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Biomedical subjects

Beatriz C Abreu

Publications and source records attributed to Beatriz C Abreu.

9 recordsLinked to original sources
PubMed2005

Appraising evidence on community integration following brain injury: a systematic review.

A systematic review of the community integration (CI) literature for persons with traumatic brain injury was undertaken to evaluate: (1) How do we best measure CI? (2) Can we predict CI following rehabilitation? (3) Does social and activity participation have an effect on CI? (4) Does CI have an effect on quality of life/life satisfaction? Seventy-two articles were analysed. The results demonstrated: (1) strong evidence supporting the use of the Community Integration Questionnaire (CIQ), (2) mixed evidence supporting the ability to predict CI, with the prominent predictive variables being severity of injury, age, gender, education, prior work, living environment, cognition, emotional status, functional performance and disability. The literature search was restricted to articles published in English and the heterogeneity in the outcomes, methods, participants and other characteristics not reported. Further research is needed to examine the complex relationship of person, environment and CI.

Activities of Daily Living↗
PubMed2005

Examining the Community Integration Measure (CIM): a replication study with life satisfaction.

OBJECTIVE: To examine instrument reliability, validity, factor structure, and conceptual underpinnings of the Community Integration Measure (CIM) with the Community Integration Questionnaire Revised (CIQ-R) and the Satisfaction with Life Scale (SWLS). DESIGN: A replication study. SETTING: Community living. PARTICIPANTS: Ninety-one participants: 51 individuals with a brain injury, and 40 without brain injury. MAIN OUTCOMES: Internal consistency, criterion validity, construct validity, discriminant validity factor structure. RESULTS: CIM items produced standardized alphas ranging from 0.72 to 0.83. Significant positive correlations were found among the CIM and both the CIQ-R and SWLS, with the CIM performing better with the SWLS than did the CIQ-R. The CIM discriminated between subject samples as well as by living arrangement. The factor loading solution revealed a three-factor model that explained 63.72 percent of the variance. CONCLUSION: The CIM shows good promise for capturing an individual's perception of community integration. The factor structure supports the original Model of Community Integration. Further research is needed to examine the influence of objective items on the CIM and Model of Community Integration.

Adult↗
PubMed2004

The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis.

OBJECTIVE: To determine by meta-analysis whether physical exercises are beneficial for people with dementia and related cognitive impairments. DATA SOURCES: Published articles and nonpublished manuscripts from 1970 to 2003 were identified by using electronic and manual searches. Key search words included exercise, rehabilitation, activities of daily living, dementia, Alzheimer's disease, aged, and geriatrics. STUDY SELECTION: Reviewed studies were limited to randomized trials evaluating exercise in persons 65 years of age or older with cognitive impairment. Studies included quantitative results (means, standard deviations, t tests, F tests) for physical fitness, physical functioning, cognition, or behavior outcomes. DATA EXTRACTION: One reviewer extracted data on study characteristics and findings. Selected articles were evaluated for methodologic quality by 2 raters. DATA SYNTHESIS: A total of 2020 subjects participated in the 30 trials that met the inclusion criteria. Summary effects were computed using a fixed effects (Hedge's g(i)) model. Significant summary effect sizes (ES) were found for strength (ES=.75; 95% confidence interval [CI], .58-.92), physical fitness (ES=.69; 95% CI, .58-.80), functional performance (ES=.59; 95% CI, .43-.76), cognitive performance (ES=.57; 95% CI, 0.43-1.17), and behavior (ES=.54; 95% CI, .36-.72). The overall mean ES between exercise and nonexercise groups for all outcomes was .62 (95% CI, .55-.70). CONCLUSIONS: Exercise training increases fitness, physical function, cognitive function, and positive behavior in people with dementia and related cognitive impairments.

Aged↗
PubMed2003

A virtual reality environment for evaluation of a daily living skill in brain injury rehabilitation: reliability and validity.

OBJECTIVE: To establish the stability and validity of information collected in a virtual reality environment from persons with traumatic brain injury (TBI). DESIGN: Prospective correlation design to examine 3-week test-retest results for equivalence reliability between computer-simulated and natural environments. SETTING: A residential rehabilitation center for brain injury. PARTICIPANTS: Fifty-four consecutive patients with TBI who received comprehensive rehabilitation services and who were at different stages of recovery. INTERVENTION: An immersive virtual kitchen was developed in which a meal preparation task involving multiple steps was performed. The subjects completed meal preparation both in a virtual reality kitchen and an actual kitchen twice over a 3-week period. MAIN OUTCOME MEASURES: Time and errors on task completion using virtual reality assessment, actual kitchen performance (analogous to the virtual reality environment), occupational therapy (OT) evaluation, and neuropsychologic tests. RESULTS: The stability of performance using the simulated virtual environment was estimated with intraclass correlation coefficients (ICCs). The ICC value for total performance, based on all steps involved in the meal preparation task, was.76 (P<.01). The construct validity of the simulated environment was examined by correlating performance in the virtual environment with that in the actual kitchen (r=.63, P<.01), the OT evaluation (r=.30, P=.05 for meal preparation; r=.40, P=.01 for cognitive subskills), and neuropsychologic tests (r=.56, P<.01 for the full-scale intelligence quotient [IQ]; r=.40, P<.01 for the verbal IQ; r=.56, P<.01 for the performance IQ). Finally, a multiple regression analysis revealed that the virtual reality environment test was a good predictor for the actual assessment kitchen (beta=.35, P=.01). CONCLUSION: The virtual reality system showed adequate reliability and validity as a method of assessment in persons with brain injury.

Adolescent↗
PubMed2002

Interdisciplinary meetings: investigating the collaboration between persons with brain injury and treatment teams.

The purpose of this study was to gain an understanding of the collaboration that occurs in interdisciplinary team meetings (ITMs) at a post-acute brain injury rehabilitation centre. A qualitative descriptive case study was chosen for its interpretative and naturalistic approach. The study included participant observation of 51 meetings, five interviews, document review of charts and memos, and inductive analyses. Four themes emerged: (1) the ITM transformation ritual (the meetings themselves); (2) the ITM shapers (the case managers); (3) the ITM collaborators (the professional interdisciplinary team members); and (4) the ritual ghosts (surprisingly, the clients). Several patterns of interactions were documented, including subservient clients, lengthy meetings, and client transformation. These findings are discussed within the context of client-centred practice. The results indicate that inclusion of the client in interdisciplinary meetings does not necessarily lead to collaboration. Clinical implications and future research are discussed.

Adult↗
PubMed2002

Comparison of the Community Integration Questionnaire, the Craig Handicap Assessment and Reporting Technique, and the Disability Rating Scale in traumatic brain injury.

OBJECTIVE: To examine the concurrent validity of the Community Integration Questionnaire (CIQ) in assessing outcomes in traumatic brain injury (TBI) by comparing it with two widely used and well-validated measurements of rehabilitation outcome. DESIGN: A retrospective relational study of the concurrent validity of the CIQ, Craig Handicap Assessment and Reporting Technique (CHART), and Disability Rating Scale (DRS). SETTING: A postacute rehabilitation facility. PARTICIPANTS: Seventy patients with a medical diagnosis of TBI admitted between April 1996 and October 1998 participated in the study. RESULTS: CIQ and CHART provide ratings that are similar in several areas to those provided by the DRS. Correlation (r) among total scores and subscales for all three instruments ranged from 0.021 to 0.671 (P <.01). Correlation between CIQ and CHART is stronger than that between CIQ and DRS or between CHART and DRS, and the correlation between CHART and DRS is stronger than that between CIQ and DRS. CONCLUSION: The CIQ appears to be the most appropriate instrument in quantifying rehabilitation outcome in patients with TBI at the participatory (handicap) level. The findings of this study can help clinicians gain a greater understanding of the nature, redundancy, and gaps among functional outcome measures. Monitoring outcomes can also help clinicians better understand the effectiveness of interventions.

Adolescent↗
PubMed2002

The effect of predictable and unpredictable motor tasks on postural control after traumatic brain injury.

This study examined the effects of environmental predictability on postural control during functional reaching while seated in healthy individuals and patients with traumatic brain injury (TBI). The postural perturbation used required reaching to the left versus reaching to the right, while seated, under predictable versus unpredictable conditions. Indexes of postural control--trajectory stability and response reach times--were measured using an electromechanical system in ten patients with TBI and ten healthy subjects. In the TBI group, greater trajectory stability and shorter response reach time were recorded under unpredictable conditions when reaching to both the right and left (d-index 0.57-2.3). In the control group, greater trajectory stability and shorter response time were recorded under predictable and unpredictable environments compared with the TBI group (d-index 0.46-0.95). This study refutes the hierarchical, predictable-to-unpredictable-environment model of postural control evaluation and treatment. The relationship between information processing demands and postural skill appears more complex than a simple linear association. Predictable and unpredictable conditions may be used concurrently, not sequentially, in TBI rehabilitation.

Adult↗