No abstract

The objective of this study was to evaluate the effectiveness of individual cognitive behavioural therapy (CBT) for post-stroke fatigue and sleep disturbance compared to treatment as usual (TAU). In a parallel two-group pilot randomised controlled trial of 15 participants, nine were allocated to eight weekly sessions of adapted CBT and six continued usual care rehabilitation. The primary outcome was the Fatigue Severity Scale (FSS-7) at two and four months from baseline. Secondary outcomes included measures of sleep, mood and quality of life. Outcomes were assessed by a rater who was blind to group membership. At the four-month endpoint, the CBT group demonstrated significantly reduced fatigue relative to TAU (FSS-7 mean difference: 1.92, 95% CI: 0.24 to 3.60). Significant group differences also emerged for sleep quality and depression, favouring the CBT group. Insomnia and physical quality of life improved immediately post-therapy but were no longer superior to TAU at follow-up. Overall, CBT is a promising treatment for improving post-stroke fatigue, sleep quality and depression. Gains were maintained for two months after therapy cessation and represented large treatment effects. These findings highlight the feasibility of the intervention and warrant extension to a phase III clinical trial.

Although cognitive-behavioural therapy (CBT) is the treatment of choice for anxiety, its delivery needs to be adapted for individuals with traumatic brain injury (TBI). It also requires clients' active engagement for maximum benefit. This study was a pilot randomised controlled trial involving an anxiety treatment programme adapted for people with TBI, based on CBT and motivational interviewing (MI). Twenty-seven participants with moderate/severe TBI (aged 21-73 years, 78% males) recruited from a brain injury rehabilitation hospital were randomly allocated to receive MI + CBT (n = 9), non-directive counselling (NDC) + CBT (n = 10) and treatment-as-usual (TAU) (n = 8). CBT and MI were manualised and delivered in 12 weekly individual sessions. Primary outcome was self-reported anxiety symptoms assessed at baseline, at the end of NDC/MI and immediately following CBT. Assessment was conducted by assessors blinded to group assignment. Intention-to-treat analyses showed that the two active treatment groups demonstrated significantly greater anxiety reduction than TAU. Participants receiving MI showed greater response to CBT, in terms of reduction in anxiety, stress and non-productive coping, compared to participants who received NDC. The results provided preliminary support for the adapted CBT programme, and the potential utility of MI as treatment prelude. Longer follow-up data are required to evaluate the maintenance of treatment effects.

Findings suggest that modified CBT with booster sessions over extended periods may alleviate anxiety and depression following TBI.

Greater understanding of challenging behaviours from the perspectives of family caregivers may help provide more effective support and interventions to improve quality-of-life for individuals with challenging behaviours after TBI and their families.

Articles were included in this review if they met 3 key criteria: (1) male or female participants aged ≥18 years; (2) confirmed ischemic or hemorrhagic stroke, and (3) analysis of the sensitivity and specificity of a cognitive screening measure compared with a gold standard neuropsychological assessment.

These findings suggest that smartphones have potential in improving independence following TBI, but receiving support in using them is vital. Implications for Rehabilitation Smartphones are accessible, acceptable, convenient devices for most individuals with traumatic brain injury (TBI), and are perceived as a useful memory and organizational aid as well as having multiple other helpful functions. Use of communication apps such as text messages and social media is associated with better social and community integration in people with TBI. Direct instruction on how to use smartphone apps is more important for people with TBI than for non-injured individuals. Developers of apps designed for this population should prioritize ease of app use, large displays, and availability of technical support, while maintaining an engaging design and interface.

The current research uses a novel methodology to examine the role of semantics in reading aloud. Participants were trained to read aloud 2 sets of novel words (i.e., nonwords such as bink): some with meanings (semantic) and some without (nonsemantic). A comparison of reading aloud performance between these 2 sets of novel words was used to provide an indicator of the importance of semantic information in reading aloud. In Experiment 1, in contrast to expectations, reading aloud performance was not better for novel words in the semantic condition. In Experiment 2, the training of novel words was modified to reflect more realistic steps of lexical acquisition: Reading aloud performance became faster and more accurate for novel words in the semantic condition, but only for novel words with inconsistent pronunciations. This semantic advantage for inconsistent novel words was again observed when a subset of participants from Experiment 2 was retested 6-12 months later (in Experiment 3). These findings provide support for a limited but significant role for semantics in the reading aloud process.