Posts Tagged brain injury

[BLOG POST] Brain Injury, Social Skills, and the Holidays – BrainLine

Ask the Expert: Social Skills and the HolidaysQuestion:

My husband fell off a ladder almost a year ago now and sustained a brain injury. I’ve noticed that his communication and social skills tend to get worse at parties, especially during the holiday season. Why is this? And what can I do to help

Answer:

The holidays can be fraught with pitfalls for someone with a brain injury. The fact that your husband’s communication and social skills worsen at parties is not unusual. For starters, routines are disrupted and there can be an increased number of social functions with less time to rest in between.

TBI related fatigue could cause a decline in social skills. Things can get even more challenging if alcohol is added to the mix. And for individuals prone to seizure activity, holiday lighting — particularly flashing lights — could increase the risk of a seizure.

A social setting, like a party with many people engaged in conversation, eating, and drinking, can easily become over-stimulating and even upsetting to a person with TBI. To help your husband deal with all these issues, you might try limiting the number of engagements during the holidays. And when in a social setting, help support your husband’s conversations by introducing easy topics, and repeating or rephrasing questions asked by others.

You know your husband better than anyone else, and when you hear him having difficulty using the right words, or even slurring his speech, it’s time to go home. All the activity has probably tired him out. For someone with TBI, it can be exhausting trying to converse in crowds, with strangers, and in over-stimulating settings.

 

via Brain Injury, Social Skills, and the Holidays | BrainLine

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[Magazine] Major Issues in Post-acute TBI Rehabilitation by Brain Injury Professional – issuu

via Major Issues in Post-acute TBI Rehabilitation by Brain Injury Professional – issuu

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[Abstract] Evidence for Training-Dependent Structural Neuroplasticity in Brain-Injured Patients: A Critical Review

Acquired brain injury (ABI) is associated with a range of cognitive and motor deficits, and poses a significant personal, societal, and economic burden. Rehabilitation programs are available that target motor skills or cognitive functioning. In this review, we summarize the existing evidence that training may enhance structural neuroplasticity in patients with ABI, as assessed using structural magnetic resonance imaging (MRI)–based techniques that probe microstructure or morphology. Twenty-five research articles met key inclusion criteria. Most trials measured relevant outcomes and had treatment benefits that would justify the risk of potential harm. The rehabilitation program included a variety of task-oriented movement exercises (such as facilitation therapy, postural control training), neurorehabilitation techniques (such as constraint-induced movement therapy) or computer-assisted training programs (eg, Cogmed program). The reviewed studies describe regional alterations in white matter architecture and/or gray matter volume with training. Only weak-to-moderate correlations were observed between improved behavioral function and structural changes. While structural MRI is a powerful tool for detection of longitudinal structural changes, specific measures about the underlying biological mechanisms are lacking. Continued work in this field may potentially see structural MRI metrics used as biomarkers to help guide treatment at the individual patient level.

via Evidence for Training-Dependent Structural Neuroplasticity in Brain-Injured Patients: A Critical Review – Karen Caeyenberghs, Adam Clemente, Phoebe Imms, Gary Egan, Darren R. Hocking, Alexander Leemans, Claudia Metzler-Baddeley, Derek K. Jones, Peter H. Wilson, 2018

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[WEB SITE] Investigating how epilepsy is triggered after a brain injury: Final Report

Posted Nov 1 2018 in News from Epilepsy Research UK

This is the final report for a 2015 project grant for £147,334 awarded to Professor Andy Trevelyan, Dr Ryley Parrish, Dr Claudia Racca, and Dr Simon Cockell at Newcastle University. 

In some cases of brain injury such as stroke, or brain trauma, people will go on to develop epilepsy. We know a little about how this happens – it can involve the death of brain cells and other rewiring of the circuits in the brain, as well as changes in which proteins are made by the brain cells, which in turn affects their function. However, we don’t understand how or why these changes happen, and more particularly how they might be prevented to stop epilepsy developing.

This project aimed to explore how a brain injury can lead to changes in how brain cells function. The research team discovered a notable feature of the rewiring, which is that one particular type of brain cell, the pyramidal cell, dictates what changes are made to the network.

High levels of pyramidal activity lead to a reduction in levels of a specific protein that is important for brain cell inhibition, whereas low levels of pyramidal activity cause the opposite change – an increase in these inhibitory proteins.

Professor Trevelyan and colleagues believe this may provide a means to understand the complexity of the brain changes that are associated with the development of epilepsy, and perhaps even a means to prevent it from happening.

Professor Trevelyan said: “This project has enabled us to further extend our understanding of the fundamental mechanisms by which seizures develop, and how the brain networks respond to these extreme periods of activity. We have uncovered important regulatory pathways which we hope will open up new avenues for treating the condition. On a personal level, the funding was also critical in allowing me to keep a key member of my research team, Dr Ryley Parrish. It is incredibly helpful for the research if we can maintain a research team together, because research is a slow process, and requires committed people who have been trained over many years. Only then can we start to make real inroads into understanding this difficult and complex condition.”

 

via Investigating how epilepsy is triggered after a brain injury: Final Report | Epilepsy Research UK

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[WEB SITE] 7 signs of executive dysfunction after brain injury

 

 

7 signs of executive dysfunction after brain injury Main Image

7 signs of executive dysfunction after brain injury

Thu 26 Jan 2017

Executive dysfunction‘ is not, perhaps, a particularly well known term, but the effects of brain injury that it covers are very common indeed. It is used to collectively describe impairment in the ‘executive functions’ – the key cognitiveemotional and behavioural skills that are used to navigate through life, especially when undertaking activities and interacting with others.

 

Although executive dysfunction is a common problem among many brain injury survivors, it is most commonly experienced following an injury to the frontal lobe.

The importance of executive functions is shown by the difficulties caused when they don’t work properly and someone has problems with executive dysfunction. Since the executive functions are involved in even the most routine activities, frontal injuries leading to executive dysfunction can lead to problems in many aspects of life.

Here we list the most common effects of executive dysfunction, with some examples of common issues that brain injury survivors can face:

Difficulties with motivation and organisation

  • Loss of ‘get up and go’, which can be mistaken for laziness
  • Problems with thinking ahead and carrying out the sequence of steps needed to complete a task

Rigid thinking

  • Difficulty in evaluating the result of actions and reduced ability to change behaviour or switch between tasks if needed

Poor problem solving

  • Finding it hard to anticipate consequences
  • Decreased ability to make accurate judgements or find solutions if things are going wrong

Impulsivity

  • Acting too quickly and impulsively without fully thinking through the consequences, for example, spending more money than can be afforded

Mood disturbances

  • Difficulty in controlling emotions which may lead to outbursts of emotion such as anger or crying
  • Rapid mood changes may occur, for example, switching from happiness to sadness for no apparent reason

Difficulties in social situations

  • Reduced ability to engage in social interactions
  • Finding it hard to initiate, participate in, or pay attention to conversations
  • Poor judgement in social situations, which may lead to saying or doing inappropriate things

Memory/attention problems

  • Finding it harder to concentrate
  • Difficulty with learning new information
  • Decreased memory for past or current events, which may lead to disorientation

Find out more

If you or someone you care for is affected by executive dysfunction, it is important to seek support. Speak to your doctor about your symptoms, and ask about referral to specialist services such as counselling, neuropsychology and rehabilitation.

You can find out more and get tips and strategies to help manage your condition on our executive dysfunction after brain injury page.

Headway groups and branches can offer support in your area, and you can contact our helpline if you would like to talk things through.

via 7 signs of executive dysfunction after brain injury | Headway

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[Factsheet] Understanding TBI: Part 1 – What happens to the brain during injury and the early stages of recovery from TBI? – Model Systems Knowledge Translation Center (MSKTC)

Soccer players huddled around injured teammate

Written by Thomas Novack, PhD and Tamara Bushnik, PhD in collaboration with the MSKTC

What is a brain injury?

Traumatic brain injury (TBI) refers to damage to the brain caused by an external physical force such as a car accident, a gunshot wound to the head, or a fall. A TBI is not caused by something internal such as a stroke or tumor, and does not include damage to the brain due to prolonged lack of oxygen (anoxic brain injuries). It is possible to have a TBI and never lose consciousness. For example, someone with a penetrating gunshot wound to the head may not lose consciousness.

Commonly accepted criteria established by the TBI Model Systems (TBIMS) to identify the presence and severity of TBI include:

Damage to brain tissue caused by an external force and at least one of the following:

  • A documented loss of consciousness
  • The person cannot recall the actual traumatic event (amnesia)
  • The person has a skull fracture, post-traumatic seizure, or an abnormal brain scan due to the trauma

Causes of TBI

Statistics from Centers for Disease Control for 2002-2006 indicate that the leading cause of brain injury is falls (35%) followed by car crashes (17%) and being struck by an object (16%). Emergency room visits due to TBI caused by falls are increasing for both younger and older people. However, if you focus only on moderate to severe TBI (those injuries that require admission to a neurointensive care unit), car crashes are the most frequent cause of TBI, followed by gunshot wound, falls, and assault.

Types of injuries

The brain is about 3.4 pounds of extremely delicate soft tissue floating in fluid within the skull. Under the skull there are three layers of membrane that cover and protect the brain. The brain tissue is soft and therefore can be compressed (squeezed), pulled, and stretched. When there is sudden speeding up and slowing down, such as in a car crash or fall, the brain can move around violently inside the skull, resulting in injury.

Closed versus open head injury

Closed means the skull and brain contents have not been penetrated (broken into or through), whereas open means the skull and other protective layers are penetrated and exposed to air. A classic example of an open head injury is a gunshot wound to the head. A classic closed head injury is one that occurs as the result of a motor vehicle crash.

In a closed head injury, damage occurs because of a blow to the person’s head or having the head stop suddenly after moving at high speed. This causes the brain to move forward and back or from side to side, such that it collides with the bony skull around it. This jarring movement bruises brain tissue, damages axons (part of the nerve cell), and tears blood vessels. After a closed head injury, damage can occur in specific brain areas (localized injury) or throughout the brain (diffuse axonal injury).

Damage following open head injury tends to be localized and therefore damage tends to be limited to a specific area of the brain. However, such injuries can be as severe as closed head injuries, depending on the destructive path of the bullet or other invasive object within the brain.

Primary versus secondary injuries

Primary injuries occur at the time of injury and there is nothing that physicians can do to reverse those injuries. Instead, the goal of the treatment team in the hospital is to prevent any further, or secondary, injury to the brain. Below are some primary injuries.

  • Skull fracture occurs when there is a breaking or denting of the skull. Pieces of bone pressing on the brain can cause injury, often referred to as a depressed skull fracture.
  • Localized injury means that a particular area of the brain is injured. Injuries can involve bruising (contusions) or bleeding (hemorrhages) on the surface of or within any layer of the brain.
  • Diffuse axonal Injury (DAI) involves damage throughout the brain and loss of consciousness. DAI is a stretching injury to the neurons (the cell bodies of the brain) and axons (fibers that allow for communication from one neuron to another neuron). Everything our brains do for us depends on neurons communicating. When the brain is injured, axons can be pulled, stretched, and torn. If there is too much injury to the axon, the neuron will not survive. In a DAI, this happens to neurons all over the brain. This type of damage is often difficult to detect with brain scans.

Secondary injuries occur after the initial injury, usually within a few days. Secondary injury may be caused by oxygen not reaching the brain, which can be the result of continued low blood pressure or increased intracranial pressure (pressure inside the skull) from brain tissue swelling.

Measuring the severity of TBI

Severity of injury refers to the degree or extent of brain tissue damage. The degree of damage is estimated by measuring the duration of loss of consciousness, the depth of coma and level of amnesia (memory loss), and through brain scans.

The Glasgow Coma Scale (GCS) is used to measure the depth of coma. The GCS rates three aspects of functioning: eye opening, movement and verbal response. Individuals in deep coma score very low on all these aspects of functioning, while those less severely injured or recovering from coma score higher. A GCS score of 3 indicates the deepest level of coma, describing a person who is totally unresponsive. A score of 9 or more indicates that the person is no longer in coma, but is not fully alert. The highest score (15) refers to a person who is fully conscious.

A person’s first GCS score is often done at the roadside by the emergency response personnel. In many instances, moderately to severely injured people are intubated (a tube is placed down the throat and into the air passage into the lungs) at the scene of the injury to ensure the person gets enough oxygen. To do the intubation the person must be sedated (given medication that makes the person go to sleep). So, by the time the person arrives at the hospital he/she has already received sedating medications and has a breathing tube in place. Under these conditions it is impossible for a person to talk, so the doctors cannot assess the verbal part of the GCS. People in this situation often receive a T after the GCS score, indicating that they were intubated when the examination took place, so you might see a score of 5T, for instance. The GCS is done at intervals in the neurointensive care unit to document a person’s recovery.

Post-traumatic amnesia (PTA) is another good estimate for severity of a brain injury. Anytime a person has a major blow to the head he or she will not remember the injury and related events for sometime afterward. People with these injuries might not recall having spoken to someone just a couple of hours ago and may repeat things they have already said. This is the period of posttraumatic amnesia. The longer the duration of amnesia, the more severe the brain damage.

CT or MRI Scan Results

The cranial tomography (CT) scan is a type of X-ray that shows problems in the brain such as bruises, blood clots, and swelling. CT scans are not painful. People with moderate to severe TBI will have several CT scans while in the hospital to keep track of lesions (damaged areas in the brain). In some cases, a magnetic resonance imaging (MRI) scan may also be performed. This also creates a picture of the brain based on magnetic properties of molecules in tissue. Most people with severe TBI will have an abnormality on a CT scan or MRI scan. These scans cannot detect all types of brain injuries, so it is possible to have a severe TBI and be in coma even though the scan results are normal.

Brain tissue response to injury

Common Problems:

Increased intracranial pressure

The brain is like any other body tissue when it gets injured: it fills with fluid and swells. Because of the hard skull around it, however, the brain has nowhere to expand as it swells. This swelling increases pressure inside the head (intracranial pressure), which can cause further injury to the brain. Decreasing and controlling intracranial pressure is a major focus of medical treatment early after a TBI. If intracranial pressure remains high, it can prevent blood passage to tissue, which results in further brain injury.

Neurochemical problems that disrupt functioning

Our brains operate based on a delicate chemistry. Chemical substances in the brain called neurotransmitters are necessary for communication between neurons, the specialized cells within our central nervous system. When the brain is functioning normally, chemical signals are sent from neuron to neuron, and groups of neurons work together to perform functions.

TBI disturbs the delicate chemistry of the brain so that the neurons cannot function normally. This results in changes in thinking and behavior. It can take weeks and sometimes months for the brain to resolve the chemical imbalance that occurs with TBI. As the chemistry of the brain improves, so can the person’s ability to function. This is one reason that someone may make rapid progress in the first few weeks after an injury.

Natural plasticity (ability of change) of the brain

The brain is a dynamic organ that has a natural ability to adapt and change with time. Even after it has been injured, the brain changes by setting up new connections between neurons that carry the messages within our brains. We now know the brain can create new neurons in some parts of the brain, although the extent and purpose of this is still uncertain.

Plasticity of the brain occurs at every stage of development throughout the life cycle. Plasticity is more likely to occur when there is stimulation of the neural system, meaning that the brain must be active to adapt. Changes do not occur without exposure to a stimulating environment that prompts the brain to work. These changes do not occur quickly. That is one of the reasons that recovery goes on for months and sometimes years following TBI.

Rehabilitation sets in motion the process of adaptation and change. Keep in mind that formal rehabilitation, such as received in a hospital from professional therapists, is a good initial step, but in most cases this must be followed by outpatient therapies and stimulating activities in the injured person’s home.

What is the TBIMS?

The TBIMS is a group of 16 medical centers funded by the National Institute on Disability and Rehabilitation Research (NIDRR). The TBIMS works to maintain and improve a cost-effective, comprehensive service delivery system for people who experience a TBI, from the moment of their injury and throughout their life span.

Disclaimer

This information is not meant to replace the advice from a medical professional. You should consult your health care provider regarding specific medical concerns or treatment.

Source

Our health information content is based on research evidence whenever available and represents the consensus of expert opinion of the TBI Model Systems directors.

Authorship

Understanding TBI was developed by Thomas Novack, PhD and Tamara Bushnik, PhD in collaboration with the Model System Knowledge Translation Center. Portions of this document were adapted from materials developed by the University of Alabama TBIMS, JFK Johnson Rehabilitation Institute, Baylor Institute for Rehabilitation, New York TBIMS, Moss TBIMS, and from Picking up the pieces after TBI: A guide for Family Members, by Angelle M. Sander, PhD, Baylor College of Medicine (2002).

 

via Understanding TBI: Part 1 – What happens to the brain during injury and the early stages of recovery from TBI? | Model Systems Knowledge Translation Center (MSKTC)

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[TEDx Talks] A critical window for recovery after stroke – John Krakauer – Johns Hopkins University – YouTube

Δημοσιεύτηκε στις 8 Απρ 2015
Dr. John Krakauer, a Professor of Neurology and Neuroscience at Johns Hopkins University, co-founded the KATA project that combines concepts of neurology and neuroscience with interactive entertainment and motion capture technology to learn how lesions affect motor learning and to aid patients in recovering from brain injury.
Dr. John Krakauer is a Professor of Neurology and Neuroscience, the Director of the Center for the Study of Motor Learning and Brain Repair, and the Director of Brain, Learning, Animation, and Movement Lab (BLAM) at Johns Hopkins. He received his undergraduate and master’s degree from Cambridge University and earned his medical degree from Columbia University College of Physicians and Surgeons, where he was elected to Alpha Omega Alpha Medical Honor Society. His clinical and research expertise is in stroke, ischemic cerebrovascular disease, cerebral aneurysms, arteriovenous malformations, and venous and sinus thrombosis.
He co-founded the KATA project that combines concepts of neurology and neuroscience with interactive entertainment and motion capture technology to learn how lesions affect motor learning and to aid patients in recovering from brain injury.
This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx

 

via A critical window for recovery after stroke | John Krakauer | TEDxJohnsHopkinsUniversity – YouTube

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[WEB SITE] Brain recovery: Activity, not rest, may speed recovery after brain injury – ScienceDaily

Summary:
When recovering from a brain injury, getting back in the swing of things may be more effective than a prolonged period of rest, according to a new study in mice. These findings offer a compelling example of the brain’s remarkable capacity to adapt in response to trauma. They also point to new, activity-centered treatment strategies that could one day result in faster and more complete recovery times for patients looking to regain mobility after a brain damage or a stroke.
FULL STORY

When recovering from a brain injury, getting back in the swing of things may be more effective than a prolonged period of rest, according to a new Columbia study in mice. These findings offer a compelling example of the brain’s remarkable capacity to adapt in response to trauma. They also point to new, activity-centered treatment strategies that could one day result in faster and more complete recovery times for patients looking to regain mobility after a brain damage or a stroke.

This research was reported today in the journal Nature.

“Lengthy rest periods are supposed to be key to the brain’s healthy recovery, but our study in mice demonstrates that re-engaging the brain immediately after injury can actually be more helpful than resting it — an observation that was completely unexpected,” said Randy Bruno, PhD, the study’s senior author and a principal investigator at Columbia’s Mortimer B. Zuckerman Mind Brain Behavior Institute. “While these findings underscore the brain’s complexity, the nature of which we are only beginning to tease apart, they also provide a new avenue of research into more effective rehabilitation efforts for serious brain injuries.”

Today’s study marks an important step in the research team’s multi-year effort to unravel the workings of the brain’s cerebral cortex. The cerebral cortex is the largest region of the mammalian brain and plays a key role in many functions, from sight and smell to movement and memory. For this study in mice, researchers focused on a part of the animals’ cerebral cortex called the barrel cortex, which is thought to be critical for sensing and analyzing signals during whisking, when a mouse moves its whiskers to strike objects.

“Mice use whiskers to sense their surroundings the way we use our fingers,” said Y. Kate Hong, PhD, a postdoctoral associate in the Bruno lab and the paper’s first author.

The researchers placed mice in a dark box and trained them to search for a nearby object with their whiskers. When the mice detected the object, they pulled a lever with their paw to dispense water as a reward. Conventional wisdom argued that this kind of detection task depends almost entirely on a functioning sensory cortex — in this case, the barrel cortex.

To confirm this was true, the researchers used laser light to temporarily turn off barrel-cortex cells, a popular technique known as optogenetics. As expected, animals had difficulty whisking while the cells were turned off. And when the team then permanently removed their barrel cortex, the animals could not perform the task the next day.

But on day two, the animals’ performance suddenly recovered to original levels. “This came as a huge surprise, since it suggested that tactile sensation, such as whisker-based touch, may not completely rely on the cortex,” said Dr. Hong. “These findings challenge the commonly held, cortex-centric view of how the brain drives touch perception.”

The researchers suspect that other, more primitive brain regions may be involved to a greater degree than previously known — a hypothesis the team is currently investigating.

“Rather than being confined to one particular brain region, sensory information is distributed across many areas,” said Dr. Hong. “This redundancy allows the brain to solve problems in more than one way — and can serve to protect the brain in case of injury.”

But to recover, did the animals simply need a day of rest, or did they need to be re-exposed to the task? To find out, the team performed another round of experiments, with one key difference: They let the mice rest for three days before re-exposing them to the task.

This time, the mice showed incomplete rehabilitation. While they did eventually regain some sensation, they recovered more slowly than the first set of mice. The key to a speedy recovery appeared to lie in re-engaging with the task early — not the passage of time.

As to why all mice perform so poorly during the first 24 hours, regardless of what they do? The reason may lie in the disturbance that the brain has just experienced.

“The cortex connects to almost every other structure in the brain, so manipulating it may temporarily disrupt connected structures — in essence shocking those areas that would normally enable a behavior,” said Dr. Bruno. “Perhaps this sudden and brief loss in sensation is due to that initial disruption to the animals’ abilities — rather than being due to the loss of any information stored in the barrel cortex itself.”

The manipulations undertaken by the Columbia team are not unlike what happens in the brain of a person having a stroke. Dr. Bruno and his team caution that their research on rodents cannot be directly applied to human beings. But they hope their findings will be further explored by neurologists looking to improve recovery times for their patients.

“We tend to immobilize people when they’ve suffered a stroke; the recovery of seemingly simple tasks — walking, grasping — can be a long road,” said Dr. Bruno. “Our findings suggest that maybe, in some cases, patients could be reintroduced to these activities much earlier in order to speed recovery.”

Story Source:

Materials provided by The Zuckerman Institute at Columbia UniversityNote: Content may be edited for style and length.


Journal Reference:

  1. Y. Kate Hong, Clay O. Lacefield, Chris C. Rodgers, Randy M. Bruno. Sensation, movement and learning in the absence of barrel cortexNature, 2018; DOI: 10.1038/s41586-018-0527-y

The Zuckerman Institute at Columbia University. “Brain recovery: Activity, not rest, may speed recovery after brain injury.” ScienceDaily. ScienceDaily, 17 September 2018. <www.sciencedaily.com/releases/2018/09/180917111622.htm>.

 

via Brain recovery: Activity, not rest, may speed recovery after brain injury — ScienceDaily

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[Study] Effects of Exoskeleton Robotic Training Device on Upper Extremity in Brain The Effects of Exoskeleton Robotic Training Device

Overview

The purpose of this study is to examine the effects of the EMG-driven exoskeleton hand robotic training device on upper extremity motor and physiological function, daily functions, quality of life and self-efficacy in brain injury patients.

Full Title of Study: “The Effects of the EMG-driven Exoskeleton Hand Robotic Training Device on Upper Extremity Motor and Physiological Function, Daily Functions, Quality of Life and Self-efficacy in Brain Injury Patients”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Crossover Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: November 1, 2018

Detailed Description

In the Robot-assisted group, participants receive training including passive movement, active movement, and game practices.

Let’s see the operation of the robot system by video. First, the passive movement. Patients could perform a movement of full hand, or thumb/second/middle finger together.

Second, the active movement. There were three types of active movement, including full hand grasp/ release/ or grasp and release together.

The researcher chose two out of three of the movements. Third, the game mode. There were several games to practice the active movement, including only distal part/ or distal plus proximal part together.

In the Conventional group, participants receive conventional occupational therapy.

The intervention was conducted 1.5 hour a day, 3 days a week for consecutive 4 weeks.

[…]

more —>  Effects of Exoskeleton Robotic Training Device on Upper Extremity in Brain…

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[BLOG POST] Brain Injury Was Never The Plan!

Having a Brain Injury Was Never the Plan!

By Barbara Webster and The Amazing Framingham Brain Injury Survivor Support Group of The Brain Injury Assoc. of Massachusetts

I never thought . . .

It would be so hard to find the right medical care.

Life could change so easily and so drastically from an “invisible” injury.

A brain injury could result from cancer treatments.

It would take so long and be so difficult.

People would treat me differently.

One can “look great” but be a total disaster inside.

Everything, even doing the simplest things, would be so hard.

My professional career would end.

I would be so miserable without my career.

I’d lose control of my income at such an early age.

The losses would penetrate every area of my life.

I’d change unintentionally.

I wouldn’t be able to think.

I would face a different me.

I’d be unable to depend on myself consistently.

I’d have a hard time expressing myself or understanding what was said.

I’d lose control of my emotions, laugh or cry spontaneously.

I could lose control and become a “Tazmanian Devil”, without warning.

I’d lose the ability to do the things I’m passionate about.

I’d cling to some basic abilities, like driving.

I’d lose the ability to enjoy to social events.

It would affect my marriage.

My family wouldn’t understand.

I’d lose “friends”.

Life would never be like it was.

I could feel like I was going crazy, hopeless and want to die.

I would have to create a new “self”.

I’d find such great joy in accomplishing the simplest things.

 

 I wish I’d known . . .

There was help for people like me much earlier.

There would be so many others like me.

How much progress I could make.

That I would feel better, eventually.

I’d find many alternate ways to get through the days.

How strong I could be.

I’d be able to laugh again.

I’d be accepted once again.

I could forgive myself.

A brain injury could ultimately change the course of my life for the better in many ways.

We invite you to add your thoughts . . .

 

If you like this piece you might also like: “What Brain Injury Survivors Want You to Know”, featured in Barbara’s book: Lost and Found, a Survivor’s Guide for Reconstructing Life After a Brain Injury, Lash Publishing and on brainline.org.

via Brain Injury Was Never The Plan! An insightful blog about surviving a TBI

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