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dc.contributor.authorPonsford, Jennie-
dc.contributor.authorTrevena-Peters, Jessica-
dc.contributor.authorMcKay, Adam-
dc.contributor.authorSpitz, Gershon-
dc.contributor.authorRachel, Suda Bach-
dc.contributor.authorRenison, Belinda-
dc.identifier.citationArch Phys Med Rehabil. 2018 Feb; 99(2): 329-337.e2en_US
dc.description.abstractOBJECTIVE: 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: Randomised controlled trial. SETTING: Inpatient rehabilitation centre. PARTICIPANTS: 104 participants with severe TBI, admitted to rehabilitation and remaining in PTA for > 7 days, were randomised to receive either treatment as usual (TAU) with daily ADL retraining (Treatment), or TAU alone (physiotherapy, necessary speech therapy), during PTA. INTERVENTION: ADL retraining was manualised, followed errorless and procedural learning principles, and included individualised goals. Both groups received occupational therapy as usual following PTA. OUTCOME MEASURES: Primary outcome was the Functional Independence Measure (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<0.01). The treatment group had greater improvement in FIM scores from baseline to PTA emergence, maintained at discharge, although 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. CONCLUSION: Individuals in PTA can benefit from skill retraining.en_US
dc.subjectActivities of Daily Livingen_US
dc.subjectPost Traumatic Amnesiaen_US
dc.subjectTreatment As Usualen_US
dc.subjectFunctional Independence Measureen_US
dc.subjectCommunity Integration Questionnaireen_US
dc.subjectAgitated Behavior Scaleen_US
dc.subjectTraumatic Brain Injuryen_US
dc.subjectSpeech Therapyen_US
dc.subjectOccupational Therapyen_US
dc.subjectPTA Emergenceen_US
dc.subjectPTA Durationen_US
dc.subjectPost Traumatic Amnesia Emergenceen_US
dc.subjectPost Traumatic Amnesia Durationen_US
dc.subjectMonash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australiaen_US
dc.titleEfficacy of activities of daily living retraining during posttraumatic amnesia: A randomised controlled trialen_US
dc.typeJournal Articleen_US
dc.identifier.doidoi: 10.1016/j.apmr.2017.08.486en_US
dc.identifier.journaltitleArchives of Physical Medicine and Rehabilitationen_US
dc.description.affiliatesMonash Institute of Cognitive & Clinical Neurosciences and School of Psychological Sciences Monash University, Clayton VIC, Australiaen_US
dc.type.studyortrialRandomized Controlled Clinical Trialen_US
Appears in Collections:Neurosciences

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