Cognitive Rehabilitation Therapy May Be Beneficial For Treating Traumatic Brain Injury

Cognitive Rehabilitation Therapy May Be Beneficial For Treating Traumatic Brain Injury, But Further Research Needed

There is some evidence about the potential value of cognitive rehabilitation therapy (CRT) for treating traumatic brain injury(TBI), but overall it is not sufficient to develop definitive guidelines on how to apply these therapies and to determine which type of CRT will work best for a particular patient, says a new report from the Institute of Medicine.

Research has yielded promising data on the effectiveness of some forms of CRT for helping patients with TBI, but the majority of the evidence is limited due to methodological shortcomings in the studies and challenges in studying the use of CRT in this patient population, said the committee that wrote the report. Obtaining the necessary evidence requires improvements to the way those data are collected and standardization of the terms used to describe these personalized therapies and their outcomes. 
Source:http://www.medicalnewstoday.com/releases/235855.php

No Benefit of Occupational Therapy After Wrist Fracture

Last Updated: October 13, 2011.
For patients with an unstable distal radial fracture treated with open reduction and volar locking plate fixation, surgeon-directed independent exercises, but not those under supervision of an occupational therapist, improve average motion and disability score of the wrist, according to a study published in the Oct. 5 issue of The Journal of Bone & Joint Surgery.

THURSDAY, Oct. 13 (HealthDay News) -- For patients with an unstable distal radial fracture treated with open reduction and volar locking plate fixation, surgeon-directed independent exercises, but not those under supervision of an occupational therapist, improve average motion and disability score of the wrist, according to a study published in the Oct. 5 issue of The Journal of Bone & Joint Surgery.
J. Sebastiaan Souer, M.D., from the Massachusetts General Hospital in Boston, and colleagues investigated whether wrist function and arm-specific disability six months after open reduction and volar plate fixation of 94 unstable distal radial fractures differed in patients who received occupational therapist-supervised exercises or surgeon-directed independent exercises. Combined wrist flexion and extension were measured six months after surgery. Wrist motion, grip strength, Gartland and Werley scores, Mayo wrist scores, and Disabilities of Arm, Shoulder and Hand (DASH) scores were measured at three and six months after surgery.
The investigators found that the mean arc of wrist flexion and extension six months after surgery was significantly improved in those patients prescribed independent exercises. A significant difference was observed in mean pinch strength, grip strength, and Gartland and Werley score at three months after surgery, and in the mean results of wrist extension, ulnar deviation, supination, grip strength, and Mayo score at six months after surgery, and favored independent exercises. No differences were found in the DASH score at any time point.
"Prescription of formal occupational therapy does not improve the average motion or disability score after volar locking plate fixation of a fracture of the distal part of the radius," the authors write.
One or more of the study authors disclosed a financial relationship with the biomedical industry.

link:http://www.doctorslounge.com/index.php/news/pb/23792

Utility of the Canadian Occupational Performance Measure in community-based brain injury rehabilitation.

Jenkinson N, Ownsworth T, Shum D.

Source

School of Psychology, Applied Cognitive Neuroscience Research Centre, Griffith University, Brisbane, Australia.

Abstract

PRIMARY OBJECTIVE:

To investigate the clinical utility of the Canadian Occupational Performance Measure (COPM) for community-based individuals with acquired brain injury (ABI).

METHODS AND PROCEDURES:

Thirty-four individuals with ABI (M = 5.32 years post-injury, SD = 3.92) were administered the COPM with self- and relative ratings of performance and satisfaction obtained. Relatives completed the Brain Injury Community Rehabilitation Outcome 39 (BICRO-39) scales. Measures of awareness of deficits, emotional status and cognitive function were obtained. A sub-group of participants was randomly allocated into a no-intervention group (n = 15) or an 8-week treatment group (n = 10). Initial assessments and 8-week follow-up assessments were conducted.

MAIN OUTCOMES AND RESULTS:

A pre- and post-assessment comparison for the treatment group identified a significant improvement on most COPM ratings (p < 0.05), but not the BICRO-39 (p > 0.05). However, self-ratings of satisfaction improved for the no-intervention group (p < 0.05). Self-ratings of satisfaction were significantly correlated with anxiety (r = -0.42, p < 0.05), although there were no other significant associations between COPM ratings and awareness, mood state and cognitive function.

CONCLUSIONS:

The findings generally support the utility of the COPM in community-based rehabilitation; however, the need for self-ratings to be interpreted in the context of other outcome indicators is recommended.

PMID:

 

18236203

 

[PubMed - indexed for MEDLINE]

Source:

http://www.ncbi.nlm.nih.gov/pubmed/18236203

Occupational therapy and achievement of self-identified goals

Occupational therapy and achievement of self-identified goals by adults with acquired brain injury: phase II.

Trombly CA, Radomski MV, Trexel C, Burnet-Smith SE.

Source

Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Massachusetts 02215, USA. ctrombly@bu.edu

Abstract

OBJECTIVE:

The purpose of this study was to investigate the association between participation in goal-specific outpatient occupational therapy and improvement in self-identified goals in adults with acquired brain injury.

METHOD:

Thirty-one persons with traumatic brain injury of mixed chronicity participated at three sites located in different regions of the United States. Using a repeated-measures design, therapy that usually was offered at each site to achieve specific goals was followed by a no-treatment period. Participants completed the Canadian Occupational PerFormance Measure Performance subscale (COPM-P) and Satisfaction subscale (COPM-S), and the Community Integration Questionnaire (CIQ) at admission, discharge, and 1 to 18 weeks after discharge. Goal attainment scales were developed at admission and scored at discharge; the differences for each site were tested, using dependent t tests. Gains for the treatment period (admission to discharge) in COPM subscales and the CIQ were compared with gains during the no-treatment period (discharge to follow-up) for each site, using dependent t tests. The results were synthesized meta-analytically across the sites.

RESULTS:

The participants identified a total of 149 goals, 81% of which were achieved. Goal attainment T scores improved significantly (Z = 7.52, p < .001), and the combined effect size was large (r = .94). The COPM-P (Z = 4.13, p < .001) and COPM-S (Z = 4.25, p < .001) showed significantly greater gains during the treatment (average 15.3 weeks) versus the no-treatment (average 9.9 weeks) period. Effect size estimates were large: .71 and .76, respectively. Gain scores of the CIQ did not differ significantly (Z = .75, p = .22, r = .29) between periods.

CONCLUSION:

Participation in goal-specific outpatient occupational therapy that focused on teaching compensatory strategies was strongly associated with achievement of self-identified goals and reduction of disability in adults with mild to moderate brain injury.

PMID:

 

12269503

 

[PubMed - indexed for MEDLINE]

Source:

http://www.ncbi.nlm.nih.gov/pubmed/12269503

Fun Facts OT and Pts

http://www.funtrivia.com/en/subtopics/Occupational-Therapy-70840.html
http://www.funtrivia.com/en/subtopics/Physical-Therapy-Basics-232442.html

Neural Linkage Between Motivation And Motor Functional Recovery Through Rehabilitative Training

An effective recovery has been observed instroke patients and those with spinal cord injuries who have strong vitality and motivation to rehabilitate in clinical practice. However, it was not really clear how motivation facilitates functional recovery in brain science. The joint research team consisting of Associate Professor Yukio NISHIMURA, and Professor Tadashi ISA from the National Institute for Physiological Sciences, Dr. Hirotaka ONOE, Team Leader in the Functional Probe Research Laboratory of RIKEN, the Center for Molecular Imaging Science, and also Dr. Hideo TSUKADA, Manager of PET Center, Hamamatsu Photonics K.K., Central Research Laboratory, revealed that the more motor function recovery progresses, the stronger the functional connectivity between the brain which regulates motivation, and in the brain regions involved in the motor learning and functional recovery. This occurs through rehabilitative training of macaque monkeys after the spinal cord injuries. The result of this study suggests that the functional recovery of motor system for a patient with damage to the central nervous system can be advanced effectively, by activating the brain region which controls "motivation". The result of this study was reported in PLoS ONE, an American science magazine (September 28, 2011 electronic edition). 
Source:http://www.medicalnewstoday.com/releases/235206.php

Extending Life Of Arthritic Joints

A medication already approved to build bone mass in patients with osteoporosis also builds cartilage around joints and could potentially be repurposed to treat millions of people suffering from arthritis, according to orthopaedic research at the University of Rochester Medical Center.

The study authors hope their laboratory findings, published in the current issue ofScience Translational Medicine, will set the stage for the first human clinical trials to test human parathyroid hormone (brand name:Forteo) in this growing patient population.

Since 2005, arthritis has been ranked as the leading cause of disability in the United States by the Centers for Disease Control and Prevention. And by 2030 an estimated 67 million people, or 25 percent of the adult population in this country will have osteoarthritis (OA), a painful, degenerative joint disease that often begins with an injury and results in the progressive loss of cartilage. Current treatments for OA do not help improve the cartilage in the diseased joint, they only make the pain more bearable. Examples include oral anti-inflammatory agents (such as Advil or Naproxen), narcotics, or steroid injections into the affected joint. Surgical replacement of the joint and cartilage is usually required, although this major intervention often carries its own set of complications. 
Link:http://www.medicalnewstoday.com/releases/234826.php