Psychosocial functioning mediates change in motor and cognitive function throughout neurorehabilitation for adults with acquired brain injury (ABI-RESTaRT)

Abstract

Objectives This study aimed to evaluate the mediational role of change in psychosocial abilities, adjustment and participation on change in motor and cognitive function from admission to discharge from a staged community-based brain injury rehabilitation (SCBIR) service in Western Australia, 2011–2020. Methods A retrospective cohort study of n = 324 adults with ABI enrolled in SCBIR using routinely collected rehabilitation outcome measures data. Motor and cognitive function were assessed with the UK Functional Independence and Assessment Measure and psychosocial function with the Mayo-Portland Adaptability Inventory-4. Six multilevel mediation regression analyses were conducted to determine whether change in psychosocial function (abilities, adjustment and participation) mediated change in motor and cognitive function from admission to discharge. Results Participants demonstrated clinically significant improvements in both motor (+ 11.8, p < 0.001) and cognitive (+ 9.5, p < 0.001) functioning from admission to discharge. Statistically significant improvements in psychosocial abilities (− 4.8, p < 0.001), adjustment (− 2.9, p = 0.001) and participation (− 2.5, p < 0.001) were also seen but were not clinically significant. Mediation analyses showed that participation accounted for 81% of improvements in motor function at discharge and 71% of cognitive function improvements. Adjustment accounted for 26% and 32% of change in motor and cognitive function, respectively. Abilities accounted for 60% of change in cognitive function but did not significantly influence change in motor function. Changes in psychosocial participation fully mediated change in motor function during neurorehabilitation. Conclusions Psychosocial function, particularly participation, is an important driver of motor and cognitive recovery throughout neurorehabilitation. Functional rehabilitation programs should target psychosocial improvement as an important mechanism of change.

CogniChallenge: Multiplayer serious games’ platform for cognitive and psychosocial rehabilitation

“…This platform is no longer available. However, the focus on psychosocial adjustment appears to be an integral component of the rehabilitation process, as found by a recent study, psychosocial functioning (e.g., social and recreational activities) mediates changes in motor (explaining 81.3% of motor improvements), and cognitive (explaining 70.7% of cognitive improvements) function during neurorehabilitation [16].…”

IMproving psYchosocial adjustment to Traumatic Brain Injury from acute to chronic injury through development and evaluation of themyTBIonline psychoeducation platform: protocol for a mixed-methods study

“…25 26 In particular, the transitions from acute injury (managed in intensive care and acute hospital units) to subacute (managed in inpatient or outpatient services) and chronic phases of injury (managed in communitybased and long-term care services) have been identified as known risk periods for TBI survivors 27 as gaps in support and continuity of care are more likely to occur. 28 Individuals with inadequate support and poor psychosocial adjustment during these transition periods risk poorer long-term outcomes including poorer global functional improvement, 29 reduced likelihood of returning to work, 30 rehospitalisation or institutionalisation, 26 and increased mortality. 27 Clinically, the importance of psychosocial care for individuals with physical illnesses to enhance physical recovery and outcomes has gained increasing recognition.…”

Neurorehabilitation Success: How Personality Influences Recovery

“…While the effectiveness of various neurorehabilitation techniques has been extensively studied (Albert & Kesselring, 2011;Bartolo, 2023;Boccuni et al, 2022;Huang & Krakauer, 2009;Knecht et al, 2015;Mann et al, 2023;Micera et al, 2020;Pasquini et al, 2022;Sartori et al, 2016;Signal et al, 2023;Viruega & Gaviria, 2022;Young et al, 2021), the role of personality in influencing recovery outcomes remains an intriguing and underexplored area. This letter aims to highlight the significance of personality traits in neurorehabilitation success and to suggest how incorporating personality assessments into rehabilitation programs can enhance recovery outcomes.…”

“…In contrast, individuals with high levels of neuroticism may experience heightened anxiety and stress, which can impede their progress in rehabilitation (Abraham et al, 2022;Ansari et al, 2021;Mosadegh et al, 2023). Mann et al (2023) explored the psychosocial functioning and its mediation of motor and cognitive function changes in neurorehabilitation. Their findings suggest that personality traits significantly impact how patients cope with the rehabilitation process and their overall recovery trajectory.…”

“…Their findings suggest that personality traits significantly impact how patients cope with the rehabilitation process and their overall recovery trajectory. This underscores the need for personalized rehabilitation programs that consider individual personality profiles (Mann et al, 2023).…”