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      Rehabilitación neuropsicológica holística: evolución cognitiva y calidad de vida de pacientes con daño cerebral adquirido

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          Abstract

          Resumen: El daño cerebral adquirido (DCA) puede provocar secuelas físicas, motrices, neuropsicológicas y generar una discapacidad en las personas afectadas. La rehabilitación neuropsicológica holística trata de reducir las secuelas cognitivas, conductuales, emocionales y sociales. El abordaje holístico plantea un trabajo que combine intervenciones individuales, grupales, la práctica en entornos lo más reales posible, así como la intervención familiar y vocacional. Este tipo de rehabilitación busca generalizar los resultados alcanzados a la vida cotidiana, para incrementar la funcionalidad, autonomía y calidad de vida. El objetivo del estudio fue analizar y comparar el rendimiento cognitivo y la calidad de vida percibida, antes y después de realizar un programa holístico de rehabilitación neuropsicológica con actividades en entornos reales. Se analizó una muestra de 20 personas con DCA. Se administraron pruebas de evaluación neuropsicológica de atención, memoria, funciones ejecutivas y calidad de vida. Los resultados mostraron diferencias estadísticamente significativas en el rendimiento de atención, memoria de trabajo, funciones ejecutivas y calidad de vida. Estos hallazgos sugieren que la rehabilitación neuropsicológica holística, que englobe el trabajo en entornos reales, podría contribuir a alcanzar posibles mejoras en la generalización de la evolución cognitiva a la vida cotidiana y ayudar a incrementar la calidad de vida de las personas con DCA.

          Translated abstract

          Abstract: Acquired brain injury (ABI) could cause physical, motor, neuropsychological, and generate a disability on affected people. The holistic neuropsychological rehabilitation attemps to reduce cognitive, behavioural, emotional and social sequels. Holistic approach propose a combined work of individual and grupal interventions, training in environments the most real as possible, as well as the family and vocational interventions. The goal of this rehabilitation is to generalise the achieved results to the patient's daily life to increase their functional, autonomy and their quality of life. The aim of this study was to analyse and compare the cognitive performance, and quality of life, before and after to follow a holistic neuropsychological rehabilitation program that included activities on real environment. A sample of 20 persons with ABI was studied. Neuropsychological assessment tests of attention, memory, executive funcions and quality of life were apply. Results showed statistically significant differences on attention, memory and executive functions performance and in quality of life. These findings suggest that holistic neuropsychological rehabilitation, that included the work on real environments, could contribute to generalizing the cognitive outcome to daily life and help to increase quality of life of ABI persons.

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          Most cited references82

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          World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.

          (2013)
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            The epidemiology and impact of traumatic brain injury: a brief overview.

            Traumatic brain injury (TBI) is an important public health problem in the United States and worldwide. The estimated 5.3 million Americans living with TBI-related disability face numerous challenges in their efforts to return to a full and productive life. This article presents an overview of the epidemiology and impact of TBI.
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              Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008.

              To update our clinical recommendations for cognitive rehabilitation of people with traumatic brain injury (TBI) and stroke, based on a systematic review of the literature from 2003 through 2008. PubMed and Infotrieve literature searches were conducted using the terms attention, awareness, cognitive, communication, executive, language, memory, perception, problem solving, and/or reasoning combined with each of the following terms: rehabilitation, remediation, and training for articles published between 2003 and 2008. The task force initially identified citations for 198 published articles. One hundred forty-one articles were selected for inclusion after our initial screening. Twenty-nine studies were excluded after further detailed review. Excluded articles included 4 descriptive studies without data, 6 nontreatment studies, 7 experimental manipulations, 6 reviews, 1 single case study not related to TBI or stroke, 2 articles where the intervention was provided to caretakers, 1 article redacted by the journal, and 2 reanalyses of prior publications. We fully reviewed and evaluated 112 studies. Articles were assigned to 1 of 6 categories reflecting the primary area of intervention: attention; vision and visuospatial functioning; language and communication skills; memory; executive functioning, problem solving and awareness; and comprehensive-holistic cognitive rehabilitation. Articles were abstracted and levels of evidence determined using specific criteria. Of the 112 studies, 14 were rated as class I, 5 as class Ia, 11 as class II, and 82 as class III. Evidence within each area of intervention was synthesized and recommendations for Practice Standards, Practice Guidelines, and Practice Options were made. There is substantial evidence to support interventions for attention, memory, social communication skills, executive function, and for comprehensive-holistic neuropsychologic rehabilitation after TBI. Evidence supports visuospatial rehabilitation after right hemisphere stroke, and interventions for aphasia and apraxia after left hemisphere stroke. Together with our prior reviews, we have evaluated a total of 370 interventions, including 65 class I or Ia studies. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for cognitive disability after TBI and stroke. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                scero
                Siglo Cero
                Siglo Cero
                Universidad de Salamanca (Salamanca, Salamanca, Spain )
                0210-1696
                2530-0350
                June 2023
                : 54
                : 2
                : 93-114
                Affiliations
                [1] orgnameUniversidad Internacional de La Rioja orgdiv1Universidad Isabel I de Castilla España
                Article
                S0210-16962023000200006 S0210-1696(23)05400200006
                10.14201/scero202354227894
                97d0995e-9656-4c4e-bcb2-c4a8d58bccb2

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 13 December 2021
                : 04 November 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 87, Pages: 22
                Product

                SciELO Spain

                Categories
                Artículos y Experiencias

                cognitive outcome,acquired brain injury,quality of life,holistic approach,Neuropsychological rehabilitation,evolución cognitiva,daño cerebral adquirido,calidad de vida,enfoque holístico,Rehabilitación neuropsicológica

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