Results: There were significantly greater improvements in life satisfaction SWLS and self-perceived success FS in the intervention group compared to the control group. Treatment effects on the additional secondary measures of well-being were not significant, although they trended in a positive direction. This study provides evidence that volunteering leads to improvements in well-being after TBI. The authors recommend assisting and facilitating volunteer placement for individuals living with TBI in the community, to improve psychological well-being. A rigorous mechanical characterization of brain tissue is crucial for biomechanical studies of traumatic brain injury TBI.
Recent experimental studies have postulated that strain rate is one of the most influential biomechanical parameters to be measured in TBI diagnosis. In this paper a poro-hyper viscoelastic constitutive model will be introduced to demystify more phenomenological behaviors of this tissue that could not otherwise be perceived with established, single-phasic approaches. In this regard, brain tissue was defined as a biphasic material consisting of a compressible solid matrix and fully saturated with an incompressible interstitial fluid.
A finite element computational scheme used to model the brain with extracted material parameters showed a relatively good prediction of tissue response under other loading rates. The detailed mechanical responses for solid and fluid phases, and their contributions to general behavior of this biological tissue, were successfully provided by this phenomenological, two-phasic model. These identified poro-hyper viscoelastic parameters were found to be sufficient for biomechanical analysis of brain injury mechanism and predict the behavior of each phase under high kinematical motions.
John Davis a , Danielle Hawthorne b. The treatment program involved the utilization of a token economy to increase the physical activity in an individual with an acquired brain injury in an in-patient unit. Physical activity was measured though the use of a recumbent cross training machine. Tokens were earned through the step rate calculated on the cross-training machine.
Tokens were redeemed for excursions to local historic sites. A changing criterion design was implemented to systematically increase the step goal. The client successfully reached each step goal. As well as engaging in the token economy, the individual was also receiving cognitive behaviour therapy and acceptance and commitment therapy. After the cessation of the token economy, the individual expressed interest in engaging in other forms of physical activity as well as feeling ready to return home and engage in meaningful occupations with her family.
Background and Aim: Although self- reporting of pain considered as the gold standard in evaluation of this sign, many of Traumatic Brain Injury TBI patients with variable levels of consciousness are not able to express their pain verbally. This point is an important and basic problem for caregivers and researchers. Therefore, this study was conducted to evaluate the behavioral pain indicators in patients with different levels of consciousness due to TBI. Method: Thirty-five TBI patients with different consciousness level were selected by convenience sampling method in Data were collected through observation of patient's behavior in two painful and non-painful situations.
The results of the observation were recorded in a checklist containing 16 facial pain-related behaviors.
It was completed through direct observation by the researcher focusing on the patient's face and examining the films recorded from the patient at various directions. Results: The findings showed that facial expression changes observed more than other behaviors during the painful procedure.
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These facial expression changes were levator contraction Conclusion: The findings of this study indicate that pain behaviors in TBI patients with different levels of consciousness are untypical. Also, changing in facial expressions can be helpful in the pain assessment in these patients. Therefore, it is suggested that specific behavioral tools should be designed and tested to evaluate the pain of TBI patients.
Introduction: Homelessness is an international problem and Canada is not immune to it as there are approximately , individuals experience one or more episodes of homelessness in a given year. This vulnerable population and adolescents in foster care are disadvantaged people who are prone to traumatic brain injury TBI. However, little is known about the associations between TBI, depression, and childhood adverse experience in these disadvantaged individuals. Objective: The objective of the study was to determine the associations between TBI, depression, and childhood adverse experience in a cohort of disadvantaged Canadians.
In addition, 57 controls 30 adults and 27 adolescents were included in the study.
They also had a significantly higher proportion Conclusions: The disadvantaged Canadians have higher risks to have experienced depression and adverse events in their childhood. Such childhood adverse experiences are associated with a positive history of TBI.
The findings will further our understanding of the risks associated with this vulnerable population. Objectives: To evaluate the cost-efficiency of specialist in-patient neurorehabilitation following hypoxic brain injury BI , through estimated life-time savings in ongoing care-costs. The remaining life expectancy and mean net lifetime savings in care costs were analysed for the whole sample and grouped by dependency high, medium and low , based on admission NPDS scores.
Results: For the whole sample, the mean age was The mean remaining life expectancy was When broken down by dependency:. Background: Sleep disruption and disorders are prevalent following traumatic brain injury TBI , which may negatively impact the restorative role sleep plays in facilitating mechanisms of neural repair. Monitoring longitudinal changes in sleep amounts and patterns is typically accomplished through use of actigraphy wrist-worn accelerometry. We have demonstrated that actigraphy is a valid proxy of the criterion standard of sleep EEG-based polysomnography in TBI patients during rehabilitation.
Guideline-recommended scoring of actigraphy is not feasible in cognitively-impaired populations who are unable to reliably provide daily sleep logs. Alternatives include examination of actigraphy indices across the hour period that are independent of known in-bed timing. A recent study highlighted that one such index, rest-activity consolidation RAC , was associated with cognitive status Rancho Scale during acute care hospitalization for TBI.
We compared two aggregate measures of RAC abnormality to operationalize an evidence-based biomarker of circadian disruption and inform treatment. Across both methods, the abnormal and normal groups were comparable on time elapsed since injury to actigraphy assessment and injury severity indices emergency department GCS, and time to follow commands. Findings inform development of an objective biomarker of circadian disruption during acute neurologic recovery and a precision medicine approach to sleep management in TBI.
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Following their ABI, many people cannot return to their pre-injury roles and face a very different life-course. Method: The research reports on a series of interviews that aimed to capture the impact and experience of brain injury.
The data was recorded and analysed. Findings: Five themes are exposed in the data.
These relate to:. Analysis: The analysis seeks to present an overview of the main issues that arise for those living with ABI.
These issues are illuminated and evidenced throughout the report by the first-person quotes. In synthesising the shared experience of participants, this research shines a light on the difficulties experienced by those living with this chronically challenging condition. Conclusion: The research, and its conclusions and recommendations, contribute to a greater understanding of the conditions among key stakeholders including service providers, policy makers and wider society. Functional electrical stimulation FES is rapidly gaining traction as a therapeutic tool for mediating the repair and recovery of the injured central nervous system CNS.
However, the underlying mechanisms and impact of these stimulation paradigms at a molecular, cellular and network level remain largely unknown. In this study, we used embryonic stem cell ESC -derived neuron and glial co-cultures to investigate network maturation following acute administration of L-glutamate, which is a known mediator of excitotoxicity following CNS injury. We then modulated network maturation using chronic low frequency stimulation LFS and direct current stimulation DCS protocols. We demonstrated that L-glutamate impaired the rate of maturation of ESC-derived neurons and glia immediately and over a week following acute treatment.
Our study also provides a novel framework for investigating the effects of electrical stimulation on neuronal responses and network formation and repair after traumatic brain injury. Some patients diagnosed with the unresponsive wakefulness syndrome UWS based on CRS-R assessments, however, were shown to have signs of higher-level consciousness using electrophysiological and neuroimaging methods Kondziella et al. This discrepancy could be due to the use of standard non-personalized stimuli in the key items of the scale. The benefits of including personalized stimuli in the CRS-R were shown in two recently published studies, one focusing on the assessment of auditory and visual items in UWS patients Sternberg et al.
Objective: We investigated whether personalized stimuli evoke better responses in DOC patients than standard CRS-R stimuli in the motor object manipulation and communication non-functional: intentional subscales. Responses to personalized versus non-personalized stimuli were analyzed.
Motor function subscale items were assessed by using personally relevant e.
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Non-functional communication was assessed by asking patient-related e. Results: 39 patients scored 4 or 5 object manipulation possible but still MCS on the motor subscale with personalized stimuli mean age Similarly, 36 patients scored 1 non-functional: intentional on the communication subscale mean age For the communication subscale, Mean number of assessments analyzed per patient was 6.
Conclusion: Our results show that more responses can be consistently evoked with personalized than standard CRS-R stimuli. This difference was observed more frequently in the communication subscale.
As data generated in clinical routine were analyzed in this study, we stress the need for further controlled experimental designs. Parisa Department a. Almost all studies of traumatic brain injuries TBI have only focused on the maximum acceleration associated with the impact. However, it has been noted that other impact characteristics should also be considered.
This study has examined the effect on brain damage maximum strain of changing three characteristics of an isosceles trapezoid acceleration profile: initial slope jerk , maximum acceleration, and impact energy maximum velocity squared. This involved using a preexisting finite element model of the brain and applying the trapezoidal acceleration impact to the center of the forehead.