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Assistive technology to enable sleep function in patients with acquired brain injury: Issues and opportunities / Anmol Biajar in The British Journal of Occupational Therapy, Vol.80 Issue 4 (April 2017)
[article]
Titre : Assistive technology to enable sleep function in patients with acquired brain injury: Issues and opportunities Type de document : texte imprimé Auteurs : Anmol Biajar ; Tatyana Mollayeva ; Sandra Sokoloff ; Angela Colantonio Année de publication : 2017 Article en page(s) : p. 225-249 Langues : Anglais (eng) Mots-clés : traumatisme cérébral trouble du sommeil assistance par la technologie ergothérapie plan de soins Résumé : Introduction
Sleep disorders in patients with acquired brain injury are highly burdensome and associated with disability. An assistive technology framework emphasises the need to develop and apply a broad range of devices, strategies, and practices to ameliorate disabilities. We aimed to summarise scientific evidence regarding the utility of assistive technology in managing sleep disorders in patients with various causes of acquired brain injury.
Method
We retrieved articles before January 2016, through database searches of Medline, Embase, PsycINFO, CINAHL, and various bibliographies. The person–environment–occupation framework was used to analyse complex data pertaining to technology application and utility.
Results
We found 21 studies that described seven assistive technologies (continuous positive airway pressure, adaptive servo ventilator, nasotracheal suction mechanical ventilation, positioning devices, cognitive behavioural therapy, light therapy, and acupuncture) utilised in patients with acquired brain injury to manage sleep disorders.
Conclusion
Assistive technologies demonstrated effectiveness in alleviating and/or managing sleep disorders after acquired brain injury. Adherence to using the technology is limited by the level of injury-induced cognitive and physical impairment, technological regime, and environmental support. Development of user-friendly sleep-assistive technologies that take into consideration functional limitations and practice guidelines on structural communication between the occupational therapist, patient, and caregiver may facilitate patients’ self-determination in managing sleep disorders.Permalink : ./index.php?lvl=notice_display&id=48407
in The British Journal of Occupational Therapy > Vol.80 Issue 4 (April 2017) . - p. 225-249[article] Assistive technology to enable sleep function in patients with acquired brain injury: Issues and opportunities [texte imprimé] / Anmol Biajar ; Tatyana Mollayeva ; Sandra Sokoloff ; Angela Colantonio . - 2017 . - p. 225-249.
Langues : Anglais (eng)
in The British Journal of Occupational Therapy > Vol.80 Issue 4 (April 2017) . - p. 225-249
Mots-clés : traumatisme cérébral trouble du sommeil assistance par la technologie ergothérapie plan de soins Résumé : Introduction
Sleep disorders in patients with acquired brain injury are highly burdensome and associated with disability. An assistive technology framework emphasises the need to develop and apply a broad range of devices, strategies, and practices to ameliorate disabilities. We aimed to summarise scientific evidence regarding the utility of assistive technology in managing sleep disorders in patients with various causes of acquired brain injury.
Method
We retrieved articles before January 2016, through database searches of Medline, Embase, PsycINFO, CINAHL, and various bibliographies. The person–environment–occupation framework was used to analyse complex data pertaining to technology application and utility.
Results
We found 21 studies that described seven assistive technologies (continuous positive airway pressure, adaptive servo ventilator, nasotracheal suction mechanical ventilation, positioning devices, cognitive behavioural therapy, light therapy, and acupuncture) utilised in patients with acquired brain injury to manage sleep disorders.
Conclusion
Assistive technologies demonstrated effectiveness in alleviating and/or managing sleep disorders after acquired brain injury. Adherence to using the technology is limited by the level of injury-induced cognitive and physical impairment, technological regime, and environmental support. Development of user-friendly sleep-assistive technologies that take into consideration functional limitations and practice guidelines on structural communication between the occupational therapist, patient, and caregiver may facilitate patients’ self-determination in managing sleep disorders.Permalink : ./index.php?lvl=notice_display&id=48407 Exemplaires (1)
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Exclu du prêtBehavioral and affective disorders after brain injury: French guidelines for prevention and community supports / Jacques Luauté in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)
[article]
Titre : Behavioral and affective disorders after brain injury: French guidelines for prevention and community supports Type de document : texte imprimé Auteurs : Jacques Luauté ; Jacques Hamonet ; Pascale Pradat-Diehl Année de publication : 2016 Article en page(s) : p.68-73 Langues : Anglais (eng) Mots-clés : traumatisme cérébral trouble du comportement trouble affectif Résumé : Objective
The purpose of this study was to elaborate practice guidelines for the prevention of behavioral and affective disorders in adult outpatients after traumatic brain injury (TBI); but also to identify the support systems available for family, caregivers of patients with TBI within the community.
Methods
The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. This involved a systematic and critical review of the literature looking for studies that investigated the impact of programs in community settings directed to behavioral and affective disorders post-TBI. Recommendations were than elaborated by a group of professionals and family representatives.
Results
Only six articles were found comprising 4 studies with a control group. Two studies showed a beneficial effect of personalized behavior management program delivered within natural community settings for persons with brain injury and their caregivers. Two other studies showed the relevance of scheduled telephone interventions to improve depressive symptoms and one study emphasized the usefulness of physical training. One study investigated the relevance of an outreach program; this study showed an improvement of the patients’ independence but did not yield any conclusions regarding anxiety and depression.
Discussion and recommendations
In addition to the application of care pathways already established by the SOFMER, prevention of behavioral and affective disorders for brain-injured outpatients should involve pain management, as well as development of therapeutic partnerships. It is recommended to inform patients, their family and caregivers regarding the local organization and facilities involved in the management of traumatic brain injury. The relevance of therapeutic education for implementing coping strategies, educating caregivers on behavioral disorder management, follow-up telephone interventions, and holistic therapy seems established. The level of evidence is low and preliminary studies should be confirmed with larger controlled trials.Permalink : ./index.php?lvl=notice_display&id=42788
in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.68-73[article] Behavioral and affective disorders after brain injury: French guidelines for prevention and community supports [texte imprimé] / Jacques Luauté ; Jacques Hamonet ; Pascale Pradat-Diehl . - 2016 . - p.68-73.
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.68-73
Mots-clés : traumatisme cérébral trouble du comportement trouble affectif Résumé : Objective
The purpose of this study was to elaborate practice guidelines for the prevention of behavioral and affective disorders in adult outpatients after traumatic brain injury (TBI); but also to identify the support systems available for family, caregivers of patients with TBI within the community.
Methods
The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. This involved a systematic and critical review of the literature looking for studies that investigated the impact of programs in community settings directed to behavioral and affective disorders post-TBI. Recommendations were than elaborated by a group of professionals and family representatives.
Results
Only six articles were found comprising 4 studies with a control group. Two studies showed a beneficial effect of personalized behavior management program delivered within natural community settings for persons with brain injury and their caregivers. Two other studies showed the relevance of scheduled telephone interventions to improve depressive symptoms and one study emphasized the usefulness of physical training. One study investigated the relevance of an outreach program; this study showed an improvement of the patients’ independence but did not yield any conclusions regarding anxiety and depression.
Discussion and recommendations
In addition to the application of care pathways already established by the SOFMER, prevention of behavioral and affective disorders for brain-injured outpatients should involve pain management, as well as development of therapeutic partnerships. It is recommended to inform patients, their family and caregivers regarding the local organization and facilities involved in the management of traumatic brain injury. The relevance of therapeutic education for implementing coping strategies, educating caregivers on behavioral disorder management, follow-up telephone interventions, and holistic therapy seems established. The level of evidence is low and preliminary studies should be confirmed with larger controlled trials.Permalink : ./index.php?lvl=notice_display&id=42788 Exemplaires (1)
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Exclu du prêtCare management of the agitation or aggressiveness crisis in patients with TBI. Systematic review of the literature and practice recommendations / Jacques Luauté in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)
[article]
Titre : Care management of the agitation or aggressiveness crisis in patients with TBI. Systematic review of the literature and practice recommendations Type de document : texte imprimé Auteurs : Jacques Luauté ; David Plantier ; Laurent Wiart Année de publication : 2016 Article en page(s) : p.58-67 Langues : Anglais (eng) Mots-clés : traumatisme cérébral agitation agressivité comportement recommandation Résumé : The agitation crisis in the awakening phase after traumatic brain injury (TBI) is one of the most difficult behavioral disorders to alleviate. Current treatment options are heterogeneous and may involve excessive sedation. Practice guidelines are required by professionals in charge of TBI patients. Few reviews were published but those are old and based on expert opinions. The purpose of this work is to propose evidence-based guidelines to treat the agitation crisis.
Methods
The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. Guidelines were elaborated on the basis of a systematic and critical review of the literature.
Results
Twenty-eight articles concerning 376 patients were analyzed. Recommendations are: when faced with an agitation crisis, the management strategy implies to search for an underlying factor that should be treated such as pain, acute sepsis, and drug adverse effect (expert opinion). Physical restraints should be discarded when possible (expert opinion). Neuroleptic agent with a marketing authorization can be used in order to obtain a quick sedation so as to protect the patient from himself, closed ones or the healthcare team but the duration should be as short as possible (expert opinion). The efficacy of beta-blockers and antiepileptics with mood regulation effects like carbamazepine and valproate yield the most compelling evidence and should be preferably used when a background regimen is envisioned (grade B for beta-blocker and C for antiepileptics). Neuroleptics, antidepressants, benzodiazepines, buspirone may be prescribed but are considered second-line treatments (expert opinion).
Conclusion
This study provides a strategy for treating the agitation crisis based on scientific data and expert opinion. The level of evidence remains low and published data are often old. New studies are essential to validate results from previous studies and test new drugs and non-pharmaceutical therapies.Permalink : ./index.php?lvl=notice_display&id=42785
in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.58-67[article] Care management of the agitation or aggressiveness crisis in patients with TBI. Systematic review of the literature and practice recommendations [texte imprimé] / Jacques Luauté ; David Plantier ; Laurent Wiart . - 2016 . - p.58-67.
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.58-67
Mots-clés : traumatisme cérébral agitation agressivité comportement recommandation Résumé : The agitation crisis in the awakening phase after traumatic brain injury (TBI) is one of the most difficult behavioral disorders to alleviate. Current treatment options are heterogeneous and may involve excessive sedation. Practice guidelines are required by professionals in charge of TBI patients. Few reviews were published but those are old and based on expert opinions. The purpose of this work is to propose evidence-based guidelines to treat the agitation crisis.
Methods
The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. Guidelines were elaborated on the basis of a systematic and critical review of the literature.
Results
Twenty-eight articles concerning 376 patients were analyzed. Recommendations are: when faced with an agitation crisis, the management strategy implies to search for an underlying factor that should be treated such as pain, acute sepsis, and drug adverse effect (expert opinion). Physical restraints should be discarded when possible (expert opinion). Neuroleptic agent with a marketing authorization can be used in order to obtain a quick sedation so as to protect the patient from himself, closed ones or the healthcare team but the duration should be as short as possible (expert opinion). The efficacy of beta-blockers and antiepileptics with mood regulation effects like carbamazepine and valproate yield the most compelling evidence and should be preferably used when a background regimen is envisioned (grade B for beta-blocker and C for antiepileptics). Neuroleptics, antidepressants, benzodiazepines, buspirone may be prescribed but are considered second-line treatments (expert opinion).
Conclusion
This study provides a strategy for treating the agitation crisis based on scientific data and expert opinion. The level of evidence remains low and published data are often old. New studies are essential to validate results from previous studies and test new drugs and non-pharmaceutical therapies.Permalink : ./index.php?lvl=notice_display&id=42785 Exemplaires (1)
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Exclu du prêtDevelopment and evaluation of an early specialised traumatic brain injury vocational rehabilitation training package / Jain Holmes in The British Journal of Occupational Therapy, Vol.79 Issue 11 (Novembre 2016)
[article]
Titre : Development and evaluation of an early specialised traumatic brain injury vocational rehabilitation training package Type de document : texte imprimé Auteurs : Jain Holmes ; Julie Phillips ; Richard Morris ; [et al...] Année de publication : 2016 Article en page(s) : p. 693-702 Langues : Anglais (eng) Mots-clés : traumatisme cérébral réadaptation Résumé : Background
In a feasibility randomised controlled trial, training was developed to equip occupational therapists to deliver early specialised traumatic brain injury vocational rehabilitation in the English National Health Service (NHS).
Method
The package was developed by experts in vocational rehabilitation and traumatic brain injury, and included a manual, direct instruction by six trainers and opportunity for mentorship by four therapists. Following training, therapists were interviewed regarding the effectiveness and ease of use of the package. Interviews were analysed using the framework approach.
Results
Five trained therapists were interviewed regarding the package. Results were organised into six categories: (1) motivation to participate in research; (2) impact of the learning environment; (3) changing confidence levels over time; (4) growing appreciation of complexities about the intervention; (5) acceptability of the training package; and (6) lessons for future implementation.
Conclusion
The therapists reported acquiring the knowledge necessary to implement the intervention. The data indicate that the training packages require detailed descriptions of the interventions being taught for local implementation in the NHS and for future research. The training materials are valued by therapists but require time for familiarisation, and reminders from mentors help put training into practice. The therapists have concerns about implementing the interventions within a research context, which researchers should address.Permalink : ./index.php?lvl=notice_display&id=47321
in The British Journal of Occupational Therapy > Vol.79 Issue 11 (Novembre 2016) . - p. 693-702[article] Development and evaluation of an early specialised traumatic brain injury vocational rehabilitation training package [texte imprimé] / Jain Holmes ; Julie Phillips ; Richard Morris ; [et al...] . - 2016 . - p. 693-702.
Langues : Anglais (eng)
in The British Journal of Occupational Therapy > Vol.79 Issue 11 (Novembre 2016) . - p. 693-702
Mots-clés : traumatisme cérébral réadaptation Résumé : Background
In a feasibility randomised controlled trial, training was developed to equip occupational therapists to deliver early specialised traumatic brain injury vocational rehabilitation in the English National Health Service (NHS).
Method
The package was developed by experts in vocational rehabilitation and traumatic brain injury, and included a manual, direct instruction by six trainers and opportunity for mentorship by four therapists. Following training, therapists were interviewed regarding the effectiveness and ease of use of the package. Interviews were analysed using the framework approach.
Results
Five trained therapists were interviewed regarding the package. Results were organised into six categories: (1) motivation to participate in research; (2) impact of the learning environment; (3) changing confidence levels over time; (4) growing appreciation of complexities about the intervention; (5) acceptability of the training package; and (6) lessons for future implementation.
Conclusion
The therapists reported acquiring the knowledge necessary to implement the intervention. The data indicate that the training packages require detailed descriptions of the interventions being taught for local implementation in the NHS and for future research. The training materials are valued by therapists but require time for familiarisation, and reminders from mentors help put training into practice. The therapists have concerns about implementing the interventions within a research context, which researchers should address.Permalink : ./index.php?lvl=notice_display&id=47321 Exemplaires (1)
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Exclu du prêtDrugs for behavior disorders after traumatic brain injury: Systematic review and expert consensus leading to French recommendations for good practice / David Plantier in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)
[article]
Titre : Drugs for behavior disorders after traumatic brain injury: Systematic review and expert consensus leading to French recommendations for good practice Type de document : texte imprimé Auteurs : David Plantier ; Jacques Luauté ; The SOMFER group Année de publication : 2016 Article en page(s) : p.42-57 Langues : Anglais (eng) Mots-clés : traumatisme cérébral troubles du comportement neuroleptique antidépresseur bêtabloquant stabilisateurs de l'humeur médicament benzodiazépine amantadine Résumé : Objective
There are no handbook or recommendations for the use of pharmacological agents to treat neurobehavioral disorders after traumatic brain injury (TBI). This work proposes a systematic review of the literature and a user guide on neuroleptics, antidepressants, beta-blockers, mood stabilizers and other medications for irritability, aggressiveness, agitation, impulsivity, depression, apathy…
Method
Steering, working and reading groups (62 people) were formed under the control of the French High Authority for Health (HAS) in collaboration with the SOFMER scientific society (French Society of Physical and Rehabilitation Medicine). Articles were searched by HAS officers in the Medline database from 1990 to 2012, crossing TBI and pharmacological agents. The HAS method to select, read and analyze papers is close to the PRISMA statements.
Results
Out of 772 references, 89 were analyzed, covering a total of 1306 people with TBI. There is insufficient evidence to standardize drug treatments for these disorders. There are however some elements to establish consensus recommendations for good clinical practice. Propranolol can improve aggression (B grade). Carbamazepine and valproate seem effective on agitation and aggression and are recommended as first line treatment (Expert Consensus [EC]). There is no evidence of efficacy for neuroleptics. Their prescription is based on emergency situation for a crisis (loxapine) but not for long-term use (EC). Antidepressants are recommended to treat depression (EC) with a higher standard of proof for Selective Serotonin Reuptake Inhibitors (SSRI, grade B). Other products are described.
Conclusion
The choice of treatment depends on the level of evidence, target symptoms, custom objectives, clinical experience and caution strategies.Permalink : ./index.php?lvl=notice_display&id=42783
in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.42-57[article] Drugs for behavior disorders after traumatic brain injury: Systematic review and expert consensus leading to French recommendations for good practice [texte imprimé] / David Plantier ; Jacques Luauté ; The SOMFER group . - 2016 . - p.42-57.
Langues : Anglais (eng)
in Annals of physical and rehabilitation medicine > Vol. 59, n°1 (February 2016) . - p.42-57
Mots-clés : traumatisme cérébral troubles du comportement neuroleptique antidépresseur bêtabloquant stabilisateurs de l'humeur médicament benzodiazépine amantadine Résumé : Objective
There are no handbook or recommendations for the use of pharmacological agents to treat neurobehavioral disorders after traumatic brain injury (TBI). This work proposes a systematic review of the literature and a user guide on neuroleptics, antidepressants, beta-blockers, mood stabilizers and other medications for irritability, aggressiveness, agitation, impulsivity, depression, apathy…
Method
Steering, working and reading groups (62 people) were formed under the control of the French High Authority for Health (HAS) in collaboration with the SOFMER scientific society (French Society of Physical and Rehabilitation Medicine). Articles were searched by HAS officers in the Medline database from 1990 to 2012, crossing TBI and pharmacological agents. The HAS method to select, read and analyze papers is close to the PRISMA statements.
Results
Out of 772 references, 89 were analyzed, covering a total of 1306 people with TBI. There is insufficient evidence to standardize drug treatments for these disorders. There are however some elements to establish consensus recommendations for good clinical practice. Propranolol can improve aggression (B grade). Carbamazepine and valproate seem effective on agitation and aggression and are recommended as first line treatment (Expert Consensus [EC]). There is no evidence of efficacy for neuroleptics. Their prescription is based on emergency situation for a crisis (loxapine) but not for long-term use (EC). Antidepressants are recommended to treat depression (EC) with a higher standard of proof for Selective Serotonin Reuptake Inhibitors (SSRI, grade B). Other products are described.
Conclusion
The choice of treatment depends on the level of evidence, target symptoms, custom objectives, clinical experience and caution strategies.Permalink : ./index.php?lvl=notice_display&id=42783 Exemplaires (1)
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Exclu du prêtElectronic assistive technology used by people with acquired brain injury in shared supported accommodation: Implications for occupational therapy / Rebecca Jamwal in The British Journal of Occupational Therapy, Vol.80 Issue 2 (Février 2017)
PermalinkFrance establishes guidelines for treating neurobehavioral disorders following traumatic brain injury / Harvey Levin in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)
PermalinkNon pharmacological treatments for psychological and behavioural disorders following traumatic brain injury (TBI). A systematic literature review and expert opinion leading to recommendations / Laurent Wiart in Annals of physical and rehabilitation medicine, Vol. 59, n°1 (February 2016)
PermalinkOccupational experience of caregiving during driving disruption following an acquired brain injury / Phyllis Liang in The British Journal of Occupational Therapy, Vol.80 Issue 1 (Janvier 2017)
PermalinkResults from a cognitive group rehabilitation programme from an occupational performance perspective / Brigitta Rustner in The British Journal of Occupational Therapy, Vol.79 Issue 12 (Décembre 2016)
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