Faculty Bibliography

OBJECTIVE/UNASSIGNED:Memory problems are among the most frequently reported cognitive complaints by individuals with an acquired brain injury (ABI). Processing speed and working memory deficits are often the result of ABI. These cognitive deficits significantly impact the acquisition and retention of information necessary for memory formation. This study investigated the influence of processing speed and working memory on immediate and delayed recall for verbal and visual memory, as well as overall memory recall in adults living with a chronic ABI. METHODS/UNASSIGNED:Sixty-three participants living with a chronic ABI, who were at least one-year post-injury, were cognitively assessed with the CNS-Vital Signs (CNS-VS) computerized cognitive battery and Wechsler Test of Adult Reading. RESULTS/UNASSIGNED:The CNS-VS Processing Speed significantly predicted delayed recall for verbal memory and overall memory performance. The CNS-VS Working Memory was not a significant predictor of memory recall. CONCLUSIONS/UNASSIGNED:Processing speed deficits negatively impact memory in individuals with a chronic ABI. These findings suggest the memory recall of adults with a chronic ABI is associated with poor processing speed and poor acquisition of information. Therefore, cognitive rehabilitation that improves processing speed should be the focus for individuals with ABI to improve memory performance as well as impaired processing speed.

IMPORTANCE/OBJECTIVE:This study provides information to clinicians about how persons with MS coped in both positive and negative ways during a potentially traumatic experience (the coronavirus disease 2019 [COVID-19] pandemic), which will help clinicians to provide better services to this population in the face of stressful events. OBJECTIVE:To describe both positive and negative outcomes among persons with multiple sclerosis (MS) and to examine whether resilience and social support were related to positive and negative outcomes during the peak of the pandemic. DESIGN/METHODS:An online survey administered during the COVID-19 pandemic. PARTICIPANTS/METHODS:Participants were 74 individuals with MS and 104 healthy controls (HCs) recruited through social media and community support groups. OUTCOMES AND MEASURES/METHODS:The survey included questionnaires that assessed both positive and negative responses to the pandemic, including benefit finding, loneliness, and distress. Resilience and social support were also assessed. RESULTS:Differences were noted between persons with MS and HCs on negative but not positive outcomes. Better social support and resilience were related to positive outcomes. CONCLUSIONS AND RELEVANCE/CONCLUSIONS:Both persons with MS and HCs were similar in benefit finding and stress management. However, negative outcomes were worse in the MS group. Our findings shed light on the importance of individuals with MS adopting a positive outlook to help during times of adversity. What This Article Adds: Among persons with disabilities such as multiple sclerosis, finding benefits during stressful times can be a potential coping mechanism. Furthermore, resilience and social support should be taken into account to moderate the effects of adverse events.

Research Objectives: To understand the relationship between use of coping skills and resilience in adults with an acquired brain injury (ABI) during the beginning of the Coronavirus Disease of 2019 (COVID-19) pandemic.
Design(s): Survey data was collected via online platform, Research Electronic Data Capture (REDCap).
Setting(s): The general community.
Participant(s): Participants as part of a convenience sample included self-identified adults with a traumatic brain injury (TBI) or stroke, 18 years or older (n = 99). Exclusion criteria were other neurological diagnoses or serious mental illnesses.
Intervention(s): Not applicable.
Main Outcome Measure(s): The outcome measures were the following: COVID-19 Experiences subsection of the COVID-19: Impact of the Pandemic and Health Related Quality of Life in Cancer Patients and Survivors Scale (Cov-PHRQoL) and the Brief Resilient Coping Scale.
Result(s): There was a significant group difference for race, (p =.04), with the Non-Coping Group having more people of minority status. The Coping Group reported a greater appreciation of family and friends (p=.001), greater appreciation for life (p=.001), more grateful for each day (p=.001), accepting of what they can't change (p=.001), and finding new ways to connect family and friends (p=.001). Compared to the Non-Coping Group, the Coping Group reported significantly greater resiliency and growth from a difficult situation (p = 0.006).
Conclusion(s): The COVID-19 pandemic provided a unique opportunity to examine the relationship between coping skills and resilience in people with ABI when faced with a novel stressor. People who utilized coping skills demonstrated positive outcomes in the form of perceived benefits and greater appreciation for who they had in their life. Furthermore, the Coping group was able to reframe difficult situations to find psychological growth. More research must be done to determine the relationship between coping skills and resilience in people with ABI, as well as what aspects of coping skills and resilience are most crucial to producing positive outcomes for people with ABI when faced with novel stressors. Author(s) Disclosures: None.
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BACKGROUND:The COVID-19 pandemic provided a unique opportunity to explore the impact of the mandated lockdown and social distancing policies on engagement in daily occupations for individuals with multiple sclerosis (MS) and able bodied (i.e. healthy) adults. The study also examined whether the changes in daily occupations were associated with health-related quality of life (HrQOL). METHODS:Between the spring and early fall of 2020, 69 persons with MS and 95 healthy adults completed an online survey that included measurements of 26 activities of daily life. For each activity, participants reported whether they continued to perform the activity (with or without adjustments), whether they stopped, or started to perform the activity during the pandemic. Social support, HrQOL, and demographics, including financial distress were also obtained. RESULTS:Participants with MS and healthy adults both reduced the number of activities performed during the pandemic. Healthy adults continued to do more activities with and without adjustments compared with participants with MS. In both groups, better HrQOL was associated with the number of activities participants continued to do with and without adjustments, and worse HrQOL with the number of activities they stopped doing. CONCLUSIONS:Fewer persons with MS engaged in everyday occupations than healthy adults following the COVID-19 pandemic. The ability to maintain occupational engagement and to participate in social and daily activities is important for maintaining high HrQOL in both groups. Thus, these results call for attention in treatment and self-management of MS symptomatology.

BACKGROUND:Traumatic brain injury (TBI) often results in chronic impairments to cognitive function, and these may be related to disrupted functional connectivity (FC) of the brain at rest. OBJECTIVE:To investigate changes in default mode network (DMN) FC in adults with chronic TBI following 40 hours of auditory processing speed training. METHODS:Eleven adults with chronic TBI underwent 40-hours of auditory processing speed training over 13-weeks and seven adults with chronic TBI were assigned to a non-intervention control group. For all participants, resting-state FC and cognitive and self-reported function were measured at baseline and at a follow-up visit 13-weeks later. RESULTS:No significant group differences in cognitive function or resting-state FC were observed at baseline. Following training, the intervention group demonstrated objective and subjective improvements on cognitive measures with moderate-to-large effect sizes. Repeated measures ANCOVAs revealed significant (p <  0.001) group×time interactions, suggesting training-related changes in DMN FC, and semipartial correlations demonstrated that these were associated with changes in cognitive functioning. CONCLUSIONS:Changes in the FC between the DMN and other resting-state networks involved in the maintenance and manipulation of internal information, attention, and sensorimotor functioning may be facilitated through consistent participation in plasticity-based auditory processing speed training in adults with chronic TBI.

Objective/UNASSIGNED:To delineate healthcare disruption for individuals with (ABI) during the peak of the pandemic, and to understand the impact of healthcare disruption on health-related quality of life (HRQoL). Design/UNASSIGNED:Cross-sectional survey. Setting/UNASSIGNED:General community. Participants/UNASSIGNED:N=207. Volunteer sample of adults with traumatic brain injury (TBI, n=33), stroke (n=66), and healthy adults (n=108) with access to the internet and personal technology. Interventions/UNASSIGNED:NA. Main Outcome Measures/UNASSIGNED:NA. Results/UNASSIGNED: = 0.148). Conclusion/UNASSIGNED:Individuals with and without ABI experienced pronounced disruption in healthcare utilization overall. However, individuals who experienced a disruption in care specific to TBI or mental healthcare were most vulnerable to decreased HRQoL. Telehealth was a viable alternative to in-person visits for individuals with and without ABI, but, limitations included difficulty with technology, difficulty with comprehensive exam, and decreased rapport with providers.

BACKGROUND:Adults with chronic traumatic brain injury (TBI) may experience long-term deficits in multiple cognitive domains. Higher-order functions, such as verbal memory, are impacted by deficits in the ability to acquire verbal information. OBJECTIVE:This study investigated the effects of a neuroplasticity-based computerized cognitive remediation program for auditory information processing in adults with a chronic TBI. METHODS:Forty-eight adults with TBI were randomly assigned to an intervention or control group. Both groups underwent a neuropsychological assessment at baseline and post-training. The Intervention group received 40 one-hour cognitive training sessions with the Brain Fitness Program. RESULTS:The intervention group improved in performance on measures of the Woodcock-Johnson-III Understanding Directions subtest and Trail Making Test Part-A. They also reported improvement on the cognitive domain of the Cognitive Self-Report Questionnaire. CONCLUSIONS:The present study demonstrated that a neuroplasticity-based computerized cognitive remediation program may improve objective and subjective cognitive function in adults with TBI several years post-injury.

Objective: Cognitive dysfunction is prevalent amongst individuals who have undergone neurosurgical intervention, significantly impacting daily functioning and quality of life. The aim of this pilot study was to investigate the impact of Cogmed Working Memory Training (CWMT), a five-week, home-based, computerized cognitive rehabilitation intervention, within a neurosurgical population. Method: Thirty adult participants who underwent neurosurgical intervention, regardless of etiology, were included in this study. Participants were administered a neuropsychological battery at three time points post-neurosurgical intervention: (a) at baseline, prior to engaging in CWMT; (b) within two weeks of completing the training; and (c) after three months of completing the training. Results: Following CWMT, participants demonstrated significant improvement on measures of attention, working memory, processing speed, verbal learning, and memory. In addition, participants reported significant improvement in quality of life (i.e., physical, social, emotional, and functional well-being), mood (i.e., anxiety and depression), and neurobehavioral functioning (i.e., apathy). Implications: Results suggest that CWMT may improve aspects of cognitive and functional outcomes for neurosurgical patients.

Participation refers to a state of health in which a person is able to fully engage in roles and life situations. Adults living with and beyond cancer often report persistent participation restrictions that affect their productivity and quality of life. The American Occupational Therapy Foundation convened a group of scientists from seven different disciplines in a Planning Grant Collective (PGC) to stimulate research to identify scalable ways to preserve and optimize participation among cancer survivors. Participants identified challenges, prioritized solutions, and generated novel research questions that move beyond symptom and impairment mitigation as outcomes to identify interventions that improve participation in roles and life situations. This article summarizes the PGC discussion and recommendations regarding three challenges: (a) the dynamic and multi-faceted nature of participation, (b) a need to integrate the concept of participation within the culture of oncology, and (c) identification of priority areas in which new lines of research regarding participation would be most impactful.