NeuroRehabilitation

Although there have been past literature reviews which have addressed the psychological adjustment, consequences, and impact/reaction to spinal cord injury, as well as reviews of depression after spinal cord injury, there appears to be an absence of reviews which have focused primarily on the relationship between spinal cord injury and anxiety. The purpose of this paper is to present a comprehensive review of the relatively recent (the past 23–31 years depending on the database utilized) scientific literature as it pertains to anxiety reactions in spinal cord injured individuals. Specifically, this paper provides reviews of the prevalence/presence of anxiety reactions, as well as the correlates of anxiety, in the spinal cord injured population. Furthermore, this paper reviews the relatively few articles which have addressed the treatment of such symptomatology in spinal cord injured individuals. Methodological concerns and limitations of the existing literature and directions for future research are also provided.

Visual field loss following brain injury often impairs the individual's rehabilitation, function and safety. Such impairments prevent individuals from returning to productive lifestyles. A previous article documents outcomes that measure increased awareness for patients suffering visual field loss. This research investigates and reports on increasing visual recovery, as well as functional and emotional rehabilitation outcomes, using the Visual Field Awareness System™ and treatment strategies. The three case studies represent issues including age, visual field loss, vision recovery as a dynamic process, and functional outcome measures. Measures of increased awareness, recovery of vision, relative visual field sensitivity, continued recovery even after completion of treatment, and improved emotional status with gained independence were among the positive outcome results of this research.

The purpose of this paper is to highlight the importance of categorization abilities for everyday functioning. The specific research objectives were to investigate the performance of post-stroke and healthy subjects on categorization tests, and examine their relationship to everyday tasks which require categorization abilities. A study with 33 subjects was conducted: 18 cerebrovascular accident (CVA) subjects, of which eight were right CVA (RVCA) and 10 left CVA (LCVA) patients. As the performance of those two subgroups did not reveal significance, the subgroups were combined for further analyses. Fifteen healthy subjects were included as control subjects. Subjects were evaluated on five different categorization tests and three different daily tasks which require categorization abilities. All evaluations were video-taped. The findings suggest that post-stroke patients evidence reduced abilities to sort into categories and shift from one category to another. Significant differences between performance of patients and healthy subjects on both tests and tasks were also found. Spearman correlations between tests scores and task scores show low to moderate relationships, which may suggest that tests scores may not explain the full task performance capacity. Clinical implications and recommendations for further research are discussed.

Currently, no clearly defined or accepted definition or model of dynamic assessment exists. Consequently, the present research provides a definitional model that can be used with adults. All participants included males and females between the ages of 18 and 55 with mild to moderate cognitive impairments due to head injury. Experiment 1 was conducted to illustrate the difference between static (N = 20), and dynamic (N = 20), assessment groups. Immediate and delayed recall performance, on the Wechsler Memory Scale — Revised Logical Memory and Visual Reproduction subtests, was compared. Experiment 2 investigated whether participants who demonstrate learning over trials and demonstrate the use of organizational strategies, without the benefit of instruction, illustrate improved delayed recall relative to those who do not. Sixty-four participants' learning potential and instruction potential were assessed using the Buschke Selective Reminding Test. Experiment 3 assessed the ecological validity of the three tenets of dynamic assessment, including measurement of learning potential, intervention potential, and transfer potential. The experiment assessed neuropsychological functioning differences in 26 participants, based on whether they exhibited learning potential, learning and instruction potential, or learning, instruction, and transfer potential.

Information processing deficits are often reported in individuals who have sustained a brain injury. These deficits interfere with the patient's rehabilitation progress because of the brain's inability to efficiently process information. This article describes specific aspects of information processing (i.e. etiology, assessment, rehabilitation). A systematic treatment approach is further discussed using both a controlled group study and a single case design. The results, while tentative, suggest that a systematic approach toward the rehabilitation of information processing deficits was as qualitatively effective, and likely more cost-effective than traditional approaches.

Appropriate allocation of rehabilitation resources requires that the rehabilitation professional have a knowledge of reliable predictors of functional outcome. To determine what influence pre-morbid demographic variables have on functional outcome following thromboembolic stroke, we analyzed prospectively collected demographic and functional data from consecutive patients admitted to rehabilitation at a tertiary university medical center. Data from 117 patients were statistically analyzed for correlations between demographic factors and functional outcome as measured by the FIM scale and hospital length of stay (LOS). While no significant correlations were found between race or gender and functional outcome, Caucasians were found to stay an average of 5 days longer in acute care than African-Americans. Non-married patients were found to have significantly longer rehabilitation LOS and return home following discharge less often. It is concluded that non-married status is a significant negative prognostic factor for functional outcome after thromboembolic stroke, while gender and race have no correlation.

A decision tree and decimal rating scales were used for psychotherapy with a patient with post-stroke subcortical motor aphasia. These two methods used in combination were highly efficient in obtaining information about the patient's mood and issues of concern. The patient was able to report on changing levels of anxiety and depression. He was able to relate his emotional state to environmental or personal factors. Values as low as 1 and as high as 10 for anxiety and depression were reported by the patient during the course of 25 psychotherapy sessions. A Pearson correlation indicated that anxiety and depression varied independently.