Search

The efficacy studies of neurocognitive training have focused on the components of the programmes and general methodological questions, not presenting a rationale for the individualization of the intervention, even though this is an essential factor for efficacy. The main objective of this manuscript is to propose a framework for the individual planning of neurocognitive training sessions based on the results of neuropsychological assessment. The proposed framework is coined Branched Programmed Neurocognitive Training (BPNT). BPNT is based on the programmed learning approach and inspired on the Luria's neurocognitive model. The main premises of this framework are the interdependence and hierarchical organization of the cognitive functions, and the individualization of neurocognitive training with multiple patient-tailored paths. The BPNT framework provides guidelines for planning an individualized neurocognitive training in four stages. The potential advantages of this proposal are discussed at various levels, including the role of reward in neurocognitive training and the potential effects of the model on the maintenance and generalization of intervention results. The BPNT framework can be used as an algorithm for the development and adaptation of paper and pencil programmes, as well as computerized rehabilitation platforms. Studies are in place to examine the feasibility of this framework. Individualized neurocognitive training guided by neuropsychological assessment is most likely to be effective. Branched Programmed Neurocognitive Training (BPNT) model provides guidelines to organize the neurocognitive training based on the results of neuropsychological assessment. BPNT is based on the programmed learning model and the Luria neurocognitive model, addresses the role of reward in neurocognitive training and considers the fundamental principle of Errorless Learning. BPNT can be used as an algorithm for the development and adaptation of paper and pencil programmes and computerized rehabilitation platforms. [ABSTRACT FROM AUTHOR]

This paper authentically represents the voices of non-verbal children with cerebral palsy using a case study design. Policy suggests that children should have the right to play and leisure opportunities, however non-verbal children with cerebral palsy have fewer choices. Additionally, children with communication, learning and mobility limitations are usually excluded from research. The aim of this research was to capture the voices of non-verbal children by exploring their well-being impact in terms of their experiences and choices about their level of participation in recreational activities. A qualitative case series study included interviews, observations, photographs and diaries. Where possible, the diaries were completed by both caregivers and children. Data were analysed thematically, and the lens of positioning theory applied. Seven children aged nine to sixteen years participated. The findings showed how equipment, people and environments enabled or hindered the children's participation. The children also advocated as champions for their own well-being. Positioning theory was applied across the data and was adapted offering a way to better understand the children's well-being responses. The findings demonstrate how these children were able to self-advocate, demonstrating their well-being by their intentional behaviours from their level of participation in a recreational activity. The voices of non-ambulant and non-verbal children are underrepresented in the literature. This study offers an innovative approach to highlight their voices using visual data. The images project the narrative about their choices for participation in recreational activities. The proposed kaleidoscope of well-being offers a way to demonstrate the fluctuations in their emotional responses from their participation. Choices for participation in recreational activities remains limited for non-ambulant and non-verbal children with cerebral palsy. Designers and policy makers should consider how equipment and environments can be adapted or created to increase the choices for non-ambulant and non-verbal children with cerebral palsy. Practitioners in health and social care should consider how to listen to the voices of non-verbal and non-ambulant children with cerebral palsy and their parents/guardians and work towards jointly setting participation goals to affirm their strengths. [ABSTRACT FROM AUTHOR]

Some parents of children with DMD find their role challenging, affecting quality of life. To inform support methods, we aimed to understand the lived experiences of parents and how these interact with disease progression. PRISMA informed protocol development. Qualitative and mixed methods studies were included. Four databases were searched and study quality was assessed using a standardised measure. Extracted data were analysed using thematic synthesis. 26 studies were included, comprising 362 parents. Seven descriptive themes were apparent: "Diagnostic Experiences", "Coping with the Caregiver Role", "Illness Trajectory and Associated Interventions", "Family Communication", "Network of Support", "Navigating Systems" and "Transition Experiences". Four analytical themes were then derived: "The Cyclical Nature of Grief", "Lifelong Expert in the Needs and Experiences of an Individual with DMD", "Navigating Deviation from Typical Life Course" and "Uncertainty as Ever Present". The extant evidence suggests that the experience of parenting a child with DMD is often characterised by: a cycle of grief that begins at diagnosis, which runs parallel to the development of expertise in caregiving; within this parents notice deviations from their child's and their own expected life course and adjust to the emotions and uncertainty that this can bring. Professionals should be cognisant to the complex grief process associated with DMD, which occurs from diagnosis onwards. There should be continued support for parents following bereavement. Peer support groups may also offer parents ways to maintain well-being. The necessity for parents to function effectively within an uncertain context that induces challenging emotions suggests a role for psychological therapies. [ABSTRACT FROM AUTHOR]

To explore patient perspectives of the integrated intervention (intervention arm) of a recent randomised clinical trial that found clinically relevant and sustained benefits of a physiotherapist delivered integrated stress inoculation training (SIT) and exercise for people with acute whiplash-associated disorders (WAD) and at risk of poor recovery. Twelve patients from the 53 who participated in the SIT and exercise arm of a randomised controlled trial (StressModex RCT) participated in semi-structured interviews. Data were analysed using inductive thematic analysis. Five main themes were identified: "balance between the physical and psychological components," "dealing with stress," "coping with the injury," "pain relief and return to function," and "elements enhancing therapeutic alliance." The majority of patients found the SIT techniques to be helpful in managing stress and pain, coping with their injury, and returning to function. The patients also found the exercises useful and acknowledged the importance of both the physical and the psychological aspects of whiplash injury. Patients with acute WAD at risk of poor recovery welcomed the inclusion of psychological strategies as part of physiotherapy treatment. The patients nominated both the psychological (SIT) component and exercise as assisting them with their stress, pain, and recovery. Physiotherapists could consider including strategies targeting early stress responses in their management of patients with acute WAD. [ABSTRACT FROM AUTHOR]

Many British military veterans that are wounded, injured, and/or sick (WIS) face significant physical, psychological and social challenges following discharge from the military. There is increasing evidence to support the application and benefit of physical activity for veterans that are WIS. Understanding engagement in physical activity is therefore imperative so that physical activity interventions and initiatives can be designed effectively, and their benefits optimised. Therefore, the aim of this study is to identify the perceived barriers to, and benefits of physical activity among veterans that are WIS. Nine semi-structured interviews were conducted to explore perceived barriers to, and benefits of physical activity amongst veterans that are WIS. A thematic analysis was conducted, and themes mapped to the Behaviour Change Wheel's capability, opportunity, motivation–behaviour (COM-B) model. Perceptions related to physical capability, psychological capability, physical opportunity and reflective motivation were predominant barriers to engagement in physical activity. As well providing opportunities to socialise, the perceived benefits of engagement in physical activity seemed to mirror the perceived barriers, suggesting a reciprocal relationship. Using the Behaviour Change Wheel, incentivisation, education, persuasion, enablement and environmental restructuring were identified as potentially beneficial intervention functions when seeking to increase levels of physical activity among veterans that are WIS living within the United Kingdom. UK-based veterans that are wounded, injured, and/or sick (WIS) often face significant challenges with respect to physical, mental, and social well-being. Perceived barriers, in the form of limited opportunities and a self-perceived lack of capability impact on levels of motivation and are viewed as obstacles to becoming physically active by veterans that are WIS. Providing education and complementary incentives may help reduce the extent of perceived barriers in veterans that are WIS. Approaches that allow veterans that are WIS to socialise while developing self-efficacy will likely increase physical activity engagement. [ABSTRACT FROM AUTHOR]