Technology-assisted rehabilitation interventions following pediatric brain injury.

    Publication Date
    Source Authors
    Source Title
    Source Issue
    Publication Date

    Aprile 2018

    Source Authors

    Wade, S.L., Narad, M.E., Shultz, E.L., Kurowski B.G., Miley, A.E., Aguilar, J.M., & Adlam A.R.

    Source Title

    Technology-assisted rehabilitation interventions following pediatric brain injury.

    Source Issue

    Journal of Neurosurgical Sciences

    62

    Page Range: 187-202

    In seguito all’insorgenza di un trauma cranico, i bambini possono sviluppare una serie di deficit fisici, motori, linguistici e cognitivi che possono avere un impatto dannoso a lungo termine.
    Per quanto riguarda gli interventi per questa popolazione, c’è una grossa lacuna di evidenza scientifica. Esistono pochi studi clinici di elevata qualità o di RCT e di conseguenza, la pratica clinica corrente è basata sull’evidenza proveniente da singoli case studies, case series o studi sperimentali non controllati.
    In aggiunta, l’eterogeneità della popolazione coinvolta negli studi, non permette di trarre conclusioni dalla letteratura esistente.
    Tra i trattamenti potenzialmente utilizzabili per i bambini che hanno avuto un trauma cranico, ritroviamo quelli che si basano sull’uso della tecnologia come apps, giochi, siti web e robotica oltre che la telehealth o e-health che non necessitano dell’intervento “face-to-face” e permettono di offrire servizi riabilitativi che spesso possono essere limitati in aree urbane/suburbane. Inoltre, la tecnologia può rappresentare un importante fattore che permette di migliorare il coinvolgimento nel trattamento, fornendo esperienze non possibili con i trattamenti tradizionali.

    Sulla base di queste premesse, gli autori del presente articolo, hanno eseguito una revisione della letteratura sugli interventi assistiti da tecnologie per la riabilitazione dei bambini con trauma cranico, con l’obiettivo di fornire una revisione narrativa del corrente stato della letteratura su questo argomento.
    Per eseguire quanto detto, sono stati ricercati articoli pubblicati tra il 2000 e il 2017 su PsycInfo, MEDLINE, Embase, PubMed e Web of Science. Gli autori hanno focalizzato la ricerca sull’identificazione del ruolo della tecnologia nella riabilitazione pediatrica mediante l’uso di parole chiave basate su diagnosi, intervento, funzioni compromesse e tecnologia. Ogni articolo incluso inoltre, è stato valutato per il livello di evidenza fornito, mediante l’Oxford Center for Evidence-based Medicine-Levels of Evidence.
    Da questa ricerca sono stati selezionati 29 studi, ognuno di questi valutava l’effetto di diversi tipi di tecnologie su funzione motoria (training per equilibrio e cammino), funzione del linguaggio e della comunicazione, funzione cognitiva, funzione del comportamento, funzione sociale, funzione dei caregiver e della famiglia e, funzioni accademiche.

    Analizzando questi studi, gli autori hanno rilevato che c’è un aumento dell’uso di tecnologie per l’erogazione di trattamenti per i bambini affetti da trauma cranico. Molti di questi lavori hanno risultati positivi, ma la generalizzazione di questi ultimi, è limitata dal piccolo ed eterogeneo campione, da una mancanza di un gruppo di controllo e dalla presenza di risultati variabili.
    Le scoperte suggeriscono diversi benefici nell’uso delle tecnologie per la riabilitazione per i traumi cranici. In effetti, questi strumenti permettono di: facilitare il coinvolgimento e l’aderenza alla terapia, aumentare le possibilità di accesso alla stessa migliorandone la diffusione e la generalizzazione tra i vari setting terapeutici.
    Inoltre, c’è evidenza piuttosto robusta riguardo l’efficacia della “online family problem-solving therapy” sul miglioramento dei problemi del comportamento, delle funzioni esecutive e delle funzioni familiari.
    Al contrario, c’è meno evidenza, anche se promettente, riguardo l’efficacia di altre tecnologie per i deficit motori, di apps per le funzioni sociali e di programmi computerizzati per le funzioni cognitive.
    Complessivamente, diversi degli studi inclusi, hanno un rigore metodologico limitato a causa dei piccoli ed eterogenei campioni utilizzati e per la mancanza di gruppi di controllo.

    Concludendo, gli interventi assistiti da tecnologie hanno il potenziale di migliorare la riabilitazione pediatrica dopo trauma cranico, ma future ricerche sono necessarie per poter ulteriormente supportare la loro efficacia attraverso degli studi controllati più ampi e per identificare la sottopopolazione di bambini che può maggiormente beneficiare di questi interventi.

    BIBLIOGRAFIA

    1. Anderson, V., Brown, S., Newitt, H., & Hoile, H. (2011). Long-term outcome from childhood traumatic brain injury: intellectual ability, personality, and quality of life. Neuropsychology, 25, 176–84.
    2. Anderson, V., Godfrey, C., Rosenfeld, J.V., & Catroppa, C. (2012). 10 years outcome from childhood traumatic brain injury. Int J Dev Neurosci, 30 ,217–24.
    3. Antonini, T.N., Raj, S.P., Oberjohn, K.S., Cassedy, A., Makoroff, K.L., Fouladi, M., et al. (2014). A pilot randomized trial of an online parenting skills program for pediatric traumatic brain injury: improvements in parenting and child behavior. Behav Ther, 45, 455–68.
    4. Babikian, T., Merkley, T., Savage, R.C., Giza, C.C., & Levin, H. (2015). Chronic Aspects of Pediatric Traumatic Brain Injury: Review of the Literature. J Neurotrauma, 32, 1849–60.
    5. Backeljauw, B., & Kurowski, B.G. (2014). Interventions for attention problems after pediatric traumatic brain injury: what is the evidence? PM R, 6, 814–24.
    6. Brutsch, K., Koenig, A., Zimmerli, L., Merillat-Koeneke, S., Riener, R., Jancke, L., et al. (2011). Virtual reality for enhancement of robotic-assisted gait training in children with neurological gait disorders. Journal of Rehabilitation Medicine, 43, 493–9.
    7. Baque, E., Barber, L., Sakzewski, L., & Boyd, R.N. (2017). Randomized controlled trial of web-based multimodal therapy for children with acquired brain injury to improve gross motor capacity and performance. Clin Rehabil, 31,722–32.
    8. Beretta, E., Romei, M., Molteni, E., Avantaggiato, P., & Strazzer, S. (2015). Combined robotic-aided gait training and physical therapy improve functional abilities and hip kinematics during gait in children and adolescents with acquired brain injury. Brain Inj, 29,955–62.
    9. Biffi, E., Beretta, E., Cesareo, A., Maghini, C., Turconi, A.C., Reni, G., et al. (2017). An Immersive Virtual Reality Platform to Enhance Walking Ability of Children with Acquired Brain Injuries. Methods Inf Med, 56,119–26.
    10. Carey, J.C., Wade, S.L., & Wolfe, C.R. (2008). Lessons learned: the effect of prior technology use on Web-based interventions. Cyberpsychol Behav, 11, 188–95.
    11. Catale, C., Marique, P., Closset, A., & Meulemans, T. (2009). Attentional and executive functioning following mild traumatic brain injury in children using the Test for Attentional Performance (TAP) battery Journal of Clinical and Experimental Neuropsychology, 31,331–8.
    12. Catroppa, C., Godfrey, C., Rosenfeld, J.V., Hearps, S.S., Anderson, V.A. (2012). Functional recovery ten years after pediatric traumatic brain injury: outcomes and predictors. J Neurotrauma, 29,2539–47.
    13. Cole, W.R., Gerring, J.P., Gray, R.M., Vasa, R.A., Salorio, C.F., Grados, M., et al. (2008). Prevalence of aggressive behaviour after severe paediatric traumatic brain injury. Brain Inj, 22, 932–9.
    14. Chapman, S.B., & McKinnon, L. (2000). Discussion of developmental plasticity: factors affecting cognitive outcome after pediatric traumatic brain injury. J Commun Disord, 33,333–44.
    15. Cheung, J., Maron, M., Tatla, S., & Jams, T. (2013). Virtual reality as balance rehabilitation for children with brain injury: A case study Technology and Disability, 25, 207–19.
    16. Conyers, J.K., Malkin, M.J., & Yang, H. (2011). An exploratory study on the effects of Nintendo Wii fit balance board on balance retraining and body mass index of adolescents with a traumatic brain injury American Journal of Recreation Therapy, 10, 38–48.
    17. De Kloet, A.J., Berger, M.A., Verhoeven, I.M., van Stein Callenfels, K., & Vlieland, T.P. (2012). Gaming supports youth with acquired brain injury? A pilot study. Brain Inj, 26, 1021–9.
    18. Depompei, R., Gillette, Y., Goetz, E., Xenopoulos-Oddsson, A., Bryen, D., & Dowds, M. (2008). Practical applications for use of PDAs and smartphones with children and adolescents who have traumatic brain injury. NeuroRehabilitation, 23, 487–99.
    19. Fager, S., & Burnfield, J. (2014). Patient’s experience with technology during inpatient rehabilitation: Opportunities to support independence and therapeutic engagement. Disab Rehab Assist Technol, 9, 121–7.
    20. Fager, S., & Spellman, C. (2010). Augmentative and alternative communication intervention in children with traumatic brain injury and spinal cord injury. J Pediatr Rehabil Med, 3, 269–77.
    21. Galbiati, S., Recla, M., Pastore, V., Liscio, M., Bardoni, A., Castelli, E., et al. (2009). Attention remediation following traumatic brain injury in childhood and adolescence. Neuropsychology, 23,40–9.
    22. Ganesalingam, K., Yeates, K.O., Sanson, A., & Anderson, V. (2007). Social problem-solving skills following childhood traumatic brain injury and its association with self-regulation and social and behavioural functioning. J Neuropsychol, 1, 149–70.
    23. Gillette, Y., & DePompei, R. (2004). The potential of electronic organizers as a tool in the cognitive rehabiliation of young people. NeuroRehabiliation, 19, 233–43.
    24. Glang, A., McLaughlin, K., & Schroeder, S. (2007). Using interactive multimedia to teach parent advocacy skills: an exploratory study. J Head Trauma Rehabil, 22,198–205.
    25. Haslam, C., Bazen-Peters, C., & Wright, I. (2012). Errorless learning improves memory performance in children with acquired brain injury: a controlled comparison of standard and self-generation techniques. Neuropsychol Rehabil, 22, 697–715.
    26. Haslam, C., Wagner, J., Wegener, S., & Malouf, T. Elaborative encoding through self-generation enhances outcomes with errorless learning: Findings from the Skypekids memory study Neuropsychology Rehabilitation 2017;27:60–79.
    27. Holmes, J., & Gathercole, S.E. (2014). Taking working memory training from the laboratory into schools Educational Psychology, 34, 440–50.
    28. Ke, F., & Im, T. (2013). Virtual-relaity-based social interaction training for children with high-functioning autism The Journal of Educational Research, 106, 441–61.
    29. Kurowski, B,G, Wade, S.L., Kirkwood, M.W., Brown, T.M., Stancin, T., & Taylor, H.G. (2014). Long-term benefits of an early online problem-solving intervention for executive dysfunction after traumatic brain injury in children: a randomized clinical trial. JAMA Pediatr, 168, 523–31.
    30. Kurowski, B.G., Wade, S.L., Kirkwood, M.W., Brown, T.M., Stancin, T., & Taylor, H.G. (2013). Online problemsolving therapy for executive dysfunction after child traumatic brain injury. Pediatrics 2013, 132, el58–66.
    31. Landis, J., Hanten, G., Levin, H.S., Li, X., Ewing-Cobbs, L., Duron, J., et al. (2006). Evaluation of the errorless learning technique in children with traumatic brain injury. Arch Phys Med Rehabil, 87, 799– 805.
    32. Li, L., & Liu, J. (2013). The effect of pediatric traumatic brain injury on behavioral outcomes: a systematic review. Dev Med Child Neurol, 55, 37–45.
    33. Manasse, N.J., Hux, K., & Rankin-Erickson, J.L. (2000). Speech recognition training for enhancing written language generation by a traumatic brain injury survivor. Brain Inj, 14, 1015–34.
    34. Max, J.E., Koele, S.L., Castillo, C.C., Lindgren, S.D., Arndt, S., Bokura, H., et al. (2000). Personality change disorder in children and adolescents following traumatic brain injury. J Int Neuropsychol Soc, 6, 279– 89.
    35. Max, J.E., Levin, H.S., Schachar, R.J., Landis, J., Saunders, A.E., Ewing-Cobbs, L., et al. (2006). Predictors of personality change due to traumatic brain injury in children and adolescents six to twenty-four months after injury. J Neuropsychiatry Clin Neurosci, 18, 21–32.
    36. Max, J.E., Robertson, B.A.M., & Lansing, A.E. (2001). The phenomenology of personality change due to traumatic brain injury in children and adolscents Journal of Neuropsychology and Clinical Neuroscience, 13,161–70.
    37. Meyer-Heim, A., Borggraefe, I., Ammann-Reiffer, C., Berweck, S., Sennhauser, F.H, Colombo, G., et al. (2007). Feasibility of robotic-assisted locomotor training in children with central gait impairment. Dev Med Child Neurol, 49, 900–6.
    38. Myers, P.J., Henry, J.A., Zaugg, T.L., Kendall, C.J. (2009). Tinnitus evaluation and management considersations for persons with mild traumatic brain injury; 2009 [Internet]. Available from: www.asha.org/ Articles/tinnitus-evaluation-and-management-considerations-for-persons-with-mild-traumaticbrain-injury/
    39. Narad, M.E., Bedell, G., King, J.A., Johnson, J., Turkstra, L.S., Haarbauer-Krupa, J., et al. (2017). Social Participation and Navigation (SPAN): Description and usability of app-based coaching intervention for adolescents with TBI. Dev Neurorehabil 2017,1–10.
    40. Odom, S.L., Thompson, J.L., Hedges, S., Boyd, B.A., Dykstra, J.R., Duda, M.A., et al. (2015). Technology-aided interventions and instruction fo adolscents with autism spectrum disorder Journal of Autism and Developmental Disorders, 45 ,3805–19.
    41. Petranovich, C.L., Wade, S.L., Taylor, H.G., Cassedy, A., Stancin, T., Kirkwood, M.W., et al. (2015). Long-term caregiver mental health outcomes following a predomincately online intervention for adolescents with complicated to mild severe traumatic brain injury Journal of Pediatric Psychology, 40, 680–8.
    42. Phillips, N.L., Mandalis, A., Benson, S., Parry, L., Epps, A., Morrow, A., et al. (2016). Computerized working memory training for children with moderate to severe traumatic brain injury: A double-blind, randomized, placebo-controled trial Journal of Neurotrauma, 33, 2097–104.
    43. Pietrzak, E., Pullman, S., & McGuire, A. (2014). Using virtual reality and videogames for traumatic brain injury rehabilitation: A structured literature review. Games for Health Journal, 3, 202–14.
    44. Prigatano, G.P., & Gupta, S. (2006). Friends after traumatic brain injury in children. J Head Trauma Rehabil, 21, 505–13.
    45. Ross, K.A., Dorris, L., & McMillan, T. (2011). A systematic review of psychological interventions to alleviate cognitive and psychosocial problems in children with acquired brain injury. Dev Med Child Neurol, 53, 692–701.
    46. Schwartz, L., Taylor, H.G., Drotar, D., Yeates, K.O., Wade, S.L., & Stancin, T. (2003). Long-term behavior problems following pediatric traumatic brain injury: prevalence, predictors, and correlates. J Pediatr Psychol, 28,251–63.
    47. Simons, D.J., Boot, W.R., Charness, N., Gathercole, S.E., Chabris, C.F., Hambrick, D.Z., et al. (2016). Do “braintraining” programs work? Psychological Science in the Public Interest, 17, 103–86.
    48. Sohlberg, M.M., Harn, B., MacPherson, H., & Wade, S.L. (2014). A pilot study evaluating attention and strategy training following pediatric traumatic brain injury Clinical Practice in Pediatric Psychology, 2, 263–80.
    49. St Clair-Thompson, H.L., & Gathercole, S.E. (2006). Excutive functions and achievements in school: Shifting, updating, inhibition, and working memory. The Quarterly Journal of Experiemental Psychology, 59, 745–59.
    50. Stephens, J., Salorio, C., Denckla, M., Mostofsky, S., & Suskauer, S. (2017). Subtle motor finding during recovery from pediatric traumatic brain injury: A preliminary report Journal of Motor Behavior, 49,20–6.
    51. Taatgen, N.A. (2013). The nature and transfer of cognitive skills. Psychol Rev, 120, 439–71.
    52. Tatla, S.K., Radomski, A., Cheung, J., Maron, M., & Jams, T. (2012). Wii-habilitation as balance therapy for children with acquired brain injury Developmental Neurorehabilitation, 17, 1–15.
    53. Thomas-Stonell, N., Johnson, P., Schuller, R., & Jutai, J. (1994). Evaluation of a computer-based program for remediation of cognitive-communication skills Journal of Head Trauma and Rehabilitation, 9,25–37.
    54. Tlustos, S.J., Kirkwood, M.W., Taylor, H.G., Stancin, T., Brown, T.M, & Wade, S.L. (2016). A randomized problemsolving trial for adolescent brain injury: Changes in social competence. Rehabil Psychol, 61, 347–57.
    55. Treble-Barna, A., Sohlberg, M.M., Harn, B.E., & Wade, S.L. (2016). Cognitive Intervention for Attention and Executive Function Impairments in Children With Traumatic Brain Injury: A Pilot Study. J Head Trauma Rehabil, 31,407–18.
    56. Yeates, K.O., Armstrong, K., Janusz, J., Taylor, H.G., Wade, S., Stancin, T., et al. (2005). Long-term attention problems in children with traumatic brain injury. J Am Acad Child Adolesc Psychiatry, 44, 574–84.
    57. Yeates, K.O., Bigler, E.D., Abildskov, T., Dennis, M., Gerhardt, C.A., Vannatta, K., et al. (2014). Social competence in pediatric traumatic brain injury: From brain to behavior. Clinical Psychological Science, 2, 97–107.
    58. Yeates, K.O., Gerhardt, C.A., Bigler, E.D., Abildskov, T., Dennis, M., Rubin, K.H., et al. (2013). Peer relationships of children with traumatic brain injury. J Int Neuropsychol Soc, 19, 518–27.
    59. Yeates, K.O., Taylor, H.G., Wade, S.L., Drotar, D., Stancin, T., & Minich, N. (2002). A prospective study of short- and long-term neuropsychological outcomes after traumatic brain injury in children. Neuropsychology, 16,514–23.
    60. Ylvisaker, M., Adelson, P.D., Braga, L.W., Burnett, S.M., Glang, A., Feeney, T., et al. (2005). Rehabilitation and ongoing support after pediatric TBI: twenty years of progress. J Head Trauma Rehabil, 20, 95–109.
    61. Verburg, G., Borthwick, B., Bennett, B., Rumney, P. (2003). Online support to facilitate the reintegration of students with brain injury: trials and errors. NeuroRehabilitation, 18 ,113–23.
    62. Verhelst, H., Linden, C.V., Vingerhoets, G., & Caeyenberghs, K. (2017). How to train an injured brain? A pilot feasbility study of home-based computerized cognitive training Games for Health Journal, 6,28–38.
    63. Wade, S.L., Carey, J., & Wolfe, C.R. (2006). The efficacy of an online cognitive-behavioral family intervention in improving child behavior and social competence following pediatric brain injury. Rehabilitation Psychology, 51, 179–89.
    64. Wade, S.L., Cassedy, A.E., Shultz, E.L., Zang, H., Zhang, N., Kirkwood, M.W., et al. (2017). Randomized Clinical Trial of Online Parent Training for Behavior Problems After Early Brain Injury. J Am Acad Child Adolesc Psychiatry, 56, 930–9 e2.
    65. Wade, S.L., Carey, J., & Wolfe, C.R. (2006). An online family intervention to reduce parental distress following pediatric brain injury. J Consult Clin Psychol, 74, 445–54.
    66. Wade, S.L., Karver, C.L., Taylor, H.G., Cassedy, A., Stancin, T., Kirkwood, M.W., et al. (2014). Counselor-assisted problem solving improves caregiver efficacy following adolescent brain injury. Rehabil Psychol ,59, 1–9.
    67. Wade, S.L., Kurowski, B.G., Kirkwood, M.W., Zhang, N., Cassedy, A., Brown, T.M., et al. (2015). Online problemsolving therapy after traumatic brain injury: a randomized controlled trial. Pediatrics, 135, e487–95.
    68. Wade, S.L., Narad, M.E., Kingery, K.M., Taylor, H.G., Stancin, T., Kirkwood, M.W., et al. (2017).Teen online problem solving for teens with traumatic brain injury: Rationale, methods, and preliminary feasibility of a teen only intervention. Rehabil Psychol, 62 ,290–9.
    69. Wade, S.L., Oberjohn, K., Burkhardt, A., & Greenberg, I. (2009). Feasibility and preliminary efficacy of a webbased parenting skills program for young children with traumatic brain injury. J Head Trauma Rehabil, 24, 239–47.
    70. Wade, S.L., Stancin, T., Kirkwood, M., Brown, T.M., McMullen, K.M., & Taylor, H.G. (2014). Counselor-assisted problem solving (CAPS) improves behavioral outcomes in older adolescents with complicated mild to severe TBI. J Head Trauma Rehabil, 29 ,198–207.
    71. Wade, S.L., Walz, N.C., Carey, J., McMullen, K.M., Cass, J., Mark, E., et al. (2012). A randomized trial of teen online problem solving: efficacy in improving caregiver outcomes after brain injury. Health Psychol, 31, 767–76.
    72. Wade, S.L., Walz, N.C., Carey, J., McMullen, K.M., Cass, J., Mark, E., et al. (2011). Effect on behavior problems of teen online problem-solving for adolescent traumatic brain injury. Pediatrics, 128 ,e947–53.
    73. Wade, S.L., Walz, N.C., Carey, J., Williams, K.M., Cass, J., Herren, L., et al. (2010). A randomized trial of teen online problem solving for improving executive function deficits following pediatric traumatic brain injury. J Head Trauma Rehabil, 25 ,409–15.
    74. Wade, S.L., Walz, N.C., Carey, J.C., & Williams, K.M. (2008). Preliminary efficacy of a Web-based family problem-solving treatment program for adolescents with traumatic brain injury. J Head Trauma Rehabil, 23, 369–77.
    75. Wade, S.L., Wolfe, C., Brown, T.M., & Pestian, J.P. (2005). Putting the pieces together: preliminary efficacy of a web-based family intervention for children with traumatic brain injury. J Pediatr Psychol, 30, 437–42.
    76. Wilson, B.A., Emslie, H., Evans, J.J., Quirk, K., Watson, P., Fish, J. (2009). The NeuroPage system for children and adolescents with neurological deficits. Dev Neurorehabil, 12, 421–6.
    77. Wuang, Y.P., Chiang, C.S., Su, C.Y., & Wang, C.C. (2011). Effectiveness of virtual reality using Wii gaming technology in children with down syndrome Research in Developmental Disabilities, 32, 312– 21.