Martínez-Pernía, D., Huepe, D., Huepe-Artigas, D., Correia, R., García, S., & Beitia, M. Enactive Approach and Dual-Tasks for the Treatment of Severe Behavioral and Cognitive Impairment in a Person with Acquired Brain Injury: A Case Study. Frontiers in Psychology, 7, 1712. 2016

Enactive Approach and Dual-Tasks for the Treatment of Severe Behavioral and Cognitive Impairment in a Person with Acquired Brain Injury: A Case Study.

AUTORES Martínez-Pernía, D., Huepe, D., Huepe-Artigas, D., Correia, R., García, S., & Beitia, M.
AÑO 2016
JOURNAL Frontiers in Psychology
VOLUMEN 7, 1712
ABSTRACT
RESUMEN One of the most important sequela in persons who suffer from acquired brain injury is a behavioral disorder. To date, the primary approaches for the rehabilitation of this sequela are Applied Behavior Analysis, Cognitive-Behavior Therapy, and Comprehensive-Holistic Rehabilitation Programs. Despite this theoretical plurality, none of these approaches focuses on rehabilitating behavioral disorders considering the relation between affordance and environmental adaptation. To introduce this therapeutic view to neurorehabilitation, we apply the theoretical tenets of the enactive paradigm to the rehabilitation of a woman with severe behavioral and cognitive impairment. Over seventeen sessions, her behavioral and cognitive performance was assessed in relation to two seated affordances (seated on a chair and seated on a ball 65 cm in diameter) and the environmental adaptation while she was working on various cognitive tasks. These two seated affordances allowed to incorporate the theoretical assumptions of the enactive approach and to know how the behavior and the cognition were modified based on these two postural settings and the environmental adaptation. The findings indicate that the subject exhibited better behavioral (physical and verbal) and cognitive (matching success and complex task) performances when the woman worked on the therapeutic ball than when the woman was on the chair. The enactive paradigm applied in neurorehabilitation introduces a level of treatment that precedes behavior and cognition. This theoretical consideration allowed the discovery of a better relation between a seated affordance and the environmental adaptation for the improvement behavioral and cognitive performance in our case study.

Una de las secuelas más importantes en las personas que sufren de daño cerebral adquirido es el trastorno conductual. En la actualidad hay tres principales enfoques para rehabilitar este trastorno (Análisis Conductual Aplicado, Terapia Cognitivo Conductual y los Programas de Rehabilitación Comprehensivo-Holístico). A pesar de esta diversidad de enfoques ninguno de ellos asume como proceso rehabilitador la relación existente entre el cuerpo y el ambiente en la emergencia de la acción y la cognición. Para introducir esta visión terapéutica en el ámbito de la neurorehabilitación aplicamos los principios teóricos del paradigma enactivo en una mujer con daño cerebral severo. Durante diecisiete sesiones terapéuticas medimos su conducta y desempeño cognitivo en dos posturas diferentes (sentada en una silla y sentada en un balón terapéutico) mientras realiza una tarea cognitiva. Los resultados de esta investigación muestran que la persona mejoró significativamente su conducta y desempeño cognitivo mientras estaba trabajando en el balón terapéutico. Este trabajo introduce en el ámbito de la neurorehabilitación un nivel de tratamiento que precede a la conducta y la cognición, y el cual no había sido contemplado previamente como catalizador del proceso de rehabilitación.