The functional recovery of 47 right-brain-damaged stroke patients was studied over a 2-year period. The researchers hypothesized that sustained attention capacity should predict the degree of motor and functional recovery over this period because of a proposed privileged role of sustained attention in learning-based recovery of function. As predicted, significant correlations were found between sustained attention capacity at 2 months and functional status (including the Barthel Index) at 2 years. This relationship was shown to exist independently of 2-month functional status. Furthermore, compared with a left-brain-damaged group of cerebrovascular accident (CVA) patients, the right-brain CVA group did not recover functional ability as well over the 2-year period. This increasing difference in functional status over a 2-year period was mirrored by an emerging difference in sustained attention capacity, in favor of the left-brain CVA group.
Using randomized control trial methodology, we evaluated the effectiveness of a 5-week cognitive-motor dual-tasking training program developed to improve performance of a group of people with dual-tasking difficulties arising from acquired brain injury. Training involved twice-daily practice on exercises involving walking being combined with tasks which increased in cognitive demand over the course of the intervention. A treatment group (n = 10) was compared with a control group (n = 9). The primary outcome measure was a task requiring participants to walk and carry out a spoken sentence verification task simultaneously. Secondary outcome measures were measures of dual-tasking involving either two motor tasks or two cognitive tasks. A questionnaire measure relating to activities of daily living requiring dual-tasking was also completed. Compliance with the training program was good. We found evidence of improvement in performance on the primary outcome measure, but little evidence of generalization to other measures. There was some evidence that participants believed that their dual-tasking performance in everyday life was improved after the intervention. The study was limited in terms of sample size, was not blinded and did not control fully for therapist contact time, but has produced valuable data relating to effect sizes associated with this form of intervention. (JINS, 2009, 15, 112-120.).
We examined a patient who was clinically much better at reporting tactile stimulation when he could see his stimulated hand. Experimentally, we found that he had difficulty detecting taps accompanied by a salient (but not predictive) light located directly above his concealed hand. However, his performance was dramatically improved if the light was attached to a rubber hand situated in line with the patient's hidden hand. Previous studies have suggested that tactile sensitivity can be improved by nearby visual stimulation. However, our effect shows that crossmodal sensory facilitation does not only depend upon simple spatial proximity alone. Rather, a simultaneous visual event dramatically improves perception of touch specifically when it is attributed to the perceiver's stimulated limb.
A randomized controlled trial of assisted intention monitoring for the rehabilitation of executive impairments following acquired brain injury. Neurorehabilitation and Neural Repair, 31(4), pp. 323-333. (doi:10.1177/1545968316680484) This is the author's final accepted version.There may be differences between this version and the published version.
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