Updated Canadian Clinical Practice Guideline for the Rehabilitation of Adults With Moderate to Severe Traumatic Brain Injury: Behavioral Recommendations.

Objective: Behavioral changes following moderate to severe traumatic brain injury (MSTBI) are common and can include agitation or aggression, reduced arousal or apathy, and inappropriate sexual behavior. These changes can negatively affect recovery, function, and quality of life. Pharmacological and nonpharmacological interventions are often used to address these challenges; however, there is limited evidence regarding the effectiveness of these treatments.

Updated Canadian Clinical Practice Guideline for the Rehabilitation of Adults With Moderate to Severe Traumatic Brain Injury: Mental Health Recommendations.

Objective: Objective: After sustaining a moderate to severe traumatic brain injury (MSTBI), individuals often experience comorbid mental health conditions that can impair the rehabilitation and recovery process. The objective of this initiative was to update recommendations on the assessment and management of mental health conditions for the Canadian Clinical Practice Guideline for the Rehabilitation of Adults with MSTBI (CAN-TBI 2023).

Objective: Design: A systematic search was conducted by the Evidence-Based Review of Moderate to Severe Acquired Brain Injury to identify new and relevant articles.

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part V: Memory.

Introduction: Memory impairments affecting encoding, acquisition, and retrieval of information after moderate-to-severe traumatic brain injury (TBI) have debilitating and enduring functional consequences. The interventional research reviewed primarily focused on mild to severe memory impairments in episodic and prospective memory. As memory is a common focus of cognitive rehabilitation, clinicians should understand and use the latest evidence.

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part II: Attention and Information Processing Speed.

Introduction: Moderate to severe traumatic brain injury (MS-TBI) commonly causes disruption in aspects of attention due to its diffuse nature and injury to frontotemporal and midbrain reticular activating systems. Attentional impairments are a common focus of cognitive rehabilitation, and increased awareness of evidence is needed to facilitate informed clinical practice.

Methods: An expert panel of clinicians/researchers (known as INCOG) reviewed evidence published from 2014 and developed updated guidelines for the management of attention in adults, as well as a decision-making algorithm, and an audit tool for review of clinical practice.

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part I: Posttraumatic Amnesia.

Introduction: Posttraumatic amnesia (PTA) is a common occurrence following moderate to severe traumatic brain injury (TBI) and emergence from coma. It is characterized by confusion, disorientation, retrograde and anterograde amnesia, poor attention and frequently, agitation. Clinicians and family need guidelines to support management practices during this phase.

INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: Methods, Overview, and Principles.

Introduction: Moderate to severe traumatic brain injury (TBI) results in complex cognitive sequelae. Despite hundreds of clinical trials in cognitive rehabilitation, the translation of these findings into clinical practice remains a challenge. Clinical practice guidelines are one solution.

Protocol for a living systematic review for the management of concussion in adults.

Introduction: Concussion/mild traumatic brain injury (mTBI) often presents initially with disabling symptoms that resolve, but for an unfortunate minority some of these symptoms may become prolonged. Although research into diagnosis and interventions for concussion is increasing, study quality overall remains low. A living systematic review that is updated as evidence becomes available is the ideal research activity to inform a living guideline targeting clinicians and patients.

Experiences of inpatient rehabilitation from the perspective of persons with acquired brain injury.

Background: Perspectives of individuals with acquired brain injury (ABI) regarding inpatient rehabilitation experiences can inform patient-centered care; however, these voices are under-represented in the literature.

Purpose: To explore the experiences, needs, and preferences of patients from an ABI inpatient rehabilitation program in Ontario.

Methods: Using an interpretive description approach, we interviewed 12 participants and analyzed the transcripts inductively to generate themes.

Motivation in rehabilitation and acquired brain injury: can theory help us understand it?

In acquired brain injury (ABI) populations, low motivation to engage in rehabilitation is associated with poor rehabilitation outcomes. Motivation in ABI is thought to be influenced by internal and external factors. This is consistent with Self-determination Theory, which posits that motivation is intrinsic and extrinsic.

Psychometric properties of measures of motivation and engagement after acquired brain injury.

Objective: This study investigated psychometric properties of the Motivation for Traumatic Brain Injury Rehabilitation Questionnaire (MOT-Q), the Brain Injury Rehabilitation Trust Motivation Questionnaire-Self (BMQ-S), the Rehabilitation Therapy Engagement Scale-Revised (RTES-R), and the BMQ-Relative (BMQ-R) in individuals with an acquired brain injury (ABI).

Design: Thirty-nine patients with an ABI completed the MOT-Q, BMQ-S, measures of apathy (Apathy Evaluation Scale-Self), insight (Patient Competency Rating Scale-Self), depression, and anxiety (HADS). Twenty clinicians provided 39 ratings using the RTES-R, BMQ-R, measures of patient apathy (Apathy Evaluation Scale-Clinician) and insight (Patient Competency Rating Scale-Clinician).

Evaluating change in virtual reality adoption for brain injury rehabilitation following knowledge translation.

Purpose: To evaluate the impact of knowledge translation (KT) on factors influencing virtual reality (VR) adoption and to identify support needs of therapists.

Hypotheses: Intervention will be associated with improvements in therapists' perceived ease of use and self-efficacy, and an associated increase in intentions to use VR.

Method: Single group mixed-methods pre-test-post-test evaluation of convenience sample of physical, occupational and rehabilitation therapists (n=37) from two brain injury rehabilitation centres.

Promoting Therapists' Use of Motor Learning Strategies within Virtual Reality-Based Stroke Rehabilitation.

Purpose: Therapists use motor learning strategies (MLSs) to structure practice conditions within stroke rehabilitation. Virtual reality (VR)-based rehabilitation is an MLS-oriented stroke intervention, yet little support exists to assist therapists in integrating MLSs with VR system use.

Method: A pre-post design evaluated a knowledge translation (KT) intervention incorporating interactive e-learning and practice, in which 11 therapists learned how to integrate MLSs within VR-based therapy.

Assessing the validity of Task Analysis as a quantitative tool to measure the efficacy of rehabilitation in brain injury.

Background: Inpatient rehabilitation with patients who have sustained an acquired brain injury (ABI), including traumatic brain injury (TBI), focuses on improving performance in activities of daily living (ADLs). Although not studied to date in patients with ABI/TBI, Task Analysis (TA) integrates assessment and the prompting/cueing levels required to complete various tasks, with the goal to achieve effective skill acquisition and rehabilitation planning. TA has demonstrated efficacy in teaching life skills in individuals with developmental disabilities and in this study is applied to teaching ADL skills in ABI/TBI rehabilitation.

A knowledge translation intervention to enhance clinical application of a virtual reality system in stroke rehabilitation.

Background: Despite increasing evidence for the effectiveness of virtual reality (VR)-based therapy in stroke rehabilitation, few knowledge translation (KT) resources exist to support clinical integration. KT interventions addressing known barriers and facilitators to VR use are required. When environmental barriers to VR integration are less amenable to change, KT interventions can target modifiable barriers related to therapist knowledge and skills.

Updated clinical practice guidelines for concussion/mild traumatic brain injury and persistent symptoms.

Objective: To introduce a set of revised guidelines for the management of mild traumatic brain injury (mTBI) and persistent symptoms following concussive injuries.

Quality Of Evidence: The Guidelines for Mild Traumatic Brain Injury and Persistent Symptoms were made available in March 2011 based on literature and information up to 2008. A search for new clinical practice guidelines addressing mTBI and a systematic review of the literature evaluating treatment of persistent symptoms was conducted.

Long-Term Health Service Outcomes Among Women With Traumatic Brain Injury.

Objectives: To (1) assess long-term health care service utilization and satisfaction with health care services among women with traumatic brain injury (W-TBI); (2) examine barriers that prevent W-TBI from receiving care when needed; and (3) understand the perceived supports available for W-TBI.

Design: Retrospective cohort study.

Setting: Community.

Using virtual reality in clinical practice: A multi-site exploratory study.

Background: Virtual reality (VR) is a relatively new treatment tool with emerging evidence supporting its use in neurorehabilitation, although no information exists about how therapists use VR clinically.

Objective: This study's purpose was to document current practice in GestureTek VR use for inpatient acquired brain injury (ABI) rehabilitation as a benchmark for clinicians integrating the approach into practice, and to inform future research to improve its clinical applicability.

Methods: As part of a larger study examining barriers and facilitators to VR use, participating therapists at two rehabilitation centres documented descriptive data about client demographics and VR treatment programme characteristics for 29 ABI clients on their caseloads over eight months.

INCOG recommendations for management of cognition following traumatic brain injury, part V: memory.

Introduction: Traumatic brain injury results in complex cognitive sequelae. Impairments in memory are among the most common sequelae resulting in significant functional problems. An international team of researchers and clinicians (known as INCOG) was formed to develop recommendations for the management of impairments in memory.

INCOG recommendations for management of cognition following traumatic brain injury, part III: executive function and self-awareness.

Introduction: Traumatic brain injury (TBI) results in complex cognitive (and other) sequelae. Impairments in executive function and self-awareness are among the most characteristic neuropsychological sequelae and can exert a profound effect on resuming previous life roles. An international group of researchers and clinicians (known as INCOG) convened to develop recommendations for interventions to improve impairments in executive functioning and self-awareness after TBI.

INCOG recommendations for management of cognition following traumatic brain injury, part II: attention and information processing speed.

Introduction: Traumatic brain injury, due to its diffuse nature and high frequency of injury to frontotemporal and midbrain reticular activating systems, may cause disruption in many aspects of attention: arousal, selective attention, speed of information processing, and strategic control of attention, including sustained attention, shifting and dividing of attention, and working memory. An international team of researchers and clinicians (known as INCOG) convened to develop recommendations for the management of attentional problems.

Methods: The experts selected recommendations from published guidelines and then reviewed literature to ensure that recommendations were current.

INCOG recommendations for management of cognition following traumatic brain injury, part I: posttraumatic amnesia/delirium.

Introduction: After traumatic brain injury (TBI) and emergence from coma, the majority of people experience posttraumatic amnesia (PTA), characterized by confusion, disorientation, retrograde and anterograde amnesia, poor attention, and sometimes agitation and delusions. An international team of researchers and clinicians developed recommendations for assessment and management of PTA.

Methods: The experts met to select recommendations, then reviewed literature to ensure they were current.

Quality of guidelines for cognitive rehabilitation following traumatic brain injury.

Introduction: Cognitive rehabilitation following traumatic brain injury can aid in optimizing function, independence, and quality of life by addressing impairments in attention, executive function, cognitive communication, and memory. This study aimed to identify and evaluate the methodological quality of clinical practice guidelines for cognitive rehabilitation following traumatic brain injury.

Methods: Systematic searching of databases and Web sites was undertaken between January and March 2012 to identify freely available, English language clinical practice guidelines from 2002 onward.

Factors influencing therapists' adoption of virtual reality for brain injury rehabilitation.

Virtual reality (VR) is an important emerging technology that is increasingly being introduced in health centers as a rehabilitation intervention. Quantitative research is needed to identify the factors influencing therapists' adoption of VR for brain injury rehabilitation, including barriers and facilitators to VR use, in order to inform successful implementation strategies. A measure based on the decomposed theory of planned behavior (DTPB) was developed and administered to 42 therapists; early psychometric properties are reported.

The relationship between coping styles and affective/behavioural symptoms among individuals with an acquired brain injury.

Primary Objective: To evaluate the impact of combined Axis I and II emotional profiles, demographic and psychosocial variables on coping responses in an Acquired Brain Injury (ABI) population using the Personality Assessment Inventory (PAI) and the Coping Response Inventory (CRI).

Research Design: This was a retrospective study examining the relationship between coping styles with affective, demographic and psychosocial variables using a multi-dimensional profile analysis.

Methods And Procedures: Participants completed the PAI and CRI during a regular clinical visit at the ABI Program (n = 100).