The research conducted in Neurorehabilitation Research and Knowledge Centre concerns patients with neurorehabilitation needs, more specifically patients with injury to the brain (ABI) or spinal cord (SCI). The consequences of such injuries are wide spreading and have considerable impact on an individual level, in the family system and on a societal level. The effects of the injury ripple on the surface spreading from the individual level throughout the family system to society.
The research conducted in Neurorehabilitation Research and Knowledge Centre aims to understand the consequences of ABI and SCI on these three different levels, and the overall vision is to strengthen neurorehabilitation across sectors to the benefit of patients with ABI or SCI and their caregivers.
Main research areas
Individual level
Injury to the brain or spinal cord - what is a favorable outcome? Both ABI and SCI result in disparate outcome ranging from severe functional deficits and disorders of consciousness to complete symptom resolution. Despite this complexity of recovery, most clinical trials dichotomize outcome arbitrarily using cut-offs. Furthermore, characterizing outcome solely from the perspective of investigators and clinicians rather than patients and caregivers causes ethical concerns. New methodology is needed in terms of providing prognostic modeling and using mixed methods design to establish a patient and caregiver- centered outcome metric. This is a prioritized line of research in VNR.
Selected research areas on the individual level:
Fatigue
One of the main barriers of returning to society and everyday life after ABI is fatigue. Fatigue is for many survivors a long-lasting symptom, which in many cases becomes a barrier to participating in neurorehabilitation as well. Understanding fatigue will enable targeted treatment and furthermore returning to everyday life following an injury to the brain. Consequently, research is needed in relation to assessment of fatigue as well as testing initiatives to alleviate fatigue.
Communication difficulties
More than half of all patients with acquired brain injury are experiencing communication difficulties due to disorders like aphasia, dysarthria, cognitive communication disorders and apraxia of speech. Neurorehabilitation Research and Knowledge Centre aim at sharing knowledge about the different types of communication difficulties and how these are identified an assessed by the interdisciplinary team.
Family level
An injury to the brain or spinal cord affects the survivors, but also the surrounding family. This has been recognized through years, but few interventions have been developed including the whole family following such injuries.
Selected research areas on the family level:
Children as relatives
A specific vulnerable group are children affected by injury to the brain or spinal cord in the immediate family. The needs of these children are rarely recognized, and it is even more seldom that this group is the specific target of interventions. Several studies conducted in Neurorehabilitation Research and Knowledge Centre with different methodology will assess psychological reactions and needs in this group.
Family Intervention following Traumatic Injury, FITS
A manualized family intervention has been developed and tested in a randomized controlled trial. The intervention has been evaluated using a mixed method design including both qualitative and quantitative methods. FITS will also be adapted to families where the member with traumatic injury has a communication disorder. Having communication disorder often incriminates the family even more since it becomes difficult to talk about the injury and its consequences for the family.
Societal level
This research area concerns the long-term consequences of an injury to the brain or spinal cord. Using the national registers in Denmark long term socio-economic consequences of injury to the brain or spinal cord are investigated on the patient as well as the closest relatives.
Assessing the socio-economic burden of these injuries will not only contribute to the scant knowledge in the area, but furthermore an important perspective of this study will be to point to the potential societal savings of implementing comprehensive rehabilitation programs, which will encompass the survivor and the surrounding family. But also including the rehabilitation in the municipalities.
Selected research areas on the societal level:
Long-term socio-economic consequences on children as relatives
Neurorehabilitation Research and Knowledge Centre investigates how children are affected if their parents or siblings acquire on injury to the brain or spinal cord. Long-term consequences are investigated in relation to educational achievements, labor market attachment and family establishment and disruption.
Communicative accessibility in health care
This area of research is about improving communication between patients with communication disabilities and health professionals to promote involvement in decision-making and rehabilitation.