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BACKGROUND: Individuals who have suffered a concussion/mild traumatic brain injury (mTBI) frequently report symptoms associated with vestibular and/or oculomotor dysfunction (VOD) like dizziness, nausea, fatigue, brain fog, headache, gait and neurocognitive impairments which are associated with the development of chronic symptoms. The Vestibular/Ocular Motor Screening (VOMS) tool has been established as a reliable and clinically relevant complement to use alongside a battery of post-concussion tests to improve screening and referral for further evaluation and treatment of VOD. OBJECTIVES: This paper will review the pathoanatomy and symptomatology of common vestibular and oculomotor disorders after concussion, as well as the utility of the VOMS to assist in diagnosis, referral, and management. METHODS: Primary articles were identified using a search via PubMed, Google Scholar, OneSearch, and CINAHL. Search key terms were combinations of "mild traumatic brain injury" or "concussion" or "pursuit" or "accommodation" or "vergence" or "convergence insufficiency" or "saccades" or "vestibulo-ocular reflex" or "vestibular ocular motor screen" or "vestibular rehabilitation", or "vision rehabilitation" including adult and pediatric populations that were published in print or electronically from 1989 to 2021 in English. Classic papers on anatomy of eye movements, vestibular system and pathological changes in mTBI were also included, regardless of publication date. RESULTS: Objective impairments are commonly found during testing of smooth pursuit, saccades, vergence, accommodation, vestibular ocular reflex, and visual motion sensitivity after mTBI. These deficits can be actively treated with vestibular physical therapy and oculomotor/neuro-optometric vision therapy. VOMS is an efficient and reliable tool that can be used by all healthcare and rehabilitation providers to aid in diagnosis of post-concussion VOD, to help facilitate the decision to refer for further evaluation and treatment to expedite symptomatic post-concussion recovery. CONCLUSIONS: VOD is common after concussion in acute, post-acute, and chronic phases. Once areas of impairments are identified through proper assessment, clinicians can maximize recovery by referring to vestibular physical therapy and/or neuro-optometry to design a targeted treatment program to address individual deficits. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The study tries to explore what effects multiple cognitive intervention, computer-based intervention, and memory training program had on dementia patients through meta-analysis. METHOD: Data was collected using an overseas search engine and 13 pieces of research published from January 2001 to April 2015 were selected. On papers that fit the selection criteria qualitative evaluation was conducted using Jadad evaluation and using pre-post average, standard deviation, and sample size of cognitive function, meta-analysis was conducted. RESULTS: The 13 studies selected included 6 multiple interventions, 4 computer-based interventions, and 3 memory training programs. In the Jadad evaluation all had 3 points or higher and there were 474 research participants and in the result of effect size analysis memory training intervention was found to be 'large effect size', computer-based intervention 'medium effect size', and multiple cognitive intervention 'small effect size'. All three intervention methods were all statistically significant (p<0.05). CONCLUSION: It was found that the effect on dementia patients was in the order of memory training intervention, computer-based intervention, and multiple cognitive intervention. Clinically, this can be objective basis for treatment method for cognitive intervention of dementia patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Management of the uncertainty inherent in a diagnosis of a progressive neurological illness is one of the major adjustment tasks facing those affected and their families. A causal relationship has been demonstrated between perceived illness uncertainty and negative psychological outcomes for individuals with progressive neurological illness. Whilst there is a small and promising intervention literature on the use of a range of individually focused strengths based psychological interventions there appears to be little guidance available how clinicians might help those family members of those affected. OBJECTIVE: To undertake a systematic review of the evidence on the use of strengths based, family focused interventions that target illness uncertainty. METHODS: A systematic literature search was undertaken using the National Library for Health abstract database. RESULTS: Five papers were included in the review, only two of which were published in peer reviewed journals. All five reported on strengths based approaches that could be used with families but only two explicitly identified illness uncertainty as a target. Outcome measures were heterogeneous so data could not be aggregated for meta-analysis. The results suggested that these interventions showed promised but the review highlighted a number of methodological issues which mean that the results must be interpreted with caution. CONCLUSIONS: There is very little evidence of the use of strengths based approaches to helping families manage the uncertainty associated with progressive neurological illness despite it having been identified as a key target for intervention. The review highlights the need for the development of an intervention framework to address this key clinical issue and suggests one model that might show promise. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite its potentially significant impact, cognitive disability may be overlooked in a number of progressive neurodegenerative conditions, as other difficulties dominate the clinical picture. OBJECTIVE: We examined the extent, nature and range of the research evidence relating to cognitive rehabilitation, self-management, psychotherapeutic and caregiver support interventions in Parkinsonian disorders, multiple sclerosis (MS), frontotemporal dementias (FTD), motor neuron disease and Huntington's disease. METHODS: Scoping review based on searches of MEDLINE and CINAHL up to 15 March 2016. RESULTS: We included 140 eligible papers. Over half of the studies, and almost all the randomised controlled trials, related to MS, while a number of single case studies described interventions for people with FTD. CR interventions addressed functional ability, communication and interaction, behaviour or memory. The majority of psychotherapy interventions involved cognitive behavioural therapy for depression or anxiety. Self-management interventions were mainly available for people with MS. There were few reports of interventions specific to caregivers. Numerous methodological challenges were identified. CONCLUSIONS: The limited range of studies for all conditions except MS suggests a need firstly to synthesise systematically the available evidence across conditions and secondly to develop well-designed studies to provide evidence about the effectiveness of CR and other psychological interventions. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study performed meta-analysis on the literatures that surveyed cognitive test to forecast unsafe driving by older drivers and identified objective and consistent cognitive test for predicting unsafe driving of older drivers. SELECTION CRITERIA: The study of RCT (Randomized Control Trial) that conducted cognitive test by classifying older drivers into safe-drivers and unsafe-drivers was done and a total of nine studies suitable for the selection criteria were chosen. SEARCH STRATEGY: To meet subject selection, online search was performed by keyword such as 'Older', 'Driving', 'Safe', 'Cognition', etc. Qualitative analysis of the study was conducted using Jadad evaluation. Quantitative analysis also conducted statistical heterogeneity, effect size, sensitivity and publication bias every cognitive assessment tool. RESULT: The Jadad evaluation grade of the studies was assessed on papers of a high quality - all study received over 3 points. The result of the effect sizes was that TMT-B, TMT-A, UFOV-subtest 2 and MMSE were statistically significant (P < .05). As a result, TMT-B was 'Big effect size', TMT-A and UFOV-subtest 2 were 'Medium effect sizes' and MMSE was 'Small effect size.' CONCLUSION: TMT-A, TMT-B and UFOV-subtest 2 were found to be useful as cognitive test tools to forecast unsafe driving of older drivers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hypoxic ischemic brain injury (HIBI) occurs as a result of complete or partial disruption of cerebral oxygen supply. The physical and cognitive sequelae of adults following hypoxia varies widely. OBJECTIVE: To systematically review studies exploring the neuropsychological outcomes following hypoxic brain insult in adults. METHODS: Data was sourced using six databases (CINAHL, Cochrane, Embase, Medline, PsycInfo and Web of Science). Initial MESH terms identified 2,962 articles. After a three-stage independent review process, 18 articles, 9 case studies and 9 group studies were available for data synthesis from 1990-2012. Case study data was converted to standardised scores and compared to available test norms. Cohen's d was calculated to permit group data interpretation. RESULTS: Intellectual decrement was observed in some studies although difficult to delineate given the lack of use of measures of premorbid ability. Cognitive sequelae varied albeit with predominant disturbance in verbal memory, learning ability and executive function observed across studies. Wechsler Memory Scale Revised (WMS-R) visual memory was comparable to normative data. Impaired Rey Osterrieth Complex Figure (ROCFT) performance was found among group studies. Across visuo-constructional and attention domains, performance varied, although no significant difference relative to reported means was observed. CONCLUSIONS: Future studies should consider the use of standardised assessment protocols, which include measures of premorbid functioning and performance validity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Post-stroke spasticity is often one of the primary impairments addressed in rehabilitation. However, limited guidance exists on the effectiveness of physical therapy (PT) interventions for post-stroke spasticity. OBJECTIVE: To evaluate the quality of evidence of PT interventions for post-stroke spasticity. METHODS: Ovid (Medline), Cochrane Library, CINAHL, Scopus, PEDro, and PROSPERO were searched to identify reviews based on the following criteria: 1) published between 2012 and 2021, 2) participants older than 18 years old, 3) post-stroke spasticity, 4) PT interventions, 5) clinical or neurophysiological measures of spasticity as primary outcomes. Assessment of Multiple Systematic Reviews 2 and the Grades of Recommendations Assessment, Development, and Evaluation assessed methodological quality. RESULTS: Eight articles were included in the analysis. No high-quality evidence was found. Moderate quality evidence exists for transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation, resistance training, and lower extremity ergometer training with or without functional electrical stimulation. Low quality evidence exists for dynamic stretching, botulinum toxin with constraint-induced movement therapy, and static stretching using positional orthoses. CONCLUSION: Findings suggest that PT should prioritize a combination of active strategies over passive interventions, but further studies are needed prioritizing analyses of the movement system in managing post-stroke spasticity in conjunction with medical therapies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Robot-assisted arm therapy (RAT) has been used mainly in stroke rehabilitation in the last 20 years with rising expectations and growing evidence summarized in systematic reviews (SRs). OBJECTIVE: The aim of this study is to provide an overview of SRs about the effectiveness, within the ICF domains, and safety of RAT in the rehabilitation of adult with stroke compared to other treatments. METHODS: The search strategy was conducted using search strings adapted explicitly for each database. A screening base on title and abstract was realized to find all the potentially relevant studies. The methodological quality of the included SRs was assessed using AMSTAR-2. A pre-determined standardized form was used to realize the data extraction. RESULTS: 18 SRs were included in this overview. Generally, positive effects from the RAT were found for motor function and muscle strength, whereas there is no agreement for muscle tone effects. No effect was found for pain, and only a SR reported the positive impact of RAT in daily living activity. CONCLUSION: RAT can be considered a valuable option to increase motor function and muscle strength after stroke. However, the poor quality of most of the included SRs could limit the certainty around the results. [ABSTRACT FROM AUTHOR]

BACKGROUND: Increasing evidence suggests autonomic nervous system (ANS) dysfunction may occur following mild traumatic brain injury (mTBI). Measures of heart rate, heart rate variability, blood pressure and baroreceptor sensitivity can be used to evaluate ANS dysfunction following mTBI. OBJECTIVE: Summarize the evidence for ANS dysfunction in adults following mTBI. METHODS: A search of Embase, MEDLINE, Cochrane Central Register, PsycINFO, CINAHL and SPORTDiscus databases was conducted. Search topics included: mTBI and ANS. Identified abstracts were independently reviewed by 2 reviewers followed by full text screening. Risk of bias was assessed using a modified SIGN checklist. A structured synthesis was performed. RESULTS: Thirty-nine studies (combined 1,467 participants diagnosed with mTBI) evaluating ANS function were included. ANS function was evaluated under various conditions including: rest, during exertion, cold pressor test, Valsalva maneuver, using face cooling and eyeball pressure paradigms. Short-term or ultra-short-term recordings were most common. The majority of studies (28/39) were rated as "unacceptable" for quality of evidence. CONCLUSIONS: Altered parameters of ANS function have been reported in multiple conditions following mTBI, both acutely and in the post-acute/chronic stages of recovery. However, due to methodological limitations, conclusions regarding the severity and timing of ANS dysfunction following mTBI cannot be drawn. [ABSTRACT FROM AUTHOR]

BACKGROUND: Parkinson's disease (PD) is a progressive neurodegenerative disorder, characterized by cardinal motor symptoms in addition to cognitive impairment. New insights concerning multisite non-invasive brain stimulation effects have been gained, which can now be used to develop innovative treatment approaches. OBJECTIVE: Map the researchs involving multisite non-invasive brain stimulation in PD, synthesize the available evidence and discuss future directions. METHODS: The databases PubMed, PsycINFO, CINAHL, LILACS and The Cochrane Library were searched from inception until April 2020, without restrictions on the date of publication or the language in which it was published. The reviewers worked in pairs and sequentially evaluated the titles, abstracts and then the full text of all publications identified as potentially relevant. RESULTS: Twelve articles met the inclusion criteria. The target brain regions included mainly the combination of a motor and a frontal area, such as stimulation of the primary motor córtex associated with the dorsolateral prefrontal cortex. Most of the trials showed that this modality was only more effective for the motor component, or for the cognitive and/or non-motor, separately. CONCLUSIONS: Despite the results being encouraging for the use of the multisite aproach, the indication for PD management should be carried out with caution and deserves scientific deepening. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Traumatic brain injury (TBI) has wide-ranging neuropsychological, physical, social and financial implications. The impact on caregivers of moderate to severe TBI survivors, particularly in low- and middle-income countries, is under-investigated. AIM: Identify and describe the experiences of caregivers' of moderate to severe TBI survivors postdischarge from healthcare facilities. METHODS: A scoping review was conducted utilising seven electronic databases. Two reviewers screened articles using eligibly criteria related to setting (postdischarge), caregiving (informal), age of TBI survivors (> 18 years) and injury severity (moderate-severe). Studies published in English between 1999 –2018 were included. RESULTS: Fourteen articles met the inclusion criteria. Articles reporting on the same sample were merged during data charting. The final analyses included 11 articles comprised of qualitative, quantitative and mixed-methods studies. Ten themes were identified: psychological distress, social functioning, financial burden, family experiences, coping strategies, access to services, time burdens and physical, cognitive and behavioural difficulties. Characteristics of caregivers and TBI survivors were also reported. CONCLUSION: Caregivers of moderate to severe TBI survivors experience challenges in various life domains, and there is limited research concerning caregivers in low- and middle-income countries. Future research should focus on understanding more nuanced experiences across various environments, which may increase comprehensive, flexible and long-term support. [ABSTRACT FROM AUTHOR]

BACKGROUND: Upper extremity activity-based therapy for neurologic disorders employs high-intensity, high repetition functional training to exploit neuroplasticity and improve function. Research focused on high-intensity upper extremity activity-based therapy for persons with spinal cord injury (SCI) is limited. OBJECTIVE: To summarize high-intensity activity-based interventions used in neurological disorders for their current or potential application to SCI. METHODS: The scoping review included articles from MEDLINE, CINAHL, Cochrane CENTRAL, and OTSeeker with the criteria: non-invasive activity-based interventions delivered at least three times/week for two weeks, upper extremity functional outcomes, age 13 years or older, English language, and neurological disorders three months post onset/injury. RESULTS: The search yielded 172 studies. There were seven studies with SCI, all in adults. Activity-based interventions in SCI included task-specific training and gaming, with and without electrical stimulation, and a robotic exoskeleton. The other populations found in the review included studies in stroke, cerebral palsy, and multiple sclerosis. Thirty-four different interventions were reported in other populations. In comparison to the extensive stroke research, work in SCI was not found for high-intensity interventions using virtual reality, brain stimulation, rehabilitation devices, and applications to the home and telerehab settings. CONCLUSION: The results highlight critical gaps within upper extremity high-intensity activity-based research in SCI. [ABSTRACT FROM AUTHOR]

BACKGROUND: Practice guidelines (CPGs) provide informed treatment recommendations from systematic reviews and assessment of the benefits and harms that are intended to optimize patient care. Review of CPGs addressing rehabilitation for people with moderate/severe traumatic brain injury (TBI), has not been fully investigated. OBJECTIVE: Identify published, vetted, clinical practice guidelines that address rehabilitation for people with moderate/severe TBI. METHODS: Six data bases were accessed using key word search terms: "Traumatic Brain Injury" and "Clinical Practice Guidelines" and "Rehabilitation". Further inclusions included "adult" and "moderate or severe". Exclusions included: "mild" and "concussive injury". Three reviewers read abstracts and manuscripts for final inclusion. The AGREE II template was applied for additional appraisal. RESULTS: There were 767 articles retrieved using the search terms, 520 were eliminated because of content irrelevance; and 157 did not specify rehabilitation treatment or did not follow a process for CPGs. A total of 17 CPGs met all criteria and only 4 of these met all AGREE II criteria. CONCLUSION: There are few CPGs addressing rehabilitation for people with moderate/severe TBI. More interventional trials are needed to determine treatment effectiveness. Timely and methodologically sound vetting of studies are needed to ensure CPG reliability and facilitate access to quality, effective treatment for people with moderate/severe TBI. [ABSTRACT FROM AUTHOR]

BACKGROUND: Peripheral nerve injury can result in both sensory and motor deficits, and these impairments can last for a long period after nerve repair. OBJECTIVE: To systematically review the effects of sensory re-education (SR) on facilitating hand function recovery after peripheral nerve repair. METHODS: This systematic review was limited to articles published from 1970 to 20 December 2020. Electronic searching was performed in CINAHL, Embase, PubMed, Web of Science, and Medline databases to include trials investigating the effects of SR training on hand function recovery after peripheral nerve repair and included only those studies with controlled comparisons. RESULTS: Sixteen articles were included in final data synthesis. We found that only four studies could be rated as having good quality and noted obvious methodological limitations in the remaining studies. The current evidence showed that early SR with mirror visual feedback and the combinational use of classic SR and topical temporary anesthetic seemed to have long- and short-term effects, respectively on improving the sensibility and reducing the disabilities of the hand. The evidence to support the effects of conventional classical SR on improving hand functions was not strong. CONCLUSIONS: Further well-designed trials are needed to evaluate the effects of different SR techniques on hand function after nerve repair over short- and long-term periods. [ABSTRACT FROM AUTHOR]

BACKGROUND: Neurofeedback training targets the relevant brain response under minimal stress. It could be a promising approach for the treatment of patients with brain injury. OBJECTIVE: This review aimed to examine the existing literature to confirm the effectiveness of applied electroencephalogram (EEG)-based neurofeedback training in the area of occupational therapy for upper limb stroke rehabilitation. METHOD: All relevant literature published until July 1, 2020 in five prominent databases (PubMed, CINAHL, PsycINFO, MEDLINE Complete, and Web of Science) was reviewed, based on the five-step review framework proposed by Arksey and O'Malley. RESULTS: After a thorough review, a total of 14 studies were included in this review. Almost studies reported significant improvements as a result of EEG-based neurofeedback training, but this had not always account for the differences in effectiveness between groups. However, the results of these studies suggested that neurofeedback training was effective as compared to the traditional treatment and more effective in combination with EEG than that with simple equipment application. CONCLUSION: This review demonstrated the effectiveness of the combination of occupational therapy and EEG-based neurofeedback training. Most of these treatments are intended for inpatients, but they may be more effective for outpatients, especially if customized to their requirements. Also, such explorations to assess the suitability of the treatment for patient rehabilitation will help reduce barriers to effective interventions. An analysis of the opinions of participants and experts through satisfaction surveys will be helpful. [ABSTRACT FROM AUTHOR]

BACKGROUND: The application of emotional stimuli is beneficial when practicing tasks that must be learned. OBJECTIVE: This scoping review examined related literature to identify the applicability of emotion-based training for therapeutic activities. METHOD: All relevant literature published as of April 1, 2020 in four prominent databases was searched (CINAHL, Embase, PubMed, and PsycINFO) using the five-stage review framework proposed by Arksey and O'Malley. RESULTS: After sophisticated searches and exclusions, ten publications were included for further review. Our results revealed three types of emotion-based stimulation methods that can influence therapeutic effects on stroke patients. However, the research did not compare the difference between the pros, cons, and effectiveness of each type of sensory stimulation. CONCLUSION: Rehabilitation specialists are encouraged to obtain a broad understanding of therapeutic situations and their possible impacts on a given environment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Obesity is a known risk factor for stroke, but its impact on functional recovery is less clear. Understanding the effect of obesity on functional recovery during inpatient rehabilitation will aid clinicians in patient counselling and help administrators with program planning. OBJECTIVE: To determine if obesity affects the functional outcomes of adults undergoing inpatient stroke rehabilitation. METHODS: MEDLINE, Embase, CINAHL, and Cochrane databases were searched using the subject headings and text word terms for stroke, rehabilitation, and obesity. Two independent reviewers screened the articles against pre-defined eligibility criteria and extracted the data. Outcomes of interest included FIM. mRS, Fugl-Meyer Assessment of Sensorimotor Recovery after Stroke, and Barthel Index. RESULTS: Seven studies from five countries with a total of 3070 participants were included. There was significant heterogeneity among the studies in the BMI cut-off points and functional outcome measures used. Two studies found a positive association between obesity and functional outcome, two studies found no association, and three studies reported a negative relationship. CONCLUSIONS: No conclusions could be drawn regarding whether the functional outcome of adults undergoing inpatient stroke rehabilitation differ between individuals with and without obesity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Advances in medical technology produce highly complex datasets in neurorehabilitation clinics and research laboratories. Artificial neural networks (ANNs) have been utilized to analyze big and complex datasets in various fields, but the use of ANNs in neurorehabilitation is limited. OBJECTIVE: To explore the current use of ANNs in neurorehabilitation. METHODS: PubMed, CINAHL, and Web of Science were used for the literature search. Studies in the scoping review (1) utilized ANNs, (2) examined populations with neurological conditions, and (3) focused on rehabilitation outcomes. The initial search identified 1,136 articles. A total of 19 articles were included. RESULTS: ANNs were used for prediction of functional outcomes and mortality (n = 11) and classification of motor symptoms and cognitive status (n = 8). Most ANN-based models outperformed regression or other machine learning models (n = 11) and showed accurate performance (n = 6; no comparison with other models) in predicting clinical outcomes and accurately classifying different neurological impairments. CONCLUSIONS: This scoping review provides encouraging evidence to use ANNs for clinical decision-making of complex datasets in neurorehabilitation. However, more research is needed to establish the clinical utility of ANNs in diagnosing, monitoring, and rehabilitation of individuals with neurological conditions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Post-stroke trunk control is reported to be associated with trunk performance and recovery of the upper limb, but the evidence for the influence of trunk exercise on both of these is unclear. OBJECTIVE: To evaluate the effect of trunk exercises on trunk performance post-stroke, and to determine if these exercises result in improved upper limb function. METHODS: A comprehensive search of the literature published between January 1990 and February 2017 was conducted using the following electronic databases; AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE, Psychlnfo and SPORTDiscus. Only randomized, controlled trials, published in English, evaluating the effect of trunk exercises on trunk performance and/or upper limb function post-stroke, were included. RESULTS: A total of 17 studies involving 599 participants were analysed. Meta-analysis showed that trunk exercises had a large significant effect on trunk performance post-stroke. This effect varied from very large for acute stroke to medium for subacute and chronic stroke. None of the included studies had measured the effect of trunk exercise on upper limb impairment or functional activity. CONCLUSIONS: Trunk exercises improve trunk performance for people with acute, subacute and chronic strokes. As yet there is no evidence to support the effect of trunk exercise on upper limb function. [ABSTRACT FROM AUTHOR]

BACKGROUND: Children with brain injuries face significant challenges in their recovery. One of the greatest is transitioning from hospital/home to school where they face issues such as reintegration, lack of understanding and catching up with missed work. Many children struggle with their altered circumstances and require additional supports to meet the academic demands of systems which are ill equipped to teach them. OBJECTIVE: To summarise the best available evidence for the use of educational interventions to improve academic attainment in childhood survivors of acquired brain injury (ABI). METHODS: Six electronic databases (Cinahl, Embase, Medline, PsycINFO, Pubmed, & Web of Science) were systematically searched for randomised controlled trials published between 1980 and 2017. Two authors independently reviewed these studies and extracted data on type of intervention, characteristics of participants, outcome measures, findings and recommendations. The Cochrane Collaboration’s Risk of Bias tool was used to assess systematic error in the included studies. RESULTS: Four studies met the inclusion criteria (n = 296 children and adolescents). Three studies (n = 287) were included in meta-analysis for the primary outcome which showed no statistically significant difference between the intervention and control conditions on academic attainment (SMD 1.31, 95% CI –0.06 to 2.68, p = 0.06). No statistically significant differences were found which favoured the intervention for the secondary outcomes of attention, internalising or externalising behavior. All effect sizes were considered as small. CONCLUSIONS: This review suggests that no currently effective educational interventions exist for children with ABI. Greater efforts are required to produce effective and rigorously tested interventions to improve outcomes for these children. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is an increasing interest in sexual and gender diversity in neurorehabilitation. Healthcare professionals wanting to improve their practice know the importance of understanding the needs and expectations of specific communities. OBJECTIVE: To critically reviewthe literature about neurological disorders in people who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual and people with other sexual orientations and forms of gender expression (LGBTQIA+). METHODS: Systematic search in electronic databases (CINAHL, EMBASE, Medline, PsycINFO, Scopus, and Web of Science and identification of relevant studies. RESULTS: Quantitative and qualitative findings are summarized and reported by neurological disorders: a) neurodisability/ epilepsy (17.7%), b) intellectual disability/autism spectrum disorders (19.6%), c) dementia/HIV-related dementia (39.2%), d) spinal cord injury (7.8% and e) traumatic brain injury/stroke (15.7%). CONCLUSIONS: LGBTQIA+ people with neurodisabilities and their partners/families of choice can conceal their sexual orientation or gender identity for fear of diminished quality of care. Their invisibility translates into health disparities, lack of policies and services that meet their unique needs. Dementia is the most common neurodisability documented in LGBTQIA+ people.We provide recommendations to increase LGBTQIA+ cultural competency for clinical practice, research and policy to help different stakeholders to promote a positive change in the culture of neurodisability. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the amount of time and types of interventions used during therapy sessions in the acute setting following stroke. METHODS: A systematic search of relevant databases was conducted. Studies were eligible if they were observational studies of adults with a confirmed diagnosis and within 4 weeks post-stroke; receiving Physiotherapy (PT) and/or Occupational Therapy (OT); and the outcome included amount of therapy time devoted to UL and/or types of interventions. Two authors independently selected studies for inclusion, assessed methodological quality and extracted data. This review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS: From the 94 studies reviewed, seven studies involving 3236 participants met the inclusion criteria. Pooled results indicated that 7.9 min/day (21.4%) of a total 36.7 min/day combined PT and OT session was devoted to UL therapy. Two of the seven studies reported types of interventions, predominantly upper limb activity and control. CONCLUSIONS: A small proportion of total PT and OT time is directed to the involved UL during acute rehabilitation. Given the evidence for early and intense rehabilitation, there is a need to explore the reasons for this low intensity of UL therapy in the acute stage post-stroke. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cognitive rest is the recommendation for all patients with acute sports concussion. OBJECTIVE/METHODS: A comprehensive literature search was conducted for the research question "What is the optimal cognitive load for patients with a sports concussion?" RESULTS: Seven studies met the inclusion criteria. The optimal cognitive load for patients after sports concussion is yet to be determined. CONCLUSIONS: Additional controlled trials of cognitive rehabilitation are needed to establish best clinical practice. The authors suggest memory training, cognitive behavioral therapy, and environmental interventions as areas of future research for sports concussion injuries. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adults who survive traumatic brain injury (TBI) often receive case (care) management to overcome the difficulties commonly faced negotiating a number of different health and social care services and systems. Little is known about the effectiveness of a case management intervention. OBJECTIVE: To examine the effects of case management for patients with severe head injury on outcome, family function, and provision of rehabilitation services. METHODS: Systematic review methodology. Electronic databases (Medline, CINAHL, Psycbite and OTSeeker) were searched up to 7/1/2013. A total of 655 articles were screened of which six met the criteria for inclusion in the review. Study quality was evaluated using the PEDro scale or AMSTAR checklist dependent on study design. RESULTS: One systematic review, three controlled trials and two case series reports were appraised. There was significant clinical heterogeneity between studies and studies scored poorly on the appraisal checklists. Due to methodological limitations, there was no clear evidence of effectiveness or ineffectiveness of case management after brain injury. CONCLUSION: Principal findings are that there is a paucity of applicable research on case management, and a need to evaluate the impact of case management on life participation outcomes. [ABSTRACT FROM AUTHOR]

BACKGROUND: Shoulder impairments are common after stroke, resulting in reduced upper limb function. Shoulder strapping may be beneficial as an adjunct to conventional therapy and warrants further investigation. OBJECTIVES: To determine i) the efficacy and ii) any adverse effects of shoulder strapping used to reduce stroke-related upper limb and shoulder impairments and to improve function. METHODS: Three reviewers independently searched CINAHL, Ovid MEDLINE, EMBASE, AMED and PEDro databases and extracted data. Results were synthesized using descriptive methods and meta-analysis and interpreted in relation to potential risk of bias. RESULTS: Eight studies met inclusion criteria, recruiting 340 stroke participants. Studies predominantly included people with shoulder paralysis and examined shoulder strapping within four weeks of stroke onset for outcomes of increased upper limb function, reduced subluxation and pain. Strapping interventions, outcomes and measures were diverse, some studies encountered high risk of bias and findings were generally inconclusive with some indication of benefit in terms of delaying onset of shoulder pain. CONCLUSIONS: There is insufficient evidence of efficacy or inefficacy with shoulder paralysis but shoulder strapping demonstrated minimal adverse effects and should be rigorously tested with shoulder paresis as well as paralysis after stroke. [ABSTRACT FROM AUTHOR]