Journal of Head Trauma Rehabilitation最新文献

{"title":"Sleep Disturbance and Postconcussive Symptoms in Pediatric Mild Traumatic Brain Injury and Orthopedic Injury.","authors":"Caroline A Luszawski, Nori M Minich, Erin D Bigler, H Gerry Taylor, Ann Bacevice, Daniel M Cohen, Barbara A Bangert, Nicholas A Zumberge, Lianne M Tomfohr-Madsen, Brian L Brooks, Keith Owen Yeates","doi":"10.1097/HTR.0000000000001005","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001005","url":null,"abstract":"<p><strong>Objective: </strong>Sleep disturbance (SD) is common after pediatric mild traumatic brain injury (mTBI) and may predict increased postconcussive symptoms (PCS) and prolonged recovery. Our objective was to investigate the relation of SD with PCS in children with mTBI and those with orthopedic injury (OI).</p><p><strong>Setting: </strong>Emergency departments (EDs) at 2 children's hospitals in the Midwestern United States.</p><p><strong>Participants: </strong>Children and adolescents aged 8 to 16 years old diagnosed with either a mTBI (n = 143) or OI (n = 74) and recruited within 24 hours postinjury.</p><p><strong>Design: </strong>Observational, prospective, concurrent cohort study with longitudinal follow-up.</p><p><strong>Main measures: </strong>Parents rated children's preinjury sleep retrospectively shortly after injury, and postinjury sleep at 3 and 6 months postinjury, using the Sleep Disorders Inventory for Students. Parents rated children's preinjury symptoms retrospectively in the emergency department, and parents and children rated PCS at 3 and 6 months, using the Health and Behavior Inventory and the Postconcussive Symptom Interview. Weekly ratings on the Health and Behavior Inventory were also obtained remotely.</p><p><strong>Results: </strong>Postinjury SD was modestly but not significantly higher in the mTBI group compared to the OI group (P = .060, d = 0.32). Children with mTBI who were symptomatic postacutely based on parent ratings had worse parent-rated sleep outcomes at 3 and 6 months postinjury compared to children who were not symptomatic. Greater preinjury SD also predicted more postinjury SD and more severe PCS regardless of injury type.</p><p><strong>Conclusions: </strong>The results suggest potential bidirectional associations between SD and PCS after mTBI. Studies of treatments for SD following pediatric mTBI are needed.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Demographic and Cognitive Predictors of Self-Management in Quasi-Randomized Fall Prevention Intervention for Older Adults With and Without Traumatic Brain Injury.","authors":"Amy M Kemp, Kim Love, Katy H O'Brien","doi":"10.1097/HTR.0000000000001006","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001006","url":null,"abstract":"<p><strong>Objective: </strong>Changes in health behavior are key to maintaining health, safety, and independence of older adults. The purpose of this study was to explore factors impacting training in self-management and behavior change in older adults with and without traumatic brain injury (TBI), informing efforts to improve safety and independent function.</p><p><strong>Methods: </strong>Forty-one older adults, 19 with TBI, completed a self-regulation intervention (mental contrasting with implementation intentions; MCII) to promote fall prevention behavior change. Participant outcomes were related to single and recurring behavior changes; implementation outcomes were measured as modifications to treatment.</p><p><strong>Results: </strong>Although participants with TBI performed more poorly on tests of neurocognitive function, there were no differences in behavior change rates following MCII, suggesting the treatment worked similarly for participants with and without TBI. Across both groups, those with higher executive function scores were more likely to complete recurring behavior changes. Participants with higher stress, higher Fall Risk Scores, or history of TBI were more likely to need modifications to treatment.</p><p><strong>Conclusions: </strong>This quasi-experimental pilot study describes cognitive and psychosocial predictors that may be critical for participation and success in health behavior change and self-management of fall prevention for older adults with and without TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Care After Intimate Partner Violence Acquired Brain Injury: Current Systems Silence Survivors and Providers.","authors":"Loretta Tsu, Maureen Varty, Desiree Reinken, Heather Coats","doi":"10.1097/HTR.0000000000001003","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001003","url":null,"abstract":"<p><strong>Objective: </strong>A qualitative meta-synthesis was conducted to answer the following question-What barriers are experienced by survivors of intimate partner violence and service providers when seeking or providing resources or care after experiencing brain injury (BI)?</p><p><strong>Setting: </strong>This approach was completed through 2 main phases-a systematic search and literature appraisal and reciprocal translation with interpretive triangulation of the extracted data. The databases searched were PubMed, CINAHL, and PsycInfo.</p><p><strong>Participants: </strong>The initial search yielded 559 articles. The final synthesis included 16 articles for the qualitative meta-synthesis.</p><p><strong>Design: </strong>After data extraction, a qualitative exploratory design evaluated the experiences of survivors and service providers when connecting with resources.</p><p><strong>Results: </strong>The findings highlight larger systemic barriers preventing smooth relationships between survivors and providers. Survivor barriers include risk-driven safety mechanisms and a lack of awareness and understanding of BI. Provider barriers are a lack of clarity within providers' scope and training limitations, diagnosis complexity, first responder's initial response to survivors, lack of open discussion, screening limitations, financial barriers, infrastructure barriers, and lack of resources. Systemic barriers include stigmatization, BI symptoms mistaken as other diagnoses like mental health, access and awareness of resources, and navigation of complex systems.</p><p><strong>Conclusion: </strong>This qualitative meta-synthesis demonstrates that survivors and providers face multiple individual and systemic barriers when seeking and providing resources after BI. Future research is needed to understand survivors' help-seeking behaviors and assistance needs and providers' education about BI and organizational relationships and networks. Recommendations are made for future research to understand how to reduce barriers for providers working with survivors, from trauma-informed education and communication to connecting with resources, where to concentrate, and initiatives for collaboration to increase the network of resources yet improve its accessibility.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizure Risk Associated With the Use of Transcranial Magnetic Stimulation for Coma Recovery in Individuals With Disordered Consciousness After Severe Traumatic Brain Injury.","authors":"David Ripley, Kelly Krese, Joshua M Rosenow, Vijaya Patil, Stephan Schuele, Marilyn S Pacheco, Eliot Roth, Sandra Kletzel, Sherri Livengood, Alexandra Aaronson, Amy Herrold, Brett Blabas, Runa Bhaumik, Ann Guernon, Catherine Burress Kestner, Elyse Walsh, Dulal Bhaumik, Theresa L Bender Pape","doi":"10.1097/HTR.0000000000000991","DOIUrl":"10.1097/HTR.0000000000000991","url":null,"abstract":"<p><strong>Objective: </strong>Repetitive Transcranial Magnetic Stimulation (rTMS) is emerging as a promising treatment for persons with disorder of consciousness (DoC) following traumatic brain injury (TBI). Clinically, however, there are concerns about rTMS exacerbating baseline seizure risk. To advance understanding of risks, this article reports evidence of DoC-TBI rTMS-related seizure risk.</p><p><strong>Setting: </strong>Acute and sub-acute hospitals.</p><p><strong>Participants: </strong>Persons in states of DoC 6.5 months to 15 years after TBI (n = 20) who received active rTMS (n = 17) or placebo rTMS (n = 3). After completing placebo procedures, placebo participants completed active rTMS procedures. These 3 participants are included in the active group.</p><p><strong>Design: </strong>Meta-analysis of data from 3 clinical trials; 2 within-subject, 1 double blind randomized placebo-controlled. Each trial used the same rTMS protocol, provided at least 30 rTMS sessions, and delivered rTMS to the dorsolateral prefrontal cortex.</p><p><strong>Main measures: </strong>During each study's rTMS treatment phase, seizure occurrences were compared between active and placebo groups using logistic regression. After stratifying active group by presence/absence of seizure occurrences, sub-groups were compared using contingency chi-square tests of independence and relative risk (RR) ratios.</p><p><strong>Results: </strong>Two unique participants experienced seizures (1 active, 1 placebo). Post seizure, both participants returned to baseline neurobehavioral function. Both participants received antiepileptics during remaining rTMS sessions, which were completed without further seizures. rTMS-related seizure incidence rate is 59 per 1000 persons. Logistic regression revealed no difference in seizure occurrence by treatment condition (active vs placebo) or when examined with seizure risk factors (P > .1). Presence of ventriculoperitoneal shunt elevated seizure risk (RR = 2.0).</p><p><strong>Conclusion: </strong>Collectively, findings indicate a low-likelihood that the specified rTMS protocol exacerbates baseline seizure rates in persons with DoC after TBI. In presence of VP shunts, however, rTMS likely elevates baseline seizure risk and mitigation of this increased risk with pharmacological seizure prophylaxis should be considered.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroinflammatory Biomarkers and Their Associations With Cognitive, Affective, and Functional Outcomes 3 to 12 Months After a Traumatic Brain Injury: A Pilot Study.","authors":"Kathryn S G Collazos, Gemayaret Alvarez, Arsham Alamian, Victoria Behar-Zusman, Charles A Downs","doi":"10.1097/HTR.0000000000000999","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000999","url":null,"abstract":"<p><strong>Background: </strong>Neuroinflammation is an important feature of traumatic brain injury (TBI) that remains poorly understood in the 3- to 12-month period post-TBI.</p><p><strong>Objective: </strong>The purpose of our pilot study was to examine the relationships between biomarkers of neuroinflammation and functional outcomes in TBI patients 3 to 12 months postinjury.</p><p><strong>Methods: </strong>TBI patients (n = 36) 3 to 12 months post-TBI were recruited from a South Florida TBI clinic from May 2022 to June 2023. The Disability Rating Scale, Satisfaction with Life Scale, NIH Toolbox Sorting Working Memory, Neuro-Quality of Life Cognitive Function, Anxiety, Depression, and Sleep assessments were performed. Multiple plasma biomarkers were assayed. Analysis of variance was used to compare between-group results. Linear regression was performed to analyze relationships between biomarkers and outcomes.</p><p><strong>Results: </strong>Brain-derived neurotrophic factor concentrations were higher as postinjury time interval increased and were associated with cognitive battery outcomes. S-100β and glial fibrillary acidic protein were associated with anxiety score and hospital length of stay; S-100β was also associated with depression. Interleukin 6 was associated with cognitive function score and time since injury.</p><p><strong>Conclusions: </strong>We found S-100β, glial fibrillary acidic protein, Interleukin 6, and brain-derived neurotrophic factor to play a larger role in the TBI recovery period than other biomarkers examined. Clinicians should continue to monitor for symptoms post-TBI, as the neuroinflammatory process continues to persist even into the later rehabilitation stage.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-Based Review of Randomized Controlled Trials of Interventions for Mental Health Management Post-Moderate to Severe Traumatic Brain Injury.","authors":"Cecilia Flores-Sandoval, Robert Teasell, Heather M MacKenzie, Amanda McIntyre, Ujjoyinee Barua, Swati Mehta, Mark Bayley, Emma A Bateman","doi":"10.1097/HTR.0000000000000984","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000984","url":null,"abstract":"<p><strong>Objective: </strong>To present an evidence-based review of randomized controlled trials (RCTs) evaluating interventions for mental health post-moderate to severe traumatic brain injury (post-MSTBI), as part of an extensive database that has been conceptualized as a living systematic review.</p><p><strong>Methods: </strong>Systematic searches were conducted for RCTs published in the English language in MEDLINE, PubMed, Scopus, CINAHL, EMBASE, and PsycINFO, up to and including December 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The methodological quality of RCTs was assessed using the Physiotherapy Evidence Database scale, and the level of evidence was assigned using a modified Sackett scale.</p><p><strong>Results: </strong>Eighty-seven RCTs examining mental health interventions and outcome measures post-MSTBI were included. These studies collectively enrolled 6471 participants. A total of 41 RCTs (47.1%) were conducted in the United States and 56 studies (64.4%) were published after 2010. A total of 62 RCTs (71.3%) examined nonpharmacological interventions and 25 RCTs (28.7%) examined pharmacological interventions. Effective pharmacological treatments included desipramine and cerebrolysin; methylphenidate and rivastigmine showed conflicting evidence. Cognitive behavioral therapy (CBT) was found to be effective for hopelessness, stress, and anxiety, compared to usual care; however, it may be as effective as supportive psychotherapy for depression. CBT combined with motivational interviewing may be as effective as CBT combined with nondirective counseling for depression, stress, and anxiety. Acceptance and commitment therapy was effective for anxiety, stress, and depression. Tai Chi, dance, and walking appeared to be effective for depression and stress, while other nonpharmacological treatments such as peer mentoring showed limited effectiveness.</p><p><strong>Conclusion: </strong>This evidence-based review provides a comprehensive overview of the research landscape of RCTs addressing mental health post-MSTBI. The findings from these RCTs may be valuable for health care professionals, researchers, and policymakers involved in the field of mental health and neurorehabilitation.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":"39 5","pages":"342-358"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updated Canadian Clinical Practice Guideline for the Rehabilitation of Adults With Moderate to Severe Traumatic Brain Injury: Behavioral Recommendations.","authors":"Heather M MacKenzie, Diana Velikonja, Julia Devito, Lauren Devito, Eleni M Patsakos, Mark Bayley, Robert Teasell, Swati Mehta","doi":"10.1097/HTR.0000000000000973","DOIUrl":"10.1097/HTR.0000000000000973","url":null,"abstract":"<p><strong>Objective: </strong>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. This article will summarize the updated recommendations for the assessment and management of behavioral changes in adults after MSTBI.</p><p><strong>Design: </strong>A systematic search was conducted by the evidence-based review of moderate to severe acquired brain injury to identify new and relevant articles. Expert panels reviewed and discussed the new and existing evidence, evaluated its quality, and added, removed, or modified recommendations and tools as needed. A consensus process was followed to achieve agreement on recommendations.</p><p><strong>Results: </strong>The 2023 Canadian Clinical Practice Guideline for the Rehabilitation of Adults with Moderate to Severe Traumatic Brain Injury (CAN-TBI 2023) includes 21 recommendations regarding best practices for the assessment and management of behavioral disorders post-MSTBI. Fifteen recommendations remained unchanged, and 6 recommendations were updated. Eight recommendations are based on level B evidence and 13 on level C evidence. There are no recommendations based on level A evidence. The guideline also includes a step-by-step algorithm for clinicians to follow outlining an approach to the assessment and management of agitation and aggression.</p><p><strong>Conclusion: </strong>CAN-TBI 2023 will assist clinicians in the assessment and safe and effective management of behavioral changes post-MSTBI. The guideline is informed by a growing scientific database although there is a need for additional high-quality research to better guide the assessment and management of this complex patient population.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":"39 5","pages":"382-394"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-Based Review of Randomized Controlled Trials of Interventions for the Management of Behavioral Issues in Individuals With Moderate to Severe Traumatic Brain Injury.","authors":"Heather M MacKenzie, Cecilia Flores-Sandoval, Emma A Bateman, Amanda McIntyre, Ujjoyinee Barua, Swati Mehta, Mark Bayley, Robert Teasell","doi":"10.1097/HTR.0000000000000971","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000971","url":null,"abstract":"<p><strong>Objective: </strong>To present an evidence-based review of randomized controlled trials (RCTs) evaluating interventions for the management of behavioral issues post moderate to severe traumatic brain injury (MSTBI), as part of an extensive database that has been conceptualized as a living systematic review.</p><p><strong>Methods: </strong>Systematic searches were conducted in MEDLINE, PubMed, Scopus, CINAHL, EMBASE and PsycINFO, up to and including December 2022, for articles published in the English language, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of RCT was assessed using the Physiotherapy Evidence Database (PEDro) scale, and level of evidence was assigned using a modified Sackett scale.</p><p><strong>Results: </strong>Forty-six RCTs examining interventions and outcome measures related to behavioral issues post-MSTBI were included. These studies collectively enrolled 3,267 participants. The majority of RCTs were conducted in the United States (n = 27; 58.7%) and 28 (60.9%) were conducted after 2010. Of these, 27 RCTs examined non-pharmacological interventions and 19 examined pharmacological interventions. Effective pharmacological treatments included amantadine and dexmedetomidine. Effective non-pharmacological interventions included sensory stimulation in the acute phase, anger self-management programs, peer mentoring, problem-solving, and emotional regulation. Psychotherapy showed conflicting evidence.</p><p><strong>Conclusion: </strong>This evidence-based review provides a comprehensive overview of the research landscape of RCTs addressing behavior post-MSTBI. The findings from these RCTs may be valuable for health care professionals, researchers, and policymakers involved in the field of TBI and behavior.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":"39 5","pages":"369-381"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INTIMASY-TBI Guideline: Optimization of INTIMAcy, SexualitY, and Relationships Among Adults With Traumatic Brain Injury.","authors":"Eleni M Patsakos, Samantha Backhaus, Kathryn Farris, Marisa King, Jhon Alexander Moreno, Dawn Neumann, Angelle Sander, Mark T Bayley","doi":"10.1097/HTR.0000000000000981","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000981","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic brain injury (TBI) can negatively impact intimacy, relationships, and sexual functioning through changes in physical, endocrine, cognitive, behavioral, and emotional function. Without intervention, diminished intimacy and/or sexual functioning in individuals with TBI may persist. Although most health care professionals agree that sexuality and intimacy in relationships are significant concerns and should be addressed in rehabilitation, these concerns are not typically discussed during rehabilitation and discharge planning for people with TBI. To address this gap, an expert panel of North American clinicians and researchers convened to develop evidence-informed recommendations to assist clinicians in providing a framework and guidance on how clinicians can support individuals after TBI.</p><p><strong>Methods: </strong>A systematic search of multiple databases was conducted to identify relevant evidence published from 2010 to 2023. The INTIMASY-TBI Expert Panel developed recommendations for optimizing discussions and interventions related to intimacy and sexuality for people with TBI in rehabilitation and community-based programs. For each recommendation, the experts evaluated the evidence by examining the study design and quality to determine the level of evidence.</p><p><strong>Results: </strong>A total of 12 recommendations were developed that address the following topic areas: (1) interprofessional team training, (2) early education on the effects of TBI on intimacy, relationships, and sexuality, (3) creating individualized interventions, (4) education, assessment, and management of the causes of sexual dysfunction, and (5) providing written materials and relationship coaching to persons with TBI and their partners. Two recommendations were supported by Level A evidence, 1 was supported by Level B evidence, and 9 were supported by Level C (consensus of the INTIMASY-TBI Expert Panel) evidence. A decision algorithm was developed to assist clinicians in navigating through the recommendations.</p><p><strong>Conclusion: </strong>The INTIMASY-TBI Guideline is one of the first comprehensive clinical practice guidelines to offer strategies to trained clinicians to discuss the physical, psychosocial, behavioral, and emotional aspects of intimacy and sexuality with persons with TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":"39 5","pages":"395-407"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurobehavioral Symptoms in Spanish-Speaking Individuals With Subconcussive Injuries.","authors":"Denise Krch, Anthony H Lequerica, Juan Carlos Arango-Lasprilla, John D Corrigan","doi":"10.1097/HTR.0000000000000939","DOIUrl":"10.1097/HTR.0000000000000939","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether exposure to high-risk events causing injury to the head or neck has an effect on neurobehavioral symptoms in the absence of an alteration of consciousness in Spanish-speakers.</p><p><strong>Setting: </strong>Web-based survey.</p><p><strong>Participants: </strong>Seven hundred forty-eight individuals from Spain and Latin America, aged 18 to 65 years, with 10 years or more of education. Thirty-nine participants failed quality checks and were excluded. Seven hundred nine participants were included in the analyses.</p><p><strong>Design: </strong>Cross-sectional study. Subconcussive exposure was defined as endorsing exposure to one or more high-risk scenarios in the absence of any alteration of consciousness. Three injury groups were derived: No Head Injury, Subconcussive Exposure, and traumatic brain injury (TBI). The Subconcussive Exposure group was further divided into Single and Multiple Exposures. Two analyses were conducted: the effect of lifetime exposure to injury (No Head Injury, Subconcussive Exposure, TBI) on neurobehavioral symptoms; the effect of Subconcussive Exposure Frequency (No Head Injury, Single Exposure, Multiple Exposures) on neurobehavioral symptoms.</p><p><strong>Main measures: </strong>Spanish Ohio State University Traumatic Brain Injury Identification Method Self-Administered-Brief (OSU TBI-ID SAB); Neurobehavioral Symptom Inventory (NSI).</p><p><strong>Results: </strong>There was a significant effect for Injury group on the NSI partial eta-squared (η p2 = 0.053) and a significant effect of Exposure Frequency group on the NSI (η p2 = 0.40). Individuals with subconcussive exposures reported significantly more neurobehavioral symptoms than those with no history of head injury and significantly less symptoms than those with TBI. Individuals with multiple subconcussive exposures reported significantly more neurobehavioral symptoms than those with single and no exposure.</p><p><strong>Conclusion: </strong>This research expands the utility of the OSU-TBI-ID SAB as a lifetime TBI history assessment tool to one capable of evaluating subconcussive exposure dosing effects in Spanish-speakers. Such an index may facilitate establishment of subconcussive exposure prevalence rates worldwide, leading to improved understanding of the chronic effects of high-risk exposures.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E399-E406"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140059579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}