-year cohort and 247 days for the two-year cohort. Participants with less education and lower pre-injury work skills took longer to RTW. This study highlights the impact of demographic, pre-injury psychiatric issues, pre-injury employment and post-injury sequelae on return to employment after traumatic injury in addition to early vocational rehabilitation.Trial registration:Australian New Zealand Clinical Trials Registry identifier: ACTRN12619000521123.

In this qualitative study, we explored the views of stroke survivors and informal caregivers regarding three types of mental practice for upper limb recovery: (1) action observation (AO); (2) motor imagery (MI); and (3) combined action observation and motor imagery (AO + MI). Semi-structured interviews and focus groups were conducted between December 2021 and October 2022 with 23 participants (13 caregivers and 10 stroke survivors).Thematic analysis generated three higher-order themes: (1) Mental practice: understanding and recent experience. Although comprehension of AO, MI, and AO + MI varied, participants could provide clear, jargon-free explanations of these methods. (2) Feasibility of home-based training. Caregivers often felt overburdened, confused, and unsupported in home-based care but considered mental practice education useful for rehabilitation. (3) User perspectives on a digital prototype (Webapp). Participants viewed the WebApp interface as overly text-heavy and recommended a more visually engaging design. This study provides new insights into stroke survivors' and caregivers' understanding and perceptions of mental practice and highlights the potential of co-designed digital resources to enhance engagement and support home-based rehabilitation. These findings will inform the iterative refinement of mental practice materials for future feasibility and acceptability testing in chronic stroke survivors.