Emotive, cognitive and motor rehabilitation post severe traumatic brain injury-A new convergent approach

Standard of care treats emotive, cognitive and motor rehabilitation needs post severe traumatic brain injury separately. This paper proposes an alternative in the form of convergent rehabilitation, which uses virtual environments to treat the three domains simultaneously. Two clients chronic post severe TBI participated in a feasibility study in which they practiced their affected upper extremity playing custom video games on the Rutgers Arm II. The ABAA protocol consisted of neuro-psychological and motor evaluation pre-, 18 training sessions, then motor and neuro-psychological evaluations post-and at 6 weeks follow up. Training sessions were gradated in duration, difficulty, included dual-tasks, and rewards for good performance. Participants improved in depression, focusing, executive function, shoulder strength and one was faster on the Jebsen test of hand function. Most gains were maintained at follow-up and resulted in improved independence in activities of daily living. Participants liked the technology, giving it a subjective rating of 4.45 out of 5.