The Journal of Head Trauma Rehabilitation最新文献

{"title":"Factors Associated With Response to Adapted Cognitive Behavioral Therapy for Anxiety and Depression Following Traumatic Brain Injury.","authors":"Jennie Ponsford,&nbsp;Nicole K Lee,&nbsp;Dana Wong,&nbsp;Adam McKay,&nbsp;Kerrie Haines,&nbsp;Marina Downing,&nbsp;Yvette Alway,&nbsp;Christina Furtado,&nbsp;Meaghan L O'Donnell","doi":"10.1097/HTR.0000000000000510","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000510","url":null,"abstract":"<p><strong>Background: </strong>Given the high frequency and significance of anxiety and depression following traumatic brain injury (TBI), there is a need to evaluate the efficacy of psychological interventions and to understand factors influencing response to such interventions. The present study investigated factors associated with positive response to cognitive behavioral therapy adapted for cognitive impairments (CBT-ABI) for individuals with anxiety and depression following TBI, including demographic and injury-related factors, pretreatment levels of anxiety and depression, working alliance, and change expectancy as predictors.</p><p><strong>Methods: </strong>Participants were 45 individuals enrolled in an active treatment condition within a randomized controlled trial, examining the efficacy of a 9-session CBT-ABI program for anxiety and depression following TBI. These participants completed all CBT sessions.</p><p><strong>Results: </strong>Mixed-effects regressions controlling for baseline anxiety and depression indicated that for anxiety, older age at injury, as well as higher level of baseline anxiety, was associated with greater symptom reduction. For depression, longer time since injury and higher expectancy for change, as well as higher baseline level of depression, were significantly associated with a greater reduction in depression symptoms.</p><p><strong>Conclusions: </strong>This study paves the way for more detailed studies of the therapeutic processes involved in alleviating anxiety and depression following TBI.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"117-126"},"PeriodicalIF":2.4,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40452022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to Productivity Projections for Individuals With Moderate to Severe TBI Following Inpatient Rehabilitation: A NIDILRR TBIMS and CDC Interagency Collaboration.","authors":"Christopher Pretz,&nbsp;Robert G Kowalski,&nbsp;Jeffrey P Cuthbert,&nbsp;Gale G Whiteneck,&nbsp;A Cate Miller,&nbsp;Jessica M Ketchum,&nbsp;Kristen Dams-O'Connor","doi":"10.1097/HTR.0000000000000506","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000506","url":null,"abstract":"<p><strong>Objective: </strong>Return to work and school following traumatic brain injury (TBI) is an outcome of central importance both to TBI survivors and to society. The current study estimates the probability of returning to productivity over 5 years following moderate to severe brain injury.</p><p><strong>Design: </strong>A secondary longitudinal analysis using random effects modeling, that is, individual growth curve analysis based on a sample of 2542 population-weighted individuals from a multicenter cohort study.</p><p><strong>Setting: </strong>Acute inpatient rehabilitation facilities.</p><p><strong>Participants: </strong>Individuals 16 years and older with a primary diagnosis of TBI who were engaged in school or work at the time of injury.</p><p><strong>Main outcome measures: </strong>Participation in productive activity, defined as employment or school, as reported during follow-up telephone interviews at 1, 2, and 5 years postinjury.</p><p><strong>Results: </strong>Baseline variables, age of injury, race, level of education and occupational category at the time of injury, disability rating at hospital discharge, substance abuse status, and rehabilitation length of stay, are significantly associated with probability of return to productivity. Individual-level productivity trajectories generally indicate that the probability of returning to productivity increases over time.</p><p><strong>Conclusions: </strong>Results of this study highlight the importance of preinjury occupational status and level of education in returning to productive activity following moderate to severe TBI.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"140-151"},"PeriodicalIF":2.4,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40551810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Lifetime and Deployment-Acquired Traumatic Brain Injury With Postdeployment Binge and Heavy Drinking.","authors":"Rachel Sayko Adams,&nbsp;Laura Campbell-Sills,&nbsp;Murray B Stein,&nbsp;Xiaoying Sun,&nbsp;Mary Jo Larson,&nbsp;Ronald C Kessler,&nbsp;Robert J Ursano,&nbsp;Sonia Jain,&nbsp;John D Corrigan","doi":"10.1097/HTR.0000000000000508","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000508","url":null,"abstract":"<p><strong>Objective: </strong>To investigate associations of lifetime traumatic brain injury (LT-TBI) prior to an index deployment, and/or deployment-acquired TBI (DA-TBI), with postdeployment binge and heavy drinking.</p><p><strong>Setting: </strong>Soldiers from 3 Brigade Combat Teams deployed to Afghanistan in 2012.</p><p><strong>Participants: </strong>A total of 4645 soldiers who participated in the Army STARRS Pre/Post Deployment Study and completed 4 assessments: T0 (1-2 months predeployment), T1 (upon return to United States), T2 (3 months postdeployment), and T3 (9 months postdeployment).</p><p><strong>Design: </strong>Prospective, longitudinal study controlling for baseline binge drinking.</p><p><strong>Main measures: </strong>Self-reported past month binge drinking (5+ alcoholic beverages on the same day) and past month heavy drinking (binge drinking at least weekly) at T2 and T3.</p><p><strong>Results: </strong>In total, 34.3% screened positive for LT-TBI, and 19.2% screened positive for DA-TBI. At T2 only, LT-TBI, but not DA-TBI, was associated with increased odds of binge drinking (adjusted odds ratio [AOR] = 1.39, 95% confidence interval [CI]: 1.20-1.60, P < .001) and heavy drinking (AOR = 1.28, 95% CI: 1.09-1.49, P = .007). Among the subgroup with LT-TBI, also having DA-TBI was associated with increased risk of heavy drinking at T3 (AOR = 1.42, 95% CI: 1.03-1.95, P = .047).</p><p><strong>Conclusion: </strong>Routine screening for LT-TBI may help target efforts to prevent alcohol misuse among military members.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"27-36"},"PeriodicalIF":2.4,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40451985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptance of Rehabilitation Technology in Adults With Moderate to Severe Traumatic Brain Injury, Their Caregivers, and Healthcare Professionals: A Systematic Review.","authors":"Atiyeh Vaezipour,&nbsp;Brooke-Mai Whelan,&nbsp;Kylie Wall,&nbsp;Deborah Theodoros","doi":"10.1097/HTR.0000000000000462","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000462","url":null,"abstract":"<p><strong>Background: </strong>Moderate to severe traumatic brain injuries (TBIs) commonly result in persistent physical, cognitive, and/or emotional deficits that require long-term rehabilitation. Technology-enabled rehabilitation provides an innovative alternative to traditional intervention models. End-user acceptance of these interventions, however, is a critical factor in determining the effective implementation and acceptance of these technologies.</p><p><strong>Objective: </strong>To systematically review the literature to identify methods and measures used to evaluate user acceptance relating to rehabilitation technologies for adults with moderate to severe TBI, their caregivers, and healthcare professionals.</p><p><strong>Methods: </strong>Six key databases including Medline, Embase, CINAHL, Cochrane, Scopus, and Web of Science were searched using the relevant search terms.</p><p><strong>Results: </strong>From a yield of 2059 studies, 13 studies met the eligibility criteria. The review revealed limited research that formally evaluated user acceptance in relation to rehabilitation technologies designed for adults with TBI. Furthermore, where such evaluations were conducted, comprehensive research designs incorporating theoretical frameworks of technology acceptance were sparse. Importantly, a range of technologies and recommendations that positively influenced user acceptance were identified. Future directions for research in this area include the use of theory-driven research designs to enhance our understanding of technology acceptance, to support the development of rehabilitation technologies that maximize functional outcomes for individuals with TBI.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E67-E82"},"PeriodicalIF":2.4,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000462","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36833520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance Validity in Collegiate Football Athletes at Baseline Neurocognitive Testing.","authors":"Christopher Abeare,&nbsp;Isabelle Messa,&nbsp;Cameron Whitfield,&nbsp;Brandon Zuccato,&nbsp;Joseph Casey,&nbsp;Nicholas Rykulski,&nbsp;Laszlo Erdodi","doi":"10.1097/HTR.0000000000000451","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000451","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence of invalid performance on baseline neurocognitive testing using embedded measures within computerized tests and individually administered neuropsychological measures, and to examine the influence of incentive status and performance validity on neuropsychological test scores.</p><p><strong>Setting: </strong>Sport-related concussion management program at a regionally accredited university.</p><p><strong>Participants: </strong>A total of 83 collegiate football athletes completing their preseason baseline assessment within the University's concussion management program and a control group of 140 nonathlete students.</p><p><strong>Design: </strong>Cross-sectional design based on differential incentive status: motivated to do poorly to return to play more quickly after sustaining a concussion (athletes) versus motivated to do well due to incentivizing performance (students).</p><p><strong>Main measures: </strong>Immediate Post-Concussion and Cognitive Testing (ImPACT), performance validity tests, and measures of cognitive ability.</p><p><strong>Results: </strong>Half of the athletes failed at least 1 embedded validity indicator within ImPACT (51.8%), and the traditional neuropsychological tests (49.4%), with large effects for performance validity on cognitive test scores (d: 0.62-1.35), incentive status (athletes vs students; d: 0.36-1.15), and the combination of both factors (d: 1.07-2.20) on measures of attention and processing speed.</p><p><strong>Conclusion: </strong>Invalid performance on baseline assessment is common (50%), consistent across instruments (ImPACT or neuropsychological tests) and settings (one-on-one or group administration), increases as a function of incentive status (risk ratios: 1.3-4.0) and results in gross underestimates of the athletes' true ability level, complicating the clinical interpretation of the postinjury evaluation and potentially leading to premature return to play.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E20-E31"},"PeriodicalIF":2.4,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000451","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36738809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for a Randomized Controlled Trial of CI Therapy for Rehabilitation of Upper Extremity Motor Deficit: The Bringing Rehabilitation to American Veterans Everywhere Project.","authors":"David M Morris, Edward Taub, Victor W Mark, Wei Liu, Lisa Brenner, Treven Pickett, Kelly Stearns-Yoder, Staci Bishop-McKay, Andrea Taylor, Laura Reder, Terrie Adams, James Rimmer, Dustin Dew, Jerzy Szaflarski, Brent Womble, Lillian Stevens, David Rothman, Gitendra Uswatte","doi":"10.1097/HTR.0000000000000460","DOIUrl":"10.1097/HTR.0000000000000460","url":null,"abstract":"<p><p>Constraint-induced movement therapy (CI therapy) has been shown to reduce disability for individuals with upper extremity (UE) hemiparesis following different neurologic injuries. This article describes the study design and methodological considerations of the Bringing Rehabilitation to American Veterans Everywhere (BRAVE) Project, a randomized controlled trial of CI therapy to improve the motor deficit of participants with chronic and subacute traumatic brain injury. Our CI therapy protocol comprises 4 major components: (1) intensive training of the more-affected UE for target of 3 hour/day for 10 consecutive weekdays, (2) a behavioral technique termed shaping during training, (3) a \"transfer package,\" 0.5 hour/day, of behavioral techniques to transfer therapeutic gains from the treatment setting to the life situation, and (4) prolonged restraint of use of the UE not being trained. The primary endpoint is posttreatment change on the Motor Activity Log, which assesses the use of the more-affected arm outside the laboratory in everyday life situations. Data from a number of secondary outcome measures are also being collected and can be categorized as physical, genomic, biologic, fitness, cognitive/behavioral, quality of life, and neuroimaging measures.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"268-279"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36833518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Medical and Psychiatric Comorbidities Following Traumatic Brain Injury.","authors":"Flora M Hammond, John D Corrigan, Jessica M Ketchum, James F Malec, Kristen Dams-OʼConnor, Tessa Hart, Thomas A Novack, Jennifer Bogner, Marie N Dahdah, Gale G Whiteneck","doi":"10.1097/HTR.0000000000000465","DOIUrl":"10.1097/HTR.0000000000000465","url":null,"abstract":"<p><strong>Objective: </strong>To examine the prevalence of selected medical and psychiatric comorbidities that existed prior to or up to 10 years following traumatic brain injury (TBI) requiring acute rehabilitation.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Six TBI Model Systems (TBIMS) centers.</p><p><strong>Participants: </strong>In total, 404 participants in the TBIMS National Database who experienced TBI 10 years prior.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure: </strong>Self-reported medical and psychiatric comorbidities and the onset time of each endorsed comorbidity.</p><p><strong>Results: </strong>At 10 years postinjury, the most common comorbidities developing postinjury, in order, were back pain, depression, hypertension, anxiety, fractures, high blood cholesterol, sleep disorders, panic attacks, osteoarthritis, and diabetes. Comparing those 50 years and older to those younger than 50 years, diabetes (odds ratio [OR] = 3.54; P = .0016), high blood cholesterol (OR = 2.04; P = .0092), osteoarthritis (OR = 2.02; P = .0454), and hypertension (OR = 1.84; P = .0175) were significantly more prevalent in the older cohort while panic attacks (OR = 0.33; P = .0022) were significantly more prevalent in the younger cohort. No significant differences in prevalence rates between the older and younger cohorts were found for back pain, depression, anxiety, fractures, or sleep disorders.</p><p><strong>Conclusions: </strong>People with moderate-severe TBI experience other medical and mental health comorbidities during the long-term course of recovery and life after injury. The findings can inform further investigation into comorbidities associated with TBI and the role of medical care, surveillance, prevention, lifestyle, and healthy behaviors in potentially modifying their presence and/or prevalence over the life span.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E1-E10"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602856/pdf/nihms-1509797.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36833525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Utilization and Missed Workdays for Parents of Children With Traumatic Brain Injury.","authors":"Richard E Nelson,&nbsp;Junjie Ma,&nbsp;Yan Cheng,&nbsp;Linda Ewing-Cobbs,&nbsp;Amy Clark,&nbsp;Heather Keenan","doi":"10.1097/HTR.0000000000000458","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000458","url":null,"abstract":"<p><strong>Background: </strong>We enrolled patients in a prospective study in which we obtained estimates of the direct and indirect burden for families of children with traumatic brain injury (TBI) relative to a control group of families of children with orthopedic injury (OI).</p><p><strong>Methods: </strong>Parents were surveyed at 3 time points following injury: 3, 6, and 12 months. At each follow-up contact, we asked parents to list the number of workdays missed, number of miles traveled, amount of travel-related costs, and whether their child had an emergency department (ED) visit, hospital admission, any over-the-counter (OTC) medications, and any prescription medications during that time period. We assessed the difference in these outcomes between the TBI and OI groups using multivariable logistic and 2-part regression models to account for high concentrations of zero values.</p><p><strong>Results: </strong>Children with TBI had significantly greater odds of having an ED visit (3.04; 95% CI, 1.12-8.24), OTC medications (1.98; 95% CI, 1.34-2.94), and prescription medications (2.34; 95% CI, 1.19-4.59) than those with OI. In addition, parents of children with TBI missed significantly more days of work (19.91 days; 95% CI, 11.64-28.17) overall during the 12 months following injury than their OI counterparts.</p><p><strong>Conclusion: </strong>Extrapolating our results to the entire country, we estimate that pediatric TBI is associated with more than 670 000 lost workdays annually over the 12 months following injury, which translates into more than $150 million in lost productivity. These missed workdays and lost productivity may be prevented through safety efforts to reduce pediatric TBI.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"257-267"},"PeriodicalIF":2.4,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000458","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36833517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of Sleep-Wake Disturbances in Childhood Traumatic Brain Injury: Relationship with Fatigue, Depression, and Quality of Life.","authors":"Edith N Botchway,&nbsp;Celia Godfrey,&nbsp;Vicki Anderson,&nbsp;Cathy Catroppa","doi":"10.1097/HTR.0000000000000446","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000446","url":null,"abstract":"<p><strong>Objective: </strong>To systematically appraise the literature on the prevalence, types, and predictors of sleep-wake disturbances (SWD), and on the relationship between SWD, fatigue, depression, and quality of life in children and adolescents with traumatic brain injury (TBI).</p><p><strong>Methods: </strong>MEDLINE, PubMed, PsychInfo, Web of Science, and EMBASE databases were searched, reference lists of retrieved articles were also searched for relevant articles, and study methods were evaluated for risk of bias.</p><p><strong>Results: </strong>Of the 620 articles assessed, 16 met inclusion criteria. Sleep-wake disturbances were common in childhood TBI. The most common types of SWD reported were insomnia and excessive daytime sleepiness, with mild TBI participants showing a trend toward more sleep maintenance insomnia, while sleep-onset insomnia was typical in those with moderate-severe TBI. Predictors of SWD reported in studies involving mild TBI participants included TBI severity, male sex, preexisting SWD, high body weight, and depression; while injury severity and internalizing problems were associated with SWD in moderate-severe TBI participants. Sleep-wake disturbances were also associated with fatigue and poor quality of life following TBI.</p><p><strong>Conclusion: </strong>Sleep-wake disturbances are highly prevalent in childhood TBI, regardless of injury severity. Routine assessments of SWD in survivors of childhood TBI are recommended.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"241-256"},"PeriodicalIF":2.4,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000446","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36737306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Appraisal of Systematic Reviews for Behavioral Treatments of Attention Disorders in Traumatic Brain Injury.","authors":"Jane Roitsch,&nbsp;Rachael Redman,&nbsp;Anne M P Michalek,&nbsp;Rachel K Johnson,&nbsp;Anastasia M Raymer","doi":"10.1097/HTR.0000000000000444","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000444","url":null,"abstract":"<p><strong>Objective: </strong>This review appraised the quality of systematic reviews (SRs) and meta-analyses (MAs) to summarize research on behavioral interventions for attention disorders in persons with traumatic brain injury.</p><p><strong>Methods: </strong>A search of 7 databases revealed 15 MAs/SRs reporting outcomes for attention treatments in traumatic brain injury. Two examiners independently coded the quality of reviews with the Critical Appraisal of Systematic Review or Meta-Analysis and the Evidence in Augmentative and Alternative Communication Systematic Review Scale.</p><p><strong>Results: </strong>The findings of both scales were highly correlated. Four reviews were conducted with high methodologic rigor indicated by a score of 60% or greater on both scales. No other study scored above 45%. Among the well-conducted SRs/MAs, evidence for direct attention training effects was limited to basic attention exercises, with little generalization to functional activities. Strategy training for activities and tasks requiring attentional abilities had a stronger evidence base in 1 rigorous MA.</p><p><strong>Conclusions: </strong>This appraisal provides valuable practice information. The conclusions of 4 rigorous reviews suggest that there is only limited positive scientific support for the effects of attention treatments for traumatic brain injury. Future SRs/MAs would benefit from adherence to review guidelines.</p>","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E42-E50"},"PeriodicalIF":2.4,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000444","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36737305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}