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One potential consequence of traumatic brain injury (TBI) is its impact on cognitive functioning, leading to challenges in an individual's capacity to concentrate, learn and remember. In certain cases, TBI may affect regions of the brain responsible for various cognitive functions. Neuropsychological testing is employed as a means of detecting if cognitive dysfunction exists, and the level of impact on the patient. Through these assessments, healthcare professionals ascertain whether there are alterations in aspects such as attention, processing speed, executive function, memory, and language skills, all of which can be influenced by TBI.
“For a lot of our patients, their cognitive symptoms may come from sleep disorders, mood symptoms, chronic stress, chronic pain and changes in hearing and vision - which then have a trickle-down effect, impacting cognitive functioning,” says Shannon Auxier, a speech-language pathologist (SLP) at the National Intrepid Center of Excellence (NICoE).
“Cognitive rehabilitation is a complex collection of techniques that are designed to enhance attention, strengthen problem solving and increase recall and processing speed,” says Evelyn Galvis, an SLP at the Intrepid Spirit Center at Eglin Air Force Base - one of 13 TBI and brain health sites that constitute the Defense Intrepid Network (DIN) for TBI and Brain Health. “Structured practice allows the patient to utilize, practice and reinforce effective compensatory strategies to enhance memory function of increasing length and complexity. All interventions are aimed at enhancing overall cognitive functioning and neuroplasticity,” adds Galvis.
To address challenges in cognitive functions, NICoE provides a group class called Cognitive Strategies taught by an SLP and an occupational therapist (OT), as part of the center’s four-week Intensive Outpatient Program (IOP). Started in 2020, this course is designed to promote cognitive functioning and health across various aspects of patients’ lives. Service members are taught encoding strategies such as mnemonic devices or note-taking techniques to help retain information.
“We’re all probably familiar - even from school – of having to memorize dates or particular facts. How do we go about that? We can use an encoding strategy like association; if my friend’s birthday is on March 17th, and since that’s St. Patrick’s Day, I know I can connect that and remember it,’” Auxier explains.
Instructions on habit formation are also a critical part of cognitive rehabilitation. Given that service members spend only four to six weeks in IOPs within the DIN, it's crucial for them to apply the acquired knowledge once they reintegrate into their daily routines.
“Patients learn not just about cognitive tools to use while in the IOP, but ways to benefit their sleep, ways to implement mindfulness and manage their stress. We discuss the scientific basis for maintaining those behaviors as they transition back home, aiming to equip them for success,” Auxier adds.
In addition to compensatory strategy training, patients can use neuroplasticy-based brain-training programs to exercise their brain like their body. The Brain Fitness Center at NICoE offers programs that enhance cognitive rehabilitation and allow patients to implement strategies learned in therapy. The IOP patients have full access to the library of programs offered through the Brain Fitness Center.
Cognitive rehabilitation at the Eglin ISC incorporates computer-based retraining as an extension of individualized cognitive retraining sessions. “Patients that participate in Eglin’s IOP are enrolled in the Brain Bootcamp class which promotes neuroplasticity via active participation in high-level executive functions/games/tasks and other cognitive challenges,” explains Galvis.
Additionally, Eglin ISC implements community reintegration group activities such as fly-tying, glass sculpting, pottery wheel classes and salsa dancing. These group activities improve memory by challenging patients to recall steps, routines, patterns and following multi-step directions, making it a great mental exercise. Physical movement classes improve cardiovascular health, flexibility, coordination and muscle strength, reducing stress and boosting mood through the release of endorphins. “We implement a multi-modal approach to wellness and cognitive rehabilitation by co-treating with our music therapist Ms. Meire Palmer and art therapist Mr. Kevin D’Augustine,” adds Galvis. For service members who are also bilingual and get Foreign Language Proficiency Pay, Eglin provides interventions in Spanish to help maintain proficiency and mental flexibility.
“After mastering those encoding techniques, it might be challenging to immediately apply them in real-world scenarios, especially when faced with social pressures or crowded environments where remembering names becomes crucial. However, by engaging in repetitive exercises within the brain training program—such as learning names and associated facts about individuals—we can reinforce and practice the strategies we've taught during our classes. This increased repetition and practice can better equip service members to utilize these techniques effectively in real-life situations,” explains Auxier.
Cognitive strategies play a key role in the rehabilitation, recovery and return to duty of service members – and ultimately, their return into civilian life. These strategies are integral aspects of the holistic and interdisciplinary model of care implemented within the DIN, that encompasses traditional rehabilitation, medical, neurological and behavioral health services combined with integrative health interventions.
| Date Taken: | 06.24.2024 |
| Date Posted: | 06.25.2024 10:35 |
| Story ID: | 474688 |
| Location: | BETHESDA, MARYLAND, US |
| Hometown: | BETHESDA, MISSISSIPPI, US |
| Hometown: | EGLIN AIR FORCE BASE, FLORIDA, US |
| Web Views: | 69 |
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This work, Empowering Recovery: The Role of Cognitive Strategies in Rehabilitation from Traumatic Brain Injury, by Sofia Desta, identified by DVIDS, must comply with the restrictions shown on https://www.dvidshub.net/about/copyright.
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