Poster Presentations

Click on the links below to view the list of poster presentations in Vancouver and for other information:

• List of Poster Presentations
  • A Preliminary Study Exploring The Acceptability And Effectiveness Of Mindfulness Based Cognitive Therapy In Acquired Brain Injury
  • Chronic Pituitary Dysfunction Associated With Cognitive And Neuropsychiatric Deficits After Blast-Related Concussion
  • Clients, Therapists And Volunteers: A Win-Win-Win Combination
  • Community Brain Injury Services: An Overview Of WorkSafeBC Services
  • Community Programs For Adults With Acquired Brain Injuries: Preliminary Findings From Participation In A Community Vegetable Garden And Community Cooking/Kitchen Program
  • Encephalitis – An Attack On The Brain
  • Improving Inter-Professional Communication: Using A Missing Patient Supervision Rating Scale
  • Intensive Comprehensive Aphasia Treatment: A Pilot Project For British Columbia
  • Interprofessional Education To Community Outpatient Rehabilitation Health Professionals For Treatment To U.S. Wounded Warriors With Brain Injuries
  • Loss Of Consciousness Is Predictive Of Poor Outcome Following Blast-Related Mild Traumatic Brain Injury In U.S. Military Personnel
  • Members Helping Members; Members And Students Working Together
  • Participatory Action Research And Community Based Experiential/Cognitive Rehabilitative Programming: Giving Brain Injury A Face And Voice
  • Sharing Lessons Learned And Information Resources Available That Are Focused At Assisting Children Of Brain Injured Parents
  • Successful Integration Of Physical Activity Into An Occupational Therapy TBI Rehab Program
  • The Relationship Between Concussions, Neuroplasticity, And Executive Functioning In Athletic Populations: A Review
• Poster Session Times
• Inquiries

List of Poster Presentations

A Preliminary Study Exploring The Acceptability And Effectiveness Of Mindfulness Based Cognitive Therapy In Acquired Brain Injury, Anna Marson

The evidence-base for Mindfulness-Based Cognitive Therapy (MBCT) is growing, but there is a lack of experimental validation among populations with acquired brain injuries (ABI). The purpose of this study was to investigate the acceptability and effectiveness of MBCT in fostering psychological recovery among adults with ABI. More specifically, this study was conducted to: (a) extend Finucane and Mercer's (2006) study by applying MBCT to another population (i.e., adults with ABI); (b) corroborate the Bedard et al. (European Psychiatry Conference, 2008) poster abstract reporting the effectiveness of MBCT in reducing depression in people with TBI; (c) establish if empirical findings of the effectiveness of MBCT on depression (Dimidjian et al., 2010; Ma & Teasdale, 2004; Segal et al., 2002; Teasdale et al., 2000) and anxiety (Evans et al., 2008; Williams et al., 2008) in the general population and in primary care patients with active symptoms of depression and anxiety (Finucane & Mercer, 2006), extended to participants with ABI; and (d) explore the effect of MBCT treatment on measures of locus of control, satisfaction with life, self-awareness, and coping in participants with ABI. The present study employed a mixed methods design and participants were recruited from two community-based brain injury programs. The final sample comprised 12 adults with mild, moderate, and severe injuries. Interview and self-report measures were administered pre- and post-treatment. Qualitative data were collected through semi-structured focus groups following the MBCT treatment. Results indicated statistically significant decreases in depression and denial, and statistically significant increases in positive reframing, active coping, and self-awareness. Focus group data corroborated MBCT as an acceptable and effective approach for adults with ABI, and additional emergent themes point to implications for practice generally and for the use of MBCT in ABI populations, specifically. The need for a larger replication study is discussed.

Chronic Pituitary Dysfunction Associated With Cognitive And Neuropsychiatric Deficits After Blast-Related Concussion, Charles Wilkinson, Kathleen Pagulayan, Jane Shofer, Elaine Peskind

Objective: Studies of traumatic brain injury from all causes have found evidence of chronic pituitary dysfunction in 25-50% of cases. Posttraumatic hypopituitarism (PTHP), particularly adult growth hormone deficiency (GHD), is associated with symptoms that include fatigue, anxiety, depression, irritability, sleep disturbances, sexual dysfunction, cognitive deficits, decreased quality of life, and increased cardiovascular mortality. This study investigates the prevalence of chronic PTHP after blast-related concussion.
Design: Concentrations of 12 pituitary and target-organ hormones were measured in blood samples from US military Veterans who had sustained blast concussions during deployment to Iraq and Afghanistan, and from a similar group without blast exposure, to determine the frequencies of PTHP and of specific hormonal deficits.
Results: Eleven of 26, or 42%, of subjects with blast-related concussions were found with abnormal hormone levels in one or more pituitary axes. Five individuals were found with probable GHD, and three blast-exposed participants showed evidence of hypogonadism. Veterans without blast exposure had no hormonal abnormalities.
Conclusions: There is a high prevalence of concussion-related PTHP, but consequent neuropsychiatric and behavioral symptoms are amenable to successful hormonal replacement therapy. Screening for hormone deficiencies after concussions shows promise for appropriately directing diagnostic and therapeutic decisions that may otherwise remain unconsidered.

Clients, Therapists And Volunteers: A Win-Win-Win Combination, Tanya Brinkerhoff, Wendy Daitch

OBJECTIVE: To share a unique approach to community rehabilitation for individuals with severe acquired brain injury.
DESCRIPTION/DESIGN: ARBI’s unique approach is achieved with a blend of professional therapists (physiotherapists, occupational therapists, speech-language pathologists and recreation therapists), rehab staff and volunteers working together to deliver rehabilitation therapy in a community setting. The client is assessed and a personalized rehabilitation program is developed by a team of therapists. After extensive training and with staff support a volunteer implements a daily rehabilitation program.
RESULTS: Volunteers dedicated over 8,300 hours of time in 2010-2011. ARBI’s model aligns with the principles of neuroplasticity by broadening the scope of rehabilitation. This cost effective means of program delivery offers the clients the possibility to extend and continue their rehabilitation and be a part of their community. ARBI continues to witness on-going positive progress even years after an injury.
CONCLUSION: Every weekday a diverse group of volunteers arrive at our facility to take on this rewarding assignment. ARBI recruits and maintains a strong team of dedicated, engaged and well-trained volunteers. This collaboration with the volunteers promotes community inclusion and a dynamic partnership between clients and volunteers enhancing everyone’s quality of life.

Community Brain Injury Services: An Overview Of WorkSafeBC Services, Andrea McNeill, Giovanna Boniface

Objective: Approximately 551 workers suffer TBI each year in BC as a result of workplace injury. WorksafeBC believes that the rehabilitation of these injured workers must include a multidisciplinary approach to treatment. WorksafeBC has many treatment provider networks in place (e.g. physiotherapy, occupational therapy, residential care, home support). The Community Brain Injury Service-(CBIS) network was established in 2009 to provide specific Occupational Therapy services to injured workers.
Design: Injured workers are referred to the CBIS program by a WorksafeBC Board Officer. Services are initiated within 1 week with a comprehensive assessment completed within 30-days. Progress reports are submitted every 3-months with a full program review every year. Results: To date, information gathered on the success of this program is anecdotal. Feedback from injured workers, family members and WorksafeBC employees is that the program is beneficial.
Conclusion: More specific measurement of success will be implemented in the future. Measurement of client satisfaction as well as review of outcome measures will be used to determine the overall outcome of the CBIS program.

Community Programs For Adults With Acquired Brain Injuries: Preliminary Findings From Participation In A Community Vegetable Garden And Community Cooking/Kitchen Program, Susan Tasker, Adrienne Quinn, Mark Fournier

Annually, 7,800 to 14,000 British Columbians sustain a brain injury (Ministry of Health Services & Ministry of Health Planning, 2001). With a population of 372,339, this means 638 to 1,145 new brain injuries in Victoria’s Capital Regional District (CRD). United States data indicate 1.74% of the population live with a brain injury-related disability (Center for Disease Control and Prevention). By extrapolation, 6479 people in the CRD live with a disability as a result of brain injury. Without appropriate supports, brain injury is associated with mental illness, depression, addictions, homelessness, suicide, criminal behaviour, divorce, domestic violence, and complicated health issues (Hwang, 2008; Ratcliff, 2005; Sarapata, 1998; Silver, 2001; Simpson, 2005; Slaughter, 2003). Multiple lines of evidence support the need for positive community supports and programs across the lifetime of injured persons. This study evaluated outcomes of two community programs designed and coordinated by two community organizations: The Cridge Brain Injury Services and Camosun College. Eight participants received instructional and hands-on learning in the development and tending of a community vegetable garden and participant-driven community cooking/kitchen program. Additional to the development of hard skills, we expected benefits from social interaction and collaboration to accrue. Results of the first study assessing concurrent and short-term outcomes are presented.

Encephalitis – An Attack On The Brain, Wendy Station

Encephalitis is an inflammation of the inner area of the brain, causing permanent damage and destruction. Months – and years! – after the inflammation subsides, survivors and loved ones must learn the most difficult lesson: patience. Patience to play a waiting game, while neighbouring areas of the brain struggle to relearn the skills and abilities which have been lost.
Wendy Station is an encephalitis survivor who has strived for more than ten years to raise awareness in North America on the topic of encephalitis. Ms. Station has personally spoken with Congress in Washington DC and at Johns Hopkins University Medical Center on the topic of encephalitis, yet finds it a struggle to raise awareness here in Canada. It is her goal to have this topic included in every Brain Injury website in North America.
If this acquired brain injury could be recognized and included by Brain Injury Associations, encephalitis survivors would understand that they are welcome to share the wonderful information and resources BIA’s have to offer.
This presentation is supported by the 1300+ members of the Encephalitis Global community.

Improving Inter-Professional Communication: Using A Missing Patient Supervision Rating Scale, Nancy Waters, Anne-Marie Goodman

This quality improvement (QI) project uses the Missing Patient Supervision Rating Scale (MPSRS) as communication tool for all staff. The MPSRS tool was created to increase patient safety by identifying patients at high risk for wandering off the inpatient care unit and becoming lost in an unfamiliar environment. The goals of project included:
• increase patient safety by communicating efficiently about patient’s physical, cognitive and behavioural tendencies which may cause patient wandering in an unfamiliar and unsafe environment and
• provide a quantitative score regarding patient’s ability to travel to therapies independently or escorted.
The tool was modified from an existing tool constructed by a psychologist on the Acquired Brain Injury (ABI) team at The Ottawa Hospital Rehabilitation Center (TOHRC). The R.N (Nancy Waters) adapted the tool to incorporate patient safety needs on an acute in-patient ABI rehabilitation unit. The MPSRS includes 5 levels of patient monitoring. The appropriate level is initially determined by the physiatrist.
The audience will understand how QI and patient safety methods can benefit the clinical and administrative process involved in the care of ABI patient’s and some of the teams challenges in achieving these common goals.

Intensive Comprehensive Aphasia Treatment: A Pilot Project For British Columbia, Wendy Duke, Alisa Ferdinandi, Ramanjit Bains

Objective: In the summer of 2011, Columbia Speech and Language Services Inc. ran a pilot Intensive Comprehensive Aphasia Treatment (ICAT) Program in Vancouver. Previously, such treatment was only available in Halifax or outside of Canada. Objectives included:
-Improved communication abilities of individuals with chronic aphasia (language impairment following brain injury)
-Training, education and support to family members and caregivers
-Peer interaction/support amongst participants with aphasia
-Providing clinical practica experiences for UBC graduate SLP students.
Design: The program ran full time for five weeks at UBC and was conducted in collaboration with the UBC School of Audiology and Speech Sciences and with the generous financial support of the Vancouver Coastal Health Authority Acquired Brain Injury Supports. Seven clients with chronic aphasia, along with their family members, seven speech language pathology interns and nine speech-language pathologists participated. Activities included three hours daily of one-on-one treatment including constraint-induced language therapy, use of technology, group treatment, adapted book club and family meetings.
Results:
-Significant improvements in scores on the Western Aphasia Battery, Communicative Activities of Daily Living and Apraxiaⁱ Battery for Aphasia,
-Improvement captured on family and client scales of participation (CETI and Mini-CAL)
-Enthusiastic feedback from the SLP interns regarding their learning experience
Conclusions: Due to the overwhelmingly positive results and feedback from participants and students, this program will be run annually on an ongoing basis. Securing funding for financially needy clients is our biggest future challenge.

Interprofessional Education To Community Outpatient Rehabilitation Health Professionals For Treatment To U.S. Wounded Warriors With Brain Injuries, Jeff Trytko, Jean Nagelkerk

Objective: This research evaluated the knowledge gain of community-based rehabilitation health providers who received traumatic brain injury (TBI) education with military relevance. These health professionals will treat U.S. OIF/OEF Wounded Warriors returning home with TBI. This abstract presents findings on the education component of this research.
Design: Grand Valley State University (GVSU) provided Mary Free Bed Rehabilitation Hospital (MFBRH) staff educational modules from July to September 2011. Modules included Pathophysiology/Symptomatology, Behavioral/Mental Health, and Case Management/Community Reintegration. Pedagogy included blended learning utilizing classroom instruction, web-based content, and live simulations. GVSU administered pre-and post-knowledge tests and evaluation measures. Fourteen of fifteen MFBRH health professionals completed the education.
Results: Health professionals demonstrated improved pre- and post-test knowledge on all three modules: Pathophysiology/Symptomatology (53.7-83.6%, p
Conclusion: There was improved knowledge on military relevant TBI rehabilitation care across all modules. The MFBRH health professionals gave overall positive evaluations, providing areas for improvement including more military culture information and increased interaction with Wounded Warriors in simulations.

Loss Of Consciousness Is Predictive Of Poor Outcome Following Blast-Related Mild Traumatic Brain Injury In U.S. Military Personnel, Andrew MacGregor, Peggy Han, Amber Dougherty, Kevin Heltemes

Mild traumatic brain injury (TBI) is one of the predominant injuries in current wartime operations, and it is often caused by blasts. Although not conclusively, current civilian literature indicates that loss of consciousness (LOC) does not have any significant predictive effect on TBI outcome with the caveat that most studies were among athletes with sports-related TBI, which differs from blast-related mechanisms of TBI among combat-deployed military personnel. The study sample was identified from point of injury clinical records in Iraq between 2004 and 2007, and consisted of 481 TBI patients with documented LOC and 614 without LOC. Clinical outcomes (diagnoses and health care utilization) were ascertained from electronic medical databases. After adjusting for covariates, LOC significantly increased the odds of post-concussion syndrome (odds ratio [OR] = 2.1, 95% confidence interval [CI]: 1.6–2.8), anxiety disorder (OR = 1.5, 95% CI: 1.1–2.1), and headache disorder (OR = 2.0, 95% CI: 1.5–2.7), and was associated with increased mental health and neurology clinic utilization. Among blast-related TBI, LOC may be an important clinical discriminator of outcome, and may be especially valuable to battlefield health care providers in guiding acute and long-term management of these injuries.

Members Helping Members; Members And Students Working Together, Taylor Randall, Lisa Klinger

This poster describes a partnership between members of Cornerstone Clubhouse and the occupational therapy (OT) students at The University of Western Ontario. Cornerstone is a community-based, member-led program for individuals living with the effects of acquired brain injury. Clubhouse members have partnered with OT students in a number of capacities since 2000, to help develop students’ practical and therapeutic skills relevant to future service roles while meeting Clubhouse needs. For example, in order to broaden the understanding of the effects of a brain injury, members have attended OT and other program lectures to discuss their experience of dealing with brain injury. OT students have also worked collaboratively with members on several projects aimed at marketing Cornerstone Clubhouse by increasing community awareness of Clubhouse programs, developing better tools to assess members’ individual goals for their participation in the Clubhouse, and developing and implementing a lawn care business that provides meaningful activities for members as well as a stream of revenue. Such a partnership has provided both members and students with positive experiences; members express growth in social skills and confidence as well as feeling valued, while students have acquired firsthand experience and insight into the effects and management of brain injury.

Participatory Action Research And Community Based Experiential/Cognitive Rehabilitative Programming: Giving Brain Injury A Face And Voice, Adrienne Quinn, Susan Tasker, Mark Fournier, Janelle Breese-Biagioni

Research involving the brain injury population seldom offers participants the opportunity for direct involvement in the process. Participants in a study evaluating a community cooking/kitchen training program for adults with a brain injury agreed to take part in a sub-study addressing how involvement in a positive support program can mutually benefit participants with a brain injury. A participatory action research design was used for the sub-study. Over the course of the research, participants identified a strong desire for members of the general public to know what it is to live with a brain injury. This evolved into a collaboratively developed cookbook showcasing lessons and experiences of participants, and gives a voice and face to what it is to be a person with a brain injury. The structure, content and features of this cookbook were collectively determined and are based on observations, participatory photography outcomes, open-ended questioning and focus group discussions. This cookbook will act as a fundraising tool to support programs similar to the one being showcased. Readers are also provided a unique insight into the complexities and joys surrounding the rediscovery of interdependence, socialization, and post injury identity through an experiential/cognitive rehabilitative opportunity such as the community cooking/kitchen training program enjoyed by these participants.

Sharing Lessons Learned And Information Resources Available That Are Focused At Assisting Children Of Brain Injured Parents, Cassandra Garcia-Bacha

Objective: The purpose is to: 1) highlight best practices in assessing needs and determining the care of children of brain injured parents, and 2) identify information resources for professionals to share with children and their families facing this life changing experience.
Design: The special needs and care plan for children are often grouped together with other family members. However, children interviewed described themselves as survivors who grew up too quickly and who, largely on their own, searched for and found the strength and resources to cope and move forward.
Interviews and an analysis of previous work reveal little research on how children survive and rebuild relationships following a parent’s brain injury. The presentation focuses on how to evaluate the needs of such children and provide age-appropriate information; especially for adolescents and teenagers.
Results/conclusions: Information shared will include methods to: 1) help children develop coping skills and, if appropriate, 2) empower children to share in supporting the injured parent and other family members to improve family dynamics.

Successful Integration Of Physical Activity Into An Occupational Therapy TBI Rehab Program, Leah Munday

Objective: To demonstrate how the integration of physical activity, specifically Nordic walking, can enhance the delivery of a TBI rehab program and positively influence a client's overall experience and engagement in Occupational Therapy.
Design: Walking was the activity chosen to incorporate into the rehab program of a young adult with a TBI, for its potential to create a less threatening therapeutic environment than face to face therapy approaches. Urban poling (a.k.a. Nordic walking) was selected and incorporated 1/week for 1year, as it provided additional balance support while placing appropriate demands on posture and coordination. Client-centered program goals were reviewed every 3 months.
Results:
-At outset, client was guarded and unwilling to discuss challenges related to TBI, one year later, urban poling OT sessions are where the most productive and open therapeutic conversations take place.
-Combined with weekly Physiotherapy, urban poling contributed to significantly improved physical outcome measures, including, Single Leg Stance (R leg by 28.9 secs; L leg by 7.9 secs) and Community Balance and Mobility Scale (11 point improvement).
Conclusion: Incorporating a physical activity such as urban poling in a TBI rehab program is an innovative therapeutic approach that can support a wide range of program goals.

The Relationship Between Concussions, Neuroplasticity, And Executive Functioning In Athletic Populations: A Review, David Jewett, Justin Karr

Athletes with multiple concussions experience adverse cognitive outcomes related to executive functioning (e.g., cognitive control, working memory) long after retiring from play, leading researchers to explore the immediate and cumulative effects of concussions among younger athletes. Objective: Athletic participation leads to positive (e.g., fitness-based neuroplasticity) and negative (e.g., concussion) brain-related outcomes, each important when exploring athletic populations. The goal of this research involved identifying the relationship between fitness-based cognitive benefits and concussion-based cognitive detriments, both in relation to executive functioning. Design: This research involved an extensive review of the concussion literature on athletic populations. Results: While researchers have shown fitness-based mechanisms enhancing executive functioning, other researchers have shown concussions adversely affecting this cognitive domain. Overall few researchers have examined both of these cognitive outcomes in the same study. Conclusion: Research exploring these dichotomous results of athletic participation remains limited, as many studies lack sedentary nonathletic controls and an operational definition of executive functioning. Fitness-based benefits may buffer against concussion-related declines in executive functioning; however, the combined influence of neuroplasticity and concussion on athletes remains unclear without comparing athletes with concussion histories to both non-concussed athletes and nonathletic controls.
 

Poster Sessions

Posters will be on display in the Exhibition area during the times below, when we request that all presenters are in the poster area and standing by their poster. Morning and afternoon refreshment breaks as well as Thursday’s lunch and Friday’s breakfast will be served in the Exhibition area.

Poster Presentation Inquiries

Kaitlin Beca
Project Coordinator
22nd Pacific Coast Brain Injury Conference

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Email: conference@brainstreams.ca
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