Brain Impairment最新文献

{"title":"Clinical characteristics of patients hospitalised with traumatic brain injury in an Australian tertiary hospital.","authors":"Aishani Desai, Vincent Oxenham, Jamie Berry, Anthony Delaney, Naomi Hammond, Frances Bass, Joanne M Bennett, Geoffrey Healy, Geoffrey Herkes, Jennifer Batchelor","doi":"10.1071/IB25044","DOIUrl":"10.1071/IB25044","url":null,"abstract":"<p><strong>Background: </strong>Recent studies report a global shift in the demographics of individuals sustaining a traumatic brain injury (TBI). An increasingly higher proportion of older adults now experience TBIs, falls have overtaken transport-related accidents as the leading cause of injury, and there is high prevalence of TBIs classified as mild. However, it remains unclear whether these demographic and clinical shifts are also occurring in Australia. This study aimed to examine the clinical characteristics of patients hospitalised following TBI and assess whether similar trends were evident.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted in a metropolitan hospital in Sydney. Data from 260 patients were extracted and analysed.</p><p><strong>Results: </strong>A total of 50% of patients hospitalised following a TBI were aged >60 years. Falls were the leading mechanism of injury (64%) for younger and older adults, and severe TBI cases (43%) were most frequently encountered. Males dominated the sample, except among adults aged >75 years, where distribution of cases was comparable for males and females.</p><p><strong>Conclusions: </strong>Results indicated that demographic trends in this Australian sample broadly reflect those reported globally, with older adults and falls predominating. Future research should focus on examining whether these findings are observed across diverse settings while improving recruitment of underrepresented populations.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"27 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A National Child Health Poll on paediatric concussion: perceived knowledge, self-efficacy and concern among Australian parents.","authors":"Vanessa C Rausa, Franz E Babl, Alannah Rudkin, Mary-Anne Measey, Anthea Rhodes, Vicki Anderson","doi":"10.1071/IB25051","DOIUrl":"10.1071/IB25051","url":null,"abstract":"<p><strong>Background: </strong>Parents play a role in the prevention, identification and management of concussion in their children. This study aimed to examine perceived concussion knowledge, self-efficacy regarding concussion identification and management, and concern about concussion among Australian parents.</p><p><strong>Methods: </strong>The Royal Children's Hospital National Child Health Poll is a periodic cross-sectional survey completed by a nationally representative sample of parents and caregivers selected from a consumer panel. Data were weighted to reflect the distribution of the Australian parent population.</p><p><strong>Results: </strong>The survey was completed by 1953 parents of 3260 children. One-third of parents reported having very little knowledge about concussion. One in five parents reported low self-efficacy in recognising signs of concussion or managing their child's recovery. Parents were most worried about their child sustaining a concussion in contact sports (85% of children). Due to their concern about the risk of concussion, some parents stopped their children participating in contact sport, non-contact sport and other physical activities.</p><p><strong>Conclusions: </strong>Parents reported having little knowledge about concussion and low self-efficacy in identification and management. Parents are concerned about the risk of concussion, with implications for child sport and physical activity participation. These findings identify knowledge, self-efficacy and concern about concussion risk as intervention targets within the Australian parent population.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"27 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation technologies perceived positively by patients and facilitated intensive therapy within sessions.","authors":"Nicholas Flynn, Ann Rahmann, Nia Luxton, Jessica Vu, Suzanne Kuys","doi":"10.1071/IB24124","DOIUrl":"10.1071/IB24124","url":null,"abstract":"<p><strong>Background: </strong>Australian inpatient rehabilitation facilities are increasingly integrating rehabilitation technologies to support patient recovery. However, little is known about patient perceptions of rehabilitation technologies and the intensity of therapy able to be facilitated. This study aimed to quantify the amount of practice being achieved by patients in an Australian inpatient rehabilitation setting and explore their perceptions of upper limb rehabilitation technologies.</p><p><strong>Methods: </strong>A multimethod study design was used to investigate the perceptions and use of rehabilitation technologies (i.e. InMotion, Fourier ArmMotus, SaeboReJoyce and Touch Accessible Platform for Interactive Technology) by adult inpatients. Semi-structured interviews and the System Usability Scale were completed. Observations of routine therapy sessions were undertaken to quantify the amount and intensity of technology-based practice.</p><p><strong>Results: </strong>Ten participants were recruited (50% male, mean age 62 years). A total of 15 sessions were observed across all participants using robot-assisted therapy and Touch Accessible Platform for Interactive Technology at an average duration of 35 min/session; of which 29 min was active therapy. Most participants described their experiences with rehabilitation technologies positively, highlighting benefits for recovery, enjoyability and easy usability. Participants rated the technologies highly on the System Usability Scale, with total scores ranging between 65 and 100 for usability, and a minimum rating of 'good' for user-friendliness.</p><p><strong>Conclusion: </strong>Rehabilitation technologies were well received by adults undergoing inpatient rehabilitation and with application for a range of impairments. The technologies facilitated enjoyment of daily therapy, and participants were comfortable with limited therapist input when using the devices. Additionally, participants were able to engage in highly intensive practice using the technologies.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"27 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating telehealth assessment of physical concussion symptoms.","authors":"Stephanie Macheras, Tess Peverill, Adam McKay, Jennie Ponsford, Trevor Russell, Katie Davies","doi":"10.1071/IB25133","DOIUrl":"10.1071/IB25133","url":null,"abstract":"<p><strong>Background: </strong>Telehealth could expand access to specialised concussion care; however, physiotherapists report low confidence in assessing physical symptoms remotely. This study adapted measures of vestibular, oculomotor, cervical and autonomic function for telehealth delivery, and evaluated their feasibility and comparability with in-person assessment.</p><p><strong>Methods: </strong>Using a repeated-measures design, 16 participants with concussion and 20 controls completed assessment modalities in random order (3 × 4 block randomisation). Feasibility was evaluated through completion rates, technical issues, adverse events and clinician feedback. Concurrent validity was examined using percentage agreement, Cohen's kappa, and sensitivity and specificity analyses.</p><p><strong>Results: </strong>Telehealth assessment was feasible; most concussion participants and all controls completed the protocols, there were minimal technical issues, no adverse events and shorter administration times. Clinicians reported high usability and efficiency. High agreement and sensitivity were observed across vestibular, ocular convergence, autonomic and cervical range of motion measures. Nuanced assessment of ocular smooth pursuits showed lower agreement, and a potential ceiling effect on autonomic assessment was identified.</p><p><strong>Conclusion: </strong>This study preliminarily supports the feasibility and comparability of telehealth compared with in-person physical concussion assessments. Assessment of smooth pursuits and autonomic function require protocol refinement to enhance accuracy. Replication in larger samples is required to establish comparability.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"27 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators experienced by primary school teachers returning to work after mild traumatic brain injury in Aotearoa, New Zealand.","authors":"Rachael E McCleary, Rachelle A Martin, Deborah L Snell","doi":"10.1071/IB25114","DOIUrl":"10.1071/IB25114","url":null,"abstract":"<p><strong>Aim: </strong>This qualitative study explored barriers and facilitators experienced by primary school teachers returning to work after mild traumatic brain injury (mTBI) in Aotearoa, New Zealand.</p><p><strong>Methods: </strong>Seven participants were recruited from a target population of primary school teachers who had sustained an mTBI that affected their ability to work. Semi-structured interviews were employed to collect data, and reflexive thematic analysis methods were used to understand participants' perspectives within their context.</p><p><strong>Results: </strong>Three themes were identified: (1) 'My classroom never stops', (2) 'Invisible injury: understanding affects expectations', and (3) 'Trying to link everyone together'. Findings indicated participants felt pressure to return to work (RTW) quickly after their injury to minimise disruption to others. Pressure to RTW was explicit from employers, whom some participants perceived as lacking an understanding of mTBI. Furthermore, teachers face challenges in implementing accommodations due to a lack of flexibility in work hours and tasks. Participants felt isolated while trying to coordinate competing stakeholder priorities.</p><p><strong>Conclusion: </strong>Overall, the barriers and facilitators experienced by teachers as they RTW after mTBI are not merely at the level of the individual and their work tasks but are embedded within the complex interactions between the individual, personal, workplace, healthcare, and insurance/legislative systems.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"27 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-pharmacologic therapies for sleep disturbances after traumatic brain injury: a systematic review and meta-analysis.","authors":"Spencer Loong, Zain A Qazi, Ingrid Jora, Tomasz Zrodlowski, Jennifer Blakenship, Sagar S Lad","doi":"10.1071/IB25014","DOIUrl":"10.1071/IB25014","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbances are common after traumatic brain injury (TBI), yet there are no guidelines specific to non-pharmacologic management in this population.</p><p><strong>Objective: </strong>To evaluate whether adults with post-TBI sleep disturbances benefit from commonly described non-pharmacologic therapies - cognitive behavioural therapy (CBT) (including for insomnia, CBT-I), hyperbaric oxygen (HBO2), blue-wavelength light therapy (BWLT) and repetitive transcranial magnetic stimulation (rTMS) - with attention to both statistical and minimally clinically important differences (MCIDs).</p><p><strong>Methods: </strong>A systematic review (registered with the International Prospective Register of Systematic Reviews) and meta-analysis of randomised controlled trials (RCTs) were used. Databases (PubMed, APA PsycInfo and PsychArticles, Medline Complete, CINAHL Plus) were originally searched in October  2023 and updated in PubMed on 14 March 2026. The searches were conducted separately for each intervention. Outcomes included sleep quality and duration (Pittsburgh Sleep Quality Index, PSQI; Insomnia Severity Index, ISI; actigraphy), daytime sleepiness (Epworth Sleepiness Scale, ESS) and daytime dysfunction. The quality of evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation approach.</p><p><strong>Results: </strong>Twelve RCTs met inclusion criteria. CBT significantly improved PSQI (MD: -3.44), ISI at 6-8 weeks (mean difference, MD: -2.23) and 12-16 weeks (MD: -0.91) and ESS (MD: -1.45) at 16 weeks. Only the change in PSQI reached the MCID. Evidence for HBO2, BWLT and rTMS remained very low, with small samples and heterogeneity precluding definitive conclusions regarding sleep outcomes; HBO2 showed a higher risk of mild ear barotrauma v. sham (relative risk: 2.66).</p><p><strong>Conclusions: </strong>CBT/CBT-I appears to improve sleep quality and daytime sleepiness in adults with TBI; online CBT-I (eCBT-I) may expand access. The paucity and heterogeneity of trials for HBO2, BWLT and rTMS precludes definitive conclusions for proposed outcomes. Larger RCTs with standardised protocols are needed.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"27 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equity in concussion assessment: Aboriginal and Torres Strait Islander peoples' perspectives of standardised sport-related concussion assessment.","authors":"Kahlia McCausland, Jonathan Bullen, Elizabeth Thomas, Trish Hill-Wall, Richard Norman, Gill Cowen","doi":"10.1071/IB25129","DOIUrl":"10.1071/IB25129","url":null,"abstract":"<p><strong>Background: </strong>The Sport Concussion Assessment Tool (SCAT) is widely used to evaluate suspected concussion, yet its cultural suitability for Aboriginal and Torres Strait Islander peoples remains underexplored.</p><p><strong>Methods: </strong>Guided by a social constructionist framework, this study examined perspectives on the SCAT5 through semi-structured yarns with community members in Perth, Western Australia.</p><p><strong>Results: </strong>Reflexive thematic analysis of data identified concerns related to medical jargon, inconsistent terminology, reliance on written instructions and overall readability of the SCAT5. Participants underscored the importance of trust, clear explanations and culturally appropriate communication formats, such as pictorial or verbal information.</p><p><strong>Conclusions: </strong>Although the SCAT6 introduces some improvements, our findings highlight the need for community-endorsed, culturally valid adaptations in future iterations. Culturally responsive concussion assessment tools are essential to support accurate diagnosis, foster patient-clinician trust, and promote safer recovery pathways for Aboriginal and Torres Strait Islander peoples.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"27 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vocational rehabilitation for traumatic injuries: a survey of current practice and training needs of Australian allied health clinicians.","authors":"Yashashree Bedekar, Jennie Ponsford, Marina Downing, Linda Barclay, Pamela Ross","doi":"10.1071/IB25057","DOIUrl":"10.1071/IB25057","url":null,"abstract":"<p><strong>Background: </strong>Vocational rehabilitation (VR) supports people to return to work after traumatic injury (traumatic brain injury, multi-trauma orthopaedic injury including traumatic amputation, and spinal cord injury). In Australia, funding circumstances and clinician knowledge can impact VR delivery. This study aimed to ascertain current VR practice by allied health clinicians working in traumatic injury rehabilitation, and to explore their knowledge, confidence and training needs.</p><p><strong>Methods: </strong>An online questionnaire was disseminated throughout Australia, targeting allied health clinicians working in traumatic injury rehabilitation. Respondents were asked to describe any prior VR training, describe current VR provision, to rate knowledge and confidence across specified VR interventions, and to identify any training needs.</p><p><strong>Results: </strong>There were 107 respondents with an average 15.87 years of experience and 7.58 years providing VR. Most worked predominantly in community or outpatient settings with variable scope of VR provision. A total of 74% reported currently providing VR interventions, but only 10% strongly agreed that they had the resources to effectively deliver VR. Over half reported little or no knowledge or confidence with employer engagement and vocational assessment, with 43.6 and 36.6% reporting that they were 'somewhat knowledgeable' and 'somewhat confident', respectively, in providing education on return to work processes. The majority (93.1%) confirmed an interest in receiving VR training.</p><p><strong>Conclusions: </strong>Among the experienced cohort of respondents, VR is practised largely outside the hospital setting, with variable scope of interventions provided, and clinicians reporting variable levels of confidence and knowledge in delivering this intervention. Respondents endorsed an interest in VR training.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":"27 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconceptualising the factor structure of the Depression Anxiety Stress Scales (DASS) for traumatic brain injury.","authors":"Alexia Samiotis, Jai Carmichael, Dana Wong, Kate Rachel Gould, Lisa Johnston, Jennie Ponsford, Gershon Spitz","doi":"10.1071/IB25139","DOIUrl":"10.1071/IB25139","url":null,"abstract":"<p><strong>Objective: </strong>We used contemporary factor analytic procedures to assess whether the Depression Anxiety Stress Scales (DASS) can reliably differentiate depression, anxiety and stress in individuals with traumatic brain injury.</p><p><strong>Methods: </strong>A total of 136 adults (Mage = 38.51 years; 77.94% male) with moderate-to-severe traumatic brain injury completed the DASS42. Various confirmatory factor models were estimated for both the DASS21 and DASS42, with a focus on novel statistical indices derived from bifactor modelling.</p><p><strong>Results: </strong>Bifactor modelling revealed a dominant general distress factor, accounting for 89% of the systematic variance in DASS21 total scores. Specific depression, anxiety and stress factors added little specific information when holding the general factor constant, accounting for only 11-27% of residual systematic variance in the subscale scores. Omitting the specific factors and instead treating the DASS21 as a unidimensional measure introduced minimal bias in parameter estimates. However, some multidimensionality was apparent when considering individual items, particularly from the depression scale. Additionally, first- and second-order factor models indicated that the specific factors were not well-differentiated from one another or from the general factor. These findings extended to the DASS42.</p><p><strong>Conclusion: </strong>In conclusion, scores on the DASS after traumatic brain injury predominately reflect a single underlying latent variable of general distress, providing support for using the total score over the three conventional scales.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the scope of clinical practice guidelines for managing psychosocial difficulties following moderate-to-severe traumatic brain injury.","authors":"Holly Emery, Dana Wong, Grahame Simpson, Paul Gertler, Sarah Carrier, Skye McDonald, Tamara Ownsworth, Jacinta Douglas, Travis Wearne, Angela T Morgan, Robyn Tate, Olivia J Zuber, Sarah Skromanis, Janet Doubleday, Cynthia A Honan","doi":"10.1071/IB25082","DOIUrl":"10.1071/IB25082","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial difficulties or reduced functioning in social-cognitive, emotional/mental health, or behavioural domains are common following moderate-to-severe traumatic brain injury. However, there is currently no Australian-based guideline for management of these difficulties. To inform development of such a guideline, we aimed to integrate evidence available with stakeholder input to establish the guideline scope.</p><p><strong>Methods: </strong>Overarching governance for the project was provided through an established Guideline Development Group who oversaw the four key steps of the scoping process: (1) initial areas of relevance were generated; (2a) scoping reviews were conducted to establish the availability of evidence; (2b) priority surveys with health professionals (n = 86) and individuals with lived experience of traumatic brain injury or close others (n = 55) were completed; (3) a panel comprising 26 experts convened at a 1-day workshop to conceptualise the initial guideline scope; and (4) the scope was then iteratively refined, leading to a scoping document specifying the key clinical questions, difficulties/disorders and treatment outcomes the guideline would address.</p><p><strong>Results: </strong>The scoping reviews identified intervention studies across mental health (n = 74), behaviour (n = 55) and social cognition (n = 19). Survey results prioritised most psychosocial difficulties and identified key treatment outcomes. The final guideline scope included one key clinical question relating to treatment effectiveness, four sub-questions related to treatment decisions for specific groups and circumstances, and two areas of additional commentary to supplement recommendations.</p><p><strong>Conclusions: </strong>The methodology used to establish the guideline scope will facilitate the development of a clinical practice guideline for the management of psychosocial difficulties in adults with moderate-to-severe traumatic brain injury.</p>","PeriodicalId":56329,"journal":{"name":"Brain Impairment","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}