Neuropsychological Rehabilitation最新文献

For some, post-concussion symptoms following a mild traumatic brain injury (mTBI) are prolonged in nature, lasting for a minimum of 12 months and up to many years. There remains limited insight into the effectiveness of psychological interventions for the treatment of prolonged post-concussion symptoms (PrPCS). This systematic review aimed to evaluate the effectiveness of psychological interventions for PrPCS (>12 months post mTBI). A search was performed across five databases (PsychINFO, Medline, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), & PubMed). Two independent researchers assessed the studies against pre-defined eligibility criteria and completed quality appraisals. Ten studies were included in the review and underwent narrative synthesis. Four psychological interventions for PrPCS were found (i.e., Cognitive Behavioural Therapy (CBT), Neurofeedback Therapy, Psychoeducation, & Mindfulness-based therapy). Emerging empirical data tends to support the assertion that psychological interventions can improve PrPCS and quality of life. CBT appears to have the strongest evidence base to date and to be the most effective in improving anxiety, anger, and overall mental well-being. However, the evidence base is still very much in its infancy and requires research with more robust methodological designs to be conducted before any conclusions can be reliably asserted.

Recent studies have demonstrated a possible association between cognitive impairments and traumatic upper limb injuries. This study aims to track the cognitive changes in individuals with such injuries. In this longitudinal study, 36 participants with traumatic upper limb injuries and 36 uninjured participants were enrolled. Cognitive functions were assessed using the Rey Auditory Verbal Learning Test (RAVLT) and the Stroop Color and Word Test (SCWT) over a period of 6 months, with evaluations conducted on three occasions: 1 month (T1), 3 months (T2), and 6 months (T3). The results revealed that participants with nerve injuries exhibited significantly lower RAVLT scores overall and at each time point (Overall: Wald χ² = 7.99, P < .05; T1: Wald χ² = 7.61, P < .05; T2: Wald χ² = 5.95, P < .05; T3: Wald χ² = 5.76, P < .05). In contrast, no significant impairment in RAVLT performance was observed in participants without nerve injuries. Additionally, the SCWT showed no significant differences between injured and uninjured participants over the six-month period (P > .05). In conclusion, traumatic nerve injuries to the upper limbs negatively affect memory, and this impairment does not spontaneously recover within six months.

Traumatic Brain Injury (TBI) significantly affects social interactions and emotional well-being. Following COVID-19, there has been growing interest in how individuals with TBI use online social media groups for support. This study examined engagement patterns in four Facebook support groups: two for TBI and two control groups. A deductive approach was used to categorize 4,133 posts and comments into a framework of support discourse, including seeking and giving support, and non-social support. Each category was further subdivided to analyze post content in more detail. Comments on posts were coded for helpfulness/appropriateness. Results revealed that posts in all groups fell into the identified discourse categories, with comments generally being appropriate. Minor differences were noted between TBI and control groups, suggesting that individuals with TBI engage in online support similarly to others. These findings highlight the role of online support groups for individuals with TBI, offering insights that can guide the development of more tailored interventions and improve support services for this population.

In the clinical context of stroke, health-related quality of life (HRQOL) is a crucial patient-reported outcome measure that is frequently used to assess the effectiveness of neurorehabilitation programs. Despite its significance, the absence of a stroke-specific quality-of-life instrument translated into Romanian and validated for use in Romanian stroke patients, including those with aphasia, presents a notable gap in current research. This study briefly describes the translation and cross-cultural adaptation of the Stroke and Aphasia Quality of Life Scale-39 g (SAQOL-39 g) into Romanian (RO-SAQOL-39 g). Subsequently, the results of a prospective cohort study on psychometric validation of the RO-SAQOL-39 g are presented. In enrolled stroke patients, measures such as the Barthel Index, HRQOL, and indices of stroke severity including NIHSS, MRC scale for Muscle Strength, and mRS were used. The RO-SAQOL-39 g exhibited excellent reliability (Cronbach's alpha = 0.95 for total score) and repeatability (ICC = 0.96). Moreover, the RO-SAQOL-39 g demonstrated utility as a metric of stroke burden in differentiating between mild and moderate-to-severe stroke, as assessed by NIHSS scores (p = 0.004). In summary, the RO-SAQOL-39 g exhibits promising attributes as a tool for assessing HRQOL in post-stroke individuals.

Posttraumatic stress disorder (PTSD) is prevalent in individuals with acquired brain injury (ABI). This study investigated the effectiveness and applicability of Eye Movement Desensitization and Reprocessing (EMDR) for PTSD in individuals with ABI. Data were collected using a non-concurrent multiple baseline single case experimental design (SCED), with a baseline, treatment, maintenance, and 3-month follow-up phase, across four cases. EMDR treatment was provided using a manualized standard EMDR protocol. The primary outcome was PTSD symptoms. Secondary outcomes were general mental health and cognitive functions. Visual analyses, TAU-U analyses, and analyses using the Reliable Change Index were performed. All four participants (two with TBI, two with stroke) showed a significant decrease in PTSD symptoms, which continued in maintenance and was retained at follow-up. The participants no longer fulfilled criteria for PTSD classification and showed reliable improvement in PTSD severity score post-treatment and at follow-up. No adverse events occurred and no adjustments in EMDR protocol were necessary. There was no consistent improvement in general mental health nor a consistent improvement in cognitive functioning. This study provided empirical support for the effectiveness and applicability of EMDR for PTSD in four participants with stroke or TBI.

Considering the implications of executive function (EF) in the core symptoms of attention deficit hyperactivity disorder (ADHD), further research is required on strategies such as therapies, treatments, and rehabilitation programs focused on improving EF. This study aimed to assess the potential of an EF training program called "Braingame Brian" in improving working memory, inhibition, and cognitive flexibility in children with ADHD. The programme was developed in the Netherlands and has been shown to be effective in pilot studies of ADHD populations conducted in this country. However, it has not been used before in the Spanish-speaking population. A total of 41 children (aged 8-12 years) were assigned to the EF training or waitlist control groups. The intervention consisted of a 25-session training programme of approximately 45 min per day for nine consecutive weeks. Treatment outcomes were assessed using cognitive tasks of the trained EF, as well as evaluations of EF behaviors by parents and teachers. The initial findings suggest that the implementation of the Braingame Brian programme may be associated with improvements in working memory, inhibition, and cognitive flexibility. These preliminary results also indicate the potential for enhancements in parents' and teachers' perceptions of EF difficulties in children with ADHD.

Prism adaptation training (PAT) as a treatment for visuospatial neglect (VSN) involves two components: recalibration and realignment. We conducted a randomized controlled trial with PAT protocols requiring different degrees of recalibration and realignment, by using a single or multi-step protocol and varying visibility of the pointing movement. Twenty-five VSN patients received an alertness treatment without prisms, followed by four PAT protocols, encompassing a multi- or single-step procedure with terminal exposure, a single-step procedure with concurrent exposure, and sham PAT, presented in random order. The primary outcome parameter was the median response time (RT) to left-sided targets in an endogenous variant of the Posner task, and we also measured the sensorimotor aftereffect. The two protocols without visibility of most of the movement trajectory produced significant aftereffects. The single-step protocol without movement visibility appeared to have a beneficial effect on non-motor leftward visuospatial attention compared to baseline, though the differences between this protocol and three other PAT protocols, includuing sham PAT, were not significant. We provide preliminary evidence that maximizing the conscious experience of movement errors may be a relevant component for remediating VSN, though the specificity of these effects remains to be further explored.Trial registration: German Clinical Trials Register identifier: DRKS00025938.

Concussions are commonly occurring injuries in sport. The short-term impacts of concussions, including symptoms and recovery trajectories, often are the focus of concussion research. However, limited studies have explored the long-term consequences of concussions, especially in adolescents. The purpose of this study was to explore adults' experiences with concussions sustained during their adolescence (5-15 years prior). This qualitative study was guided by an interpretivist philosophy. Twenty young adults (11 men, 9 women, median age 26) who had sustained at least one sport-related concussion during their adolescence participated in a one-on-one semi-structured interview. We aimed to explore their experiences with their concussion at the time of injury and any consequences they experienced as a result of their concussion. We organized participants' concussion experiences into six main themes: (1) Concussion diagnosis and experiences with health care providers; (2) Emotional symptoms following concussion; (3) Concussion recovery; (4) Change in sport participation and engagement; (5) Concern about the potential long-term consequences; and (6) Impact on social relationships. We used the Biopsychosocial Model of Sport Injury Rehabilitation to organize the themes. Future research should explore how acute multi-disciplinary support could reduce the negative long-term consequences of concussion in adolescents.

A tailored psychological intervention has the potential to prevent and manage migraines in relapsing-remitting multiple sclerosis (RRMS) and improve wellbeing and meaningful participation. Acceptability of this approach is yet to be established. We explored participant perspectives on the content and delivery of a five-week telehealth intervention, tailored to RRMS and migraine, combining CBT and cognitive strategies (CBT-MMS). Transcripts from qualitative interviews were analysed through reflexive and codebook thematic analyses. Participants were 27 adults aged 22-59 years old with a RRMS history of 5.96±5.57 years, migraine history of 16.30±13.69 years, and 8.26±6.44 days of migraine per month. Five themes were generated reflecting the perceived value of CBT-MMS, including: 1-Feeling lost within a health system that has not met their needs, 2-Understanding their struggles and strengths, 3-Supported through a new therapeutic endeavour, 4-Developing a toolkit for life's challenges, and 5-One size CBT does not fit all. The therapy content and delivery were considered acceptable and relevant, though more detailed migraine education and cognitive strategy implementation were recommended. Our findings highlight the benefits of tailoring interventions to the individual with RRMS and their specific needs, and building self-efficacy through guided and practical strategies delivered by a supportive therapist.