Journal of Head Trauma Rehabilitation最新文献

{"title":"Association Between Follow-Up Visit Timing After A Concussion and Subsequent Care Seeking in Children and Youth: A Population-Based Study in British Columbia.","authors":"Scott Ramsay, V Susan Dahinten, Manon Ranger, Shelina Babul, Elizabeth Saewyc","doi":"10.1097/HTR.0000000000001001","DOIUrl":"10.1097/HTR.0000000000001001","url":null,"abstract":"<p><strong>Objective: </strong>To assess the relationship between follow-up visit timing and occurrence of the first subsequent health care seeking visit.</p><p><strong>Setting: </strong>The province of British Columbia, Canada.</p><p><strong>Participants: </strong>A total of 21 029 children and youth who were diagnosed with an initial concussion from January 1, 2016, to December 31, 2017. These data were obtained from Population Data BC.</p><p><strong>Design: </strong>A retrospective, descriptive correlational study.</p><p><strong>Main measures: </strong>Follow-up timing was measured categorically as timely (4 weeks), delayed (1-3 months), or no follow-up; the occurrence of a subsequent health care visit beyond 3 months postinjury was measured up to 12 months at 3-month intervals (ie, 4-6, 7-9, and 10-12 months). These variables were measured using diagnostic codes for concussion, post-concussion syndrome, and the 17 concussion symptoms.</p><p><strong>Results: </strong>After controlling for sociodemographic characteristics, having a delayed follow-up, relative to timely follow-up, was associated with higher odds of a subsequent health care seeking visit at 4 to 6 months (odds ratio [OR] = 2.68; confidence interval [CI], 2.08-3.47), 7 to 9 months (OR = 1.71; CI, 1.21-2.40), and 10 to 12 months (OR = 1.67; CI, 1.13-2.48). In contrast to having a delayed follow-up, having no follow-up, relative to timely follow-up, was associated with not having a subsequent health care seeking visit at 4 to 6 months (OR = 0.57; CI, 0.48-0.67) and 7 to 9 months (OR = 0.79; CI, 0.66-0.96), respectively.</p><p><strong>Conclusions: </strong>Follow-up visit timing after a concussion in children and youth is associated with subsequent health care seeking. Greater efforts are needed to investigate the importance of initial follow-up visit timing, as they may play an integral role in injury prevention and symptom management following injury.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E263-E271"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622078","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":"Return to Driving Following Moderate-to-Severe Traumatic Brain Injury: A TBI Model System Longitudinal Investigation.","authors":"Thomas A Novack, Yue Zhang, Richard Kennedy, Jennifer Marwitz, Lisa J Rapport, Elaine Mahoney, Thomas Bergquist, Charles Bombardier, Candy Tefertiller, William Walker, Thomas K Watanabe, Robert Brunner","doi":"10.1097/HTR.0000000000000983","DOIUrl":"10.1097/HTR.0000000000000983","url":null,"abstract":"<p><strong>Objective: </strong>To examine longitudinal patterns of return to driving (RTD), driving habits, and crash rates associated with moderate-to-severe traumatic brain injury (TBI).</p><p><strong>Setting: </strong>Eight TBI Model System sites.</p><p><strong>Participants: </strong>Adults ( N = 334) with TBI that required inpatient acute rehabilitation with follow-up of 197 and 218 at 1 and 2 years post-injury, respectively. Data collection at 2 years occurred almost exclusively during the pandemic, which may have affected results.</p><p><strong>Design: </strong>Longitudinal and observational.</p><p><strong>Main measures: </strong>Driving survey completed during rehabilitation and at phone follow-up 1 and 2 years after injury.</p><p><strong>Results: </strong>The rate of RTD was 65% at 1-year follow-up and 70% at 2-year follow-up. RTD at both follow-up time points was positively associated with family income. The frequency of driving and distance driven were diminished compared to before injury. Limitation of challenging driving situations (heavy traffic, bad weather, and at night) was reported at higher rates post-injury than before injury. Crash rates were 14.9% in the year prior to injury (excluding crashes that resulted in TBI), 9.9% in the first year post-injury, and 6% during the second year.</p><p><strong>Conclusion: </strong>RTD is common after TBI, although driving may be limited in terms of frequency, distance driven, and avoiding challenging situations compared to before injury. Incidence of crashes is higher than population-based statistics; however, those who sustain TBI may be at higher risk even prior to injury. Future work is needed to better identify characteristics that influence the likelihood of crashes post-TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"193-202"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893598","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":"203-215"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","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":"Psychometric Properties of Vestibular and Ocular Measures Used for Concussion Assessments: A Scoping Review.","authors":"Keely Barnes, Heidi Sveistrup, Motahareh Karimijashni, Mark Bayley, Shawn Marshall","doi":"10.1097/HTR.0000000000000985","DOIUrl":"10.1097/HTR.0000000000000985","url":null,"abstract":"<p><strong>Background: </strong>Concussions most commonly affect the vestibular and ocular systems. Clinical measures used in the assessment of vestibular and ocular deficits should contain strong psychometric properties so that clinicians can accurately detect abnormality to guide treatment interventions.</p><p><strong>Objectives: </strong>The aim of this scoping review was: (1) to identify the measures used to evaluate the vestibular and ocular domains postconcussion and (2) to document the psychometric properties of the measures.</p><p><strong>Methods: </strong>Two databases (Medline (Ovid) and Embase) were searched from inception to May 2023. An updated search was completed in January 2024 using the same databases and search terms. Studies were screened and data were extracted independently by 2 reviewers. Measures were categorized into vestibular, ocular, or both (vestibular and ocular) domains, and relevant psychometric properties were documented.</p><p><strong>Results: </strong>Fifty-two studies were included in this review. 28 studies explored the use of vestibular measures, 12 explored ocular measures, and 12 explored both vestibular and ocular measures or explored the use of vestibulo-ocular reflex measures. Most studies explored the properties associated with balance measures, particularly the balance error scoring system. Diagnostic accuracy (sensitivity and specificity metrics) of the associated measures was the most frequently documented characteristic in the literature.</p><p><strong>Conclusion: </strong>Identification of clinical measures used to evaluate vestibular and ocular deficits postconcussion is needed to understand the evidence supporting their use in practice. Documenting the psychometric properties will allow clinicians and researchers to understand the status of the current literature and support for the use of certain measures in practice in terms of their ability to appropriately detect deficits in people with concussion when deficits are truly present.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E240-E250"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348140","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":"Supportive Elements and Challenges to Return to Work Following a Concussion: A Scoping Review.","authors":"Maryam Shahzad, Joyce Lo, Beatrice Yuen, Andrea Duncan, Nick Reed, Behdin Nowrouzi-Kia","doi":"10.1097/HTR.0000000000001064","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001064","url":null,"abstract":"<p><strong>Objective: </strong>This scoping review aims to comprehensively explore the facilitators and barriers influencing the return to work (RTW) process following a concussion, with a focus on the person impacted by concussion, medical system, funder, and workplace domains.</p><p><strong>Design: </strong>A scoping review of electronic databases, including CINAHL, Embase, MEDLINE, PsycINFO and Web of Science, was conducted to identify relevant studies published up to April 6, 2024. Studies were included if they examined factors influencing RTW following a concussion and were available in English. Data extraction, numerical analysis and deductive content analysis were performed to determine key themes from the data. Reporting guidelines provided by the PRISMA-ScR were adhered to, and the protocol has been registered and can be accessed at the Open Science Framework.</p><p><strong>Results: </strong>Twenty studies met the inclusion criteria and were included in the review. Findings were organized into 4 main themes influencing the RTW process: the person impacted by concussion, medical system, funder, and workplace. These were further categorized into 2 subthemes: supportive elements and challenges. Various supportive elements within each theme were identified, such as individualized rehabilitation services, graduated return to work, and developing personal agency in the individual impacted by concussion. Challenges such as lack of patient education, delayed access to services, and isolating workplace accommodations were highlighted. These findings underscore the complex interplay of factors shaping the RTW trajectory post-concussion.</p><p><strong>Conclusion: </strong>This scoping review provides a detailed examination of supportive elements and challenges in the RTW process following a concussion. The identified themes offer valuable insights for clinicians and researchers seeking to optimize RTW outcomes and support individuals re-entering the workforce after a concussion. Future research should prioritize an examination of relevant policies and practices, assessing long-term outcomes, and explore strategies to integrate support systems to enhance the RTW experience.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029448","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":"Impacts of Traumatic Brain Injury and Severe Limb Injury on Death by Suicide: Concurrent Investigations Using Path Analysis.","authors":"Samuel Y Chung, Jordan A Levine, Emily A Schmied, John C Shero, Christopher L Dearth, Jennifer N Belding","doi":"10.1097/HTR.0000000000001053","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001053","url":null,"abstract":"<p><strong>Objective: </strong>Utilize path analysis to examine the concurrent associations of traumatic brain injury (TBI) and severe limb injury (SLI) with death by suicide mediated by psychological health (PH) conditions and substance use disorders (SUDs).</p><p><strong>Setting: </strong>Archival career and medical data were obtained from the Career History Archival Medical and Personnel System, the Expeditionary Medical Encounter Database, and the Defense Suicide Prevention Office Suicide Data Repository.</p><p><strong>Participants: </strong>Service members of the air force, army, marines corps, and navy who served more than 30 consecutive days between September 11, 2001, and September 30, 2016.</p><p><strong>Design: </strong>This retrospective cohort study utilized path analysis to examine associations among TBI, SLI, PH conditions, SUD, and death by suicide. Stratification by TBI was tested.</p><p><strong>Main measures: </strong>Concurrent associations of 2 focal predictors, TBI and SLI, with death by suicide were investigated, mediated by PH conditions (ie, posttraumatic stress disorder, depression, or anxiety disorder), and SUDs (ie, alcohol use disorder or other drug use disorder), adjusting for age, sex, race/ethnicity, service branch, and officer status.</p><p><strong>Results: </strong>In preliminary analyses, TBI, SLI, PH conditions, and SUD were all independently associated with death by suicide. In the first path model, neither of the direct effect of SLI or TBI on death by suicide were significant. TBI shared a stronger association with PH conditions and SUD than SLI did; the association between SLI and SUD was negative. When stratified by TBI status, the association between SUD and death by suicide was stronger among those without (vs with) TBI.</p><p><strong>Conclusions: </strong>Findings suggest complex and nuanced associations between TBI, SLI, PH conditions, SUD, and death by suicide, and underscore the importance of integrated and holistic treatment of injured military service members.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997186","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":"Impact of a New Program of Care for Work-Related Mild Traumatic Brain Injury on Recovery and Return to Work.","authors":"Yuriy Chechulin, Natasha Nanwa, John J Leddy, Aaron M S Thompson","doi":"10.1097/HTR.0000000000001055","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001055","url":null,"abstract":"<p><strong>Background: </strong>The Workplace Safety and Insurance Board (WSIB) in Ontario, Canada, launched a new community-based mild traumatic brain injury (mTBI) program of care (POC) in November 2020. The new program included graded exercise therapy and vestibular rehabilitation (where required). The objective of this study was to assess the impact of the new mTBI POC on recovery and return to work among patients who suffered a work-related mTBI.</p><p><strong>Methods: </strong>We identified WSIB claims that accessed the previous and new mTBI POC over a 4-year timeframe (October 1, 2017, to September 30, 2019, and July 1, 2021, to June 30, 2023). A quasi-experimental pre-post study, propensity score matching design with a difference-in-difference modelling component was applied to approximate estimation of causal effects on loss of earnings (LOE) benefit duration at 3-, 6-, and 12-months and HC costs for patients treated in the previous and new programs.</p><p><strong>Results: </strong>Over the 4-year timeframe, 5625 patients accessed the previous and new mTBI POC. The new program achieved improved 3-, 6-, and 12-month disability durations (incremental percentage difference of -11.7%, -9.3%, and -9.0%, respectively), and shorter durations of disability, reflected by decreased LOE benefit costs (incremental percentage difference of -32.6%) and decreased HC costs (incremental percentage difference of -5.6%). The overall combined savings in LOE and HC costs was 21%.</p><p><strong>Conclusions: </strong>This analysis indicates that the implementation of this new evidence based mTBI POC resulted in improved outcomes (decreased disability duration and lower health care utilization) on a per patient basis for people with work-related mTBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996868","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":"Sex Differences in Response to Low- Versus High-Volume Aerobic Exercise for Sport-Related Concussion: A Pilot Randomized Controlled Trial.","authors":"Haley M Chizuk, Elizabeth Castro, Sarah Robinson, Jaffer Sayeed, Alex Rawlings, John J Leddy, Mohammad N Haider","doi":"10.1097/HTR.0000000000001061","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001061","url":null,"abstract":"<p><strong>Objective: </strong>To assess sex differences in behavior and motivation of adolescent athletes with sport-related concussion (SRC) versus controls during a 2-week individualized aerobic exercise intervention.</p><p><strong>Setting: </strong>Academic center research laboratory.</p><p><strong>Participants: </strong>Participants were enrolled within 10 days of SRC (n = 32; 15.6 ± 1.4 years, 33% female, 6.18 ± 2.21 days from injury). Twenty-eight control participants (16.0 ± 1.6 years, 33% female) were recruited.</p><p><strong>Design: </strong>Randomized control trial with a 1:1 block randomization scheme stratified by participant sex.</p><p><strong>Main measures: </strong>Clinical recovery time as determined by the study physician, heart rate threshold (HRt) on the Buffalo Concussion Treadmill Test, adherence rates (calculated as exercise volume completed/exercise volume prescribed), and behavioral assessments including the perceived competence scale (PCS) and the treatment self-regulation questionnaire (TSRQ).</p><p><strong>Results: </strong>Females achieved higher initial HRts (P = .007), ie, the maximum HR during exercise testing. Males and females with a concussion showed minimal differences in motivation and perceived competence. Although it did not reach statistical significance (P = .058), females in the low-volume group appeared to recover faster than the high-volume group. This trend was not seen in males. Seven (88%) of exercise-intolerant females had to stop an exercise bout early on 1 or more days due to more-than-mild symptom exacerbation versus 3 (17%) of exercise-intolerant males (P = .002).</p><p><strong>Conclusion: </strong>Females with a concussion prescribed a high volume of aerobic exercise treatment appeared to take longer to recover than females with a concussion who were prescribed a lower volume, which was not seen in males. Increased training heart rate prescriptions due to higher initial HRts and symptom exacerbation during at-home exercise may have affected female exercise behavior. Although aerobic exercise benefits SRC recovery, this study highlights the need for future research to optimize exercise treatment prescriptions for females after SRC.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039785","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":"Revisiting the Common Misconceptions About Traumatic Brain Injury Scale (CM-TBI); What Does It Really Measure?","authors":"Christine Padgett, Hoang Nguyen, Peta S Cook, Olivia Hannon, Kathleen Doherty, Jenna Ziebell, Claire Eccleston","doi":"10.1097/HTR.0000000000001059","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001059","url":null,"abstract":"<p><strong>Objective: </strong>To examine the factor structure and validity of the 40-item common misconceptions in traumatic brain injury (CM-TBI) scale, and to develop and evaluate additional concussion-focussed items to broaden the instrument's scope.</p><p><strong>Method: </strong>A purposive sample of 988 participants from across all habitable continents (M age 43, range 16-90 years, 84% female) completed the CM-TBI and 5 additional concussion items at commencement of an online course on TBI.</p><p><strong>Results: </strong>Item analysis resulted in the removal of 19 items due to ambiguous wording and poor conceptual integrity, and/or low discrimination and low inter-item correlations. An exploratory factor analysis on the remaining 26 items revealed a 3-factor model had best fit, with an additional 8 items removed due to low or cross-loadings, low communalities, and/or low conceptual relevance, resulting in an 18-item revised scale.</p><p><strong>Conclusion: </strong>There is no psychometric support for the current structure of the CM-TBI. This is likely due to changes in understanding of TBI since the scale's inception, and issues of conceptual ambiguity. It is also proposed that a distinction must be made between knowledge and misconceptions, as these are 2 related but different constructs that are not clearly delineated in the current CM-TBI. Using the revised scale here offers researchers a more modern, focussed, and valid measure, but a new scale to measure knowledge and misconceptions in TBI is urgently needed.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020420","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":"Assessing Task-Dependent Neurophysiology During Virtual Reality Treadmill Training in Adults With Traumatic Brain Injury: A Functional Near-Infrared Spectroscopy Feasibility Study.","authors":"Jaclyn Stephens, Kaitlin Hays, Haylee Winden, Brandon Busch, Candace Tefertiller","doi":"10.1097/HTR.0000000000001057","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001057","url":null,"abstract":"<p><strong>Objective: </strong>Individuals with traumatic brain injury (TBI) often experience residual mobility deficits that can be improved with treadmill and virtual reality interventions. However, previous studies have not measured the underlying neurophysiology during these interventions nor assessed if acquiring such data is feasible in a TBI population. Thus, the primary purpose of this study was to assess the feasibility of using portable functional near-infrared spectroscopy (fNIRS) to measure neurophysiology during a treadmill task and a treadmill with virtual reality task.</p><p><strong>Setting: </strong>Data were collected in an outpatient setting at Craig Hospital.</p><p><strong>Participants: </strong>Eight individuals with chronic moderate to severe TBI were recruited. The primary eligibility criteria include age of 18 years or older, diagnosis of moderate to severe TBI that initially required inpatient rehabilitation at least 1 year prior and could walk at least 10 feet without support from more than 1 person.</p><p><strong>Design: </strong>Cross-sectional feasibility study. Participants were assessed with fNIRS while completing a 12-minute treadmill task and a 12-minute treadmill with virtual reality task. Feasibility benchmarks were established a priori and included safety, acceptability, data acquisition and quality metrics.</p><p><strong>Main measures: </strong>Pre-determined feasibility objectives served as the primary outcome of this study. Global brain activity as measured by FNIRS was acquired during treadmill training alone and treadmill training with virtual reality in early, middle, and late epochs.</p><p><strong>Results: </strong>The fNIRS protocol used in this study was safe for all participants and acceptable to 87.5% of participants. FNIRS data acquisition and quality benchmarks were achieved for 87.5% participants. Exploratory fNIRS analyses revealed significantly greater global brain activity during the treadmill with virtual reality task compared to the treadmill task alone in late epochs. No adverse events occurred.</p><p><strong>Conclusion: </strong>All feasibility benchmarks were achieved suggesting that this fNIRS protocol can be used in future, larger-scale studies.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013657","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}