Efficacy of Activities of Daily Living Retraining During Posttraumatic Amnesia: A Randomized Controlled Trial

Jessica Trevena-Peters, Adam McKay, Gershon Spitz, Rachel Suda, Belinda Renison, Jennie Ponsford

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective To assess the efficacy of activities of daily living (ADL) retraining during posttraumatic amnesia (PTA) compared with ADL retraining commencing after emergence from PTA. Design Randomized controlled trial. Setting Inpatient rehabilitation center. Participants Participants with severe TBI (N=104), admitted to rehabilitation and remaining in PTA for >7 days, were randomized to receive either treatment as usual (TAU) with daily ADL retraining (treatment), or TAU alone (physiotherapy and/or necessary speech therapy) during PTA. Interventions ADL retraining was manualized, followed errorless and procedural learning principles, and included individualized goals. Both groups received occupational therapy as usual after PTA. Main Outcome Measures Primary outcome was the FIM completed at admission, PTA emergence, discharge, and 2-month follow-up. Secondary outcomes included length of rehabilitation inpatient stay, PTA duration, Agitated Behavior Scale scores, and Community Integration Questionnaire (CIQ) scores at follow-up. Groups did not significantly differ in baseline characteristics. Results On the primary outcome, FIM total change, random effects regression revealed a significant interaction of group and time (P<.01). The treatment group had greater improvement in FIM scores from baseline to PTA emergence, which was maintained at discharge, but not at follow-up. Twenty-seven percent more of the treatment group reliably changed on FIM scores at PTA emergence. Group differences in length of stay, PTA duration, agitation, and CIQ scores were not significant; however, TAU trended toward longer length of stay and PTA duration. Conclusions Individuals in PTA can benefit from skill retraining.

Original languageEnglish
Pages (from-to)329-337
Number of pages9
JournalArchives of Physical Medicine and Rehabilitation
Volume99
Issue number2
DOIs
Publication statusPublished - 1 Feb 2018

Keywords

  • Activities of daily living
  • Brain injuries, traumatic
  • Neuropsychology
  • Occupational therapy
  • Rehabilitation

Cite this

@article{187c5f4021634278a81336815f727a69,
title = "Efficacy of Activities of Daily Living Retraining During Posttraumatic Amnesia: A Randomized Controlled Trial",
abstract = "Objective To assess the efficacy of activities of daily living (ADL) retraining during posttraumatic amnesia (PTA) compared with ADL retraining commencing after emergence from PTA. Design Randomized controlled trial. Setting Inpatient rehabilitation center. Participants Participants with severe TBI (N=104), admitted to rehabilitation and remaining in PTA for >7 days, were randomized to receive either treatment as usual (TAU) with daily ADL retraining (treatment), or TAU alone (physiotherapy and/or necessary speech therapy) during PTA. Interventions ADL retraining was manualized, followed errorless and procedural learning principles, and included individualized goals. Both groups received occupational therapy as usual after PTA. Main Outcome Measures Primary outcome was the FIM completed at admission, PTA emergence, discharge, and 2-month follow-up. Secondary outcomes included length of rehabilitation inpatient stay, PTA duration, Agitated Behavior Scale scores, and Community Integration Questionnaire (CIQ) scores at follow-up. Groups did not significantly differ in baseline characteristics. Results On the primary outcome, FIM total change, random effects regression revealed a significant interaction of group and time (P<.01). The treatment group had greater improvement in FIM scores from baseline to PTA emergence, which was maintained at discharge, but not at follow-up. Twenty-seven percent more of the treatment group reliably changed on FIM scores at PTA emergence. Group differences in length of stay, PTA duration, agitation, and CIQ scores were not significant; however, TAU trended toward longer length of stay and PTA duration. Conclusions Individuals in PTA can benefit from skill retraining.",
keywords = "Activities of daily living, Brain injuries, traumatic, Neuropsychology, Occupational therapy, Rehabilitation",
author = "Jessica Trevena-Peters and Adam McKay and Gershon Spitz and Rachel Suda and Belinda Renison and Jennie Ponsford",
year = "2018",
month = "2",
day = "1",
doi = "10.1016/j.apmr.2017.08.486",
language = "English",
volume = "99",
pages = "329--337",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "Elsevier",
number = "2",

}

Efficacy of Activities of Daily Living Retraining During Posttraumatic Amnesia : A Randomized Controlled Trial. / Trevena-Peters, Jessica; McKay, Adam; Spitz, Gershon; Suda, Rachel; Renison, Belinda; Ponsford, Jennie.

In: Archives of Physical Medicine and Rehabilitation, Vol. 99, No. 2, 01.02.2018, p. 329-337.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Efficacy of Activities of Daily Living Retraining During Posttraumatic Amnesia

T2 - A Randomized Controlled Trial

AU - Trevena-Peters, Jessica

AU - McKay, Adam

AU - Spitz, Gershon

AU - Suda, Rachel

AU - Renison, Belinda

AU - Ponsford, Jennie

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Objective To assess the efficacy of activities of daily living (ADL) retraining during posttraumatic amnesia (PTA) compared with ADL retraining commencing after emergence from PTA. Design Randomized controlled trial. Setting Inpatient rehabilitation center. Participants Participants with severe TBI (N=104), admitted to rehabilitation and remaining in PTA for >7 days, were randomized to receive either treatment as usual (TAU) with daily ADL retraining (treatment), or TAU alone (physiotherapy and/or necessary speech therapy) during PTA. Interventions ADL retraining was manualized, followed errorless and procedural learning principles, and included individualized goals. Both groups received occupational therapy as usual after PTA. Main Outcome Measures Primary outcome was the FIM completed at admission, PTA emergence, discharge, and 2-month follow-up. Secondary outcomes included length of rehabilitation inpatient stay, PTA duration, Agitated Behavior Scale scores, and Community Integration Questionnaire (CIQ) scores at follow-up. Groups did not significantly differ in baseline characteristics. Results On the primary outcome, FIM total change, random effects regression revealed a significant interaction of group and time (P<.01). The treatment group had greater improvement in FIM scores from baseline to PTA emergence, which was maintained at discharge, but not at follow-up. Twenty-seven percent more of the treatment group reliably changed on FIM scores at PTA emergence. Group differences in length of stay, PTA duration, agitation, and CIQ scores were not significant; however, TAU trended toward longer length of stay and PTA duration. Conclusions Individuals in PTA can benefit from skill retraining.

AB - Objective To assess the efficacy of activities of daily living (ADL) retraining during posttraumatic amnesia (PTA) compared with ADL retraining commencing after emergence from PTA. Design Randomized controlled trial. Setting Inpatient rehabilitation center. Participants Participants with severe TBI (N=104), admitted to rehabilitation and remaining in PTA for >7 days, were randomized to receive either treatment as usual (TAU) with daily ADL retraining (treatment), or TAU alone (physiotherapy and/or necessary speech therapy) during PTA. Interventions ADL retraining was manualized, followed errorless and procedural learning principles, and included individualized goals. Both groups received occupational therapy as usual after PTA. Main Outcome Measures Primary outcome was the FIM completed at admission, PTA emergence, discharge, and 2-month follow-up. Secondary outcomes included length of rehabilitation inpatient stay, PTA duration, Agitated Behavior Scale scores, and Community Integration Questionnaire (CIQ) scores at follow-up. Groups did not significantly differ in baseline characteristics. Results On the primary outcome, FIM total change, random effects regression revealed a significant interaction of group and time (P<.01). The treatment group had greater improvement in FIM scores from baseline to PTA emergence, which was maintained at discharge, but not at follow-up. Twenty-seven percent more of the treatment group reliably changed on FIM scores at PTA emergence. Group differences in length of stay, PTA duration, agitation, and CIQ scores were not significant; however, TAU trended toward longer length of stay and PTA duration. Conclusions Individuals in PTA can benefit from skill retraining.

KW - Activities of daily living

KW - Brain injuries, traumatic

KW - Neuropsychology

KW - Occupational therapy

KW - Rehabilitation

UR - http://www.scopus.com/inward/record.url?scp=85034418464&partnerID=8YFLogxK

U2 - 10.1016/j.apmr.2017.08.486

DO - 10.1016/j.apmr.2017.08.486

M3 - Article

VL - 99

SP - 329

EP - 337

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 2

ER -