What is the Test of Admissibility?

  • by Galit Liffshiz
  • Oct 25, 2022
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What is the Test of Admissibility?

In this blog, we will discuss the recent court decision: Morris et al. v. Prince et al., 2022 ONSC 1291. In this voir dire, the judge ruled the defense expert life care planner’s evidence inadmissible due to his “failure to be impartial and unbiased.”

In the subject case, the Plaintiff was a pedestrian who was struck by a motor vehicle driven by the Defendant. As a result of the MVA, the Plaintiff suffered a traumatic brain injury.

An expert in life care planning and vocational rehabilitation was retained by the Defendant to provide the court with evidence regarding the Plaintiff’s future care needs and vocational capabilities.

In this case, the Plaintiff seeks a ruling to declare the evidence of the defense expert life care planner inadmissible because it does not meet the Mohan test for admissibility.

The judge determined the admissibility of the defense expert’s proposed evidence using the Mohan criteria which state that:

“Admissibility of expert evidence has to be (a) relevant (b) necessary in assisting the trier of fact, (c) does not fall within any exclusionary rule and (d) is given by a properly qualified expert.”

Justice Mitchell determined that the defense expert was not a properly qualified expert due to his lack of impartiality and independence as an expert witness.

According to Justice Mitchell, a proposed expert’s impartiality is one of the basic standards for the admissibility of expert evidence.

He further states that expert witnesses have a “special duty to the court to provide fair, objective and non-partisan assistance [and] if they are unable or unwilling to comply with this duty, they are unqualified to give their opinion and should not be permitted to do so.”

The defense expert life care planner erred in overstepping and aligning himself with the Defendant who is also his client.

Justice Mitchell determined that the Defendant’s life care planner assumed the role of an advocate for the Defendant’s position from the outset of his retainer and therefore is unable to provide fair objective evidence in this case.

In the defense expert’s report, he highlighted the positive information about the Platintiff and downplayed injuries and capabilities. The positive information highlighted was not relevant to the assessment of the Plaintiff’s future care needs.

To highlight the positives and downplay the negatives regardless of evidence is, in the judge’s view, an indication of bias in favor of the Defendant and demonstrates that the defense expert does not understand his role and duty to the Court to remain impartial and free of bias.

In addition, rather than meeting with the Plaintiff to conduct an independent assessment of his vocational abilities and his ability to perform activities of daily living (which the defense expert admitted was industry best practice), he relied entirely on reports, interviews and assessments conducted by others.

One-half of the defense expert’s 60-page report was a summary of the information he reviewed. The defense expert did not request, let alone conduct, an in-person, virtual or telephone interview with the Plaintiff.

Justice Mitchell opines that this strongly suggests a lack of independence in his approach to the assessment of the issue.

Justice Mitchell further states the defense expert has the responsibility to provide the Court with his opinion as to the realistic future needs of the Plaintiff. His optimism for the Plaintiff’s future should have played no part in his assessment of future care needs.

To conclude, life care planners should bear in mind the importance of providing unbiased, impartial and independent evidence in court, as these are basic standards for the admissibility of expert opinion and evidence.

To be precise, the expert’s opinion must be impartial in the sense that it reflects an objective assessment of the question at hand. It should also be independent in the sense that it must be a product of the expert’s independent judgment, uninfluenced by who retained him/her, or the outcome of the litigation.

Sources

Bartlett, Danielle. “Morris Et Al. v. Prince Et Al., 2022 ONSC 1291.” Ontario Trial Lawyers Association Blog, 26 May 2022, https://otlablog.com/morris-et-al-v-prince-et-al-2022-onsc-1291/.

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The Importance of OT Input in the Diagnosis of Chronic Pain

  • by Galit Liffshiz
  • Oct 25, 2022
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The Importance of OT Input in the Diagnosis of Chronic Pain

In Mustafa v. Aviva General Insurance Company, 2022 CANLII 81523 (ONLAT), Mr. Mustafa was involved in an MVA on April 25, 2018 and developed psychological and physical impairments including pain.

Mr. Mustafa reported symptoms of headaches, neck, shoulder, and back pain, disturbance of sleep, and disturbance of physical activities. He also experienced psychological symptoms of worry, anxiety, anger, low energy, fatigue, sleep problems, difficulties with concentration, and memory problems.

Following assessments with his family physician, Mr. Mustafa attended an examination at Mediwise Healthcare Centre. This resulted in the OCF-18 for functional impairment assessment and physiotherapy.

Mr. Mustafa attended a functional impairment assessment with Dr. Nathanson, chiropractor, in June 2020 who diagnosed him with chronic pain.

The OCF-18s were denied and an IE was sent. The September 2020 IE assessor indicated that there was no evidence of musculoskeletal or neurologic impairment in this case.

Aviva submits that the OCF-18 issued by Mediwise Healthcare Centre is not reasonable and necessary due to the “lack of contemporaneous medical evidence.”

The insurer further submits that the applicant does not meet the test for a diagnosis of chronic pain as described in the American Medical Association (“AMA”) Guides.

Vice-Chair Brett Todd states that answering the chronic pain question is necessary to justify the OCF-18s. He agrees with the respondent that the examiner did not properly assess the applicant against the criteria required to provide a diagnosis of chronic pain.

To meet a diagnosis of chronic pain, an individual must meet at least three of the six criteria set out in the AMA Guides:

  • Use of prescription drugs beyond the recommended duration and/or abuse of or dependence on prescription drugs or other substances;
  • Excessive dependence on health care providers, spouse, or family;

Secondary physical deconditioning due to disuse and or fear-avoidance of physical activity due to pain;

  • Withdrawal from social milieu, including work, recreation, or other social contacts;
  • Failure to restore pre-injury function after a period of disability, such that the physical capacity is insufficient to pursue work, family, or recreational needs; and
  • Development of psychosocial sequelae after the initial incident, including anxiety, fear-avoidance, depression, or non-organic illness behaviours.

In the subject case, there was no OT on file.

OT assessment and intervention could have helped the chiropractor or any physician to illustrate the impact of Mr. Mustafa’s pain on his function.

In the chronic pain assessment set by the AMA Guides, as listed above, criteria (II)- (VI) are asking about the client’s level of dependency on health care providers, spouse, or family with daily functions; development of physical deconditioning due to disuse and or fear-avoidance of physical activity due to pain; withdrawal from social milieu, including work, recreation, or other social contacts; failure to restore pre-injury function after a period of disability, such that the physical capacity is insufficient to pursue work, family, or recreational needs; and development of psychosocial sequelae after the initial incident, including anxiety, fear-avoidance, depression, or non-organic illness behaviours.

OTs are uniquely trained to evaluate the impact of pain on the client’s ability to engage in meaningful activities as per the domains listed above.

OT assessment and intervention reports are describing the extent of the pain symptoms on a client’s physical, cognitive, and psychosocial function and are identifying challenges in clients’ engagement of daily activities.

This would assist the chiropractor in Mr. Mustafa’s case to substantiate the diagnosis of chronic pain.

Here at GLA Rehab, our OTs are experienced in evaluating functional status and assessing changes in all these domains. Our OTs have the tools to address dependency on others, deconditioning, fear of movement, withdrawal from activities of daily living and the effect of the client’s mood on his/her function.

We are also skilled in conducting situational assessments, which help illuminate the relative impacts of various impairments on a client’s ability to engage in self-care, housekeeping, caregiving, driving, work and recreational activities.

If necessary, our OTs can also recommend referrals to other specialists, who can explore diagnosis and prognosis related to pain and emotional symptoms.

All this information is useful to assist physicians in reaching the diagnosis of chronic pain.

If you have a client who demonstrates changes in ability to manage daily function and is reporting changes in behaviour, it is imperative that an OT be part of the assessment and rehab team.

Please contact us. We would love to help.

Best wishes for a safe and productive Autumn season!

From all of us at GLA Rehab!

Sources:

 Mustafa v Aviva General Insurance Company, 2022 CanLII 81523 (ON LAT), <https://canlii.ca/t/jrtcv>, retrieved on 2022-10-22

Rondinelli, R. D., Genovese, E., Katz, R. T., Mayer, T. G., Mueller, K. L.,

Ranavaya, M. I., & Brigham, C. R. (2022). Pain-Related Impairment. In AMA

Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2022 (Vol. Sixth,

2022, pp. 0): American Medical Association.

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Cognitive Functional Capacity Evaluation (Cog-FCE)

  • by Galit Liffshiz
  • May 05, 2022
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Cognitive Functional Capacity Evaluation (Cog-FCE)

GLA Rehab now offers an assessment called the Cognitive Functional Capacity Evaluation (Cog-FCE.)

This is in addition to Cognitive Functional Capacity Evaluation (FCE) and Vocational Assessment which we have been doing so far.

The FCE mostly addresses the physical capacity and physical limitations, as they affect work capacity and employability. The FCE is not designed to accommodate for the cognitive and/or behavioural challenges, faced by individuals with traumatic brain injury or mental health conditions.

The Cognitive Functional Capacity Evaluation (Cog-FCE) accounts for the functional cognitive barriers, and psycho-emotional and behavioural barriers to return to work, faced by this diagnostic group. It compliments the FCE that addresses the physical barriers.

This assessment will be completed by our occupational therapists in collaboration with our trained FCE+Cog-FCE assessors.

So, what is the Cognitive Functional Capacity Evaluation?

The Cognitive Functional Capacity Evaluation (Cog-FCE) is designed to evaluate the ability to work for individuals with cognitive disabilities.

This assessment helps to explain how clients’ cognitive challenges may affect their ability to work. This evaluation will be used to assist with a client’s return-to-work plan and goals, as it combines a cognitive analysis with a focus on how the client is able to perform functionally and vocationally.

The first step involves an analysis of the cognitive job demands of the client’s pre accident job.

The second step is when the OT will be using a variety of different assessment methods, including a combination of subjective and objective measures. The OT will use high-level cognitive screens and questionnaires that will provide a baseline of the client’s cognitive status.

Some of the work-related cognitive tasks that the OT will look for are the client’s ability to follow instructions, remember procedures, sustain attention on a task, problem solve, plan and organize, reason, self-regulate, self-correct decisions, meet deadlines, work under pressure, be flexible and shift thoughts and plan when needed, multi-task, use adequate judgement and more.

We will address the client’s ability to communicate with others, be clear, understand instructions and self-advocate in a work environment.

The third step, work simulation, is when the OT will be asking the client to complete tasks that mirror the demands they would be responsible for if they were to return to work. This is through simulated situational assessments and analysis of the client’s ability to meet job demands. The OT will create situational tasks that model real-life work demands to see how these cognitive disabilities may manifest during work tasks.

Why is this evaluation helpful?

The Cognitive Functional Capacity Evaluation can be a very helpful tool to assess a client’s occupational performance and cognitive disabilities, in relation to their ability to perform their pre-accident job or any job that is “reasonably suited by education, training or experience.”

By taking a comprehensive and holistic approach to assessment, the client is observed through several different avenues of obtaining information.  The assessor can develop further insight into how the client’s cognitive disability is apparent in a variety of tasks and situations.

The assessment findings and the identified gaps in ability to perform the cognitive job demands will be of assistance for Income Replacement Benefits claims and disputes

The team at GLA Rehab is excited to start using the Cognitive Functional Capacity Evaluation as this will allow us to collect data related the client’s ability to work, while he/she/they are coping with cognitive-behavioural impairments, following a motor vehicle accident.

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Workplace Safety and Insurance Appeals Tribunal: An Appeal that Recognized the Evolution of Cognitive Disability Symptoms

  • by Galit Liffshiz
  • Oct 28, 2021
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Workplace Safety and Insurance Appeals Tribunal: An Appeal that Recognized the Evolution of Cognitive Disability Symptoms

Written by Lian Yaffe, Occupational Therapist, OT Reg. (Ont.)

Individuals who have experienced traumatic brain injuries experience cognitive-behavioural symptoms that can affect them in their daily lives. Many individuals report impairments including fatigue, inability to concentrate, lack of attention, low frustration tolerance, memory difficulties, problem with organization and sequencing, impaired judgement and difficulty with emotional regulation.

It is important to collect proper data on client’s cognitive-behavioural abilities from observation and standardized testing.

In a recent appeal decision made by the WSIB board in 2020, Decision No. 657/20, 2020 ONWSIAT 1423 (CanLII), the arbitrator revised the benefits awarded to an individual after further information was provided, suggesting a change in the individual’s symptomology and ability to function.

The worker was employed as a sales director when he was involved in a serious ATV accident while on a work trip in April of 2005. He sustained a compression fracture in his spine requiring surgery and  a traumatic brain injury (TBI).

In August 2005, the worker returned to his pre-accident position as a sales director However his duties were limited and remained limited until 2008 when his contract was not renewed.

In 2010, he was assessed by a psychiatrist and was granted Non-Economic Loss (NEL) benefit of 20% for his cognitive impairment and psychological sequelae resulting from his TBI. He was considered 38% whole person impairment at the time due to the injury to his spine. Combined, the worker was considered to have a 50% whole person impairment.

He then went on to study for his real estate license. He started working as a real estate agent but was soon let go from his job, due to his inability to perform real estate transactions. When his license expired in 2012, he was unable to pass the required exams to recertify himself.

The worker continued to report cognitive and emotional difficulties and claimed inability to work.

In March of 2011, the worker was seen by another psychiatrist, who stated that the worker “will be limited from pursuing any suitable and realistic occupational options and/or retraining programs.”
However, in December 2011, the Case Manager (CM) on file referred the worker’s case to the Regulatory Service, to conduct video surveillance of the worker, as the CM was suspecting that the worker was misrepresenting his cognitive and psychological impairments.

This footage showed that the worker was driving short distances to stores and driving his kids to school, seemingly to suggest that the worker was not demonstrating cognitive difficulties.

In 2012, there was the final review regarding the work’s Loss of Earning Benefits, based on his ability to maintain employment as a sales manager and real estate agent.

Although it was noted that the worker was unable to work at an executive level, it felt there was not enough information regarding his ability to perform the job.

In 2013, the worker underwent a neuropsychological exam, where the doctor reports the following diagnoses: Cognitive Disorder Not Otherwise Specified (mild to moderate neurocognitive impairment); Major Depressive Disorder; Generalized Anxiety Disorder; and Pain Disorder associated with both psychological factors and a general medical condition (chronic).

In 2016, his neuropsychologist notes “He has significant difficulties in performing most instrumental activities of daily living as well as some basic activities of daily living due to problems with severe depression and severe traumatic brain injury. He presents with high levels of depression and anxiety, which results in him isolating himself from any sort of social functioning. His severe traumatic brain injury has significantly impacted his ability with respect to concentration, pace and persistence as most tasks are left incomplete and are not performed unless the assistance of other individuals primarily family members.”

After further corroborating assessments from other doctors, along with testimony from his wife, his case was reviewed by the board.

It was determined that the worker has experienced a significant deterioration in his psychological condition and as such is entitled to a reassessment in his Non-Economic Loss award for psycho-traumatic disability. He was compensated for his losses.

Why is this case important?

This case provides an example of the challenges that many individuals face after a brain injury. Cognitive difficulties are disabilities that are not visible the way a broken leg may be.

Common physical, cognitive, and emotional impairments following an accident, such as chronic fatigue, chronic pain, or cognitive impairments, affect the client’s ability to participate in their lives in a meaningful way.

As we can see from this case, an individual’s symptoms and experiences as a result of a brain injury may be invisible to some. Basic self care and basic ADLs, such as driving children to school for 10 minutes, should not be perceived as proper reflection on client’s ability to work.

Continuous functional observation and proper data collection is necessary to identify the level of limitation the client is experiencing in relation to work task.

At GLA Rehab, we place a strong importance on quality reporting and in-depth assessments and analysis of performance, so that we responsibly and accurately identify how one’s impairments are affecting them.

Our therapy team makes a strong effort to ensure that assessments of clients are holistic and comprehensive of the client’s abilities in a variety of demands, settings, and difficulties, so that we can accurately gain the information we need to best support our clients.

Source:
https://www.canlii.org/en/on/onwsiat/doc/2020/2020onwsiat1423/2020onwsiat1423.html?searchUrlHash=AAAAAQAgQ29nbml0aXZlIEZ1bmN0aW9uYWwgRXZhbHVhdGlvbiAAAAAAAQ&resultIndex=37

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Structured Work Activity Group Test (SWAG)

  • by Galit Liffshiz
  • Oct 28, 2021
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Structured Work Activity Group Test (SWAG)

Written by Lian Yaffe, Occupational Therapist, OT Reg. (Ont.)

As noted in our fall newsletter, several types of assessments are used to complete the Cognitive Functional Capacity Evaluation. Specific cognitive measures are used to assess for how cognitive difficulties are presented through occupation.

Assessments conducted in this step of the evaluation seek to use situational tasks that model real-world demands to assess a client’s ability to perform functionally.

One of the assessments commonly used to address this step is called the Structured Work Activity Group Test (SWAG).

Originally developed by the program of Occupational Therapy at Washington University School of Medicine, this test can be used with individuals with cognitive difficulties in therapeutic treatment or as an assessment tool.

The SWAG Test is comprised of a series of 8 activities that mirror commonly required job demands, such as bookkeeping and secretarial tasks which are graded in terms of difficulty and demand.

These activities provide an avenue for therapists to observe, in a real-life context, the client’s ability to follow written direction, follow multi-step directions correctly, and sustain divided attention. These tasks also look at processing speed, memory, organization, and an ability to prioritize.

As each activity increases in difficulty, the client is able to find their “just-right” challenge. Therapists can use this information to determine the client’s ability to meet the demands of their pre-accident employment, by comparing their current abilities with what would be required of them if they were to return-to-work.

This information may also provide evidence to support an individual’s claim for Income Replacement Benefits or upon disputes.

GLA Rehab will begin using this test in combination with a series of other cognitive assessments to evaluate our client’s cognitive-behavioural functioning.

By providing clients with the opportunity to demonstrate their abilities in a variety of ways, such as on an application test like this, we can better observe the impact of cognitive difficulties in daily life.

With this information we can work hard to best support our clients, and help them achieve their rehabilitative goals.

If you have any questions or would like further information, please contact GLA Rehab.

Source:  https://www.epicrehab.com/products/products-background/swag-original-activities/

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Using “Occupational Gifts” to Maintain Meaningful Routine during COVID-19

  • by Galit Liffshiz
  • Mar 22, 2021
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Using “Occupational Gifts” to Maintain Meaningful Routine during COVID-19

By Jamie Laframboise, MSc (OT), OT Reg. (Ont.)

Daily routines, or the regular sequences of activities we follow in our daily lives, are crucial for our health and well-being (Matuska & Barrett, 2014).

Consistent, meaningful routines that maintain balance between work, school, play, rest, and sleep, help create structure in our daily lives, improve our health and well-being, and reduce anxiety and stress (Matuska & Barrett, 2014). Imbalanced routines result in stress and low subjective well-being (Matuska, 2012).

The COVID-19 pandemic has disrupted the routines of people across Canada and across the world.

Public safety measures such as stay at home orders, physical distancing, and mandatory self-isolation are necessary but mean that many of our usual activities are unavailable to us.

We can’t spend our desired amount of time engaged in activities that foster physical well-being, positive relationships, productivity, and personal growth. These are important functions of routines (Matuska & Christiansen, 2008)

Community Occupational Therapists like those at GLA Rehab help injured clients re-engage in meaningful daily routines, but this has become challenging during the COVID-19 pandemic.

Some therapists, including Zafran (2020), have started to look to the teachings of Rachel Thibeault for ideas to enable meaningful routines during the pandemic.

Ms. Thibeault is an Occupational Therapist whose career focused on community-based rehabilitation in post-conflict zones, with refugees and Indigenous populations, who often experience a lack of access to spaces and resources.

While working with these communities, Ms. Thibeault coined the term the “5 occupational gifts” to refer to activities that she believed were integral parts of any repertoire to foster a sense of resilience and control in the context of occupational disruption.

The 5 occupational gifts are (Thibeault, 2011):

  • Centering
  • Contemplation
  • Creation
  • Connectedness
  • Contribution

Community OTs can use the 5 occupational gifts as a framework for engaging clients in conversations to identify unique activities that embody the qualities of the gifts, which can be incorporated into their daily lives (Zafran, 2020).

By ensuring routines include a variety of these activities, OTs can people foster meaningful, balanced routines within the constraints of public health safety measures, helping to increase feelings of resilience and well-being during challenging times.

Centering activities are ones that are familiar to us (Thibeault, 2011). They aren’t demanding on physical, cognitive, or psychological resources. When performing them, we might feel like we are in a state of “flow”.

Centering activities vary from person to person, but can range from folding laundry, to colouring, to cooking a favourite meal. These activities allow us to feel calm and open.

Contemplation activities evoke a sense of admiration and awe for life and the world (Thibeault, 2011). Examples include nature walks, meditation, and mindfulness.

When engaged in contemplation activities, we reflect on meaning. Other examples can include praying, scrapbooking, or talking about life experiences.

Creative activities allow us to let out our natural desire to explore and create (Thibeault, 2011). These activities allow us to use our imagination and think of new ideas.

People might enjoy painting, writing stories, or engaging in conversations about revolutionary concepts.

Connecting activities strengthen a sense of belonging to a community and to life (Thibeault, 2011). These activities should allow us to feel connected to things that are important to us.

Some people might enjoy participating in activities that allow them to feel connected to sports, family, culture, nature, or a place they identify closely with.

Contribution activities allow us to feel like we have done something for others (Thibeault, 2011). These are activities that allow us to use our strengths and interests to say, do, or make something that is of value in our community.

Some people may enjoy participating in activities related to fundraising, advocating, or producing needed goods.

Now is the best time to start appreciating the calming affect of basic daily tasks, reconnecting with old interests, reflecting on our lives, tapping into our creative tendencies and support each our communities.

Try using Thibeault’s occupational gifts to help your clients do the same!

References

Thibeault, R. (2011). Chapter 10: Occupational gifts. In M. A. McColl (Ed.), Spirituality and Occupational Therapy (2nd ed., pp. 111-120). CAOT Publications ACE.

Matuska, K., & Christiansen, C. (2008). A proposed model of lifestyle balance. Journal of Occupational Science, 15(1), 9-19.

Matuska, K. (2012). Validity evidence for a model and measure of life balance. Occupational Therapy Journal of Research, 32(1), 220-228.

Matuska, K., & Barrett, K. (2014). Chapter 15: Patterns of occupation. In B. A. Boyt Schell, G. Gillen, M. E. Scaffa, & E. S. Cohn (Eds.), Willard & Spackman’s Occupational Therapy (12th ed.) (pp. 163-172). Lippincott Williams & Wilkins.

Zafran, H. (2020). Occupational Gifts in the time of a pandemic. Occupational Therapy Now, 22(4), 5-6. https://caot.ca/uploaded/web/otnow/OT%20Now_JULY_20.pdf#page=7

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Will Canada approve a Hand-Held Diagnostic Tool for Traumatic Brain Injury?

  • by Galit Liffshiz
  • Mar 22, 2021
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Will Canada approve a Hand-Held Diagnostic Tool for Traumatic Brain Injury?

By Jamie Laframboise, MSc (OT), OT Reg. (Ont.)

Traumatic brain injuries (TBIs) occur when brain function is disrupted by injury to the head, and they are a leading cause of death and disability worldwide (CDC, 2020).

TBIs vary in severity from mild (commonly diagnosed as concussion), to severe.

With proper diagnosis and treatment, people with mild TBIs are expected to recover within three months post-injury.

Moderate-severe TBIs are commonly diagnosed using imaging tests such as a CT scan or an MRI (FDA, 2019). Mild TBIs are more difficult to accurately diagnose.

Currently, they are diagnosed based on a combination of subjective reports, objective observations of symptoms and functional limitations, screening questionnaires, physical exams, and cognitive assessments conducted by physicians, occupational therapists, and other medical professionals.

As such, many mild TBIs go undetected. With the methods currently available to us, it’s estimated that approximately half of all mTBIs go undiagnosed in the emergency department (Deutschmann, 2021).

When mild TBI goes undiagnosed and untreated, symptoms persist beyond the expected recovery period for many people (Elias, 2018).

This is known as Post Concussion Syndrome, which is when the physical, cognitive, and emotional symptoms of mTBI persist 3 months after the accident, resulting in ongoing functional difficulties (Concussion Legacy Foundation, n.d.).

Occupational Therapists at GLA Rehab see these functional challenges persist in their clients’ daily lives for years following their accidents.

Clients experience reduced independence in their activities of daily living including those related to self-care, work, school, leisure, driving, and socialization.

The challenges associated with detecting, diagnosing, and treating mild TBI are especially concerning, given the fact that 90% of all brain injuries are mild (Elias, 2018).

New research led by Dr. Beth McQuiston (M. D., R. D.) at Abbott Point of Care Inc., a company that manufactures and markets diagnostic products, has the potential to revolutionize the way mild TBIs are diagnosed.

The new iStat Alinity, which some are calling a “blood test for the brain”, is a handheld device which can quickly and objectively detect the presence of a mild TBI by drawing a sample of blood and testing it for molecular markers that are released by the brain when trauma occurs (Deutschmann, 2021).

If Canada approves the iStat Alinity device for use like our neighbours in the USA have, it has the potential to benefit the thousands of people who sustain mild TBIs every year.

It’s a cost-effective, accurate, and radiation free alternative to diagnosing moderate-severe TBIs and could potentially enable quick and accurate identification of the thousands of mild TBIs that go undiagnosed every year to allow people to access treatment so they can continue to meet the demands of their daily lives (Deutschmann, 2021).

References

Centers for Disease Control and Prevention. (2020, August 28). Traumatic brain injury & concussion. https://www.cdc.gov/traumaticbraininjury/index.html#:~:text=CDC%20defines%20a%20traumatic%20brain,head%2C%20or%20penetrating%20head%20injury.).

Concussion Legacy Foundation. (n.d.). What is PCS? https://concussionfoundation.org/PCS-resources/what-is-PCS?gclid=EAIaIQobChMIm7WqocLs7gIVtwiICR1B6Q3kEAAYASAAEgJePPD_BwE

Cyrus et al., (2014). Clinical utility of SPECT neuroimaging in the diagnosis and treatment of traumatic brain injury: A systematic review. PLoS One, 9(3). doi:10.1371/journal.pone.0091088

Deutschmann, R. (2021). Experts call new TBI test a “game changer”. Deutschmann Personal Injury & Disability Law. https://www.deutschmannlaw.com/blog/post/experts-call-new-tbi-test-a-game-changer

Elias, D. (2018). Diagnostic and treatment challenges in mTBI (concussion). [Lecture notes, PowerPoint slides]. CHS & Canadian Concussion Institute. https://oemac.org/wp-content/uploads/2018/09/David-Elias-Diagnostic-and-Treatment-Challenges-in-mTBI-Concussion.pdf

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Screening women who have been victims of domestic abuse for Traumatic Brain Injury – A new bill is being processed in the UK

  • by Galit Liffshiz
  • Oct 02, 2020
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Screening women who have been victims of domestic abuse for Traumatic Brain Injury – A new bill is being processed in the UK

With the rate of domestic abuse rising, as a result of isolation and quarantine efforts due to COVID-19, as well as, October is Domestic Violence Awareness Month here is an article that deserves some attention.

On July 2, 2019, A Labour MP from the United Kingdom (UK) asked the government to pass a bill that would allow screening for a traumatic brain injury for women who have been victims of domestic abuse.

The screen would take place two weeks from the domestic abuse charge being laid against an alleged perpetrator.

Labour MP Chris Bryant, is heading this bill. He has also added that female inmates should also be screened.  “My clause seeks to say every single woman prisoner coming onto [the] prison estate should be screened,” Bryant said in the UK’s House of Commons hearing of the bill yesterday.

Traumatic Brain Injury (TBI) is a disruption in the normal function of the brain that can be caused by a blow, bump or jolt to the head, the head suddenly and violently hitting an object or when an object pierces the skull and enters the brain tissue.

TBI can be mild, moderate, or severe, depending on the extent of damage to the brain.

Traumatic brain injury can have wide-ranging physical and psychological effects. Some signs or symptoms may appear immediately after the traumatic event, while others may appear days or weeks later.

TBI can result in prolonged or permanent changes in a person’s state of consciousness, awareness or responsiveness.

Labour MP Chris Bryant states that women, who have already been deemed victims of domestic abuse, should also be screened and should be given access to the proper neurorehabilitation needed for them to live a more able life.

Of 173 women within the prison, 64 percent reported a history indicative of brain injury, and of those, 96 percent reported a history indicative of TBI.

Almost two-thirds of those supported through the service, reported sustaining a brain injury through domestic violence.

The MP faced backlash, as he was misunderstood to want to screen every inmate in the UK’s prison system.

He later met with other MPs and cleared the matter, his intentions are to start screen on all-female prisons as they are more likely to have suffered from TBI.  You can read his speech in its entirety here.

Please stay tuned and up-to-date with everything GLA Rehab on our LinkedIn account and our Twitter account.

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World Alzheimer’s Month

  • by Galit Liffshiz
  • Sep 27, 2020
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World Alzheimer’s Month

September 2020 will mark the 9th World Alzheimer’s Month. Every September is used to raise awareness and challenge the stigma that surrounds dementia.

Dementia is a term used to describe different brain disorders that affect memory, thinking, behaviour and emotion.

There are over 100 forms of dementia. The most well-known form of dementia is Alzheimer’s disease, which accounts for 50-60% of all cases. Other forms of dementia include vascular dementia, dementia with Lewy bodies and frontotemporal dementia.

Dementia affects 50 million people worldwide, with a new case of dementia occurring somewhere in the world every 3 seconds according to Alzheimer’s Disease International.

Dementia is often hidden away, not spoken about, or ignored at a time when the person living with dementia and their families are most in need of support.

Early symptoms of dementia can include memory loss, difficultly performing familiar tasks, problems with language and changes in personality.

Declining memory, especially short-term memory, is the most common early symptom of dementia. Occasionally everyone has trouble finding the right word but a person with dementia often forgets simple words.

Everyone can become sad or experience moody swings from time to time. A person with dementia may become unusually emotional and experience rapid mood swings for no apparent reason. Alternatively, a person with dementia may show less emotion than was usual.

Dementia can affect mental capacity to manage self-care and property (finances).

The stigmatization of dementia is a global problem and it is clear that the less we talk about dementia, the more the stigma will grow.

Here at GLA Rehab, we help families cope with the stigma.

Our main goal is to improve the quality of life of people with dementia and their caregivers at home and in the community.

Our rehab team, including OT, SW, RT and PT is developing strategies to reduce caregiver burnout. We make sure that proper referrals are being made and that all medical and rehabilitation professionals are collaborating and managing the symptoms as a team.

We are also offering capacity assessment for managing self-care and property.

Please stay tuned and up-to-date with everything GLA Rehab on our LinkedIn account and our Twitter account.

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