Indian Journal of Neurotrauma 2017; 14(01): 006-014
DOI: 10.1055/s-0037-1602722
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Does Functionality Cease after Acquired Brain Injury? Vignettes from a Neuropsychosocial Perspective

Sakshi Chopra
1   Clinical Neuropsychology, Division of Clinical Psychology, All India Institute of Medical Sciences, New Delhi, India
,
Sumit Sinha
2   Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
,
Deepak Gupta
2   Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
,
Guru Dutta Satyarthee
2   Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
,
Deepak Agrawal
2   Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
,
Gaurishanker Kaloiya
3   Department of National Drug De-addiction And Treatment Centre, Division of Clinical Psychology, All India Institute of Medical Sciences, New Delhi, India
,
Rajesh Sagar
4   Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
,
Manjari Tripathi
5   Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
,
Ashima Nehra
1   Clinical Neuropsychology, Division of Clinical Psychology, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations
Further Information

Publication History

02 February 2017

29 March 2017

Publication Date:
19 May 2017 (online)

Abstract

Background The outcome of acquired brain injury (ABI) depends largely on the nature and severity of injury, appropriate treatment, and rehabilitation that plays a vital role in recovery.

Materials and Methods A total of 18 patients after ABI, aged 18 to 50 years, were assessed pre- and post-neuropsychological rehabilitation (NR) on various psychosocial functions. The patient-specific NR included an eclectic approach using cognitive retraining for memory, attention and concentration, executive functioning, perceptuomotor speed, motor dexterity, basic functional skill training, cognitive behavior therapy, rational emotive behavior therapy, relearning, relaxation therapy, assertiveness training, anger management, and vocational and individual counseling following a neuropsychosocial perspective.

Results The post-rehabilitation assessment revealed improvements of statistical and clinical significance in the score of on dysfunction analysis (t = 7.10) that was significant at 0.001 level. Significant improvements were found in each of the areas: social, vocational, personal, family, and cognitive as compared with pre-rehabilitation as described by the patient.

Discussion and Conclusion Eclectic approach to NR was successful in decreasing the overall dysfunction of the patients despite the severity of injury or the time elapsed after injury. Several therapeutic approaches have been used to assist individuals after brain injury, but more outcome studies are still needed to dictate which therapy works best, or if using an eclectic therapy is the key. The challenge is to make the therapy as person centered and individualistic as possible, depending on the individual needs as there is no “gold standard” for treatment for various issues arising following brain injury.

 
  • References

  • 1 Ontario Brain Injury Association. What Is Acquired Brain Injury. 2011; Retrieved 5 March 5
  • 2 King NS, Dean D. Neuropsychological rehabilitation following acquired brain injury. Clin Psychol Prac 2009; 152
  • 3 Savage RC. The ABI Handbook: serving students with acquired brain injury in higher education. J Head Trauma Rehabil 1989; 4 (01) 97-98
  • 4 The Brain Injury Association of Queensland. Acquired Brain Injury: The Facts. The Practical Guide to Understanding and Responding to Acquired Brain Injury and Challenging Behaviors. 4th ed. Brisbane, Australia: Synapse; 2013
  • 5 Ownsworth TL, Mcfarland K. Memory remediation in long-term acquired brain injury: two approaches in diary training. Brain Inj 1999; 13 (08) 605-626
  • 6 das Nair R, Lincoln N. Cognitive Rehabilitation for Memory Deficits following Stroke. The Cochrane Library; 2007
  • 7 das Nair R, Cogger H, Worthington E, Lincoln NB. Cognitive Rehabilitation for Memory Deficits after Stroke. The Cochrane Library; 2016
  • 8 Sohlberg MM, McLaughlin KA, Pavese A, Heidrich A, Posner MI. Evaluation of attention process training and brain injury education in persons with acquired brain injury. J Clin Exp Neuropsychol 2000; 22 (05) 656-676
  • 9 Evans JJ, Wilson BA, Needham P, Brentnall S. Who makes good use of memory aids? Results of a survey of people with acquired brain injury. J Int Neuropsychol Soc 2003; 9 (06) 925-935
  • 10 Mayo Clinic. http://www.mayoclinic.com/health/post-concussion-syndrome/DS01020 2011
  • 11 Leininger BE, Gramling SE, Farrell AD, Kreutzer JS, Peck III EA. Neuropsychological deficits in symptomatic minor head injury patients after concussion and mild concussion. J Neurol Neurosurg Psychiatry 1990; 53 (04) 293-296
  • 12 al-Adawi S, Powell JH, Greenwood RJ. Motivational deficits after brain injury: a neuropsychological approach using new assessment techniques. Neuropsychology 1998; 12 (01) 115-124
  • 13 Medd J, Tate RL. Evaluation of an anger management therapy programme following acquired brain injury: a preliminary study. Neuropsychol Rehabil 2000; 10 (02) 185-201
  • 14 Ownsworth TL, McFarland K, Mc Young R. Self-awareness and psychosocial functioning following acquired brain injury: an evaluation of a group support programme. Neuropsychol Rehabil 2000; 10 (05) 465-484
  • 15 Mazaux JM, Ricbourg B. Neuropsychologie: son apport dans l'expertise des traumatisés crâniens adultes. Rev Stomatol Chir Maxillofac 2006; 107 (04) 287-293
  • 16 Wilson BA. Neuropsychological rehabilitation. Annu Rev Clin Psychol 2008; 4 (01) 141-162
  • 17 Turner-Stokes L, Disler PB, Nair A, Wade DT. Multi-disciplinary rehabilitation for acquired brain injury in adults of working age. Cochrane Database Syst Rev 2005; (03) CD004170
  • 18 Dalton C, Farrell R, De Souza A. , et al. Patient inclusion in goal setting during early inpatient rehabilitation after acquired brain injury. Clin Rehabil 2012; 26 (02) 165-173
  • 19 Orman JAL, Kraus JF, Zaloshnja E, Miller T. Epidemiology. In: Silver JM, McAllister TW, Yudofsky SC. , eds. Textbook of Traumatic Brain Injury. 2nd ed. Washington, DC: American Psychiatric Pub; 2011: 3-22
  • 20 Castellanos-Pinedo F, Cid-Gala M, Duque P, Ramirez-Moreno JM, Zurdo-Hernández JM. ; Grupo de Trabajo del Plan de Atención al Daño Cerebral Sobrevenido de Extremadura. [Acquired brain injury: a proposal for its definition, diagnostic criteria and classification][in Spanish]. Rev Neurol 2012; 54 (06) 357-366
  • 21 Pershad D. Measurement of Dysfunction and Dysfunction Analysis Questionnaire (DAQ). National Psychological Corporation; 1985
  • 22 Wilson BA, Baddeley A, Evans J, Shiel A. Errorless learning in the rehabilitation of memory impaired people. Neuropsychol Rehabil 1994; 4 (03) 307-326
  • 23 Simpson G, Secheny T, Lane-Brown A, Strettles B, Ferry K, Phillips J. Post-acute rehabilitation for people with traumatic brain injury: a model description and evaluation of the Liverpool Hospital Transitional Living Program. Brain Impair 2004; 5 (01) 67-80
  • 24 Ellis A. Feeling Better, Getting Better, Staying Better: Profound Self-Help Therapy for Your Emotions. Impact Publishers; 2001
  • 25 Demark J, Gemeinhardt M. Anger and it's management for survivors of acquired brain injury. Brain Inj 2002; 16 (02) 91-108
  • 26 Starkstein SE, Robinson RG. Mechanism of disinhibition after brain lesions. J Nerv Ment Dis 1997; 185 (02) 108-114
  • 27 Martelli MF, Nicholson K, Zasler ND. Skill reacquisition after acquired brain injury: a holistic habit retraining model of neurorehabilitation. NeuroRehabilitation 2008; 23 (02) 115-126
  • 28 Kennedy MR, Turkstra L. Group intervention studies in the cognitive rehabilitation of individuals with traumatic brain injury: challenges faced by researchers. Neuropsychol Rev 2006; 16 (04) 151-159
  • 29 Cernich AN, Kurtz SM, Mordecai KL, Ryan PB. Cognitive rehabilitation in traumatic brain injury. Curr Treat Options Neurol 2010; 12 (05) 412-423
  • 30 Burns L. Cognitive rehabilitation following traumatic brain injury. Continuing Medical Education 2008; 26 (03) 160
  • 31 Timmermans AA, Spooren AI, Kingma H, Seelen HA. Influence of task-oriented training content on skilled arm-hand performance in stroke: a systematic review. Neurorehabil Neural Repair 2010; 24 (09) 858-870
  • 32 Alderman N. Contemporary approaches to the management of irritability and aggression following traumatic brain injury. Neuropsychol Rehabil 2003; 13 (1-2): 211-240
  • 33 http://www.brainline.org/content/2009/06/interventions-for-behavioral-problems-after-brain-injury_pageall.html
  • 34 Arundine A, Bradbury CL, Dupuis K, Dawson DR, Ruttan LA, Green RE. Cognitive behavior therapy after acquired brain injury: maintenance of therapeutic benefits at 6 months posttreatment. J Head Trauma Rehabil 2012; 27 (02) 104-112
  • 35 Sharma MP, Andrade C. Behavioral interventions for insomnia: theory and practice. Indian J Psychiatry 2012; 54 (04) 359-366
  • 36 Chen WC, Chu H, Lu RB. , et al. Efficacy of progressive muscle relaxation training in reducing anxiety in patients with acute schizophrenia. J Clin Nurs 2009; 18 (15) 2187-2196
  • 37 Tunks E. Managing pain caused by neurological disease. Can Fam Physician 1985; 31: 1487-1490
  • 38 Pologe B. About Psychotherapy. http://www.aboutpsychotherapy.com . 2001. Retrieved March 2004
  • 39 Cicerone KD, Dahlberg C, Malec JF. , et al. Evidence-based cognitive rehabilitation: updated review of the literature from 1998 through 2002. Arch Phys Med Rehabil 2005; 86 (08) 1681-1692
  • 40 Fadyl JK, McPherson KM. Approaches to vocational rehabilitation after traumatic brain injury: a review of the evidence. J Head Trauma Rehabil 2009; 24 (03) 195-212
  • 41 Cicerone KD, Mott T, Azulay J. , et al. A randomized controlled trial of holistic neuropsychologic rehabilitation after traumatic brain injury. Arch Phys Med Rehabil 2008; 89 (12) 2239-2249
  • 42 Carney N, Coudray du D. Cognitive rehabilitation outcomes for traumatic brain injury. In: Halligan PW, Wade DT. , eds. Effectiveness of Rehabilitation for Cognitive Deficits. New York, NY: Oxford University Press; 2005: 295-317
  • 43 Prigatano GP. Disturbances of self-awareness and rehabilitation of patients with traumatic brain injury: a 20-year perspective. J Head Trauma Rehabil 2005; 20 (01) 19-29
  • 44 Halligan PW, Wade DT. The Effectiveness of Rehabilitation for Cognitive Deficits. Oxford University Press; 2005
  • 45 Cattelani R, Zettin M, Zoccolotti P. Rehabilitation treatments for adults with behavioral and psychosocial disorders following acquired brain injury: a systematic review. Neuropsychol Rev 2010; 20 (01) 52-85
  • 46 Grilli MD, Glisky EL. Self-imagining enhances recognition memory in memory-impaired individuals with neurological damage. Neuropsychology 2010; 24 (06) 698-710
  • 47 Wegener ST. Sustaining Rehabilitation Outcomes: Helping People Flourish. Dun Laoghaire, Ireland: National Rehabilitation Hospital. Presentation on October 21, 2011