http://hdl.handle.net/11434/25 Sat, 09 May 2026 10:19:13 GMT 2026-05-09T10:19:13Z http://hdl.handle.net/11434/2426 Title: Predictors of improved attentional control after virtual reality-based cognitive rehabilitation in chronic traumatic brain injury. Epworth Authors: Ponsford, Jennie Abstract: The purpose of this paper was to explore predictors of change in attentional control observed in a randomized controlled trial (RCT) investigating VR-based cognitive training, using the game BeatSaber. Materials and methods: Data were collected at baseline of the RCT, including 100 participants in the chronic phase of TBI, defined as at least one year post-injury. The 51 participants randomized to the VR group were included in this analysis. Primary outcome measure was based on the main significant finding from the RCT, a ratio score between speed and accuracy, Inverse Efficiency Score (IES). To explore potential predictors of post-treatment change in IES, a multivariable regression analysis was performed. Based on previous research, age, years since injury, executive functioning, level of abstract thinking, and immersive tendencies were selected as predictors. Results: The model explained 40% of the variance of the post treatment change in IES. More years since injury, lower baseline executive functioning and higher immersive tendencies towards games explained greater change in VR-training. However, after bootstrapping, only years since injury remained a significant predictor. Conclusion: In light of the bootstrapped analyses, the findings should be interpreted as exploratory and considered hypothesis-generating, warranting further investigation in larger samples. Wed, 01 Apr 2026 00:00:00 GMT http://hdl.handle.net/11434/2426 2026-04-01T00:00:00Z http://hdl.handle.net/11434/2399 Title: The Impact of strength changes on active function following Botulinum Neurotoxin-A (BoNT-A): A systematic review. Epworth Authors: Banky, Megan; Gill, Renee; Olver, John; Medina Mena, Pablo; Woo, Angie; Moore, Elizabeth; Williams, Gavin Abstract: Botulinum neurotoxin-A (BoNT-A) injections are effective in reducing focal limb spasticity; however, their impact on strength and active function needs to be established. This review was a secondary analysis aimed at evaluating changes to active function in the context of muscle strength changes following BoNT-A intramuscular injection for adult upper and lower limb spasticity. The original review searched eight databases (CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Google Scholar, MEDLINE, PEDro, PubMed, Web of Science) and was conducted with methodology that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines as described in section 6.2 of Gill et al. For this secondary analysis, no databases were searched; only further data were extracted. The current and preceding review were registered in the Prospective Register of Systematic Reviews (PROSPERO: CRD42022315241). Twenty studies were screened for inclusion, and three studies were excluded because active function was not assessed in all participants. Seventeen studies (677 participants) met the inclusion criteria for analysis. Quality was examined using the PEDro scale and modified Downs and Black checklist and rated as fair to good. Pre- and post-BoNT-A injection strength (agonist, antagonist, and global), active function (activity), participation, and quality-of-life outcomes at short-, mid-, and long-term time points were extracted and analysed. Significant heterogeneity and limited responsiveness in strength and active function outcome measures limited the ability to determine whether changes in strength mediate an effect on active function. Further, variability in BoNT-A type and dose, adjunctive therapies provided, and variability in reporting limited analyses. Overall, no clear relationship existed between the change in muscle strength and active function following BoNT-A injections to the upper and lower limbs for focal spasticity in adult-onset neurological conditions. Tue, 01 Jul 2025 00:00:00 GMT http://hdl.handle.net/11434/2399 2025-07-01T00:00:00Z http://hdl.handle.net/11434/2368 Title: Rehabilitation through a cultural lens: the experience of cultural and linguistically diverse (CALD) traumatic brain injury (TBI) survivors in Australia. Epworth Authors: Nalaye, Halima; Downing, Marina; Ponsford, Jennie Abstract: CALD TBI survivors face poorer functional outcomes post-injury, however, the reasons for this are poorly understood. The body of qualitative research in Western countries (e.g., Australia) is limited: to date it has not captured the experiences of those who speak little/no English or been in Australia for a short period of time. There has also been limited focus on how culturally bound factors (e.g. beliefs and understanding of injury) may interact with their experience. A deeper understanding can aid clinicians in tailoring culturally safe rehabilitation and potentially improve outcomes. Fri, 01 Aug 2025 00:00:00 GMT http://hdl.handle.net/11434/2368 2025-08-01T00:00:00Z http://hdl.handle.net/11434/2347 Title: Early intervention vocational rehabilitation for return to work following traumatic injury: A randomized controlled trial. Epworth Authors: Ponsford, Jennie; Downing, Marina; O'Kearney, Emily; Bedekar, Yash; Olver, John; McKenzie, Dean; Ross, Pamela Abstract: Background: Returning to work (RTW) is an important goal for individuals sustaining traumatic injury (Multi-Trauma Orthopaedic [MTO], traumatic brain injury [TBI], and spinal cord injury [SCI]). Vocational rehabilitation is often unavailable or delayed, and controlled evaluation limited. Objectives: This study evaluated the impact of providing an Early Intervention Vocational Rehabilitation Service (EIVRS) following traumatic injury on employment outcomes, mental health and quality of life 1- and 2-years post-injury. Methods: A randomised parallel 2-group design was used to compare the EIVRS group with a control group receiving usual rehabilitation. Outcomes included hours worked and time to return to first job (primary outcomes), anxiety, depression and quality of life 1- and 2-years post-injury. Participants were adults aged 16-70, employed pre-injury. Eighty-eight EIVRS treatment and 82 controls were recruited; mean 47 days post-injury, 75% male, mean age 38 years. Dedicated EIVRS therapists provided activities associated with fostering hope for RTW, thinking about and preparing for returning to work, building RTW goals into rehabilitation, identifying an employer liaison, and peer support. Results: There were no significant group differences in employment outcomes at 1-year follow-up, but EIVRS participants reported lower anxiety. Median quartile regressions revealed that at 2-year follow-up, the EIVRS group worked more hours (38, 24; 40) and took significantly less time from injury to RTW (166, 87; 280) than controls (29, 23; 36 and 238, 144; 325). Quartile regressions by diagnosis showed a significant main effect of group (P = 0.02) but no interaction between group and diagnosis (P = 0.60). Trends for shorter time to RTW were strongest in the MTO and TBI groups at 2 years. At 2 years there were no group differences in anxiety, depression or quality of life. Conclusions: Offering EIVRS may reduce time to RTW and increase hours worked 2 years after traumatic injury. Tue, 01 Apr 2025 00:00:00 GMT http://hdl.handle.net/11434/2347 2025-04-01T00:00:00Z