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Novel Forms of Cognitive Rehabilitation
Published in Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth, Neuropsychological Rehabilitation, 2017
Li et al. (2013) used another program called Parrot Software. They conducted a quasi-experimental one-group pre-/post-test study with 12 ABI patients. Patients were offered eight 60-minute sessions using the attention and memory program components. After treatment they found significant improvement on the attention and memory scores of the Cognistat assessment, a cognitive screening tool. Outcome in other domains, such as everyday functioning, was not measured.
Contribution of the neuropsychological evaluation to traumatic brain injury rehabilitation
Published in Mark J. Ashley, David A. Hovda, Traumatic Brain Injury, 2017
Instruments that provide global information about general cognitive functioning can be useful in the assessment of patients with TBI to provide a brief look at level of ability. This tends to occur in the early phases of recovery when the patient may not be capable of engaging in a more complex or comprehensive examination. Table 31.2 provides a listing of common cognitive screening measures and their characteristics. These measures provide some coverage of important cognitive domains, such as recent memory, attention, visuospatial analysis and visuoconstruction skills, and abstracting and executive functioning skill (e.g., Cognistat, RBANS, Scales of Cognitive Ability for Traumatic Brain Injury). Others provide a global index of cognitive functioning (Mini-Mental State Examination, Clock Drawing Test). Although not used for diagnostic purposes, these tests are helpful when trying to determine whether or not a more comprehensive battery of neuropsychological tests may be recommended. Many of these tests are performed by other than neuropsychologists, including speech pathologists, occupational therapists, psychiatrists, physical medicine and rehabilitation physicians, and neurologists.
Cranioplasty
Published in Barbara A. Wilson, Samira Kashinath Dhamapurkar, Anita Rose, Surviving Brain Damage After Assault, 2016
Barbara A. Wilson, Samira Kashinath Dhamapurkar, Anita Rose
Agner and associates (2002) reported improvement in cognition following cranioplasty using the Cognistat measure. This is a neurobehavioural cognitive status examination which assesses different aspects of language, performing complex constructions, memory, calculations and reasoning. They also used the EXIT interview, which assesses executive, functioning at the bedside. In both these measures they report 48.3% and 32.9% improvement, respectively, between pre cranioplasty and after cranioplasty in a single case study.
Assessments of Functional Cognition Used with Patients following Traumatic Brain Injury in Acute Care: A Survey of Australian Occupational Therapists
Published in Occupational Therapy In Health Care, 2023
Katherine Goodchild, Jennifer Fleming, Jodie A. Copley
Pencil-and-paper screening tests, such as the MoCA, which is relatively quick to administer and requires no specific resources to implement, were identified as being used frequently (89.5%). Similarly, the kit-based assessment Neurobehavioural Cognitive Status Examination (Cognistat) was used frequently by 64.9% of participants. Over-reliance on pencil-and-paper or kit-based assessments may be problematic for occupational therapists for a number of reasons. Pencil-and-paper tests such as the Mini-Mental State Examination (MMSE) (Folstein et al., 1983) were designed as a global cognitive screening test and use of these to comment on a patient’s functional cognition in real world settings goes beyond the scope of the original assessment’s purpose (Burgess et al., 2006). Kit-based assessments themselves may be problematic due to the prescribed sub-tasks they contain, which cannot be tailored to capture performance of daily tasks that are meaningful to each individual patient. Some authors have chosen to modify sub-tasks within kit-based assessments to suit cultural norms. For example, the Modified Naturalistic Action Test (Jung et al., 2013) substituted tasks such as ‘wrapping a present ‘with ‘folding laundry and putting it away’, to suit a Korean population. However, time and resources spent modifying tests can add significant delays to making tests available for practice.
Implementation of a Neurogenic Bowel Program for Spinal Cord Injury in the Acute Care Setting: Perceptions of Patients and Staff
Published in Occupational Therapy In Health Care, 2019
Sarah Borsh, Seema Sikka, Librada Callender, Monica Bennett, Megan Reynolds, Simon Driver
A case-control study design was employed for patients, which examined prospective cases and retrospective controls to evaluate patient outcomes after the implementation of a NB program. Patients with traumatic SCI with NB dysfunction who were admitted between September 1, 2014 and December 31, 2015 to the Level I Trauma Center were included in the study. NB dysfunction was measured using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) sacral exam, and upper or lower motor neuron pattern of injury was evaluated (American Spinal Injury Association, 2015). All ISNCSCI exams were performed by trained physiatrists. Patients were excluded if they were a prisoner or if they had severe cognitive impairment. Cognitive impairment was measured by the occupational therapists and clinical research coordinators using the Cognistat, a cognitive screening tool, and patients had to score ≥ 10 in order to participate in the study (Kiernan, Langston, & Mueller, 1995). Cases with traumatic SCI were approached for informed consent by occupational therapists and clinical research coordinators in the trauma unit once they were medically stable and outside of the intensive care unit or emergency department setting. A retrospective control group diagnosed with traumatic SCI was selected from the trauma registry using ICD-9 codes for patients who received care between the dates of January 1, 2013 and August 31, 2014 prior to implementation of the structured program. During this time there was no standard medication management, timing, or intervention (i.e., digital stimulation).
Facilitators for travelling with local public transport among people with mild cognitive limitations after stroke
Published in Scandinavian Journal of Occupational Therapy, 2018
Agneta Ståhl, Eva Månsson Lexell
Assessments tools: The assessments gave an overview of the participants’ physical and cognitive limitations as well as frequency of participation in daily activities. Data on physical limitations were collected by using the personal component of the Housing Enabler (HE) instrument [21]. This version comprised 15 items but one item was excluded (difficulty interpreting information) since this was covered by the other data collection. Cognition was assessed by means of the Cognistat screening instrument [22], comprising three general areas (consciousness, orientation and attention), and another five major areas (language, visual constructive skills, memory, calculation and reasoning) of which two are divided into sub-areas (language and reasoning). Each area/sub-area is scored as average or mild/moderate/severe. Self-evaluated cognition was measured by a study-specific questionnaire, developed in a previous study [20]. The questionnaire consisted of 18 questions with three response alternatives (yes, no or do not know), where each yes-answer was considered a cognitive limitation. Frequency of participation in daily activities was captured by means of an extended and modified version of the Frenchay Activity Index (E-FAI) [23] with 22 items, where items concerning use of mode of transport, and telephone use were added to the original version of the instrument [24]. The sum score of the new version ranges between 0 and 66, where a higher number indicates a higher frequency of participation in daily activities.