2015 Grant Recipients

Congratulations to our 2015 recipients!

Moving Ahead’s Small Seed Grant recipients are selected on the basis of project merit, the project’s consistency with the overall goals of Moving Ahead, and the project’s ability to progress our knowledge or understanding of psychosocial issues in TBI.

Every year the standard of applications is very high, with a significant number of applicants obtained.

The Moving Ahead NHMRC Centre for Research Excellence Small Seed Grant recipients for 2015 are:
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Hayley Walsh

Hayley Walsh

University of Queensland
Sensory motor function and the effects of multisensory stimulation and enriched environments during post-traumatic amnesia following a traumatic brain injury
Hayley Walsh, Dr Jennifer Fleming and Dr Narda Murillo Licea


What the study will be about:
There has been little development of evidence-based rehabilitation therapies for people in Post-traumatic Amnesia (PTA) to reduce the length of PTA duration and improve functional outcomes following a traumatic brain injury (TBI). This may have long term consequences for the independent function of personal and instrumental activities of daily living, cognitive outcomes and quality of life for both the patient and family.

The primary aims of this study are two-fold: (1) to monitor sensory motor function of people in PTA to further understand the link between behaviour, sensory motor function and stages of PTA emergence; (2) to compare the benefits of a multisensory occupation-based protocol with the standard hospital protocol for management and treatment during PTA.

What we have done:
Recruitment, implementation of the protocols and data collection has recently begun at a neurorehabilitation hospital in Spain and will continue until the end of 2016. Participants receive regular testing to monitor their progression through PTA as well as several tests of sensory motor function, behaviour and activities of daily living.

Participants are randomised and allocated to either the experimental or control group for treatment and management. Those in the experimental group participate in meaningful occupation-based multisensory stimulations (OBMS) during two daily 30-minute individual therapy sessions with an occupational therapist, as well as transformation of their room into a sensory stimulating enriched environment (EE). Those in the control group follow the standard protocol at the hospital which consists of either one daily 30-minute individual session or a one-hour group occupational therapy session based on table-top activities or upper limb exercises.

Once the participants come out of PTA, measurements are taken regarding their cognitive, physical and sensory motor performance. These measures are taken again at the time of hospital discharge followed by a questionnaire after 6-months from the date of their TBI regarding their participation and function in daily life.

What we expect to find:
The findings from this study will provide greater knowledge of broader symptoms and characteristics of PTA that can help to shape treatment techniques and rehabilitation goals at this stage of recovery. Furthermore, determining if the application of occupation-based multisensory stimulation and enriched environments can reduce PTA duration and improve cognitive, physical and functional outcomes would support a new protocol for early intervention practice in TBI. It could also lead to a better understanding of the relationship between basic sensory motor areas and higher level cognitive and behavioural performance in terms of learning and memory for people following a TBI.

Melinda Hickey

Melinda Hickey

University of Wollongong
Neurocognitive training in traumatic brain injury: Cognitive, behavioural and electrophysiological outcomes
Melinda Hickey, Dr Stuart Johnstone and Dr Jaqueline Rushby


What the study will be about:
Cognitive impairment is the most prominent and persistent cause of disability in individuals with moderate to good neurological recovery from Traumatic Brain Injury (TBI). According to the Cognitive Energetic Model (Sanders, 1983) efficient cognitive processing results from the interplay of computational processes (e.g. encoding and response selection) and state processes (e.g. effort, arousal, and activation). Studies of cognitive performance and electrical activity of the brain (EEG) support impairment in both computational and state processes after a TBI and current rehabilitation approaches typically target each of these domains independently. This project represents the first evaluation of a rehabilitation program that simultaneously targets both of these domains. The commercially available Focus Pocus (Neurocog) neurocognitive training program incorporates:
1) A cognitive training component to improve computational processing involved in executive function
2) A neurofeedback component to teach self-regulation of the brain’s arousal state (EEG).
We aim to assess the effectiveness of this program for improving cognitive, behavioural, and electrophysiological outcomes for adults with a TBI.

What we have done:
A pilot study of five participants has been conducted (Hickey, Johnstone & Rushby, 2014). Participants were required to complete 25 sessions of training over 5-8 weeks in their own homes. The pilot study supported the feasibility and tolerability of the training program and research protocol for adults with mild-moderate TBI. While the primary aim of the pilot study was not to assess outcomes, observation of data at an individual level revealed changes in the expected direction for relative EEG power, and accompanying reductions in self- and informant-reported behaviours relating to executive dysfunction.
We have also collected data from a normative sample of university students and community members on a broad range of cognitive, behavioural, and electrophysiological outcome measures to inform our understanding of TBI-related deficits and of training effects. Finally, we have begun recruitment for a series of Single-Case Experimental Design studies to examine the effectiveness of the neurocognitive training program in adults with TBI.

What we expect to find:
After the training program is introduced it is expected that individuals will show performance improvements on a range of attention and executive function tasks, improvements in the ability to self-regulate EEG arousal, and a reduction in everyday behaviours related to executive dysfunction, compared to their baseline measurements. Given its commercial availability, flexible mode of delivery, and minimal need for involvement of health professionals, we expect that this program will be a valuable component in the cognitive rehabilitation of adults with TBI.


Sarah Prescott

Sarah Prescott

University of Queensland
Goal setting in community-based brain injury rehabilitation - Exploration of the process and relationship between client-centredness, contextual factors and outcome
Sarah Prescott, Dr Jenny Fleming and Emmah Doig

What the study is about:
Goal setting is a vital process in rehabilitation as it provides the focus for multi-disciplinary intervention. Client inclusion in the goal setting process benefits rehabilitation outcomes through increased client motivation and satisfaction with rehabilitation as well as longer term maintenance of gains. However engagement of clients with brain injury in the goal setting process can be difficult due to psychological impairments experienced after brain injury, especially self-awareness impairment. Motivation and therapeutic alliance also influence participation in goal setting. This study aims to investigate the extent to which client-centred goal setting is influenced by impaired self-awareness, motivation and therapeutic alliance and to examine the strategies, techniques and processes used by clinicians to implement client-centred goal setting in routine community-based brain injury rehabilitation.

What we have done:
A total of 44 client participants have been recruited to date, the majority of whom have a diagnosis of traumatic brain injury (n=25). Clinician participants have been drawn from multiple disciplines including occupational therapy (n=7), speech pathology (n=5), physiotherapy (n=5 ), social work (n= 2) and neuropsychology (n=1). Data have been collected from the following sources including: (1) self-report questionnaires with client participants measuring key variables of client-centredness, self-awareness, motivation and therapeutic alliance (2) semi-structured interviews with clinicians to explore clinician perceptions of client inclusion in goal setting in brain injury rehabilitation (n=17), and (3) audio-recorded goal setting sessions to examine implementation of goal setting in routine clinical practice settings (n=69). Data have been collected from multiple sites including an outpatient brain injury unit, private practice community-based settings and a publicly funded community-based brain injury service. Therapist interviews have been transcribed and analysis commenced using a grounded theory approach. Transcription of goal setting sessions and analysis is yet to be completed.

What we have found and expect to find:
So far, we have found a strong positive association between therapeutic alliance and client-centredness (perceived engagement in goal setting and perceived importance of rehabilitation goals to clients). We have also found that clients made significantly more progress on goals that were perceived as highly important to them compared to goals of lesser importance to them. We have further data analysis to complete. We expect to find that clients with brain injury who have self-awareness impairment can be included in goal setting by therapists, however we suspect that therapists may use a range of strategies to enable the development of client-centred goals. Overall use of data from three sources (clinician interviews, audio taped goal setting sessions and self-report measures) will enable recommendations to be developed regarding clinical techniques to facilitate enhanced involvement of clients with traumatic brain injury in the goal setting process. This is particularly important given the finding that client-centred goals are associated with better treatment outcomes.