Effectiveness of Interventions to Improve Occupational Performance for People With Psychosocial, Behavioral, and Emotional Impairments After Brain Injury: A Systematic Review

Wheeler, Steven; Acord-Vira, Amanda; Davis, Diana

doi:10.5014/ajot.115.020677

Cited by 23 publications

(36 citation statements)

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“…Befitting such a complex condition, the questions for the systematic reviews are wide ranging. They include examination of interventions to improve arousal and alertness after TBI (Padilla & Domina, 2016) and to treat visual and visualperceptual (Berger, Kaldenberg, Selmane, & Carlo, 2016); motor (Chang, Baxter, & Rissky, 2016); cognitive (Radomski, Anheluk, Bartzen, & Zola, 2016); and psychosocial, behavioral, or emotional (Wheeler, Acord-Vira, & Davis, 2016) dysfunction. Some of the primary outcomes of interest are specific to improvement in the impairment being treated, whereas others examine the effect of the intervention on occupational performance and participation.…”

Section: Contents Of the Special Issuementioning

confidence: 99%

“…One challenge is the need to address multiple interrelated impairments simultaneously, making it difficult to examine the effect of a single intervention on a single impairment (Berger et al, 2016;Chang et al, 2016). Another is the difficulty that the typical interdisciplinary or multidisciplinary nature of TBI rehabilitation brings to investigating the specific contribution of occupational therapy services (Powell et al, 2016;Wheeler et al, 2016). Several author teams highlight the need for better performance-and occupationbased outcome measures (Chang et al, 2016, Radomski et al, 2016Wheeler et al, 2016) and for increased use of these measures as primary study outcomes (Radomski et al, 2016).…”

Section: Contents Of the Special Issuementioning

confidence: 99%

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Special Issue on Occupational Therapy for Adults With Traumatic Brain Injury

Powell

2016

The American Journal of Occupational Therapy

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Awareness of the incidence and consequences of traumatic brain injury (TBI) has increased in recent years, along with interest in knowing how best to treat this complex condition. This editorial provides an overview of the various factors that contribute to the complexity of TBI and introduces the six systematic reviews and one qualitative study included in this special issue of the American Journal of Occupational Therapy focusing on interventions for TBI from an occupational therapy perspective. Issues with the generation and interpretation of research evidence are discussed, along with the importance of valuing clinician expertise and client perspectives along with research findings in implementing evidence-based and evidence-informed practice.

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Section: Contents Of the Special Issuementioning

confidence: 99%

Section: Contents Of the Special Issuementioning

confidence: 99%

Special Issue on Occupational Therapy for Adults With Traumatic Brain Injury

Powell

2016

The American Journal of Occupational Therapy

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“…However, for patients who can communicate at some basic level, emotional explosions and abnormal behaviors are often observed as nonverbal responses over the clinical course following neurorehabilitation [ 9 , 10 , 14 – 16 ]. Consequently, therapists and caregivers are adversely affected by this unsettling patient behavior that is based on insufficient communication [ 1 , 2 , 8 – 10 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Association between uncooperativeness and the glucose metabolism of patients with chronic behavioral disorders after severe traumatic brain injury: a cross-sectional retrospective study

Yamaki¹,

Suzuki

Sudo

et al. 2018

BioPsychoSocial Med

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BakgroundPatients with behavioral disorders following severe traumatic brain injury (sTBI) often have disorders of consciousness that make expressing their emotional distress difficult. However, no standard method for assessing the unsettled and unforeseen responses that are associated with behavioral disorders has yet to be established. Because the thalamus is known to play a role in maintaining consciousness and cognition, we used 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) to examine the association between brain glucose metabolism in the thalamus and behavioral disorders.MethodsWe retrospectively analyzed 70 consecutive patients with sTBI who had been involved in motor vehicle accidents. To assess behavioral disorders, we evaluated 18 symptoms using the Brief Psychiatric Rating Scale (BPRS): Emotional Withdrawal, Conceptual Disorganization, Tension, Mannerisms and Posturing, Motor Retardation, Uncooperativeness, Blunted Affect, Excitement, Somatic Concern, Anxiety, Feeling of Guilt, Grandiosity, Depressive Mood, Hostility, Suspiciousness, Hallucinatory Behavior, Unusual Thought Content, and Disorientation. First, we identified clinical characteristics of sTBI patients with behavioral disorders. Next, we retrospectively analyzed 18F-FDG-PET/CT data to assess how thalamic activity was related with abnormal behaviors.ResultsTwenty-six patients possessed the minimum communicatory ability required for psychiatric interview. Among them, 15 patients (57.7%) were diagnosed with behavioral disorder, 14 of whom had reached a stable psychiatric state after about 426.6 days of treatment. Excitement (13 patients) and uncooperativeness (10 patients) were the most frequently observed symptoms. Available 18F-FDG-PET/CT data indicated that thalamic glucose metabolism was imbalanced and lateralized (p = 0.04) in 6 patients who exhibited uncooperativeness.ConclusionsBehavioral symptoms of excitement and uncooperativeness were common in patients with sTBI, although most symptoms improved as the chronic stage continued. Our data support the idea that imbalanced laterality of glucose metabolism in the thalamus might be related to behavioral disorders characterized by uncooperativeness.Trial registrationUMIN 000029531. Registered 27 March 2017, retrospectively registered.Electronic supplementary materialThe online version of this article (10.1186/s13030-018-0125-0) contains supplementary material, which is available to authorized users.

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“…Occupational therapists work with adolescents and adults diagnosed with mental illness (Downing, 2006); those newly diagnosed with chronic diseases, such as diabetes (Pyatak et al, 2018); and those with a recent life-changing injury (spinal cord injuries and/or traumatic brain injuries) (Wheeler, Acord-Vira, & Davis, 2016). Since many of these clients are also concurrently in school or considering PSE, occupational therapists in the community may work on educational goals but without the ability to reinforce interventions in the environment where the interventions may be most effective.…”

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confidence: 99%

Mapping Occupational Therapy Practice with Postsecondary Students: A Scoping Review

Keptner¹,

McCarthy²

2020

The Open Journal of Occupational Therapy

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Background: Legislation supports a role for occupational therapy in postsecondary settings, but this area is not a common practice area and the practice area is not well understood. This scoping review maps current literature of occupational therapists working with students in postsecondary settings in order to inform future research and practice.Method: After identifying included articles, a narrative description of the quantitative studies along with a concept map were completed. A qualitative thematic analysis of the articles was also conducted.Results: Twenty-five articles met the inclusion criteria. Quantitative results describe occupational therapy services as both a direct and indirect service provided through offices of disability services, assistive technology, and supported education programs, among others. The primary population with whom occupational therapists engage with are students with mental illness. Three qualitative themes emerged from the scoping review, including the focus on occupation and skills needed for success, using the campus environment, and campus collaboration.Conclusion: The structure of occupational therapy services varies from location to location and occupational therapists work with various populations of students. Future research needs to support the distinct value of occupational therapy in this practice area, including the scope and outcomes of occupational therapy services with different populations of students. CommentsThe authors report that they have no conflicts of interest to disclose.

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Effectiveness of Interventions to Improve Occupational Performance for People With Psychosocial, Behavioral, and Emotional Impairments After Brain Injury: A Systematic Review

Abstract: An increasing body of evidence supports specific interventions to improve occupational performance and participation for people with psychosocial, behavioral, or emotional impairments after TBI.

Cited by 23 publications

References 39 publications

Special Issue on Occupational Therapy for Adults With Traumatic Brain Injury

Special Issue on Occupational Therapy for Adults With Traumatic Brain Injury

Association between uncooperativeness and the glucose metabolism of patients with chronic behavioral disorders after severe traumatic brain injury: a cross-sectional retrospective study

Mapping Occupational Therapy Practice with Postsecondary Students: A Scoping Review

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