Effectiveness of holistic neuropsychological rehabilitation for Spanish population with acquired brain injury measured using Rasch analysis

Abstract

Introduction: The Rasch model is increasingly used in the field of rehabilitation because it improves the accuracy of measurements of patient status and their changes after therapy. Objective: To determine the long-term effectiveness of a holistic neuropsychological rehabilitation program for Spanish outpatients with acquired brain injury (ABI) using Rasch analysis. Methods: Eighteen patients (ten with long evolution -patients who started the program >6 months after ABI-and eight with short evolution) and their relatives attended the program for 6 months. Patients' and relatives' answers to the European Brain Injury Questionnaire and the Frontal Systems Behavior Scale at 3 time points (pre-intervention. post-intervention and 12 month follow-up) were transformed into linear measures called logits. Results: The linear measures revealed significant improvements with large effects at the follow-up assessment on cognitive and executive functioning, social and emotional self-regulation, apathy and mood. At follow-up, the short evolution group achieved greater improvements in mood and cognitive functioning than the long evolution patients. Conclusions: The program showed long-term effectiveness for most of the variables, and it was more effective for mood and cognitive functioning when patients were treated early. Relatives played a key role in the effectiveness of the rehabilitation program.

Evidence-Based Cognitive Rehabilitation: Systematic Review of the Literature From 2009 Through 2014

“…The current evidence is consistent with our existing recommendation that post-acute, comprehensive-holistic neuropsychological rehabilitation should be provided to reduce functional, cognitive and psychosocial disability after TBI (Practice Standard). Whereas the previous research focused on individuals with TBI, the present results support extending the recommendation to individuals with both traumatic and non-traumatic brain injuries, regardless of severity or time post injury 128,[138][139][140][141]. Comprehensive neuropsychological programs should integrate individualized interventions to address cognitive and interpersonal functioning after…”

“…In addition, the presence of co-morbid PTSD or depressive symptoms should not preclude participation in cognitive rehabilitation interventions in this population 150. Current findings from 1 Class II 128 and 2 Class III138,139 studies support and extend existing evidence showing that individualized comprehensive multidisciplinary neurorehabilitation programs may lead to significantly improved short and long term functional, cognitive and psychosocial outcomes in the areas of independent living, societal participation (including occupational functioning), and self-reports of emotional well-being and quality of life.…”

“…injury is associated with greater improvements in mood, cognitive functioning, quality of life 138,142 and better functional outcomes 140, than treatment that begins late post-injury.…”

George P. Prigatano’s contributions to neuropsychological rehabilitation and clinical neuropsychology: A 50-year perspective

“…Ben-Yishay. In the first decade of the twenty-first century, a clinical research project is now being developed at the Virgen de las Nieves Hospital of Granada (Spain) (Caracuel Romero et al, 2005;Caracuel et al, 2012).…”