NeuroRehabilitation - Volume 30, issue 1

Authors: Linsenmeyer, Todd A.

Article Type: Research Article

Abstract: Urinary incontinence and other voiding dysfunctions are common sequelae post CVA (cerebrovascualar accident). Urinary incontinence declines over time; however, other voiding issues appear. Voiding dysfunctions not only have a significant impact on a person's quality of life and mortality, but also impact the person's caregiver. Urodynamic studies are important to help further understand, develop and direct bladder management. However, studies evaluating urodynamic findings in those with urinary incontinence shortly after CVA (within 3 months) are limited. While uninhibited contractions are the most common urodynamic finding in post-CVA incontinence, a number of men and women have other urodynamic findings causing incontinence. …The type, onset, resolution and urodynamics of post-CVA symptoms other than urinary incontinence are rarely discussed. A literature review emphasizes that further research is needed not only in the evaluation of the most effective bladder management strategies for urinary incontinence, but also in the area of post stroke voiding dysfunction as a whole. Show more

Keywords: Cerebrovascular accidents, voiding dysfunction, urodynamics, urinary incontinence

DOI: 10.3233/NRE-2012-0721

Citation: NeuroRehabilitation, vol. 30, no. 1, pp. 1-7, 2012

Authors: Arango-Lasprilla, Juan Carlos

Article Type: Editorial

DOI: 10.3233/NRE-2012-0722

Citation: NeuroRehabilitation, vol. 30, no. 1, pp. 9-11, 2012

Authors: Ketchum, Jessica M. | Almaz Getachew, Mimi | Krch, Denise | Baños, James H. | Kolakowsky-Hayner, Stephanie A. | Lequerica, Anthony | Jamison, Laura | Arango-Lasprilla, Juan Carlos

Article Type: Research Article

Abstract: Objective: To determine which demographic, injury, and rehabilitation factors are associated with employment rates in Hispanic individuals 1 year post traumatic brain injury (TBI). Design: Retrospective study. Setting: Longitudinal dataset of the TBI Model Systems National Database. Participants: 418 Hispanic individuals with TBI hospitalized between 1990 and 2009 having year 1 follow-up data (18–55 years and not retired at injury). Main outcome measure: Competitive employment status 1 year post-injury (yes/no). Results: A multiple logistic regression model indicated that pre-injury employment status, pre-injury level of education, etiology, days of posttraumatic amnesia …(PTA), associated spinal cord injury, Functional Independence Measure (FIM) motor at rehabilitation discharge, and length of stay in rehabilitation were significant predictors of competitive employment post-injury, controlling for the effects of each other (all p -values ⩽ 0.014). Increases in the odds of not being employed post-injury were associated with not being employed pre-injury, having lower levels of education pre-injury, etiologies due to violence or falls, increased PTA, an associated spinal cord injury, lower FIM motor scores, and greater lengths of stay in rehabilitation. Conclusions: The first year post-TBI is critical for recovery and gainful employment, particularly for Hispanic individuals. Early identification of factors influencing successful gainful employment and expeditious implementation of services to ameliorate these issues are paramount in improving employment outcomes for Hispanic individuals with TBI. Show more

Keywords: Employment, traumatic brain injury, hispanics

DOI: 10.3233/NRE-2011-0723

Citation: NeuroRehabilitation, vol. 30, no. 1, pp. 13-22, 2012

Authors: Ketchum, Jessica M. | Almaz Getachew, Mimi | Krch, Denise | Kolakowsky-Hayner, Stephanie A. | Baños, James H. | Lequerica, Anthony | Wright, Jerry | Arango-Lasprilla, Juan Carlos

Article Type: Research Article

Abstract: Objective: To determine which demographic, injury, rehabilitation, and follow-up characteristics are associated with satisfaction with life in a population of Hispanic individuals 1 year post-traumatic brain injury (TBI). Design: Retrospective study. Setting: Longitudinal dataset of the TBI Model Systems National Database. Participants: 291 Hispanic adults with TBIs occurring between 1999 and 2008 having year 1 follow-up data. Main outcome measure: Satisfaction with Life Scale (SWLS) measured 1 year post-TBI. Results: The relationships between SWLS 1 year post-injury and a variety of demographic, injury, rehabilitation, and follow-up characteristics were modeled using …generalized linear models. The final multivariable model explained 25.2% of variability in SWLS (F (7, 261) = 12.6, p < 0.001) and included quadratic effects for both age at injury and FIM cognitive scores 1 year post-injury, as well as effects for associated SCI and employment status 1 year post-injury (all p -values ⩽ 0.036). In general, higher age, no associated SCI, not being unemployed at 1 year post-injury, and very high or very low FIM cognitive scores were associated with greater SWLS scores 1 year post-injury. Conclusions: These results suggest a variety of demographic, injury, and follow-up characteristics are related with SWLS 1 year post-TBI in Hispanic individuals. Focusing rehabilitation efforts on improving cognition and vocational skills may improve SWLS in Hispanics 1 year post-TBI. Show more

Keywords: Traumatic brain injury, Hispanic, satisfaction with life

DOI: 10.3233/NRE-2012-0724

Citation: NeuroRehabilitation, vol. 30, no. 1, pp. 23-33, 2012

Authors: Guàrdia-Olmos, Joan | Jarne Esparcia, Adolfo | Urzua Morales, Alfonso | Gudayol Ferré, Esteve

Article Type: Research Article

Abstract: Objective: The purpose of this study is to conduct a meta-analysis on the effects of neuropsychological rehabilitation procedures on the quality of life in Spanish-speaking individuals with cognitive deficits. Method: Twenty four studies published during the last ten years were analyzed, and relevant information was extracted from each, including sample size, data analyses, measures, and publication year, among others. These data were then analyzed following the usual procedures for estimation of effect size. Results: The data show a statistical significant value in all variables associated with the characteristics of the intervention (Duration, type of intervention, gender, …year of publication and, more important, quality of life and neuropsychological outcomes). Conclusion: QOL can improve in certain conditions with neuropsychological rehabilitation, but this change is not permanent. Show more

Keywords: Neuropsychological rehabilitation, meta-analysis, quality of life

DOI: 10.3233/NRE-2012-0725

Citation: NeuroRehabilitation, vol. 30, no. 1, pp. 35-42, 2012

Authors: Caracuel, A. | Cuberos-Urbano, G. | Santiago-Ramajo, S. | Vilar-Lopez, R. | Coín-Megias, M.A. | Verdejo-García, A. | Pérez-García, M.

Article Type: Research Article

Abstract: Introduction: The Rasch model is increasingly used in the field of rehabilitation because it improves the accuracy of measurements of patient status and their changes after therapy. Objective: To determine the long-term effectiveness of a holistic neuropsychological rehabilitation program for Spanish outpatients with acquired brain injury (ABI) using Rasch analysis. Methods: Eighteen patients (ten with long evolution – patients who started the program >6 months after ABI- and eight with short evolution) and their relatives attended the program for 6 months. Patients’ and relatives’ answers to the European Brain Injury Questionnaire and the Frontal Systems Behavior …Scale at 3 time points (pre-intervention. post-intervention and 12 month follow-up) were transformed into linear measures called logits. Results: The linear measures revealed significant improvements with large effects at the follow-up assessment on cognitive and executive functioning, social and emotional self-regulation, apathy and mood. At follow-up, the short evolution group achieved greater improvements in mood and cognitive functioning than the long evolution patients. Conclusions: The program showed long-term effectiveness for most of the variables, and it was more effective for mood and cognitive functioning when patients were treated early. Relatives played a key role in the effectiveness of the rehabilitation program. Show more

Keywords: Acquired brain injury, stroke, traumatic brain injury, holistic neuropsychological rehabilitation, outcome measures, Rasch analysis

DOI: 10.3233/NRE-2011-0726

Citation: NeuroRehabilitation, vol. 30, no. 1, pp. 43-53, 2012

Authors: De los Reyes Aragón, Carlos José | Arango-Lasprilla, Juan Carlos | Perea Bartolomé, María | Ladera Fernández, Valentina | Krch, Denise

Article Type: Research Article

Abstract: The objective of this study was to determine the moderating effect of cognitive impairment (CI) on the usefulness of the generation effect to improve learning and memory in Hispanics with traumatic brain injury (TBI). Sixty-one Hispanic individuals with TBI (29 without CI, 22 with mild to moderate CI, and 10 with severe CI) and 44 healthy controls (HC) were required to remember the last word in each of 32 sentences. Target words were presented in a self-generated and provided condition. Recall and recognition were examined immediately, after 30 minutes, and at one week. Individuals remembered and recalled significantly more words …in the generated condition than the provided condition, regardless of group or time. The self-generation technique equally benefitted all participants regardless of TBI status or degree of CI. Future cognitive rehabilitation programs designed to improve short-term recall and recognition in Hispanic individuals with TBI should include the self-generation technique. Further research into the longer-term effects of the generation effects is warranted. Show more

Keywords: Traumatic brain injury, self-generation technique, cognitive rehabilitation

DOI: 10.3233/NRE-2011-0727

Citation: NeuroRehabilitation, vol. 30, no. 1, pp. 55-64, 2012

Authors: Ojeda, N. | Peña, J. | Sánchez, P. | Bengoetxea, E. | Elizagárate, E. | Ezcurra, J. | Gutiérrez Fraile, M.

Article Type: Research Article

Abstract: Introduction: Cognitive rehabilitation in schizophrenia has been proved to benefit cognition depending on the severity of the illness and the cognitive deficits. Nevertheless studies of efficiency with chronic patients, refractory to additional treatment interventions, have not yet been published. Design: Ninety three patients with schizophrenia were recruited from the Treatment Resistant Schizophrenia Unit in Alava (Spain). All subjects underwent a baseline and a 3 months assessment including cognition, clinical symptoms and functional capacity. Patients were randomly assigned to receive either neuropsychological rehabilitation or occupational therapy for 3 months in addition to treatment as usual (TAU). Results: …Patients at the Rehacop group showed significantly greater improvements at 3 months in most areas of cognition evaluated including speed of processing, language, memory and executive functioning, compared to the occupational therapy group (group x time interactions p < 0.001). The Rehacop group also showed significant improvement in positive symptoms, functional and insight measures. Although data was not statistically significant, the Rehacop group showed a tendency to also improve negative symptoms compared to controls. Conclusions: Despite to their limited respond to TAU, our data suggest that chronic refractory patients can improve their cognitive performance after neuropsychological rehabilitation with the Rehacop. These findings support the feasibility of integrating neuropsychological rehabilitation into TAU programs for patients with lower responses to other treatment plans. Show more

Keywords: Chronic schizophrenia, treatment resistant, cognitive rehabilitation, Rehacop

DOI: 10.3233/NRE-2011-0728

Citation: NeuroRehabilitation, vol. 30, no. 1, pp. 65-74, 2012

Authors: Lehan, Tara J. | Stevens, Lillian Flores | Arango-Lasprilla, Juan Carlos | Díaz Sosa, Dulce María | Espinosa Jove, Irma Guadalupe

Article Type: Research Article

Abstract: Much of what is known about family functioning in the face of traumatic brain injury (TBI) is based on research conducted in the United States. The purpose of this study was to (1) describe the levels of family adaptability, cohesion, communication, and satisfaction as reported by Mexican TBI survivors and their family caregivers, (2) test the hypothesis of the Circumplex Model that balanced families would exhibit better communication and greater satisfaction, and (3) explore how TBI survivors' and their family caregivers' perceptions of family adaptability and cohesion influenced their own and the other's perceptions of family communication and satisfaction. In …the majority of dyads, both the TBI survivor and the family caregiver endorsed balanced family adaptability and cohesion. Both TBI survivors and their family caregivers reported a relatively high level of family communication and satisfaction. TBI survivors and family caregivers who reported greater levels of family adaptability and cohesion also endorsed better family communication and greater family satisfaction. In addition, individuals with TBI whose family caregiver endorsed balanced family adaptability and cohesion reported better family communication. Further, family caregivers of TBI survivors who reported balanced family adaptability and cohesion reported better family communication. Implications for research and practice are discussed. Show more

Keywords: Brain injury, family structure, family functioning, FACES IV, adaptability, cohesion

DOI: 10.3233/NRE-2012-0729

Citation: NeuroRehabilitation, vol. 30, no. 1, pp. 75-86, 2012

Authors: Lehan, Tara | Arango-Lasprilla, Juan Carlos | de los Reyes, Carlos José | Quijano, María Cristina

Article Type: Research Article

Abstract: Advances in medical and assistive technology have increased the likelihood of survival following a traumatic brain injury (TBI). Consequently, families frequently must provide care to individuals with TBI. Because they are rarely prepared for the associated demanding medical needs and financial burden, family caregivers are at risk for physical and emotional problems, which can negatively influence their individual and family functioning. Whereas scholars have examined the influence of survivor functioning on caregiver burden, few have explicitly recognized that caregiver burden also influences survivor functioning. Results of a multivariate linear regression suggest that, in a sample of 51 pairs of TBI …survivors and their caregivers living in Colombia, survivors receiving care from a family member who reported a higher level of burden had poorer objective neuropsychological functioning than those receiving care from a family member who reported a lower level of burden, after controlling for survivor education and history of occupational therapy. Therefore, a family-focused approach might maximize intervention effectiveness, especially for Latin American and Hispanic families, which tend to be characterized by a strong sense of familism. The emphasis on family can create problems in a healthcare system that views the individual as the primary unit. Show more

Keywords: Caregivers, burden, traumatic brain injury, neuropsychological functioning, family system

DOI: 10.3233/NRE-2011-0730

Citation: NeuroRehabilitation, vol. 30, no. 1, pp. 87-95, 2012