An evaluation of the strategic approach to the rehabilitation of traumatic brain injury (TBI) patients

Abstract

SummaryBackgroundThe objective of our study was to evaluate a goal-driven strategic plan for the step-by-step rehabilitation of traumatic brain injury (TBI) patients, with effectiveness measured in terms of quality of life, as compared to patients treated according to a standard, progressive rehabilitation program.Material/MethodsWe studied 40 patients after TBI awakened from a long-term coma. The patients were divided into two equal groups: a control group (n=20) involving patients treated before the introduction of the strategic approach, and an experimental group (n=20) involving patients rehabilitated under the strategic approach. In evaluating the effectiveness of rehabilitation we used a structured interview with clinical observation and a scale for assessing the quality of life of patients after TBI.ResultsThe deterioration in the quality of life of TBI patients is mainly related to difficulties in satisfying physiological needs, self-care, reduced mobility and disorders of cognitive, regulatory, and social functions. In both groups, the feature most susceptible to rehabilitation related change was movement, while the least susceptible functions were associated with the use of different means of transport. This change is significantly greater in persons in the experimental group, as compared to controls.ConclusionsWe found that a rehabilitation program controlled by a strategic plan, with the cooperation of the patient, is more effective in improving the quality of life, as the patient is more self-motivated to individually designed objectives.

The effectiveness of selected Tai Chi exercises in a program of strategic rehabilitation aimed at improving the self-care skills of patients aroused from prolonged coma after severe TBI

“…Relatively few works have been written on the subject of the rehabilitation of these patients [13,14,18,19], and even fewer on the improvement of their self-care skills, which form an integral part of their quality of life [19–23]. In general, authors raise the problem of self-care skills by merely asking a rhetorical question: how to best help the patient who, having survived the worst, must now put their life back together again, though they are often disabled and unprepared for this task.…”

“…In general, authors raise the problem of self-care skills by merely asking a rhetorical question: how to best help the patient who, having survived the worst, must now put their life back together again, though they are often disabled and unprepared for this task. The performance of even the simplest activities of daily living is often impossible because of chronic pain [20,22,23]. The patients gradually withdraw from social life, which worsens their social dependency [13,18,19].…”

“…Neither the Polish School of Rehabilitation nor significant rehabilitation centers around the world have yet developed an effective program of rehabilitation that would make it possible for these patients to solve the problems they are facing [13,23]. Accordingly, the search is on for new and different rehabilitation programs that would provide some solutions.…”