Rehabilitation and Therapy Commons^™

A Tailored Occupational Therapist-Led Vocational Intervention For People With Stroke: Protocol For A Pilot Randomized Controlled Trial, Sophie O'Keefe, Kathryn Radford, Amanda Farrin, Jodi Oakman, Serena Alves-Stein, Geoffrey Cloud, Jacinta Douglas, Mandy Stanley, Natasha A. Lannin

Research outputs 2022 to 2026

Background: Resuming work after stroke is a common goal of working-age adults, yet there are few vocational rehabilitation programs designed to address the unique challenges faced following stroke. The Work intervention was developed to address these gaps. Objective: This paper presents a protocol that outlines the steps that will be undertaken to pilot both the intervention and trial processes for the Work trial. Methods: The Work trial is a 2-arm, prospective, randomized, blinded-assessor study with intention-to-treat analysis. A total of 54 adults of working age who have experienced a stroke <4 months prior will be randomized 1:1 to either (1) an experimental group who will receive a 12-week early vocational intervention (Work intervention) plus usual clinical rehabilitation or (2) a control group who will receive only their usual clinical rehabilitation. Results: Outcomes include study and intervention feasibility and intervention benefit. In addition to evaluating the feasibility of delivering vocational intervention early after stroke, benefit will be assessed by measuring rates of vocational participation and quality-of-life improvements at the 3- and 6-month follow-ups. Process evaluation using data collected during the study, as well as postintervention individual interviews with participants and surveys with trial therapists, will complement quantitative data. Conclusions: The results of the trial will provide details on the feasibility of delivering the Work intervention embedded within the clinical rehabilitation context and inform future trial processes. Pilot data will enable a future definitive trial to determine the clinical effectiveness of vocational rehabilitation when delivered in the early subacute phase of stroke recovery.

Age-Dependent White Matter Disruptions After Military Traumatic Brain Injury: Multivariate Analysis Results From Enigma Brain Injury, Heather C. Bouchard, Delin Sun, Emily L. Dennis, Mary R. Newsome, Seth G. Disner, Jeremy Elman, Annelise Silva, Carmen Velez, Andrei Irimia, Nicholas D. Davenport, Scott R. Sponheim, Carol E. Franz, William S. Kremen, Michael J. Coleman, M. Wright Williams, Elbert Geuze, Inga K. Koerte, Martha E. Shenton, Maheen M. Adamson, Raul Coimbra, Gerald Grant, Lori Shutter, Mark S. George, Ross D. Zafonte, Thomas W. Mcallister, Murray B. Stein, Paul M. Thompson, Elisabeth A. Wilde, David F. Tate, Aristeidis Sotiras, Rajendra A. Morey

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Mild Traumatic brain injury (mTBI) is a signature wound in military personnel, and repetitive mTBI has been linked to age-related neurogenerative disorders that affect white matter (WM) in the brain. However, findings of injury to specific WM tracts have been variable and inconsistent. This may be due to the heterogeneity of mechanisms, etiology, and comorbid disorders related to mTBI. Non-negative matrix factorization (NMF) is a data-driven approach that detects covarying patterns (components) within high-dimensional data. We applied NMF to diffusion imaging data from military Veterans with and without a self-reported TBI history. NMF identified 12 independent components derived from fractional …

The Role Of Reported Affective Symptoms And Anxiety In Recovery Trajectories After Sport-Related Concussion, Bernadette A. D'Alonzo, Abigail C. Bretzin, Douglas J. Wiebe, Ivy League–Big Ten Epidemiology Of Concussion Study Investigators, Arthur C. Maerlender, Cary R. Savage

Center for Brain, Biology, and Behavior: Faculty and Staff Publications

Background: There is growing awareness and clinical interest in athletes with affective symptoms after sport-related concussion (SRC), as these symptoms may contribute to overall symptoms and represent a modifiable risk factor of longer recovery. However, evidence of their effects on the entire return-to-play (RTP) trajectory, particularly among women and men, is limited.

Purpose/Hypothesis: To examine the relationship between affective symptom reporting and RTP progression after SRC among a cohort of Division 1 student-athletes. We hypothesized that those endorsing affective symptoms, specifically nervous-anxious symptoms, spend more time in RTP progression and recovery.

Study Design: Cohort study; Level of evidence, 3.

Methods: …

Understanding Advocacy For Promoting Occupational Engagement Among Individuals With Disabilities, Rebecca L. Benson

Occupational Therapy Capstone Presentations

Advocacy can greatly affect many individuals throughout the community in their ability to engage in occupations. Individuals’ with disabilities engagement in daily activities (occupations) is greatly affected by their diagnosis whether it be physical, psychological, or developmental. This population experiences disadvantages due to many barriers in society including physical, sensual, visual, and cognitive barriers as well as societal attitudes, and absence of policy and implementation. These disadvantages are not always recognized or known by the general public despite the number of individuals who are impacted. The lack of knowledge creates a need for advocacy, education, and training of the community …

Insufficient Sleep Following Pediatric Mild Traumatic Brain Injury Correlates With Neurocognitive Dysfunction, Bailey Hull, Patrick Karabon, Neal Alpiner

Posters

INTRODUCTION
Sleep disturbance of any nature is reported in more than half of all mild traumatic brain injury (mTBI) patients. The pathophysiology of sleep disturbance following an mTBI is associated with structural and functional disruptions of sleep circuitry and circadian rhythm. Specifically, in the pediatric population, untreated sleep disturbance has been shown to delay mTBI recovery and compound other morbidities including neurocognitive dysfunction. It was our goal to further analyze the impact sleep disturbance has on neurocognitive function in children recovering from an mTBI.

Functional Cognition: An Opportunity To Highlight The Role Of Occupational Therapy In Post-Concussion Care, Rachel Taylor Postma, John V. Rider, Robyn Otty

The Open Journal of Occupational Therapy

As concern surrounding concussion and the associated long-term effects grow, a continued need for comprehensive, holistic concussion care emerges. Occupational therapists are well-equipped to address the wide variety of symptoms and deficits that clients may experience post-concussion. Functional cognition is one area in which occupational therapists can demonstrate their unique value on the interdisciplinary treatment team. In this Opinions in the Profession paper, we describe how occupational therapists are poised to further establish their role in post-concussion care by becoming the primary discipline for assessing and treating functional cognition. The aim of this paper is to outline the role of …

Women’S Self-Concept, Sexual Activity, And Intimacy After Sustaining A Traumatic Brain Injury, Erin Skotzke

The Open Journal of Occupational Therapy

A traumatic brain injury (TBI) can have a profound impact on how people think and feel about themselves and their abilities, values, goals, personalities, physical characteristics, and roles. Preliminary research findings suggest that barriers to developing a positive self-concept after injury in women include the desire to be perceived as “normal” after the injury or the feeling that society dismisses their injuries. In the field of occupational therapy, it is critical that therapists and researchers understand that self-concept can be altered after sustaining a TBI. This outcome can have a significant impact on participation in valued occupations, including participation in …

Practice Guidelines: Addressing Vestibular And Visual Problems In The Neurologically Impaired Adult, Mary J. Mcguire

The Open Journal of Occupational Therapy

The visual and vestibular problems experienced by adults post brain injury (concussion, traumatic brain injury, cerebral vascular accident, tumor removal, etc.) must be evaluated and treated in conjunction with each other for best outcomes. The American Occupational Therapy Association’s (AOTA) Practice Framework categorizes both the visual and vestibular sensory systems as client factors (body functions) that are a part of the scope of practice of occupational therapy (AOTA, 2020). AOTA’s statement on vestibular impairment, vestibular rehabilitation, and occupational performance emphasizes the importance of occupational therapists addressing this critical client factor. The skills of entry-level and advanced-level occupational therapists are outlined …

Occupational Therapy Return To Work Program For Individuals Following A Traumatic Brain Injury, Kalynn R. Johnson, Lisa Griggs-Stapleton

Spring 2022 Virtual OTD Capstone Symposium

Individuals with a traumatic brain injury (TBI) often experience difficulty returning to the workforce and lack the necessary resources to facilitate a successful return to work. This capstone project focuses on developing a resource that equips occupational therapists with tools and resources to provide valuable and effective return to work services for this population.

The Effect Of Concussion History On Lower Extremity Injury Risk In College Athletes: A Systematic Review And Meta Analysis, Vanessa Ramirez, Ryan Mccann, Eric Schussler, Jessica Martinez

Rehabilitation Sciences Faculty Publications

INTRODUCTION: Collegiate athletes who suffer a concussion may possess prolonged impairments even after clearance for return-to-participation, which may place them at an increased risk of lower extremity injury.

OBJECTIVE: To conduct a systematic review and meta-analysis of studies examining risk of lower extremity musculoskeletal injury following a concussion in collegiate athletes.

METHODS: A literature search was performed using the following databases: PubMed, CINAHL, SPORTDiscus. The following search terms were used to identify relevant articles, ["concussion" OR "brain injury" OR "mild traumatic brain injury" OR "mTBI"] AND ["lower extremity injury" OR "musculoskeletal injury"]. Articles were included if they were published between …