NeuroRehabilitation - Volume 13, issue 1

Authors: Kreutzer, Jeffrey S.

Article Type: Introduction

DOI: 10.3233/NRE-1999-13102

Citation: NeuroRehabilitation, vol. 13, no. 1, pp. 1-1, 1999

Authors: DeHope, Eli | Finegan, Joanne

Article Type: Research Article

Abstract: This article reports on the use of a theoretical model addressing integrated self-awareness in the treatment of individuals with traumatic brain injury. The Self- Determination Model, developed by ReMed a community-based provider of post-acute services, is presented here along with three case studies. The ability for an individual with a traumatic brain injury to monitor their own behavior is essential to increase their levels of independence in their activities of daily living and in handling social situations. The Self-determination Model is an interventive practice model to assist individuals in home and community based long-term rehabilitation settings in developing self-awareness.

Keywords: brain injury, clinical treatment, self-awareness, self-determination, community re-entry

DOI: 10.3233/NRE-1999-13101

Citation: NeuroRehabilitation, vol. 13, no. 1, pp. 3-12, 1999

Authors: Parente, Rick | Stapleton, Mary

Article Type: Research Article

Abstract: This study evaluated the effectiveness of a group cognitive skills training model. Thirty-three clients with traumatic brain injury participated in the group over a one year period. Their vocational rehabilitation rate was compared to that of a baseline condition of 64 matched clients who receive similar services but who did not participate in the group. The results indicated a 76% Fifty-eitht percent of the baseline clients returned to work. A description of the group activities is presented that can be implemented by virtually any facility.

Keywords: Cognitive Rehabilitation, group therapy, memory training

DOI: 10.3233/NRE-1999-13103

Citation: NeuroRehabilitation, vol. 13, no. 1, pp. 13-20, 1999

Authors: Hogan, Barbara A.

Article Type: Research Article

Abstract: Narrative therapy can help people overcome psychological barriers to progress in rehabilitation after brain injury. The case of one client, eighteen years post-injury illustrates how narrative approaches are helping him claim an identity as an author not only of a book telling his story of life after brain injury but also of his life from which he has felt alienated since his injury.

Keywords: narrative therapy, brain injury, psychosocial rehabilitation

DOI: 10.3233/NRE-1999-13104

Citation: NeuroRehabilitation, vol. 13, no. 1, pp. 21-25, 1999

Authors: Kolakowsky-Hayner, Stephanie A. | Kishore, Rekha

Article Type: Research Article

Abstract: Objectives: Investigate pervasiveness of unhealthy family functioning and psychological distress among primary caregivers of 28 adult outpatients with traumatic injuries. Describe caregiver functioning and psychological distress in caregivers of persons with traumatic brain injury and caregivers of persons with a traumatic spinal cord injury. Determine similarities and differences between the two populations. Study Design: Caregivers completed self-report measures including the Brief Symptom Inventory (BSI) and Family Assessment Device (FAD). Data were matched on respondent’s gender, patient’s age at injury, ethnicity, and marital status. Descriptive statistics were compiled for all variables. Independent samples t-tests and chi squares were computed …to test for between group differences. Results: Similarities found between groups with regard to severity and mechanism of injury. Caregivers exhibited the highest levels of unhealthy functioning with regard to communication skills. Highest levels of healthy functioning were noted with regard to behavioral control. Almost 75% of caregivers reported elevated stress levels. Primary caregivers of persons with SCI report significantly (t 25 = 2.619 , p = .015 ) more stress secondary to phobic anxiety than caregivers of persons with TBI. Conclusion: Previous research demonstrates that the BSI and FAD are valuable clinical tools. Current results suggest they are inappropriate for significantly distinguishing between SCI and TBI caregiver samples. Show more

Keywords: caregiver functioning, traumatic brain injury, traumatic spinal cord injury, brief symptom inventory, family assessment device

DOI: 10.3233/NRE-1999-13105

Citation: NeuroRehabilitation, vol. 13, no. 1, pp. 27-33, 1999

Authors: Taskinen, Pirjetta

Article Type: Research Article

Abstract: Objectives: The aim of this pilot study was to examine 1) how different components of health related fitness developed in patients participating in exercise groups, 2) how the patients experience their health and physical activity level before and after the intervention and then six months later, and 3) whether the patients could find a convenient way for health enhancing exercise, either individually or in a group. Study design: The pilot group consisted of five patients, one male and four females with mean age 51 years. One of the patients had aphasia and three had other cognitive disorders. All …participants were 2–6 years post a stroke. Their functional independence rate was 90–110 FIM and spasticity was measured 1–3 on Ashworth scale. Participation in the exercise group was included in the written rehabilitation plan of each patient and each of them had a personal assistant helping in the group. The patients underwent medical examination prior to and after the intervention. The tests for health related fitness (muscle performance tests, balance test, timed walking test, BMI) FIM, Ashworth and questionnaires on self-reported health and physical activity were collected immediately prior to and after the intervention and then six months later. The group met 24 times in four months, three times a week, 60 minutes at a time. The intensity of exercising was 55–70% of max HR. Each patient kept a diary on exercising. Exercising consisted of circuit training type of conditioning, outing, adapted physical activities , and NLP. The effects were followed up by measuring steady state, exercise, and recovery pulse, RPE , and blood pressure. A case study method was introduced. Results and coclusions: The best results were scored on muscle endurance / performance and timed walking. Exercising in the group was motivating and rewarding, and it enhanced the quality of every day life. A health enhancing exercise group is a remarkable alternative or an addition worth attention to individual therapy on hemiplegic patients in post-acute stages of recovery. Show more

Keywords: cerebrovascular disorders, hemiplegia, health enhancing physical activity/activities, health related fitness

DOI: 10.3233/NRE-1999-13106

Citation: NeuroRehabilitation, vol. 13, no. 1, pp. 35-43, 1999

Authors: Martelli, Michael F. | Zasler, Nathan D. | Grayon, Revonda

Article Type: Research Article

Abstract: Specific training for medicolegal evaluation of persons with neurologic injury or impairment is not always obtained. Most physicians and psychologists acknowledge that they receive insufficient formal training or education with regard to identifying and coping with the various potential ethical conflicts that can arise in this arena. However, increasing guidelines are being issued for managing the disparities between conflicting interests and ethics for distinctly different roles of independent examiner/expert witness versus treating clinician. In the current paper, relevant ethical issues are reviewed in order to illustrate ethical conduct as it relates to many common aspects of medicolegal situations. Although some …of the current dilemmas described are unique to the interaction of the American legal and health care systems, most have international relevance. Finally, recommendations are provided toward the goal of promoting standardization of objective and ethical conduct in medical and psychological practice. Show more

Keywords: ethics, medicolegal, forensics, expert witness, trial consultant, independent examination, neuropsychology

DOI: 10.3233/NRE-1999-13107

Citation: NeuroRehabilitation, vol. 13, no. 1, pp. 45-66, 1999