Objective: To identify the systems available to sub-classify mild traumatic brain injury (TBI) and to determine their utility in predicting 1-year outcome.

Methods: A systematic review to identify mild-TBI sub-classification systems was conducted until March 2016. The identified systems were applied to a cohort of N = 290 adults who had experienced a mild-TBI, and who had been assessed for post-concussion symptoms 1-year post injury. ANOVAs and regression models were used to determine whether each sub-classification system could distinguish between outcomes and to explore their contribution to explaining variance in post-concussion symptoms 1-year post injury.

Results: Nineteen sub-classification systems for mild-TBI met the inclusion criteria for this review. The Saal (1991) classification system significantly differentiated the experience of post-concussion symptoms in our cohort 1-year post injury (F = 2.39, p = 0.05). However, the findings did not remain significant following correction for multiple comparisons and inclusion of socio-demographic and contextual factors in the regression model.

Conclusions: Current sub-classification systems fail to explain much of the variance in post-concussion symptoms 1 year following mild-TBI. Further research is needed to identify the factors (including socio-demographic and contextual factors) to determine, who may be at risk of developing persistent post-concussion symptoms.

This experimental study with a controlled pre-test and post-test group design investigated the possible effects of four sessions of heading training on cognitive performance. A total of 118 participants (mean age of 22.25 years) were assigned to one of the three following groups: a heading-training group, a passing-training group and a waiting control group. The participants completed a cognitive test battery of attention (D2-test), working memory (Paced Auditory Serial Addition Task, PASAT-2) and visual spatial intelligence (Mental Rotation Test) tests before, immediately after the second training session and one week after the fourth training session. There were no between-group differences in cognitive performance after the second or the fourth heading training sessions. However, within the heading-training group, women complained more of headaches than men after the fourth training session. These results build on the results from the study of Rieder and Jansen (2011) that showed no neuropsychological consequences after one heading session, showing no cumulative effects of repeat heading.

Objective: To develop a tool for assessing intentions to continue or change activities for recovery following mild traumatic brain injury (mTBI) and determine if they are dependent on injury context or activity type. Method: Adult volunteers with no (or no recent) history of mTBI were randomly allocated to one of two vignette conditions, each with a different injury context. The vignette described an mTBI due to a motor vehicle accident (MVA, n = 76) or sport (SPORT, n = 89). Volunteers reported their rest or activity plans for 39 behaviours comprising three behaviour types (cognitive, physical, and restful). Results: Compared to a cut-score representing no change, on average there was a significant (p <= .001) planned decrease in physical and cognitive behaviours (MVAphysicalt(53) = 7.373; SPORTphysicalt(41) = 9.281; MVAcognitivet(41) = 9.367; SPORTcognitivet(51) = −3.521) and a significant planned increase in restful behaviours, such as sleep (MVArestfult(72) = 10.006; SPORTrestfult(86) = 9.566). An overall within-group effect for behaviour-type was not identified and there was no effect of condition (MVA vs. SPORT). Conclusion: The acute rest and activity plans for a simulated mTBI are behaviour specific and not dependent on context. An expectation for blanket-rest was not was observed but rest was planned for specific behaviours. This tool could be used to guide discussions with mTBI patients about their recovery so that their plans align with advice, and it could aid further research into the relation between intended and actual rest and activity and the effect on eventual outcomes.

Objective: Adults are at risk for unemployment following a moderate-severe traumatic brain injury (TBI). Less is known about employment patterns following mild TBI. This study aims to examine patterns of return to pre-injury job in adults following mild TBI over a 12-month post injury period, and to investigate factors associated with return to work. Methods: It is a prospective longitudinal study of 205 adults (aged ≥16 years at injury) identified as part of a larger population-based incidence study in the Waikato, New Zealand. In-person assessments were completed at baseline (within 14 days) and 1-, 6-, and 12-month post-injury. Results: A total of 159 (77.6%) adults returned to their pre-injury job at baseline and 185 (90.2%) returned within 12 months. Of those who did not return to their pre-injury job at baseline (n = 46), younger age at injury (≤30 years, p = .02) and poor overall neurocognitive functioning at 1-month (p = .02) was associated with non-return to pre-injury job at 12 months. Conclusion: In a sample of employed adults, the majority returned to their pre-injury job shortly after injury. Cognitive functioning and younger age at time of injury may be associated with delayed return to work. Interventions to support younger workers may facilitate their return to work.

Background and aims: Many sustaining traumatic brain injury (TBI) suffer ongoing post-concussion symptoms (PCS). The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) is widely used, although there is disagreement about its structure. This study compared the fit of published RPQ structures with a four-factor structure derived from a large adult sample with TBI in Tasmania.

Method: 661 adults with TBI completed the RPQ at approximately one month post injury. Exploratory factor analysis (EFA), using the first half of the sample (n = 330), suggested a four-factor solution. This was compared with models reported in the literature with the second half of the sample (n = 331), using structural equation modelling. Trajectory of recovery across these factors was examined within subsamples at 1, 3, 6 and 12 months following TBI.

Results: Inter-correlations between items were strongest for somatic, cognitive and emotional functioning items and the EFA identified a four-factor model. Fit was examined utilising bootstrapping for model comparison. The data at 1 month following TBI best fitted the four-factor model (CFI = .95, RMSEA = .060 (.049–.071) and factors had adequate internal consistency (r = .61–.89). This model appeared a good fit and clinically useful across time points to 12 months post injury.

Conclusions: Data best fitted a four-factor model, identified using a rigorous statistical approach. Clinicians and clinical researchers may use this preferred model to provide more specific measurement of the severity of PCS. Future research could attempt replication within international samples.

A stroke can have implications for all areas of a person's life. In research on adaptation to stroke, finding meaning is associated with better adaptation. This study focuses on one of the driving principles behind meaning-making processes: global meaning. The aim of this study was to explore whether global meaning (i.e., fundamental beliefs and life goals concerning core values, relationships, worldview, identity and inner posture) is associated with processes and outcomes of rehabilitation, as experienced by people with stroke. In-depth, semi-structured interviews were conducted, and analysed using qualitative research methods. Aspects of global meaning were associated with the following elements of process and outcome of rehabilitation: motivation, handling stress and emotions, physical functioning and acceptance. The influence was mostly positive. If rehabilitation professionals took global meaning into account, respondents tended to associate this with better or faster recovery.

Objective: To examine whether elbow coordination training can improve elbow coordination in cerebral palsy and whether any benefit carries over to upper limb activity.

Methods: A case series A–B–C multiple baseline study was carried out. Two weeks of no intervention (A) was followed by 2 weeks of computerised tracking (B), which was followed by 2 weeks of no intervention (C). Six children (age range 7–12 years) with hemiplegic cerebral palsy (Level I–III of the Manual Ability Classification System) participated. Coordination training consisted of 10 × 1-min trials of computerised tracking each session for 10 sessions over a 2-week period. Coordination was measured as tracking performance using a different target from the training target. Upper limb activity was measured using the 9-Hole Peg Test. Data were analysed using the 2-SD band method.

Results: None of the participants appeared to improve tracking performance or 9-Hole Peg Test (9HPT) scores (p > 0.05) after the 2 weeks of intervention. On withdrawal of the intervention, visual analysis showed that tracking performance and 9HPT scores remained at the same level as the intervention phase.

Conclusions: Ten minutes of computerised elbow tracking daily for 10 sessions did not improve coordination in six children with cerebral palsy.