Protocol development and feasibility study of environmental enrichment in adult acquired brain injury
Date
2018
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of Delaware
Abstract
Long-term physical, cognitive and psychosocial impairments are common after moderate to severe Acquired Brain Injury (ABI). Impairments associated with ABI decrease the well-being of the individual, their family, and the broader community. Also, challenges faced in the community drastically decrease the individual’s ability to meaningful citizenship including work, socialization, participation in leisure activities, and activities related to daily independent living. Under most current models of care, individuals get discharged into the community well before their families, and healthcare professionals would recommend[1]. Community-based rehabilitation programs are essential to decrease long-term deficits of chronic individuals with ABI. Thus, this dissertation focuses on advancing community-based rehabilitation. ☐ Despite advancement in rehabilitation, research to support the effectiveness of different post-acute rehabilitation programs is still inadequate, raising several procedural concerns[2]–[4]. Information offered by ABI Model Systems provide different guidelines essentially developed by individual states based on state and federal budget, resources, and services available. Therefore, the treatment approach varies in different settings, therapies, and methodology[5]–[7]. Consequently, current evidence for traditional therapy and model systems lack provisions for determination of optimal dosage, timing, and intensity for each stage of recovery [8]–[10]. This dissertation takes the first step towards Protocol development and conducting a Feasibility study of a novel community-based intervention. ☐ As such, this dissertation addresses the national call for an integrated rehabilitation model to bridge the gap between discharge and meaningful community re-entry for individuals with moderate to severe ABI[11]. The primary objective is to develop a Protocol and test the Feasibility of the Go Baby Go Cafe, which combines a new body weight support technology with the enriched environment of a functioning business. Chapter 1 provides background on the selected population and information on past and current rehabilitation techniques. Limitations of the literature guide the reader to the focus of the study. Chapter 2 provides background and rationale for the major components of a formal clinical research protocol for a feasibility study of using a real-world environment equipped with a novel body weight support system. Components include study design, methodology, and intervention. The protocol will then set the guidelines for implementing the proposed feasibility study. Chapter 3 provides information on the outcomes of the trial. Final results support moving forward with Phase 1 clinical trial with a few modifications to research design, recruitment, and outcome measures. ☐ Conclusions from this dissertation will strengthen our understanding of developing, designing, and implementing a feasibility study located within a fully functional business. By developing the groundwork for the initial phase of a clinical study pipeline, the next step should focus on conducting a pilot study or Phase 1 clinical trial to establish the preliminary effectiveness of a real-world based community rehabilitation model.