Landmarks and Future Perspectives in Neurorehabilitation: Conference Abstracts
Abstracts
For conference booking, please visit: 40-Year Anniversary Conference: Landmarks and Future Perspectives in Neurorehabilitation | Center for Hjerneskade
Thursday, Aug 21st: Cross-disciplinary plenaries.
University of Copenhagen, South Campus, Emil Holms Kanal 6, 2300 S.
Auditorium 23.0.49
10.00 Welcome address and introduction: CRBI through 40 years
Speaker: Frank Humle, CEO, Center for Rehabilitation of Brain Injury.
10.45 Holistic Neuropsychological Rehabilitation, Artificial Intelligence and Human Experiences: A Historical and Contemporary Perspective
Speaker: George P. Prigatano Ph.D. Emeritus Chairman of Clinical Neuropsychology. Barrow Neurological Institute
Abstract:
Holistic Neuropsychological Rehabilitation Programs began to develop in the late 1970’s and early 1980’s and continue to have a positive influence on brain injury rehabilitation programs throughout the world. These programs address the complexity of human experiences and their clinical management following an insult to the human brain. The recently developing field of Artificial Intelligence (AI) is starting to infiltrate many different types of services that we enjoy and is rapidly developing into the field of both physical and cognitive rehabilitation. AI encompasses many different computer-generated services including machine learning algorithms, predictive analytics and brain-machine interfaces. How AI will impact holistic neuropsychological rehabilitation programs remains unclear, but the impact will surely be felt.
On this Anniversary Celebration of the Center for Hijerneskade, I will briefly review the theoretical foundations and methodologies of holistic neuropsychological rehabilitation programs in the context of the history of cognitive recovery and rehabilitation. I will emphasize that the patient’s subjective experience (which is determined by their cognitive and affective status) has always influenced the outcome of rehabilitation treatments. I will then briefly discuss selected brain-machine interface studies on motor control and cognitive functions that have relevance to the future of holistic neuropsychological rehabilitation. I will attempt to demonstrate how the patient’s experience may modulate the outcome of some forms of AI based interventions. My knowledge of brain-computer interface technology is limited, but I will draw on the historical insights of Herbert Simon and recent papers on AI to illustrate points that seem reasonable given my experiences in the psychological care of persons with brain disorders.
13.00 Improving Outcome After TBI with Evidence-Based Rehabilitation
Speaker: Jennie Ponsford, Ph.d. Professor of Neuropsychology. Director, Monash Epworth Rehabilitation Research Centre
Abstract:
This lecture will provide an overview of findings from a 35-year longitudinal head injury outcome study involving over 3400 people with moderate-severe traumatic brain injury (TBI). It will highlight the long-term significance of fatigue and sleep disturbance, and cognitive, behavioural and psychiatric sequelae of TBI. This work has underpinned several clinical trials of interventions to address problems with memory and attention, fatigue and sleep disturbance, challenging behaviour, anxiety and depression and sexuality as well as a trial of early intervention for return to employment.
Findings from these trials and the translation of findings into clinical practice will be presented.
14.45 New Directions for the Treatment of Impairment After Stroke
Speaker: Dr. John Krakauer, Professor of Neurology and Neuroscience, Director of the Center for the Study of Motor Learning and Brain Repair, the Director of the Brain, Learning, Animation, and Movement (BLAM) laboratory at Johns Hopkins University School of Medicine and Head of Vision for MindMaze.
Friday, Aug 22nd: Parallel Workshops
I. Workshop for Neuropsychologists.
Title: Clinical Issues in Neuropsychological Rehabilitation.
University of Copenhagen, South Campus, Emil Holms Kanal 6, 2300 S
Auditorium 23.0.49
9.30 Disturbances in Self-Awareness Observed in Neurorehabilitation and Supportive Psychotherapy After A Brain Disorder: Implications for Clinical Management.
Presenter: George P. Prigatano Ph.D. Emeritus Chairman of Clinical Neuropsychology. Barrow Neurological Institute.
Abstract:
It is not uncommon to observe that persons with various brain disorders subjectively report less cognitive and behavioral impairments than observed by family members and treating clinicians. It has been challenging to describe and categorize these phenomena since they can be quite varied in their manifestations. In this presentation, Dr Prigatano will present a model for conceptualizing and categorizing disturbances in higher order consciousness (namely impaired self-awareness (ISA) and denial) observed in persons with various brain disorders. He will then briefly describe approaches to clinically manage them in neurorehabilitation and psychotherapy via clinical case vignettes. It will be emphasized how premorbid features of the individual’s personality is major determinant of rehabilitation outcome and psychosocial adaptation when there are disturbances in self-awareness.
13.15 Managing Anxiety and Depression After TBI, and Interventions for Fatigue and Sleep Disturbance.
Presenter: Jennie Ponsford, Ph.d. Professor of Neuropsychology. Director, Monash Epworth Rehabilitation Research Centre.
Abstract:
In the first half of the workshop, Dr. Ponsford will outline the evidence showing the high frequency of depression and anxiety after TBI and factors associated with this – most notably having a pre-injury history of mental health problems. A cognitive behaviour therapy approach to addressing anxiety and depression will be presented. Methods of case formulation and of adapting therapy to accommodate cognitive impairments will be outlined with case examples. Treatment modules will be described. Outcome data from a clinical trial will be presented.
In the second half of the workshop, Dr. Ponsford will present a cognitive behavioural approach to the management of fatigue and sleep disturbance after brain injury. This will include approaches to case formulation and adaptations to accommodate cognitive impairments. A description of the treatment modules will be presented, with case examples. Findings from a clinical trial of the intervention together with participant experience of the intervention will be presented.
II. Workshop for Physio- and Occupational Therapists:
Title: Optimizing Potential for Recovery and Quality of Life - Current Evidence and Possible Future Directions for Rehabilitation After Acquired Brain Injury.
University of Copenhagen, South Campus, Emil Holms Kanal 6, 2300 Copenhagen S
Auditorium 23.4.39
9.30 Acute to Late Subacute Phase
Speaker: Dr. John Krakauer, Professor of Neurology and Neuroscience, Director of the Center for the Study of Motor Learning and Brain Repair, the Director of the Brain, Learning, Animation, and Movement (BLAM) laboratory at Johns Hopkins University School of Medicine and Head of Vision for MindMaze.
11.30 Early Subacute to Chronic Phase
Presenter: Dr. Nick Ward (UK), Professor of Clinical Neurology and Neurorehabilitation at UCL, London
Nick Ward Profile | University College London
14.15 Chronic Phase, Re-entry to Community and Maintenance
Presenter: Susanne Guidetti Professor in Occupational Therapy, Karolinska Institutet.
Abstract:
There is a life after stroke - the view of the stroke survivors and caregivers. On this anniversary celebration of the Center for Hjerneskade, Susanne will present the theoretical foundations and methodological background of a rehabilitation program within the context of home rehabilitation. This presentation will be framed within the Medical Research Council guidelines for developing, implementing, and evaluating complex interventions within health care science.
Susanne will emphasize and describe how the experiences of individuals who have had a stroke, as well as their family members, have influenced the development of a complex person-centered rehabilitation intervention through a qualitative synthesis of fifteen research studies.
Person-centeredness is essential in stroke rehabilitation, as the complexity of the condition can result in diverse effects on everyday life. The F@ce-intervention aims to support home-based stroke rehabilitation through person-centered goal setting. To identify goals related to personally relevant activities of everyday life, the Canadian Occupational Performance Measure is used. Strategies for goal achievement and problem-solving are then discussed with the team. The intervention also utilizes information and communication technology (ICT) in the form of SMSs to support goal achievement.
Susanne will then discuss their outcomes, which have had an impact on work within rehabilitation and are relevant to the future development of interventions.
III. Workshop for Speech- and Language Therapists
Title: Adaptation of Aphasia Rehabilitation to New Technological Possibilities
University of Copenhagen, South Campus, Emil Holms Kanal 6, bygning 23.
Auditorium 23.2.47
9.30 PHOLEXSEM training-program
Speaker: Professor Elisabetta Banco (ITA), Neuropsychologist and Speech and Language Therapist.
Abstract:
Aphasia rehabilitation is a challenging issue, which must adapt to new technological possibilities while also taking into account the limitations of the context. Rehabilitation goals are multifaceted and we need time and tools to achieve every aspect of the puzzle that makes up a better quality of life. Pholexem is a programmed treatment that aims to be applicable in any severity and free of contextual barriers, suitable in presence or telematically, relegated to caregivers if hospitalization is not an option. Time is a crucial issue in rehabilitation. So many interventions need to be planned, so limited is the energy of the person with aphasia particularly in the post acute phase. Therefore, we devised a half-hour daily rehabilitation program related to phonological, lexical and semantic stimulation, in which the use of repetition plays a central role in reducing fatigue, especially in patients with attention or executive functions deficit.