Early Intensive Rehabilitation for Patients with Traumatic Brain Injury: A Prospective Pilot Trial

Fan, Ming-chao; Li, Shifang; Sun, Peng; Bai, Guangtao; Wang, Nian; Han, Chao; Sun, Jian; Li, Yang; Li, Huanting

doi:10.1016/j.wneu.2020.01.113

Cited by 12 publications

(6 citation statements)

References 20 publications

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“…Despite a relatively decreased mortality of ischemic stroke, thanks to the advancement of medical technology, 3/4 of surviving patients still suffer from varying degrees of compromised life quality [ 5 ]. Thus, timely and effective rehabilitation may facilitate the recovery of neurological function, improve the quality of life, and ameliorate the prognosis of patients with ischemic stroke [ 6 ]. According to traditional Chinese medicine (TCM), the pathogenesis of ischemic stroke is complex and is mainly associated with blood stasis, deficiency of qi and blood, and the accumulation of fire, which result in insufficient blood supply to the brain and cerebral hemorrhage and then lead to brain blockage and impaired body function.…”

Section: Introductionmentioning

confidence: 99%

Effects of Different Doses of Clopidogrel plus Early Rehabilitation Therapy on Motor Function and Inflammatory Factors in Patients with Ischemic Stroke

Zhao

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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This prospective randomized controlled study was intended to assess the effects of different doses of clopidogrel plus early rehabilitation therapy on motor function and inflammatory factors in patients with ischemic stroke. Between August 2018 and October 2020, 90 cases of ischemic stroke treated in the Second People’s Hospital of Yibin were randomized at a ratio of 1 : 1 to receive either oral 50 mg/d clopidogrel plus early rehabilitation therapy (low-dose group) or oral 75 mg/d clopidogrel plus early rehabilitation therapy (high-dose group), with 45 cases in each group. The outcome measures including the Barthel Index (BI), National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer simplified scale, hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and occurrence of adverse events were collected. After treatment, the high-dose group had higher BI results than the low-dose group. All eligible patients showed significantly declined NIHSS scores, and the high-dose group had markedly lower results ( P < 0.05 ). After treatment, the Fugl-Meyer scores of both upper and lower extremities of the high-dose group were significantly higher than those in the low-dose group. The high-dose group achieved a greater decrease in inflammatory factor levels after treatment versus the low-dose group. The two groups showed a similar incidence of adverse events. High-dose clopidogrel plus early rehabilitation outperforms the low-dose treatment for patients with ischemic stroke by effectively mitigating the inflammatory response in the body, promoting the restoration of neurological function, improving the level of motor function, and enhancing the patient’s quality of life, with manageable safety.

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Section: Introductionmentioning

confidence: 99%

Effects of Different Doses of Clopidogrel plus Early Rehabilitation Therapy on Motor Function and Inflammatory Factors in Patients with Ischemic Stroke

Zhao

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Higher values indicate greater disability. The Fugl-Meyer Motor Scale (FMMS) is commonly used to capture changes in motor impairment after stroke and has also been applied to patients with TBI 14 . The FMMS uses a scale from 0 to 100 to describe the impairment of the motor status of the upper (0-66 points) and lower (0-34 points) extremities.…”

Section: Introductionmentioning

confidence: 99%

Estimating minimal clinically important differences for two scales in patients with chronic traumatic brain injury

Mattke

Cramer

Wang

et al. 2020

Current Medical Research and Opinion

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Background: This study aimed to establish the minimal clinically important difference (MCID) for the Fugl-Meyer Motor Scale (FMMS) and the Disability Rating Scale (DRS) to evaluate interventions in patients with motor deficits in the chronic phase after traumatic brain injury (TBI). Methods: MCIDs were established with a structured expert consultation process, the RAND/UCLA modified Delphi method. This process consisted of a literature review and input from a 10-person, multidisciplinary expert panel. The experts were asked to rate meaningfulness of improvements in hypothetical patients and numeric changes via two rounds of ratings and an in-person meeting. Results: The estimated MCIDs were six and five points on the FMMS Upper and Lower Extremity Scale, respectively, and one point on the DRS. The experts argued against establishing an MCID for the combined FMMS because the same change was more likely to be meaningful if concentrated in one extremity and because a meaningful improvement in one extremity implies meaningfulness irrespective of the changes in the other. Conclusions: This study is the first to establish MCIDs for the FMMS and the DRS in the chronic phase after TBI. The results may be helpful for the design and interpretation of clinical trials of interventions.

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“…The Inpatient Rehabilitation Facility (IRF) environment offers a unique opportunity for the provision of high-intensity, high-collaboration care in the early stages of TBI recovery. As has previously been demonstrated in stroke research, there is emerging evidence that early intensive rehabilitation is associated with better neurological outcomes in TBI 26 . Often the collaborative efforts of the SLP, PT, and OT working together to provide cognitive rehabilitation to a client, can address specific cognitive targets related to their discipline's goals, including those relevant to communication, mobility, and self-care, respectively [27][28][29] .…”

Section: Introductionmentioning

confidence: 69%

Cognitive Rehabilitation Approaches to Traumatic Brain Injury: A Review of Efficacy and Outcomes

Johnson,

Weinberg

2023

MRAJ

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Cognitive rehabilitation is a critical component of intervention for many individuals with both short- and long-term impairments associated with traumatic brain injury (TBI). By focusing on major cognitive domains, emotional processing, and behavioral strategies, clinicians use cognitive rehabilitation to improve cognitive related functional outcomes, quality of life, and social relationships. Cognitive rehabilitation is traditionally divided into restorative and compensatory approaches, though increasingly combined approaches within the larger medical, multidisciplinary team are being incorporated and explored. Literature related to cognitive rehabilitation within the TBI population continues to be needed in order to assist clinicians in developing evidence-based intervention protocols and therapy plans. This paper details current approaches to cognitive rehabilitation and provides an updated review of the literature associated with the efficacy of cognitive rehabilitation. Reviewed evidence supports the use of cognitive rehabilitation to improve multiple cognitive domains, including attention, memory, executive function, and metacognitive skills. The long-term outcomes of continued cognitive rehabilitation services post-TBI are not as comprehensively documented as the relative short-term outcomes. The efficacy of cognitive rehabilitation is impacted by patient-specific variables, timing and intensity of treatment. This paper concludes with noted information related to the limitations of the current evidence of cognitive rehabilitation, including study design concerns, and reduced generalizability of the relevant research.

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Early Intensive Rehabilitation for Patients with Traumatic Brain Injury: A Prospective Pilot Trial

Cited by 12 publications

References 20 publications

Effects of Different Doses of Clopidogrel plus Early Rehabilitation Therapy on Motor Function and Inflammatory Factors in Patients with Ischemic Stroke

Effects of Different Doses of Clopidogrel plus Early Rehabilitation Therapy on Motor Function and Inflammatory Factors in Patients with Ischemic Stroke

Estimating minimal clinically important differences for two scales in patients with chronic traumatic brain injury

Cognitive Rehabilitation Approaches to Traumatic Brain Injury: A Review of Efficacy and Outcomes

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