Glen Gillen; Rehabilitation Research Focused on Neurorehabilitation. Am J Occup Ther 2010;64(2):341-356. doi: 10.5014/ajot.64.2.341.
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Level I: Systematic reviews, meta-analyses, and randomized controlled trials
Level II: Two groups, nonrandomized studies such as cohort or case-control designs
Level III: One group, nonrandomized studies such as pretest and posttest designs
Level IV: Descriptive studies including analysis of outcomes such as single-subject designs or case series
Level V: Case reports and expert opinion including narrative literature reviews and consensus statements.
Interventions for problem-solving impairments caused by acquired brain injury using a metacomponential approach have some advantage compared with conventional cognitive training as indicated by 2 of 10 scores included on the Metacomponential Interview but do not generalize to real-life problem solving (Fong & Howie, 2009);
Use of blocked or random practice has a positive effect on learning specific vocational skills that is retained for ≥2 wk for people living with a traumatic brain injury, and random practice seems to be advantageous in terms of transferring learning to a new and similar task (Guiffrida et al., 2009);
Use of a spacing effect strategy to learn and remember specific skills is superior to massed learning conditions for people with traumatic brain injury and healthy control participants (Goverover et al., 2009); and
A combination of speeded instruction and ipsilateral reach may optimize movement performance of the less affected limb in those living with stroke (Lin et al., 2008).
Documenting the presence of deficits in executive functions, participation restrictions, and a significant correlation between these two variables in those with mild traumatic brain injury (Erez et al., 2009);
Identifying the meaning of context in the process of regaining the ability to participate in self-care after stroke or spinal cord injury using qualitative methods (Guidetti et al., 2009);
Identifying motor deficits via kinematic analysis in the presumed-to-be-unaffected upper extremity after brain injury (Nakamura et al., 2008);
Using qualitative methods to explore the experiences of reengagement in meaningful occupations during the hospital-to-home transition after acquired brain injury (Turner et al., 2009);
Documenting mild difficulties performing basic ADLs and significant limitations in IADLs in those with visual field deficits (Warren, 2009); and
Documenting how the health care community’s understanding of stroke is changing as the age of stroke is decreasing; most strokes are mild to moderate in severity, and most discharge decisions are based on impairment measures (Wolf et al., 2009).
Using qualitative methods, Doig et al. (2009) documented that goal-directed therapy is described positively and that a structured goal-setting process in which the client, therapist, and significant others work in partnership seems to enhance the process of goal setting and goal-directed community-based rehabilitation.
Smallfield and Karges (2009) classified the type of occupational therapy intervention used during inpatient stroke rehabilitation. They observed that most (65.77%) occupational therapy sessions were classified as prefunctional (i.e., not consisting of an actual occupation) in nature compared with 48.26% of sessions focused on relearning daily living tasks.
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