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Psychology
strokes
strokes Provides an overview of stroke rehabilitation covering patient management in the acute, subacute, and chronic phases of poststroke treatment. Cognitive, behavioral, and functional assessment in the subacute poststroke phase is discussed, neuropsychiatric problems occurring during this phase are identified, and cognitive deficits and perceptual deficits encountered during occupational therapy are described. Speech, recreational, and music therapy and social support services are also considered. Objective: To investigate the efficacy of music therapy techniques as an aid in improving mood and social interaction after traumatic brain injury or stroke. Design: Eighteen individuals with traumatic brain injury or stroke were assigned either standard rehabilitation alone or standard rehabilitation along with music therapy (3 treatments per week for up to 10 treatments). Measures: Pretreatment and posttreatment assessments of participant self-rating of mood, family ratings of mood and social interaction, and therapist rating of mood and participation in therapy. Results: There was a significant improvement in family members' assessment of participants' social interaction in the music therapy group relative to the control group. The staff rated participants in the music therapy group as more actively involved and cooperative in therapy than those in the control group. There was a trend suggesting that self-ratings and family ratings of mood showed greater improvement in the music group than in the control group. Conclusions: Results lend preliminary support to the efficacy of music therapy as a complementary therapy for social functioning and participation in rehabilitation with a trend toward improvement in mood during acute rehabilitation. music therapy, mood and social interaction and participation in therapy, 31-84 yr olds with traumatic brain injury or stroke describes the Loewenstein model of group art therapy for stroke patients as a part of a rehabilitation program. Soon after the onset of stroke, patients usually experience a major emotional turbulence due to loss of motor, language, or cognitive capacities. The primary goal of art therapy in stroke rehabilitation is to help patients process and readapt to the multiple aspects of this new situation. The case of a 51-yr-old male stroke patient is presented to illustrate the use of this therapeutic model. Constraint-induced (CI) movement therapy greatly increases the amount of use of an impaired upper extremity in patients with chronic stroke by repeatedly practicing use of the stroke-affected arm and constraining use of the unaffected arm. This new approach to physical rehabilitation elaborated from basic research in behavioral psychology and neuroscience. This chapter provides a brief exploration of reasons why psychologists are not regularly involved in motor rehabilitation research and practice, a discussion of the importance of basic research for progress in rehabilitation, and a sketch of the contributions of basic behavioral psychology and neuroscience research to rehabilitation psychology. The authors also review the basic research on which CI therapy is founded, provide a model explaining the operation of CI therapy in terms of learning followed by use-dependent cortical reorganization, summarize the research on the application of CI therapy to chronic upper- and lower-extremity hemiparesis in patients with chronic stroke, and describe new methods in treatment outcome measurement that were developed in the laboratory. Topics in Stroke Rehabilitation: *** Presents the case of a 73-yr-old woman who presented to an inpatient rehabilitation hospital with right hemiplegia, dysphagia, and Broca's aphasia after suffering a left-hemisphere stroke. The S expressed a desire to return home after her discharge from the rehabilitation hospital, but in the absence of adequate family support, the treatment team recommended a nursing home as a better choice for continued care. The author discusses ethical issues presented by this case, including (1) assessment of decision-making capacity, (2) autonomy and self-determination of the patient, (3) medical paternalism, and (4) contextual features, such as social/family issues. ethical issues in postrehabilitation continuing care decisions in absence of family support, 73 yr old female with poststroke right hemiplegia and dysphagia and Broca's aphasia Bibliography: CVA/Stroke Bibliography Alderidge, D. (1993). The music of the body: Music therapy in medical settings. Advances, 9(1),17-35. Barker, V.L. & Brunk, B. (1991). The role of a creative arts group in the treatment of clients with traumatic brain injuries. Music Therapy Perspectives, 9, 26-31. Brodsky, W. & Niedorf, H. (1986). “Songs from the heart”: New paths to greater maturity. Arts in Psychotherapy, 13(4), 333-341. Carruth, E. K. (1997). The effects of singing and spaced retrieval techniques on improving face–name recognition in nursing home residents with memory loss. Journal of Music Therapy, 34(3), 165-186. Cohen, N.S. (1992). The effect of singing instruction on the speech production of neurologically impaired persons. Journal of Music Therapy, 29(2), 87-102. Goldberg, F.S. & Hoss, T.M. & Chesna, T. (1988). Music and imagery as psychotherapy with a brain damaged patient: A case study. Music Therapy Perspectives, 5, 41-45. Gonen, J. & Soroker, N. (2000). Art therapy in stroke rehabilitation: A model of short term group treatment. Arts in Psychotherapy, 27(1), 41-50. Jochims,S. (1995). Emotional processing of coping with disease in the early stages of acquired cerebral lesions. Arts in Psychotherapy, 22 (1), 21-30. O’Callaghan, C.C. (1993). Communicating with brain impaired palliative care patients through music therapy. Journal of Palliative Care, 9(4), 53-55. O’Callaghan, C.C. (1999). Recent findings about neural correlates of music pertinent to music therapy across the life span. Music Therapy Perspectives, 17(1),
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