Return-to-driving following acquired brain injury: A neuropsychological perspective

2021 ◽  
pp. 1-14
Author(s):  
Robert Perna ◽  
Jyoti Pundlik ◽  
Ana Arenivas
Keyword(s):  
Brain Injury ◽  
Cognitive Abilities ◽  
Dynamic Environment ◽  
Acquired Brain Injury ◽  
Self Awareness ◽  
Cognitive Screening ◽  
Road Test ◽  
Post Injury ◽  
Safe Driving ◽  
The Road

BACKGROUND: Return to driving after an acquired brain injury (ABI) has been positively associated with return to employment, maintenance of social relationships, and engagement in recreational and other community activities. Safe driving involves multiple cognitive abilities in a dynamic environment, and cognitive dysfunction resulting from ABI can negatively impact driving performance. OBJECTIVE: This manuscript examines the post-injury return-to-driving process, including performances on the in-office and on-road assessments, and the role of a rehabilitation neuropsychologist in helping patients resume driving. METHOD: In this study, 39 of 200 individuals (approximately 20%) treated at an outpatient neurorehabilitation facility, who performed satisfactorily on a pre-driving cognitive screening, completed a behind-the-wheel driving test. RESULTS: Of the 200 individuals, 34 (87%) passed the road test. Among the remaining five individuals who did not pass the road test, primary reasons for their failure included inability to follow or retain examiner directions primarily about lane position, speed, and vehicle control. The errors were attributable to cognitive difficulties with information processing, memory, attention regulation, and dual tasking. CONCLUSION The rehabilitation neuropsychologist contributed to the process by assessing cognition, facilitating self-awareness and error minimization, providing education about driving regulations and safety standards, and preparing for the road test and its outcomes.

The Development of Insight following Severe Traumatic Brain Injury: Three Case Studies

1997 ◽  
Vol 60 (7) ◽  
pp. 295-300 ◽  
Author(s):  
J M Fleming ◽  
J Strong
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Acquired Brain Injury ◽  
First Year ◽  
Self Awareness ◽  
Good Recovery ◽  
Post Injury ◽  
One Year

A longitudinal study of 55 adults with severe traumatic brain injury was conducted to investigate the development of self-awareness, emotional distress and motivation during the first year after injury. Cluster analysis was performed on data gathered at one year post-Injury. Three clusters labelled ‘high self-awareness’, ‘low self-awareness’ and ‘good recovery’ were retrieved. A case study is presented from each cluster, contrasting the stages in the development of self-awareness of deficits over the year. This research suggests that clients with acquired brain injury can be classified on the basis of level of self-awareness. Issues for the rehabilitation of and occupational therapy with clients from the three groups are raised.

Consumer perspectives of vocational rehabilitation and return to work following acquired brain injury

2021 ◽  
pp. 1-21
Author(s):  
Kerrin Watter ◽  
Areti Kennedy ◽  
Vanette McLennan ◽  
Jessica Vogler ◽  
Sarah Jeffery ◽  
...  
Keyword(s):  
Brain Injury ◽  
Return To Work ◽  
Vocational Rehabilitation ◽  
Acquired Brain Injury ◽  
System Level ◽  
Structured Interviews ◽  
Post Injury ◽  
Vocational Rehabilitation Services ◽  
Workplace Supports ◽  
Vocational Goals

Abstract Introduction: Following acquired brain injury, the goal of return to work is common. While return to work is supported through different rehabilitation models and services, access to vocational rehabilitation varies within and between countries, and global rates of employment post-injury remain low. The literature identifies outcomes from vocational programs and experiences with return to work, yet little is known about individuals’ perceptions and experiences regarding rehabilitation to support their vocational goals and experiences in attempting to return to work. Method: This qualitative study investigated the experiences of community-living adults with acquired brain injury (n = 8; mean age 45 years; mean time post-injury of 5.5 years) regarding their vocational rehabilitation and return to work. Focus groups and semi-structured interviews were conducted, with data analyzed via thematic analysis. Results: Participants identified negative and positive experiences with vocational rehabilitation and return to work. Five overarching themes were identified: addressing vocational rehabilitation in rehabilitation; facilitators of recovery and return to work; the importance and experience of working again; acquired brain injury and identity; and services, systems and policies. Participants also identified five key areas for early vocational rehabilitation services: education; service provision; employer liaison; workplace supports; and peer mentors. Study findings inform current and future practice and service delivery, at a clinical, service and system level.

A Mixed Methods Study of the Experience of Transition to the Community of Working-Aged People with Non-Traumatic Brain Injury

2012 ◽  
Vol 13 (1) ◽  
pp. 85-98 ◽  
Author(s):  
Alexandra Hall ◽  
Brooke Grohn ◽  
Emily Nalder ◽  
Linda Worrall ◽  
Jennifer Fleming
Keyword(s):  
Mixed Methods ◽  
Brain Injury ◽  
Cognitive Abilities ◽  
Qualitative Content Analysis ◽  
Transition Services ◽  
Post Injury ◽  
Aged People ◽  
Transition Experience ◽  
Working Age ◽  
Hospital To Home

Background and aims: The ‘transition’ phase from hospital to home following brain injury is well established as a critical period of adjustment for individuals and their families. There is, however, a lack of knowledge about the experience of transition following nontraumatic brain injury (e.g., stroke, aneurysm) for individuals of working age. The purpose of this study was to explore the transition experiences of individuals with nontraumatic brain injury using mixed methods approach.Methods: Six individuals with nontraumatic brain injury were recruited from a larger study using maximum variation sampling criteria. Individuals participated in semistructured interviews at 6-months postdischarge and completed quantitative measures of psychosocial outcomes predischarge and at 6-months postdischarge. Results: Qualitative content analysis of interviews identified three themes: (1) changes in role performance, (2) support and services and (3) coping with life after brain injury. The transition experience was characterised by loss of valued roles including driving and work, identified as major barriers to regaining independence postdischarge. Informal support provided by family and friends were relied on, while formal supports were accessed infrequently. Life post-injury presented a number of challenges including adjusting to changes in physical and cognitive abilities and a fear of reinjury. Qualitative data were supported by an overall trend of improved functioning on the quantitative measures over the 6 months.Conclusions: Key life circumstances of working age adults with nontraumatic brain injury influence the transition experience. Clinically, the findings support the need for individualised, structured transition services pre- and postdischarge for this group.

Neurological outcome in children and youth with acquired brain injury 2-year post-injury

2018 ◽  
Vol 21 (7) ◽  
pp. 465-474 ◽  
Author(s):  
Suzanne A.M. Lambregts ◽  
Frederike Van Markus-Doornbosch ◽  
Coriene E. Catsman-Berrevoets ◽  
Monique A.M. Berger ◽  
Arend J. De Kloet ◽  
...  
Keyword(s):  
Brain Injury ◽  
Neurological Outcome ◽  
Acquired Brain Injury ◽  
Children And Youth ◽  
Post Injury

scholarly journals Psychometric evaluation of the Self-Awareness in Daily Life-3 Scale (SADL-3) for the assessment of self-awareness after acquired brain injury

Brain Injury ◽  
2019 ◽  
Vol 33 (5) ◽  
pp. 598-609
Author(s):  
Ieke Winkens ◽  
Arno Prinsen ◽  
Annemieke Meijerink ◽  
Caroline Van Heugten ◽  
Rudolf Ponds
Keyword(s):  
Brain Injury ◽  
Daily Life ◽  
Psychometric Evaluation ◽  
Acquired Brain Injury ◽  
The Self ◽  
Self Awareness

The reproducibility and responsiveness of subjective assessment of upper limb associated reactions in people with acquired brain injury during walking

2019 ◽  
Vol 34 (2) ◽  
pp. 252-262 ◽  
Author(s):  
Michelle B Kahn ◽  
Ross A Clark ◽  
Kelly J Bower ◽  
Benjamin F Mentiplay ◽  
Pua Yong Hao ◽  
...  
Keyword(s):  
Brain Injury ◽  
Upper Limb ◽  
Acquired Brain Injury ◽  
Elbow Flexion ◽  
Subjective Assessment ◽  
Flexion Angle ◽  
International Classification Of Functioning ◽  
Post Injury ◽  
Rehabilitation Centre ◽  
Injury Rehabilitation

Objective: The aim of this study is to determine inter-rater, test–retest and intra-rater reproducibility and responsiveness of subjective assessment of upper limb associated reactions in people with acquired brain injury using (1) the ‘Qualifiers Scale’ of the International Classification of Functioning, Disability and Health Framework, and (2) visually estimated elbow flexion angle during walking. Design: Observational study. Setting: A brain injury rehabilitation centre, Melbourne, Australia. Subjects: People with acquired brain injury and upper limb associated reactions and experienced neurological physiotherapists. Main measures: The Qualifiers Scale applied to individual upper limb joints and global associated reaction on a 5-point scale (0–4), a summed upper limb severity score and visually estimated elbow flexion angle. Results: A total of 42 people with acquired brain injury (mean age: 48.4 ± 16.5 years) were videoed walking at self-selected and fast speeds. A subset of 30 chronic brain injury participants (mean time post injury: 8.2 ± 9.3 years) were reassessed one week later for retest reproducibility. Three experienced neurological physiotherapists (mean experience: 22.7 ± 9.1 years) viewed these videos and subjectively rated the upper limb associated reactions. Strong-to-very strong test–retest, intra- and inter-rater reproducibility was found for elbow flexion angle (ICC > 0.86) and the Qualifiers Scale applied to global and individual upper limb joints (ICC > 0.60). Responsiveness of change from self-selected to fast walking speed (mean increase 0.46 m/s) was highest for elbow flexion angle (effect size = 0.83) and low-to-moderate for the Qualifiers Scale. Conclusion: Subjectively rated associated reactions during walking demonstrated strong reproducibility and moderate responsiveness to speed change. The Qualifiers Scale and elbow flexion angle can both subjectively quantify associated reactions during walking in a clinical setting.

scholarly journals Self-awareness assessment during cognitive rehabilitation in children with acquired brain injury: a feasibility study and proposed model of child anosognosia

2015 ◽  
Vol 37 (22) ◽  
pp. 2092-2106 ◽  
Author(s):  
Agata Krasny-Pacini ◽  
Jennifer Limond ◽  
Jonathan Evans ◽  
Jean Hiebel ◽  
Karim Bendjelida ◽  
...  
Keyword(s):  
Brain Injury ◽  
Feasibility Study ◽  
Cognitive Rehabilitation ◽  
Acquired Brain Injury ◽  
Self Awareness ◽  
Proposed Model
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