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Cognitive Rehabilitation Following Traumatic Brain Injury: A Survey of Current Practice in Australia

Published online by Cambridge University Press:  13 September 2018

Marina Downing
Affiliation:
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
Peter Bragge
Affiliation:
Behaviour Works Australia, Monash Sustainable Development Institute, Monash University, Melbourne, Victoria, Australia
Jennie Ponsford*
Affiliation:
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
*
Address for correspondence: Prof Jennie Ponsford, Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Melbourne, Victoria 3800, Australia. Email: [email protected]
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Abstract

Background and Objective: As cognitive impairments represent the greatest impediment to participation following moderate–severe traumatic brain injury (TBI), cognitive rehabilitation is vital. Several sets of guidelines for cognitive rehabilitation have been published, including INCOG in 2014. However, little is known about current practice by therapists working with individuals with TBI. This study aimed to characterise current cognitive rehabilitation practices via an online survey of therapists engaged in rehabilitation in individuals with TBI.

Method: The survey documented demographic information, current cognitive rehabilitation practice, resources used to inform cognitive rehabilitation, and reflections on cognitive rehabilitation provided.

Results: The 221 Australian respondents were predominantly occupational therapists, neuropsychologists, and speech pathologists with an average 9 years of clinical experience in cognitive rehabilitation and TBI. Cognitive retraining and compensatory strategies were the most commonly identified approaches used in cognitive rehabilitation. Executive functioning was mostly targeted for retraining, whereas memory was targeted with compensatory strategies. Attentional problems were less frequently addressed. Client self-awareness, family involvement, team collaboration, and goal-setting were seen as important ingredients for success.

Conclusion: Clinical practice of cognitive rehabilitation in Australia is broadly consistent with guidelines. However, addressing the impediments to its delivery is important to enhance the quality of life for individuals with TBI.

Type
Articles
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2018 

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References

Bayley, M.T., Tate, R., Douglas, J.M., Turkstra, L.S., Ponsford, J., Stergiou-Kita, M., . . . Panel, I.E. (2014). INCOG guidelines for cognitive rehabilitation following traumatic brain injury: Methods and overview. Journal of Head Trauma Rehabilitation, 29 (4), 290306. doi:10.1097/HTR.0000000000000070.Google Scholar
Bragge, P., Pattuwage, L., Marshall, S., Pitt, V., Piccenna, L., Stergiou-Kita, M., . . . Bayley, M. (2014). Quality of guidelines for cognitive rehabilitation following traumatic brain injury. Journal of Head Trauma Rehabilitation, 29 (4), 277289. doi:10.1097/HTR.0000000000000066.Google Scholar
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychololgy. Qualitative Research in Psychology, 3, 77101.Google Scholar
Cicerone, K.D., Dahlberg, C., Kalmar, K., Langenbahn, D.M., Malec, J.F., Bergquist, T.F., . . . Morse, P.A. (2000). Evidence-based cognitive rehabilitation: Recommendations for clinical practice. Archives of Physical Medicine and Rehabilitation, 81 (12), 15961615.Google Scholar
Cicerone, K.D., Dahlberg, C., Malec, J.F., Langenbahn, D.M., Felicetti, T., Kneipp, S., . . . Catanese, J. (2005). Evidence-based cognitive rehabilitation: Updated review of the literature from 1998 through 2002. Archives of Physical Medicine and Rehabilitation, 86 (8), 16811692.Google Scholar
Cicerone, K.D., Langenbahn, D.M., Braden, C., Malec, J.F., Kalmar, K., Fraas, M., . . . Ashman, T. (2011). Evidence-based cognitive rehabilitation: Updated review of the literature from 2003 through 2008. Archives of Physical Medicine and Rehabilitation, 92 (4), 519530.Google Scholar
Corrigan, J.D., Selassie, A.W., & Orman, J.A. (2010). The epidemiology of traumatic brain injury. Journal of Head Trauma Rehabilitation, 25 (2), 7280.Google Scholar
Ehlhardt, L.A., Sohlberg, M.M., Kennedy, M., Coelho, C., Ylvisaker, M., Turkstra, L., & Yorkston, K. (2008). Evidence-based practice guidelines for instructing individuals with neurogenic memory impairments: What have we learned in the past 20 years? Neuropsychological Rehabilitation, 18 (3), 300342.Google Scholar
Finkelstein, E., Corso, P., & Miller, T. (2006). The incidence and economic burden of injuries in the United States. New York: Oxford University Press.Google Scholar
Harvey, L.A., & Close, J.C. (2012). Traumatic brain injury in older adults: Characteristics, causes and consequences. Injury, 43 (11), 18211826. doi:10.1016/j.injury.2012.07.188.Google Scholar
Institute of Medicine. (2011). Cognitive rehabilitation therapy for traumatic brain injury: Evaluating the evidence. Washington, DC: The National Academic Press.Google Scholar
Kewman, D.G., Seigerman, C., Kintner, H., Chu, S., Henson, D., & Reeder, C. (1985). Simulation training of psychomotor skills: Teaching the brain-damaged to drive. Rehabilitation Psychology, 30, 1127.Google Scholar
Khan, F., Baguley, I.J., & Cameron, I.D. (2003). Rehabilitation after traumatic brain injury. Medical Journal of Australia, 178 (6), 290295.Google Scholar
Langlois, J.A., Rutland-Brown, W., & Wald, M.M. (2006). The epidemiology and impact of traumatic brain injury: A brief overview. Journal of Head Trauma Rehabilitation, 21 (5), 375378.Google Scholar
Levine, B., Schweizer, T.A., O'Connor, C., Turner, G., Gillingham, S., Stuss, D.T., . . . Robertson, I.H. (2011). Rehabilitation of executive functioning in patients with frontal lobe brain damage with goal management training. Frontiers Human Neuroscience, 5, 9. doi:10.3389/fnhum.2011.00009.Google Scholar
Max, W.P., MacKenzie, E.J.P., & Rice, D.P.S. (1991). Head injuries: Costs and consequences. Journal of Head Trauma Rehabilitation, 6, 7691.Google Scholar
Mazmanian, P.E., Kreutzer, J.S., Devany, C.W., & Martin, K.O. (1993). A survey of accredited and other rehabilitation facilities: Education, training and cognitive rehabilitation in brain-injury programmes. Brain Injury, 7 (4), 319331.Google Scholar
McDonald, S., Togher, L., Tate, R., Randall, R., English, T., & Gowland, A. (2013). A randomised controlled trial evaluating a brief intervention for deficits in recognising emotional prosody following severe ABI. Neuropsychological Rehabilitation, 23 (2), 267286. doi:10.1080/09602011.2012.751340.Google Scholar
National Institute of Neurological Disorders and Stroke (2013). Traumatic Brain Injury Information Page [Website]. Retrieved from https://www.ninds.nih.gov/Disorders/All-Disorders/Traumatic-Brain-Injury-Information-Page.Google Scholar
Pagan, E., Ownsworth, T., McDonald, S., Fleming, J., Honan, C., & Togher, L. (2015). A survey of multidisciplinary clinicians working in rehabilitation for people with traumatic brain injury. Brain Impairment, 16 (3), 173195.Google Scholar
Pattuwage, L., Olver, J., Martin, C., Lai, F., Piccenna, L., Gruen, R., & Bragge, P. (2017). Management of spasticity in moderate and severe traumatic brain injury: Evaluation of clinical practice guidelines. Journal of Head Trauma Rehabilitation, 32 (2), E1–E12. doi:10.1097/HTR.0000000000000234.Google Scholar
Ponsford, J., Bayley, M., Wiseman-Hakes, C., Togher, L., Velikonja, D., McIntyre, A., . . . Panel, I.E. (2014). INCOG recommendations for management of cognition following traumatic brain injury, part II: Attention and information processing speed. Journal of Head Trauma Rehabilitation, 29 (4), 321337. doi:10.1097/HTR.0000000000000072.Google Scholar
Ponsford, J., Downing, M.G., Olver, J., Ponsford, M., Acher, R., Carty, M., & Spitz, G. (2014). Longitudinal follow-up of patients with traumatic brain injury: Outcome at two, five, and ten years post-injury. Journal of Neurotrauma, 31 (1), 6477. doi:10.1089/neu.2013.2997.Google Scholar
Ponsford, J., Janzen, S., McIntyre, A., Bayley, M., Velikonja, D., Tate, R., & Panel, I.E. (2014). INCOG recommendations for management of cognition following traumatic brain injury, part I: Posttraumatic amnesia/delirium. Journal of Head Trauma Rehabilitation, 29 (4), 307320. doi:10.1097/HTR.0000000000000074.Google Scholar
Ponsford, J., Sloan, S., & Snow, P. (2012). Traumatic brain injury: Rehabilitation for everyday adaptive living (2nd ed.). New York, NY: Psychology Press.Google Scholar
Radice-Neumann, D., Zupan, B., Tomita, M., & Willer, B. (2009). Training emotional processing in persons with brain injury. Journal of Head Trauma Rehabilitation, 24 (5), 313323. doi:10.1097/HTR.0b013e3181b09160.Google Scholar
Rees, L., Marshall, S., Hartridge, C., Mackie, D., & Weiser, M. (2007). Cognitive interventions post acquired brain injury. Brain Injury, 21 (2), 161200. doi:10.1080/02699050701201813.Google Scholar
Sander, A.M., Caroselli, J.S., High, W.M. Jr., Becker, C., Neese, L., & Scheibel, R. (2002). Relationship of family functioning to progress in a post-acute rehabilitation programme following traumatic brain injury. Brain Injury, 16 (8), 649657.Google Scholar
Schonberger, M., Ponsford, J., Olver, J., Ponsford, M., & Wirtz, M. (2011). Prediction of functional and employment outcome 1 year after traumatic brain injury: A structural equation modelling approach. Journal of Neurology, Neurosurgery & Psychiatry, 82 (8), 936941. doi:10.1136/jnnp.2010.210021.Google Scholar
Sherer, M., Sander, A.M., Nick, T.G., High, W.M. Jr., Malec, J.F., & Rosenthal, M. (2002). Early cognitive status and productivity outcome after traumatic brain injury: Findings from the TBI model systems. Archives of Physical Medicine and Rehabilitation, 83 (2), 183192.Google Scholar
Shum, D., Fleming, J., Gill, H., Gullo, M.J., & Strong, J. (2011). A randomized controlled trial of prospective memory rehabilitation in adults with traumatic brain injury. Journal of Rehabilitation Medicine, 43 (3), 216223. doi:10.2340/16501977-0647.Google Scholar
Slomine, B., & Locascio, G. (2009). Cognitive rehabilitation for children with acquired brain injury. Developmental Disability Research Review, 15 (2), 133143. doi:10.1002/ddrr.56.Google Scholar
Sohlberg, M.M., Kennedy, M., Avery, J., Coelho, C., Turkstra, L., Ylvisaker, M., & Yorkston, K. (2007). Evidence-based practice for the use of external aids as a memory compensation technique. Journal of Medical Speech-Language Pathology, 15 (1), xv–li.Google Scholar
Sohlberg, M.M., & Mateer, C.A. (1987). Effectiveness of an attention-training program. Journal of Clinical and Experimental Neuropsychology, 9 (2), 117130. doi:10.1080/01688638708405352.Google Scholar
Spitz, G., Ponsford, J.L., Rudzki, D., & Maller, J.J. (2012). Association between cognitive performance and functional outcome following traumatic brain injury: A longitudinal multilevel examination. Neuropsychology, 26 (5), 604612. doi:10.1037/a0029239.Google Scholar
Tate, R., Kennedy, M., Ponsford, J., Douglas, J., Velikonja, D., Bayley, M., & Stergiou-Kita, M. (2014). INCOG recommendations for management of cognition following traumatic brain injury, part III: Executive function and self-awareness. Journal of Head Trauma Rehabilitaiton, 29 (4), 338352. doi:10.1097/HTR.0000000000000068.Google Scholar
Tavender, E.J., Bosch, M., Green, S., O'Connor, D., Pitt, V., Phillips, K., . . . Gruen, R.L. (2011). Quality and consistency of guidelines for the management of mild traumatic brain injury in the emergency department. Academic Emergency Medicine, 18 (8), 880889. doi:10.1111/j.1553-2712.2011.01134.x.Google Scholar
Togher, L., Wiseman-Hakes, C., Douglas, J., Stergiou-Kita, M., Ponsford, J., Teasell, R., . . . Panel, I.E. (2014). INCOG recommendations for management of cognition following traumatic brain injury, part IV: Cognitive communication. Journal of Head Trauma Rehabilitation, 29 (4), 353368. doi:10.1097/HTR.0000000000000071.Google Scholar
Twum, M., & Parente, R. (1994). Role of imagery and verbal labeling in the performance of paired associates tasks by persons with closed head injury. Journal of Clinical and Experimental Neuropsychology, 16 (4), 630639. doi:10.1080/01688639408402674.Google Scholar
Velikonja, D., Tate, R., Ponsford, J., McIntyre, A., Janzen, S., Bayley, M., & Panel, I.E. (2014). INCOG recommendations for management of cognition following traumatic brain injury, part V: Memory. Journal of Head Trauma Rehabilitation, 29 (4), 369386. doi:10.1097/HTR.0000000000000069.Google Scholar
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