Faculty Bibliography

BACKGROUND/UNASSIGNED:Attention impairment is common in post-traumatic brain injury. We synthesized evidence on pharmacological treatments for adults with attention deficits in the acute-to-chronic phases. METHODS/UNASSIGNED:We searched Ovid MEDLINE and Cochrane Library (1946-December 2024). Two reviewers screened studies, extracted data, and assessed study quality. Risk of bias was assessed using the Cochrane Risk of Bias tool and the PEDro scale for RCTs. Levels of evidence (LoE) were determined by the Sackett framework. RESULTS/UNASSIGNED:Twenty-nine studies met inclusion criteria across five drug classes and 14 medications. Results of LoE 1 were mixed: Methylphenidate improved classroom attention/processing speed, and exhibited neutral outcome; amantadine showed no improvement (LoE 1, 4, 5). MLC901 (a multi-herb antioxidant) improved complex attention (LoE 1). Donepezil improved sustained (LoE 1) and divided attention (LoE 4). Physostigmine/lecithin (LoE 1) and antidepressants (LoE 1, 3, 5) had mixed effects; growth hormone (LoE 4), and L-carnitine (LoE 1) showed no effect. Anticonvulsants impaired cognition (LoE 1). CONCLUSION/UNASSIGNED:Methylphenidate showed the strongest evidence at lower doses. Donepezil and MLC901 showed potential benefits. Phenytoin and carbamazepine showed adverse effects on cognition. Standardized attention outcome measures and other high-quality alternative clinical trials with larger study samples are recommended to overcome the current limitations.

Historically hindered by a lack of access to academic, political, financial, technological, scientific, and social resources, most people living with disability have been unable to successfully merge their lived experience with the traditional research process. The lack of this community's perspective has been an ongoing missed opportunity for the broadening and relevance of research around disability. Patient-scientists, however, bridge the gap. They are individuals who act as patient research partners (PRPs) with the valuable addition of a research and/or medical degree. Their embodied expertise, combined with their academic accreditation, seamlessly positions them to work within the academic system. With a foot in both worlds, they are equipped to generate real change for themselves and others living with their condition. Patients are encouraged to participate in their own clinical care, although PRPs remain relatively uncommon. Even more scarce are patient-scientists, who serve as intellectual peers with expertise in technical and experiential domains. Their research training gives them an invaluable role: to act as both scientist and patient at once. This special communication builds on ongoing efforts to bolster patient participation in rehabilitation research by focusing on patient-scientists and highlighting their potential to enhance rehabilitation research processes.

An existing scale of personal growth in caregivers of people with multiple sclerosis (MS) was expanded for use with an acquired brain injury (ABI) population, and was modified following additional psychometric analyses. A cross-sectional online survey was administered to 315 caregiving partners of persons with MS and 310 family caregivers of persons with ABI. Principal component analysis (PCA) performed on the original 32-item instrument yielded a 4-component, 17-item solution with correlated subscales with solid psychometric properties. Subscales were labelled Appreciation, Positivity, Adjustment, and Spirituality. Secondary PCA conducted revealed three subscales (five items each) correlated moderately while the fourth, Spirituality, remained distinct. The sum of the three five-item subscales may serve as a total score. Reliability analysis yielded acceptable-to-high internal consistency. Comparisons of the PGS with existing instruments demonstrated its discriminant/convergent validity. Two kinds of latent class analyses were conducted on the 15-item PGS to identify three latent classes that spanned the neurologic groups, revealing that measurement invariance was held for the instrument in this sample. An instrument with sound psychometric properties was established, designed to assess personal growth in caregivers of individuals with ABI or MS. Future work should explore its value in other populations and as a metric of changes over time.

OBJECTIVE:To characterize how mentorship has been perceived, received, and practiced by individuals in the field of rehabilitation psychology across the career lifespan. METHOD/METHODS:Current members of the American Psychological Association Division 22 (Rehabilitation Psychology) were invited to complete an electronic survey via REDCap assessing individual experiences and perspectives on mentorship. Thematic analysis was used to identify key constructs and themes. RESULTS:= 25 mentors) completed the survey with valid responses. Participants spanned the career lifespan, ranging from predoctoral trainees to late-senior psychologists. Mentorship was generally perceived as helpful for both mentors and mentees. Several important qualities of mentors (e.g., availability, communication skills, self-disclosure, and emotional support) and mentees (e.g., flexibility, motivation, and openness to feedback) were identified. Among both groups, mentorship was viewed as especially beneficial for obtaining American Board of Professional Psychology (ABPP) board certification, which may reflect an aspect of mentoring unique to Division 22. Existing gaps in mentorship and key areas for improvement were also identified; access to mid- to late-career mentorship emerged as a notable gap in mentorship. Increased program structure, networking opportunities, and research mentorship were also identified as possible areas of growth. CONCLUSIONS:This study provides meaningful insights into mentorship within the field of rehabilitation psychology. Our findings demonstrate the value of mentorship across the career lifespan, and the beneficial role of mentorship in obtaining ABPP board certification. In addition, we identify key areas of growth that can inform and improve mentorship within the field. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The WHO argues that a pharmacy-first approach should no longer be the reflexive treatment for mental health diagnoses. Heart rate variability biofeedback (HRVB) demonstrably treats various conditions"”especially effective at regulating emotion, particularly managing and alleviating anger, stress, anxiety, and depression, common co-morbid diagnoses for rehabilitation medicine patients. HRVB trains users to study their biofeedback data in real time, alter bodily functions previously believed to be automatic, and garner health benefits. Despite convenience, relatively low cost, and empowering patients to manage their own symptoms, the current lack of reimbursability, and the lack of Phase III RCTs limit HRVB application. Ideally, the confidence of practitioners, patients, and insurers would follow the known efficacy of HRVB for the treatment of mental health conditions.

OBJECTIVE:To examine the evidence levels, study characteristics, and outcomes of nonpharmacologic complementary and integrative medicine (CIM) interventions in rehabilitation for individuals with traumatic brain injury (TBI). DATA SOURCES/METHODS:MEDLINE (OvidSP), PubMed (NLM), EMBASE (Embase.com), CINAHL (EBSCO), PsycINFO (OvidSP), Cochrane Library (Wiley), and National Guidelines Clearinghouse databases were evaluated using PRISMA guidelines. The protocol was registered in INPLASY (protocol registration: INPLASY202160071). DATA EXTRACTION/METHODS:Quantitative studies published between 1992 and 2020 investigating the efficacy of CIM for individuals with TBI of any severity, age, and outcome were included. Special diets, herbal and dietary supplements, and counseling/psychological interventions were excluded, as were studies with mixed samples if TBI data could not be extracted. A 2-level review comprised title/abstract screening, followed by full-text assessment by 2 independent reviewers. DATA SYNTHESIS/RESULTS:In total, 90 studies were included, with 57 001 patients in total. This total includes 2 retrospective studies with 17 475 and 37 045 patients. Of the 90 studies, 18 (20%) were randomized controlled trials (RCTs). The remainder included 20 quasi-experimental studies (2-group or 1-group pre/posttreatment comparison), 9 retrospective studies, 1 single-subject study design, 2 mixed-methods designs, and 40 case study/case reports. Guided by the American Academy of Neurology evidence levels, class II criteria were met by 61% of the RCTs. Included studies examined biofeedback/neurofeedback (40%), acupuncture (22%), yoga/tai chi (11%), meditation/mindfulness/relaxation (11%), and chiropractic/osteopathic manipulation (11%). The clinical outcomes evaluated across studies included physical impairments (62%), mental health (49%), cognitive impairments (39%), pain (31%), and activities of daily living/quality of life (28%). Additional descriptive statistics were summarized using narrative synthesis. Of the studies included for analyses, 97% reported overall positive benefits of CIM. CONCLUSION/CONCLUSIONS:Rigorous and well experimentally designed studies (including RCTs) are needed to confirm the initial evidence supporting the use of CIM found in the existing literature.

The inclusion of people with disabilities has historically been, and continues to be, challenging work. In the health professions, the practice of inclusion should promote and advance the dissemination of efforts to decrease the impact of societal and physical barriers on the lives of people with disability, as well as promote innovative approaches to effectively foster an inclusive society. In addition to a focus on concepts such as the intact abilities of people with disabilities and the facilitation of community participation, an important shift in inclusion-related research requires listening to the lived experience of individuals with disabilities. Listening to their lived experiences and including the valuable insights gleaned from their insider's perspective can enrich efforts to evaluate clinical and educational programs, define population needs, and set research agendas and rehabilitation goals. Building on seminal work from Tamara Dembo, Beatrice Wright, and Margaret Brown, this communication from the Disability Representation Task Force at the American Congress of Rehabilitation Medicine also explores how healthcare providers living with a disability can make a significant contribution to rehabilitation treatment by analyzing how their own experience applies to clinical practice.

Introduction: Despite increasing use of complementary and integrative health (CIH) by rehabilitation providers, information on rehabilitation professionals"™ perceptions and utilization of CIH is limited. The purpose of this study was to investigate rehabilitation professionals"™ perceptions, utilization, barriers and research of CIH in the United States. Methods: A cross-sectional online survey was conducted on the perceptions, utilization, barriers and research regarding CIH. Survey invitations were posted on community boards of rehabilitation associations and sent to rehabilitation institutions listserv in 2020. Results: Of 405 respondents, the majority of respondents were physical therapists (PTs) (34%), then, occupational therapists (OTs) (20%), and physicians (16.8%). Most respondents (68%) worked in settings offering integrative health. Forty three percent of respondents were trained and 22% were certified in CIH practice. Breathing exercises, meditation, massage, and yoga were the most commonly utilized practices for self-care and patient care. Physicians and PTs were more likely than OTs to initiate discussion about CIH with patients (p=.001 and p=.046 respectively), and senior practitioners were more likely to initiate these discussions than junior practitioners (p=.037 and p<.001, respectively). Peer-reviewed publications, clinical experience, and personal experience with CIH were the most selected factors affecting respondents"™ attitudes toward CIH practices. Rehabilitation clinicians reported that insufficient provider reimbursement and insufficient skills were the primary obstacles to CIH practice. Rehabilitation researchers reported that insufficient funding as the primary obstacle to conducting CIH research. Conclusions: Rehabilitation professionals commonly utilize CIH in practices for self-care and patient care, and they perceive insufficient training, clinical reimbursement and research funding as the main barriers to advancing CIH.