Partnering to Increase Access to Community Exercise Programs for People With Stroke, Acquired Brain Injury, and Multiple Sclerosis

2014 ◽  
Vol 11 (4) ◽  
pp. 838-845 ◽  
Author(s):  
Nancy Margaret Salbach ◽  
Jo-Anne Howe ◽  
Karen Brunton ◽  
Kathryn Salisbury ◽  
Lorene Bodiam
Keyword(s):  
Multiple Sclerosis ◽  
Brain Injury ◽  
Physical Therapists ◽  
Exercise Program ◽  
Acquired Brain Injury ◽  
Berg Balance Scale ◽  
Community Dwelling ◽  
Municipal Recreation ◽  
Neurological Conditions ◽  
Exercise Classes

Background:The purpose of this article is to describe the development and evaluation of a task-oriented group exercise program, delivered through a municipal recreation program, for community-dwelling people with neurological conditions.Methods:Physical therapists (PTs) at a rehabilitation hospital partnered with a municipal recreation provider to develop and evaluate a 12-week exercise program for people with stroke, acquired brain injury, and multiple sclerosis at 2 community centers. Fitness instructors who were trained and supported by PTs taught 1-hour exercise classes twice a week. In a program evaluation of the safety, feasibility and effects of the program, standardized measures of physical function were administered before and after the program.Results:Fourteen individuals (mean age: 63 years) participated and attended 92% of exercise classes, on average. Two minor adverse events occurred during 293 attendances. Improvement in mean score on all measures was observed. In people with stroke, a statistically significant improvement in mean Berg Balance Scale (mean ± SD change = 3 ± 2 points, P = .016, n = 7) and 6-minute walk test scores (change = 26 ± 26 m, P = .017, n = 9) was observed.Conclusions:This model of exercise delivery provides people with neurological conditions with access to a safe, feasible and potentially beneficial exercise program in the community.

Home Balance Training Intervention for People With Multiple Sclerosis

2007 ◽  
Vol 9 (3) ◽  
pp. 111-117 ◽  
Author(s):  
Kurt Jackson ◽  
Janet A. Mulcare ◽  
Betsy Donahoe-Fillmore ◽  
H. Ira Fritz ◽  
Mary M. Rodgers
Keyword(s):  
Multiple Sclerosis ◽  
Repeated Measures ◽  
Control Period ◽  
Balance Training ◽  
Exercise Program ◽  
Berg Balance Scale ◽  
Community Dwelling ◽  
Home Exercise ◽  
Training Intervention ◽  
Home Exercise Program

This study investigated the effects of a home balance training intervention on people with multiple sclerosis (MS). This quasi-experimental repeated-measures study involved 14 ambulatory community-dwelling individuals with MS. Subjects were assessed on three separate occasions: before and after a 6-week control period and after a 6-week home exercise program. After the intervention, subjects demonstrated significant improvement in measures of balance, including the Berg Balance Scale and specific components of the Sensory Organization and Limits of Stability Tests. In conclusion, a multidimensional home exercise program can improve certain measures of balance in individuals with MS who have mild to moderate disability. Whether these improvements lead to improved quality of life or a reduction in fall risk is yet to be determined.

Berg Balance Scale and Outcome Measures in Acquired Brain Injury

2001 ◽  
Vol 15 (3) ◽  
pp. 239-244 ◽  
Author(s):  
Jody A. Feld ◽  
Meheroz H. Rabadi ◽  
Alan D. Blau ◽  
Barry D. Jordan
Keyword(s):  
Brain Injury ◽  
Functional Independence Measure ◽  
Quantitative Measure ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Community Dwelling ◽  
Strongly Correlated ◽  
Balance Scale ◽  
Clinical Measures

Objective: To examine the relationship of the Berg Balance Scale (BBS) to out come after acquired brain injury. Methods: Forty consecutive patients with acquired brain injury were admitted for multidisciplinary rehabilitation. Patients were assessed with the BBS. The BBS was originally designed as a quantitative measure of balance and risk for falls in community-dwelling elderly patients. The BBS comprises 14 dif ferent tasks graded on a 56-point scale. Community-dwelling elders with a BBS score of ≤42 have >90% risk for falls. Results: In our study, there were 27 patients with a low BBS score (≤42) and 13 patients with a high BBS score (≥43). The discharge total Functional Independence Measure (FIM) scores were lower in the low BBS pa tients (96.4 ± 21.2) compared with the high BBS patients (111.5 ± 12.5) (p < 0.007). The length of stay (LOS) was significantly longer in the low BBS patients (38.9 ± 18.5 days) compared with the high BBS patients (14.2 ± 6.1 days; p < 0.000). Among the three patients that experienced falls during their hospitalization, all exhibited low BBS scores. The admission BBS score strongly correlated with admission total FIM scores (r = 0.86; p < 0.000) and moderately correlated with discharge total FIM scores (r = 0.56; p < 0.000) and LOS (r = -0.55; p < 0.000). Using a multiple regression analysis, the admission FIM score was found to be the better predictor of discharge FIM scores, and time admitted after injury was the better predictor of LOS. Conclusions: Prediction of rehabilitative outcome might be enhanced by the use of the BBS scores in combination with other clinical measures on admission to inpatient acute rehabil itation. Key Words: Functional Independence Measure—Berg Balance Scale—Ac quired brain injury.

Goal statements in brain injury rehabilitation: A cohort study of client-centredness and relationship with goal outcome

2019 ◽  
Vol 20 (3) ◽  
pp. 226-239
Author(s):  
Sarah Prescott ◽  
Emmah Doig ◽  
Jennifer Fleming ◽  
Nicole Weir
Keyword(s):  
Brain Injury ◽  
Goal Setting ◽  
Acquired Brain Injury ◽  
Community Dwelling ◽  
Outpatient Rehabilitation ◽  
Injury Rehabilitation ◽  
Rehabilitation Outcomes ◽  
Cohort Design ◽  
Specific Goal ◽  
Goal Specificity

AbstractBackground:Currently, there is increasing recognition of the need to use a client-centred approach to goal setting in rehabilitation. However, there is limited research to guide practice with community-dwelling clients with acquired brain injury. An understanding of the characteristics of client-centred goals and the extent to which client-centeredness influences goal outcomes is required.Objective:To examine the relationships between the client-centredness of goals and their characteristics, content, recall and outcomes of client-centred goals in brain injury rehabilitation.Methods:A prospective cohort design study was employed. Participants were 45 clients with brain injury receiving outpatient rehabilitation, who completed measures of client-centredness after goal setting. Each goal was classified according to whether it was specific, measurable, non-jargonistic, and participation-focussed, included a timeframe and was recalled by participants.Results:Participants set 223 goals with 20 clinicians from multiple disciplines. Levels of client-centredness did not differ according to the characteristics, content and recall of goals, with the exception of goal specificity (p< 0.01). Client-centredness was significantly and positively correlated with goal outcomes (p< 0.05).Conclusions:The use of client-centred goals is recommended for improved rehabilitation outcomes. Applying goal documentation criteria does not necessarily mean that goals will be client-centred, and highly specific goal statements may not reflect what is important and meaningful to clients.

Defining and Diagnosing Involuntary Emotional Expression Disorder

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S6) ◽  
pp. 1-11 ◽  
Author(s):  
Jeffrey L. Cummings ◽  
David B. Arciniegas ◽  
Benjamin R. Brooks ◽  
Robert M. Herndon ◽  
Edward C. Lauterbach ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Traumatic Brain Injury ◽  
Amyotrophic Lateral Sclerosis ◽  
Brain Injury ◽  
Diagnostic Criteria ◽  
Emotional Expression ◽  
Diagnosis And Treatment ◽  
Neurological Conditions ◽  
Lateral Sclerosis

AbstractUncontrollable episodes of emotional expression occur in a variety of neurological conditions. This emotional disinhibition syndrome is characterized by episodes of crying or laughing that are unrelated to or out of proportion to the eliciting stimulus. This syndrome is common among patients with amyotrophic lateral sclerosis, multiple sclerosis, stroke, and traumatic brain injury and a variety of terms and definitions have been used to describe it. The confusing nomenclature has been a barrier to understanding, diagnosis, and treatment of this disorder. The authors propose a unifying term, involuntary emotional expression disorder (IEED), and provide diagnostic criteria for this disorder.

A therapeutic songwriting intervention to promote reconstruction of self-concept and enhance well-being following brain or spinal cord injury: pilot randomized controlled trial

2019 ◽  
Vol 33 (6) ◽  
pp. 1045-1055 ◽  
Author(s):  
Felicity A Baker ◽  
Jeanette Tamplin ◽  
Nikki Rickard ◽  
Jennie Ponsford ◽  
Peter W New ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Brain Injury ◽  
Controlled Trial ◽  
Intervention Group ◽  
Acquired Brain Injury ◽  
Well Being ◽  
Community Dwelling ◽  
Retention Rates ◽  
Cord Injury

Objective: To determine the size of the effects and feasibility (recruitment and retention rates) of a therapeutic songwriting protocol for in-patients and community-dwelling people with acquired brain injury or spinal cord injury. Design: Randomized controlled trial with songwriting intervention and care-as-usual control groups, in a mixed measures design assessed at three time points. Participants: A total of 47 participants (3 in-patients with acquired brain injury, 20 community participants with acquired brain injury, 12 in-patients with spinal cord injury, and 12 community participants with spinal cord injury: 23 1208 days post injury). Interventions: The intervention group received a 12-session identity-targeted songwriting programme, where participants created three songs reflecting on perceptions of past, present, and future self. Control participants received care as usual. Measures: Baseline, postintervention, and follow-up measures comprised the Head Injury Semantic Differential Scale (primary outcome measure), Patient Health Questionnaire-9, Emotion Regulation Questionnaire, and Satisfaction with Life Scale. Results: No significant between group pre–post intervention differences were found on the primary self-concept measure, the Head Injury Semantic Differential Scale ( p = 0.38, d = 0.44). Significant and large effect sizes from baseline to post between groups in favour of the songwriting group for Satisfaction with Life ( p = 0.04, n2 p = 0.14). There were no significant between group pre-post interaction effects for the Emotion Regulation Suppression subscale ( p = 0.12, n2 p = –0.08) although scores decreased in the songwriting group over time while increasing for the standard care group. There were no significant differences in baseline to follow-up between groups in any other outcome measures. Recruitment was challenging due to the small number of people eligible to participate combined with poor uptake by eligible participants, particularly the in-patient group. Retention rates were higher for the community-dwelling cohorts. Conclusion: This study demonstrates the challenges in recruitment and retention of participants invited to participate in a music therapy study. Findings suggest this identity-focused therapeutic songwriting protocols may be more beneficial for people who have transitioned from in-patient to community-contexts given the greater proportion of participants who consent and complete the intervention. Preliminary effects in favour of the intervention group were detected in a range of well-being measures suggesting that a larger study is warranted.

scholarly journals Analysis of the Results from Use of Haptic Peg-in-Hole Task for Assessment in Neurorehabilitation

2011 ◽  
Vol 8 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Farshid Amirabdollahian ◽  
Garth Johnson
Keyword(s):  
Multiple Sclerosis ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Healthy Volunteers ◽  
Force Feedback ◽  
Neurological Impairment ◽  
Hole Diameter ◽  
Transfer Velocity ◽  
Neurological Conditions ◽  
Robotic Technologies

Haptic and robotic technologies have the potential to provide assessment during interaction with humans. This manuscript presents our earlier research during the I-Match project where a haptic peg-in-hole test was used in order to compare between healthy volunteers' performance and those with neurological impairment. Subjects all performed a series of haptic virtual peg-in-hole tasks with varying degrees of difficulty determined by the hole diameter. Haptic instrument, Phantom Desktop 1.5, allowed for recording of biomechanical data which is used to present some variant features between the two subject groups. This paper analyses the placement time, maximum peg transfer velocity, collision forces recorded during peg placement and also insertion accuracy. The first three parameters showed statistically significant differences between the two groups while the last, insertion accuracy, showed insignificant differences (p= 0.152). This is thought to be due to the large clearance value between the smallest hole diameter and the peg. To identify differences between the haptic peg-in-hole and the established NHPT, we are currently in process of conducting a further experiment with a haptic replica of the NHPT test, in order to investigate effects resulting from addition of haptic force feedback compared to the original NHPT test, as well as allowing to explore influences caused by the 1 mm clearance value as originally proposed by Wade.Furthermore, in order to investigate if this method can identify differences between subjects with different neurological conditions, a larger group of subjects with neurological conditions such as stroke, multiple sclerosis, and traumatic brain injury is required to explore potency of this approach for identifying differences between these different conditions.

Physical Therapy Management of Adults with Mild Traumatic Brain Injury

2019 ◽  
Vol 40 (01) ◽  
pp. 036-047 ◽  
Author(s):  
Deborah Diaz ◽  
Carolyn Moore ◽  
Ashley Kane
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Exercise Program ◽  
Semicircular Canals ◽  
Return To Play ◽  
Home Exercise ◽  
Motion Sensitivity

AbstractRehabilitation for individuals after mild traumatic brain injury (mTBI) or concussion requires emphasis on both cognitive and physical rest, with a gradual return to activity including sports. As the client becomes more active, the rehabilitation professional should pay close attention to symptoms associated with mTBI, such as headache, dizziness, nausea, and difficulty concentrating. The systematic approach to return to play provided by the Berlin Consensus Statement on Concussion in Sport can apply to adults with mTBI. This protocol calls for gradually increasing the intensity of physical activity while attending to postconcussion symptoms. During the incident that led to an mTBI, the injured individual may incur injuries to the vestibular and balance system that are best addressed by professionals with specific training in vestibular rehabilitation, most commonly physical therapists. Benign paroxysmal positional vertigo is a condition in which otoconia particles in the inner ear dislodge into the semicircular canals, resulting in severe vertigo and imbalance. This condition frequently resolves in a few sessions with a vestibular physical therapist. In conditions such as gaze instability, motion sensitivity, impaired postural control, and cervicogenic dizziness, improvement is more gradual and requires longer follow-up with a physical therapist and a home exercise program. In all of the above-stated conditions, it is essential to consider that a patient with protracted symptoms of mTBI or postconcussion syndrome will recover more slowly than others and should be monitored for symptoms throughout the intervention.

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