Browsing by Subject "traumatic brain injury"

Now showing 1 - 5 of 5
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    Incidence of traumatic brain injury, prevalence of dysphagia, and factors predicting health outcomes following traumatic brain injury in adults
    (2015) Rossouw, Joanne Courtney; Singh, Shajila
    South Africa has a high incidence of injury-related disorders, such as traumatic brain injury (TBI) as a result of motor vehicle accidents and assault. Dysphagia is a common sequela of TBI, which may result in malnutrition or aspiration pneumonia. There is limited epidemiological data available for TBI and dysphagia in South Africa which is important for health care planning. There is also inadequate literature reporting predictive factors for dysphagia and health outcomes of patients with TBI and swallowing disorders for the South African context, which would provide management guidelines for Speech-Language Pathologists (SLPs) for patients with TBI and dysphagia. This study aims to begin to provide up-to-date information regarding the incidence of TBI and the prevalence of dysphagia in the population with TBI in Bloemfontein, South Africa. Predictive factors for dysphagia and health outcomes were also investigated in order to provide management guidelines for TBI-related dysphagia for SLPs. A prospective cohort study followed 77 participants aged 18 to 68 years (M = 33.1) with mild to severe traumatic brain injury, admitted to 2 state and 2 private hospitals in the Bloemfontein metropole, South Africa, to investigate the incidence of TBI and the prevalence of TBI-related dysphagia in the adult population in 2013. Participants were tracked from admission to hospital to discharge. Demographic and medical data was collected for each participant, including: gender, age, TBI aetiology, means of nutritional intake, respiratory status, length of hospital stay, and number of speech therapy sessions. Glasgow Coma Scale (GCS) scores at time of admission, swallowing evaluation, and discharge were noted as an indicator of TBI severity and each participant was assessed with the Mann Assessment of Swallowing Ability on admission and prior to discharge to assess the presence of dysphagia. The incidence of TBI for the Bloemfontein metropole was 353 per 100,000 people and was greater in the male than in the female population (11.83:1). The main mechanism for TBI in Bloemfontein was interpersonal violence (67.53%), followed by road traffic accidents (motor and pedestrian vehicle accidents; 23.38%). The prevalence rate for dysphagia was 32%. Twenty-eight percent of those who presented with dysphagia also aspirated. Severe TBI (GCS ≤ 8) was identified as a predictive factor for dysphagia. Participants with dysphagia had longer hospital stays (days; M = 22.04, SD = 17.67) than those with normal swallowing (M = 6.23, SD = 4.28), t(75) = 6.13, p < .001, and took significantly more days to achieve oral intake (M = 6.23, SD = 10.32) than those without dysphagia (M = .31, SD = 1.41), t(75) = 4.08, p < .001. Ventilation was associated with longer hospital stays, rs(25) = -.47, p = .02 and longer duration until achievement of oral intake, rs(22) = -.80, p < .001. Tracheotomised participants also had significantly longer hospital stays, rs(25) = -.67, p < .001, and took longer to achieve oral intake, rs(22) = -.52, p = .01. An increased period of time with a tracheostomy was also significantly associated with mortality, χ2(2, n = 11) = 6.52, p = .04. Participants with dysphagia (M = 3.84, SD = 5.44) required significantly more therapy sessions with an SLP than those without dysphagia (M = .15, SD = .64), t(75) = 4.85, p < .001, and those with low GCS scores were significantly less likely to achieve oral intake prior to discharge, rs(25) = -.45, p = .02, and had longer hospital stays than participants with mild head injuries, rs(25) = -.49, p = .01. All participants who received nutrition via nasogastric tubes returned to oral intake; however, individuals who had percutaneous endoscopic gastrostomies did not achieve oral intake prior to discharge. It is recommended that objective swallowing evaluations be conducted for patients admitted with severe TBIs, and patients with mild and moderate TBIs be screened to determine the presence of dysphagia. TBI prevention initiatives should be developed to reduce the incidence of TBI, specifically in the young adult male population.
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    Investigating the prevalence of traumatic brain injury and post-traumatic stress disorder in a sample of South African women who have experienced intimate partner violence
    (2025) Haniff, Khadija; Schrieff, Leigh; Boonzaier, Floretta
    Intimate partner violence (IPV) is widely recognized as a significant public health concern, resulting in substantial physical and psychological harm, particularly among women. IPV refers to abuse occurring within intimate relationships and is linked to a range of neurological injuries, such as traumatic brain injuries (TBIs), as well as adverse mental health outcomes like post-traumatic stress disorder (PTSD). Although IPV and its effects have been extensively studied, there remains a gap in research both globally and within South Africa exploring the overlap between IPV, general and IPV-specific TBIs, and PTSD outcomes. Specifically, the literature lacks a thorough understanding of the prevalence of, and mechanisms for IPV-related TBIs, their severity and their link to PTSD. This study employed a cross-sectional, quantitative approach to examine IPV exposure, TBIs (both general and IPV-specific) and PTSD outcomes in a sample of South African women (N = 81) using self-report measures, including a Demographic Questionnaire and Asset Index, Primary Care PTSD Screen for DSM-5, Life Events Checklist for DSM-5, Women Abuse Screening Tool, and Brain Injury Screening Questionnaire. The results demonstrated a high prevalence of IPV within the sample, with physical and emotional abuse being the most frequently co-occurring forms thereof. IPV-related TBIs were also commonly reported. Simple regression analyses indicated that IPV-related TBIs were a significant predictor (p = 0.009) of PTSD outcomes, highlighting the important role of these injuries in psychological distress. However, multiple regression analyses indicated that, collectively, no single variable stood out as the strongest predictor of PTSD outcomes. The findings of this study are largely aligned with existing research regarding the prevalence and effects of IPV. However, there is a clear need for further research to enhance the understanding of the intersection between IPV, TBIs and PTSD. Given the widespread and debilitating nature of IPV, examining its neurological and psychological effects is essential for informing trauma-sensitive interventions, practices, and policies to better support survivors experiencing IPV-related TBIs and associated mental health challenges.
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    Social Communication Intervention via Telehealth Following Traumatic Brain Injury in Adults: A Systematic Review
    (2022) Christie-Taylor, Taryn; Schrieff, Leigh
    Introduction: Traumatic brain injury (TBI) is a leading cause of death and disability, affecting millions of individuals annually worldwide. Neuropsychological sequalae following TBI are multiple and heterogenous, with the combination of such deficits having a marked impact on individuals' ability to effectively communicate. Functional implications of impaired communicative competence are profound and long-lasting, therefore warranting intervention. Neurorehabilitation targeting social communication post-TBI has to date been dominated by social skills and communication partner training, with telehealth (TH) delivery thereof recently emerging as a promising avenue of intervention. Method: This systematic review of social communication intervention via TH following TBI, was structured according to PRISMA guidelines, involved searching six scientific databases and included four studies which were evaluated using Cicerone et al.'s (2009) and Tate et al.'s (2008) checklists for methodological quality. Results: In both a single-case experimental design and clinical trial of a TH intervention program, TBIconneCT, improvements in conversational skills and quality were recorded on independent observer and self-report measures. Results of participants receiving TH intervention appear comparable to that of in-person (IP) counterparts. Across studies the logistics of TH delivery did not seem to detract from the subjective experience of intervention with participants reporting high levels of acceptability, and feasibility. Conclusion: The current evidence base for TH options for social communication intervention post-TBI is scarce, yet findings of initial studies are promising. Given the potential of TH to expand the variety and reach of neurorehabilitation services, and the current global shift towards virtual functioning, further such research appears warranted.
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    The development of two novel interhemispheric transfer time tasks and application within a pilot paediatric moderate severe traumatic brain injury cohort
    (2024) Kordom, Kelly; Figaji, Anthony
    Introduction: Children are particularly vulnerable to injuries sustained during and following moderate or severe traumatic brain injury (TBI) as it can interrupt normal childhood development. Our ability to assess functional outcomes in the post-acute phase of injury is still limited, but imperative for appropriate prognosis and allocation of resources for rehabilitation. Advanced MRI techniques such as diffuse tensor imaging have shown that moderate-severe TBI often results in compromised white matter integrity and has been associated with poor neurocognitive outcomes in children. The corpus callosum is the main commissural region of the brain and one of the most widely reported regions of injury during TBI. Interhemispheric transfer time (IHTT) has therefore been suggested to assess the functional integrity of the corpus callosum. Aim: In this study we aimed to explore the development of two novel electroencephalogram (EEG) based IHTT tasks by investigating the reliability of the measured IHTTs and their feasibility for use in young children who had sustained a TBI. Methods: Two IHTT tasks were developed on MATLAB; a simple motor task and a non-motor task. Both tasks consisted of checkerboard visual stimuli presentation to evoke visual event related potentials (ERPS) on an EEG recording. An adult cohort was recruited to perform these two tasks on a laptop while an EEG was recorded to ascertain if the tasks were effective in producing visual ERPs, and to assess the test-retest and interrater reliability of the two tasks. Reliability was assess using the Intraclass Correlation Coefficient (ICC). Once assessment was complete in the adult cohort, six paediatric moderate-severe TBI patients were recruited to evaluate if the tasks were feasible and appropriate for a young paediatric TBI cohort. Similarly, they were required to perform both the motor and non-motor IHTT tasks on a laptop while an EEG was recorded. IHTTs for both cohorts were measured by calculating latencies of ERP components. Results: All adult participants were able to carry out the tasks with minimal difficulty. The EEG recordings show that the tasks effectively produced ERPs at the occipital and parietal sites. For IHTTs measured from the occipital sites, the calculated IHTTs provided high test-retest reliability for the motor task and moderate test-retest reliability for the non-motor task. Overall moderate inter-rater reliability between the motor and non-motor tasks was also calculated for IHTT measured at the occipital sites. All ICC test-retest and inter-rater reliability values for the IHTT calculated from the parietal sites were considerably low. In our paediatric TBI cohort all participants were able to complete both tasks, however IHTT could not be calculated from the motor task in 50% of the patients due to excessive movement. IHTT could be measured from the non-motor tasks for all patients. Conclusions: The high test-retest reliability for the motor tasks indicates that the IHTT measures are reproducible and independent of the task and EEG set-up. The moderate reliability values for the non-motor tasks are promising and also suggests that further investigation is required to assess what test conditions could improve the ICC scores of the non-motor tasks. The non-motor task served as a better option to calculated IHTT in the paediatric TBI cohort, and indicates that the current motor task may still not be simple enough for the young paediatric TBI population. The non-motor task seems to be a promising tool to measure IHTT in young patients, especially in individuals with cognitive, physical and behavioural limitations following TBI.
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    The Prevalence of Traumatic Brain Injury and an Investigation of Behavioural, Emotional and Executive Functioning in a Sample of Male Young Offenders
    (2021) Steenkamp, Nina Simone; Schrieff, Leigh
    Introduction: Previous research describes significant associations between criminal offending behaviour and traumatic brain injury (TBI). In young offenders, particularly, TBI is significantly more prevalent than in the general youth population. This association might be explained by the fact that key TBI sequelae (e.g., aggression, behavioural and cognitive impulsivity, emotional dysregulation) can place individuals at risk for criminal offending. However, at least two critical questions remain relatively under-investigated: Is there crossnational variability in the prevalence of TBI in young offenders and in the emotional, behavioural, and cognitive profile of young offenders with and without TBI? Few studies report on prevalence of TBI in young offender populations from low- or middle-income countries (LMICs), and fewer describe the neuropsychological profiles of TBI-afflicted young offenders from LMICs. Method: Participants were a South African sample of 25 young offenders and 56 non-offender controls. Conducting such investigations in South Africa is valuable because (a) crime rates, particularly those related to violent offences, are higher in this country than elsewhere in the world, and (b) the prevalence of TBI in South Africa is three times the global rate. All participants were administered self-report measures of emotion regulation, aggression, antisocial behaviour, as well as standardized tests of various executive functions (planning, cognitive flexibility, generative fluency, inhibition, problem solving, and rule learning/maintenance) from the Delis-Kaplan Executive Function System (D-KEFS) battery. I also gathered self-report information about their history of TBI, including whether it was accompanied by loss of consciousness (LoC). Results: Prevalence of TBI was higher in offenders (n = 18/25; 72%) than in non-offenders (n = 24/56; 43%). Offenders reported experiencing more severe TBI: The distribution of TBI with LoC was significantly different across offender and non-offender groups, p < .001. Analyses detected significant main effects of offender status on all outcomes; significant main effects of TBI on emotion regulation, aggression, and antisocial behaviour; and significant offender x TBI interaction effects on emotion regulation and aggression, ps < .036. Conclusion: These findings are broadly consistent with previous studies in this literature. Hence, the present study confirms the importance of understanding associations between TBI and offending (particularly in LMICs) and how the co-occurrence of the two is predictable and can have cumulative effects on affect, behaviour, and cognition. Because sustaining a TBI is preventable, describing the risk for negative outcomes and the socioeconomic costs thereof can inform policy development, rehabilitation planning, and initiatives to reduce recidivism rates.