What is Known About Transitional Living Services for Adults With an Acquired Brain Injury? A Scoping Review

2017 ◽  
Vol 18 (2) ◽  
pp. 240-257 ◽  
Author(s):  
Anna Potter ◽  
Danielle Sansonetti ◽  
Kate D'Cruz ◽  
Natasha Lannin
Keyword(s):  
Brain Injury ◽  
Subjective Experience ◽  
Community Integration ◽  
Grey Literature ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Eligibility Criteria ◽  
Transitional Living ◽  
Staff Intervention ◽  
Programme Outcomes

Transitional living service (TLS) programmes for adults with an acquired brain injury are considered an important part of rehabilitation. However, considerable variability exists in the design and structure of these services, with limited research to guide the development of a programme based on best evidence. A scoping literature review was completed to answer the question ‘What is known about TLS programmes for adults with an acquired brain injury?’ Four electronic databases were systematically searched, followed by a grey literature search (from 1996 to 2015). 3183 articles were screened and 13 articles were included in the final review. Themes that emerged from the literature include the types of residents using TLS programmes, the subjective experience of residents and staff, intervention approaches, programme staffing, and programme outcomes. The research reviewed supports the use of TLS programmes to maximise functional independence and community integration of individuals with an acquired brain injury. Clinical practise recommendations were developed to help support implementation of TLS programmes based on best evidence, these included: to use multiple outcome measures, implement collaborative goal setting, support generalisation of skills learnt in the TLS to the home environment and for eligibility criteria for these programmes to include individuals across all phases of recovery.

The Community Approach to Participation: Outcomes Following Acquired Brain Injury Intervention

2009 ◽  
Vol 10 (3) ◽  
pp. 282-294 ◽  
Author(s):  
Sue Sloan ◽  
Libby Callaway ◽  
Dianne Winkler ◽  
Kirsten McKinley ◽  
Carlo Ziino ◽  
...  
Keyword(s):  
Brain Injury ◽  
Community Integration ◽  
Case Series ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Post Injury ◽  
Community Approach ◽  
Case Series Study ◽  
Severe Acquired Brain Injury ◽  
Community Environments

AbstractObjective: To investigate the participation outcomes of individuals with severe acquired brain injury (ABI) who were provided with up to 12 months of intervention based on the Community Approach to Participation (CAP). Method: A case series study design was undertaken with a total of 85 participants from two private practices specialising in community-based, CAP rehabilitation for people with severe ABI. Inclusion criteria were the person had sustained an acquired brain injury, was aged over 18 years and had received up to 12 consecutive months of CAP input from one of the two practices within a three-year period between January 2004 and January 2007. Twenty-six of the 85 participants were an average of 343 days post injury (Early group) and 59 of the participants were an average of 10.2 years post injury (Late group). They were living in a range of community environments and residential facilities. Initial participants were identified for the study in January 2005. Data were gathered using the Functional Independence Measure (FIM™), Community Integration Questionnaire (CIQ), and Role Checklist (RC Part 1) at two time points: prior to intervention (baseline), and after a 12-month period or at discharge (TI). Within the intervention period, all participants received a customised community occupational therapy (OT) rehabilitation program based on the key principles of the CAP. Intervention focused on participation goals of the individual, and development of the associated skills that underpinned valued role performance. Results: Participants each received an average of 51.01 hours of CAP OT during the 12-month period of intervention. Considerable improvement was seen in functional independence, community integration, and role participation after intervention in both the Early and Late groups. A statistically significant increase in FIM™ and CIQ total scores was found for all participants from Baseline to T1. The number of roles in which participants engaged increased on average by almost one role per participant following intervention, from a mean of 3.06 to 3.99. Increased participation in volunteer, home maintainer, participant in organisations and hobbyist roles were most common. Conclusion: Increased functional independence, community integration, and participation in both the Early and Late groups over a 12 month period demonstrates the potential for improved participation outcomes for people with complex needs following ABI, even many years post injury.

Changes in Care and Support Needs Following Community-Based Intervention for Individuals With Acquired Brain Injury

2009 ◽  
Vol 10 (3) ◽  
pp. 295-306 ◽  
Author(s):  
Sue Sloan ◽  
Libby Callaway ◽  
Dianne Winkler ◽  
Kirsten McKinley ◽  
Carlo Ziino ◽  
...  
Keyword(s):  
Brain Injury ◽  
Community Integration ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Support Needs ◽  
Intervention Period ◽  
Post Injury ◽  
Community Based ◽  
Care And Support ◽  
Life Roles

AbstractObjective:To examine the care and support and participation outcomes for individuals with severe Acquired Brain Injury (ABI) provided with three consecutive years of Community Approach to Participation (CAP) intervention.Method:A case series study design was undertaken with a total of 43 participants from two private occupational therapy practices specialising in community-based, CAP rehabilitation for people with severe ABI. Data were collected at four time points: January 2004 (Baseline), January 2005 (T1), January 2006 (T2), and January 2007 (T3) and included rating on the Care and Needs Scale (CANS); number of hours of paid and gratuitous weekly support; FIM™ and Community Integration Questionnaire scores; and number of current life roles (as recorded on Part 1 of the Role Checklist). Participants were an average of 6.73 years post injury and were living in a range of community environments and residential facilities.Results:There was considerable change in participants' CANS rating across the intervention period, with statistically significant decreases occurring from Baseline to T1 and T1 to T2. Ninety-five per cent of participants received some level of weekly paid support throughout the intervention period, with the amount varying considerably. Paid care decreased by an average of 10.78 hours per week from 85.85 hours per week at Baseline to 75.06 at T3. Although not statistically significant, this equated to an average cost saving of AU$324.84 per participant per week by the end of CAP intervention. There was an overall mean reduction of 4.96 hours of gratuitous care per week per participant over the intervention period, which was statistically significant. Increases in functional independence, community integration, and role participation were also found. On the FIM™, statistically significant improvement occurred between Baseline and T1 and on the CIQ between Baseline and T1 and T1 and T2. Significant increase on the Role Checklist occurred between Baseline and T1 and between T2 and T3. The number of life roles in which participants engaged increased by an average of 1.65 roles by the end of the intervention period. A reduction in care and support needs (measured by the CANS) was significantly associated with: (1) a reduction in total care hours, (2) and an increase in functional independence on the FIM™, and (3) an increase in community integration on the CIQ.Conclusion:With a long term approach and contextualised intervention targeted at skill development in the areas that underpin personally valued participation, increased role performance and community integration can be achieved by people with severe ABI, even many years post injury. This increased capacity has been found to be associated with a reduction in care and support needs, including paid and gratuitous care hours, over time.

scholarly journals Kitchen-related tasks used in occupational therapy during rehabilitation of adults with acquired brain injury: A systematic review

2020 ◽  
Vol 84 (1) ◽  
pp. 22-41
Author(s):  
Sushmita Mohapatra ◽  
Stefan Tino Kulnik
Keyword(s):  
Systematic Review ◽  
Brain Injury ◽  
Occupational Therapy ◽  
Methodological Quality ◽  
English Language ◽  
Grey Literature ◽  
Acquired Brain Injury ◽  
Eligibility Criteria ◽  
Therapy Interventions ◽  
Occupational Therapy Interventions

Introduction Kitchen-related tasks are widely used in occupational therapy for adults with acquired brain injury. This study aimed to investigate the effectiveness of kitchen-related, task-based occupational therapy interventions for improving clinical and functional outcomes in the rehabilitation of adults with acquired brain injury. Method A systematic review of the literature was conducted with narrative synthesis (PROSPERO registration CRD42019141898), by searching relevant electronic databases (BNI, CINAHL Plus, MEDLINE, DORIS, OT Seeker etc.), registries of ongoing studies (ISRCTN, PROSPERO, etc.), and grey literature (OpenGrey, etc.). English-language studies that evaluated kitchen-related tasks in the rehabilitation of adults with acquired brain injury were included and independently appraised for their methodological quality by two reviewers. Results Seventeen primary studies met the eligibility criteria. Studies were heterogeneous in methods, methodological quality, setting, sample size, purpose, and design of kitchen-related tasks. Fifteen studies evaluated kitchen-related, task-based treatments for improving function, and two studies examined kitchen-related task assessments for safety and task performance. This provides very limited evidence for the effectiveness of kitchen-related, task-based interventions compared to interventions not based on kitchen-related tasks. Conclusion While kitchen-related, task-based occupational therapy interventions in acquired brain injury rehabilitation are common practice, there is currently limited research evidence to support this. Further studies are warranted to strengthen the evidence base.

scholarly journals Dysphagia rehabilitation following acquired brain injury, including cerebral palsy, across the lifespan: a scoping review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Rhiannon Halfpenny ◽  
Alexandra Stewart ◽  
Paula Kelly ◽  
Eleanor Conway ◽  
Christina Smith
Keyword(s):  
Brain Injury ◽  
Systematic Reviews ◽  
Scoping Review ◽  
Grey Literature ◽  
Acquired Brain Injury ◽  
Paediatric Population ◽  
Open Science ◽  
Language Therapy ◽  
Dysphagia Rehabilitation ◽  
Swallowing Exercises

Abstract Background Swallowing impairment (dysphagia) following brain injury can lead to life-threatening complications such as dehydration, aspiration pneumonia and acute choking episodes. In adult therapeutic practice, there is research and clinical evidence to support the use of swallowing exercises to improve swallowing physiology in dysphagia; however, the use of these exercises in treating children with dysphagia is largely unexplored. Fundamental questions remain regarding the feasibility and effectiveness of using swallowing exercises with children. This review aims to outline the published literature on exercise-based treatment methods used in the rehabilitation of dysphagia secondary to an acquired brain injury across the lifespan. This will allow the range and effects of interventions utilised to be mapped alongside differential practices between adult and child populations to be formally documented, providing the potential for discussions with clinicians about which rehabilitative interventions might be appropriate for further trial in paediatrics. Methods This study will use a scoping review framework to identify and systematically review the existing literature using Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews (PRISMA) scoping review guidelines. Electronic databases (MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Allied and Complementary Medicine Database (AMED)), grey literature and the reference lists of key texts including systematic reviews will be searched. Information about the rehabilitation design, dosage and intensity of exercise programmes used as well as demographic information such as the age of participants and aetiology of dysphagia will be extracted. The number of articles in each area and the type of data source will be presented in a written and visual format. Comparison between the literature in adult and child populations will be discussed. Discussion This review is unique as it directly compares dysphagia rehabilitation in adults with that of a paediatric population in order to formally identify and discuss the therapeutic gaps in child dysphagia rehabilitation. The results will inform the next stage of research, looking into the current UK-based speech and language therapy practices when working with children with acquired dysphagia. Systematic review registration Open science framework osf.io/ja4dr

Community-Based Rehabilitation Following Brain Injury: Comparison of a Transitional Living Program and a Home-Based Program

2012 ◽  
Vol 13 (1) ◽  
pp. 44-61 ◽  
Author(s):  
Kate Hopman ◽  
Robyn L. Tate ◽  
Annie McCluskey
Keyword(s):  
Brain Injury ◽  
Longitudinal Design ◽  
Community Integration ◽  
Self Awareness ◽  
Community Based ◽  
Significant Group ◽  
Rehabilitation Programs ◽  
Home Based ◽  
Community Based Rehabilitation ◽  
Transitional Living

Background and aims: Community-based rehabilitation programs for people with a brain injury are diverse. Comparative program evaluation is required to identify optimal type, intensity and duration of programs. The aim of this study was to compare the effectiveness of two community-based rehabilitation programs using a set of standardised outcome measures.Methods: The study used a quantitative, multicentre, longitudinal design. Persons with severe traumatic brain injury (TBI,n= 39) and acquired brain impairment (n= 2) were recruited from two residential, transitional living programs (TLU;n= 21) and two home-based community rehabilitation programs (CR;n= 20). Participants were assessed via interview at program entry, 2 months and 6 months later using a broad range of standardised measures. The quantity and types of intervention provided to study participants were recorded. Results: No significant differences were identified between the TLU and CR groups at baseline or 6-month follow-up. Two significant group-by-time interactions were identified on the Community Integration Questionnaire (CIQ). First, the CR group had significantly greater changes in productivity (p= .003;d= 1.0) compared to the TLU group over time; by contrast, the TLU group showed significantly greater improvements in social integration (p= .007;d= .86). The TLU participants received up to five times more intervention than the CR participants. This finding is significant considering the similar levels of improvement in function made by both TLU and CR participants.Conclusions: Both TLU and CR groups improved on a range of measures. The TLU group however, received significantly more face-to-face interventions. Further examination of the relationship between participant contextual factors, such as coping style and self-esteem, and impairments such as challenging behaviour and decreased self-awareness, of people attending TLU and CR programs is required.

scholarly journals Assessment of Intensive Inpatient Rehabilitation Program in Acquired Brain Injury Patients using UK FIM+FAM Scale: A Retrospective Study

2021 ◽  
Author(s):  
Harleen Uppal ◽  
Shipra Chaudhary ◽  
Siddharth Rai
Keyword(s):  
Brain Injury ◽  
Functional Outcome ◽  
Outcome Measure ◽  
Acquired Brain Injury ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
P Value ◽  
Functional Outcome Measure ◽  
The Uk

Introduction: Acquired Brain Injury (ABI) can lead to a combination of physical, cognitive, and behavioural impairments and requires comprehensive and structured inpatient rehabilitation program. A multidisciplinary rehabilitation program can deal comprehensively with all these issues together rather than focussing on a single aspect like motor function. Number of people suffering from Traumatic Brain Injury (TBI) in India has been documented to be between 1.5 million to two million per year whereas out of this approximately one million die due to TBI. The rationale of the present study was to document the outcome of multidisciplinary inpatient rehabilitation program objectively using a standard functional outcome measure. Aim: To determine the change in functional outcomes of ABI patients being rehabilitated with a multidisciplinary inpatient neurorehabilitation program using UK version of Functional Independence Measure and Functional Assessment Measure (UK FIM+FAM). Materials and Methods: The retrospective observational study was conducted in Medanta Hospital, Gurugram, Haryana, India, from September 2017 to June 2018. Retrospective analysis of previously maintained data was done from June 2018 to November 2018. Data was collected from the Department of Neurorehabilitation. Demographic data was collected including age, sex, type of injury, time from injury to admission and duration of stay in the neurorehabilitation unit. Functional outcome measure used in the study was the UK FIM+FAM. Data was collected in paper forms and collated in Microsoft Excel and transferred to IBM® Statistical Package for the Social Sciences (SPSS)® version 22.0 (IBM Corp., Armonk, NY) for analysis. The UK FIM+FAM data was analysed as aggregate total scores and motor and cognitive subscales. Non parametric tests were used as UK FIM+FAM is an ordinal scale. The test used to measure the change in score was Wilcoxon Test. The p-value <0.05 was considered statistically significant. Results: Total number of patients who were analysed in the study were 45. Motor subset of scores showed significant improvement from admission (50) to discharge (72) (p-value=0.001). Similarly, the cognitive subset of scores also showed a significant improvement from admission (58) to discharge (68, p value=0.002). Apart from motor and cognitive subscales of UK FIM+FAM, change in score in sub divisions of self-care and transfers showed the maximum change with p-value=0.001. Other sub divisions of locomotion, sphincter, communication, psychological and cognition also showed a significant difference of p-value <0.05. Conclusion: A physiatrist led intensive interdisciplinary inpatient rehabilitation program for patients with ABI may significantly reduce residual disability and improve functional independence. Such a program is not only effective in high income countries but also in Low Middle Income Countries (LMIC).

scholarly journals Vision Evaluation Tools for Adults With Acquired Brain Injury: A Scoping Review

2021 ◽  
pp. 000841742110429
Author(s):  
Camille Dubé ◽  
Yu Jin ◽  
Brienne G. Powers ◽  
Ginny Li ◽  
Amélie Labelle ◽  
...  
Keyword(s):  
Brain Injury ◽  
Scoping Review ◽  
Grey Literature ◽  
Occupational Therapists ◽  
Acquired Brain Injury ◽  
Future Research ◽  
Evaluation Tools ◽  
Visual Deficits ◽  
Visual Skills ◽  
High Level

Background. Unrecognized visual deficits (VDs) following an acquired brain injury (ABI) may impact clients’ rehabilitation. Little is known about evaluation tools used in vision rehabilitation. Purpose. To systematically explore the literature describing evaluation tools used for VD on adults with ABI. Method. Using a scoping review methodology, we searched in MEDLINE(Ovid), Embase, CINAHL, PsycINFO, and the grey literature from inception to 2020. Quantitative and thematic analyses were performed. Findings. Of the 83 studies reporting on 86 evaluation tools, 47% used multiple tools to assess VD. Tools were mostly used by occupational therapists and psychologists to evaluate intermediate, intermediate to high, and high-level visual skills. Clinicians tend to select specific tools that focus on different levels of the hierarchy of visual skills. Implications. Future research should investigate the optimal timeframe for assessment of VD and the psychometric properties of tools to ensure comprehensive VD evaluation.

scholarly journals Self-Awareness Moderates the Association Between Executive Dysfunction and Functional Independence After Acquired Brain Injury

2020 ◽  
Vol 35 (7) ◽  
pp. 1059-1068
Author(s):  
Dolores Villalobos ◽  
José M Caperos ◽  
Álvaro Bilbao ◽  
Umberto Bivona ◽  
Rita Formisano ◽  
...  
Keyword(s):  
Executive Function ◽  
Brain Injury ◽  
Significant Interaction ◽  
Declarative Memory ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Common Symptom ◽  
Self Awareness ◽  
Moderator Effect ◽  
Low Levels

Abstract Objective Impaired self-awareness (SA) is a common symptom after suffering acquired brain injury (ABI) which interferes with patient’s rehabilitation and their functional independence. SA is associated with executive function and declarative memory, two cognitive functions that are related to participants’ daily living functionality. Through this observational study, we aim to explore whether SA may play a moderator role in the relation between these two cognitive processes and functional independence. Method A sample of 69 participants with ABI completed a neuropsychological assessment focused on executive function and declarative memory which also included a measure of SA and functional independence. Two separated linear models were performed including functional independence, SA, and two neuropsychological factors (declarative memory and executive function) derived from a previous principal component analysis. Results Moderation analysis show a significant interaction between SA and executive function, reflecting an association between lower executive functioning and poorer functional outcome, only in participants with low levels of SA. Notwithstanding, declarative memory do not show a significant interaction with SA, even though higher declarative memory scores were associated with better functional independence. Conclusions SA seems to play a moderator effect between executive function, but not declarative memory, and functional independence. Accordingly, participants with executive deficits and low levels of SA might benefit from receiving specific SA interventions in the first instance, which would in turn positively impact on their functional independence.

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