Neurorehabilitation in traumatic brain injury: does it make a difference?

Greenwald, Brian D.; Rigg, John L.

doi:10.1002/msj.20103

Cited by 26 publications

(18 citation statements)

References 18 publications

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“…Many years of experience in the treatment and neurorehabilitation of patients with focal brain damage as a result of strokes or traumatic brain injury and other disorders of the central nervous system have shown a need for a special uniform organizational structure of treatment, which includes multidisciplinary comprehensive programs for the treatment and rehabilitation processes. This allows for the maximum possible recovery and active social functioning of these patients (Greenwald & Rigg, 2009;Shklovsky, Lukashevich, Gerasimova, Selishchev, & Remennik, 2015).…”

Section: Outcome Of the Long-term Individualized Rehabilitation Progrmentioning

confidence: 99%

A fight for life and dignity: A case of massive traumatic brain injury and the paths for treatment and neurorehabilitation

et al. 2016

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We present a clinical case of treatment and neurorehabilitation of a patient with severe neurological deficit due to extensive traumatic lesion of the left hemisphere of the brain. Until recently, such cases were considered incurable and remained marginalized throughout their lives. This clinical case illustrates the compensatory brain possibilities under long-term integrated multidisciplinary treatment and neurorehabilitation with mandatory application of medical, medico-psychological, medico-pedagogical, and medico-social methods, the importance and intensity of which vary at different stages of the disease. This process is addressed in the individual patient. The greatest efficiency of the neurorehabilitation treatment of patients with severe consequences of a stroke and traumatic brain injury can be reached under the following conditions: the earliest possible start of rehabilitation with a sufficient duration and intensity; interdisciplinary and integrative rehabilitation process at various stages of rehabilitation treatment; systematic clinical and neuropsychological diagnostics; systematic monitoring of somatic, neurological, psychiatric, and psychological condition of the patient; assistance with sociopsychological and labor issues; and problem-solving support.

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Section: Outcome Of the Long-term Individualized Rehabilitation Progrmentioning

confidence: 99%

A fight for life and dignity: A case of massive traumatic brain injury and the paths for treatment and neurorehabilitation

et al. 2016

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“…Physiologically, posture has a significant influence on vigilance and arousal reaction (12,13), which is well known and applied daily, e.g. in rehabilitation therapy (14,15). Vigilance and arousal reactions are mainly influenced by the brain stem areas such as the ascending reticular activating system, which is connected to the hypothalamic regions.…”

Section: Discussionmentioning

confidence: 99%

Differences in the insulin tolerance test in patients with brain damage depending on posture

Kopczak

Rosen²,

Krewer³

et al. 2011

European Journal of Endocrinology

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Objective: The insulin tolerance test (ITT) is the gold standard for the diagnosis of GH deficiency (GHD) and hypocortisolism. As hypopituitarism is a common disorder after traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH), the test is increasingly used in patients with pre-existing brain damage. Design: A cross-sectional, observational study. Methods: Fifty-six patients (41 TBI and 15 SAH) were tested with the ITT (0.15 IE/kg body weight, mean glucose 33 mg/dl). In 38 patients, the test was performed in a supine position; the other 18 patients were in a sitting position during the ITT. Results: Hypocortisolism and GHD were more often diagnosed in a supine than in a sitting position (hypocortisolism: 55.3% supine versus 0% sitting, P!0.0001; GHD: 42.1% supine versus 11.1% sitting, PZ0.03). Patients in a sitting position suffered more often from symptoms such as tachycardia (61.1% sitting versus 15.8% supine, PZ0.001), trembling (22.2 vs 7.9%, NS), and sweating (66.7 vs 28.9%, PZ0.007). There were no significant differences between the groups in drowsiness (72.2% sitting versus 65.8% supine, NS), dizziness (44.4 vs 44.7%, NS), and fatigue (33.3 vs 15.8%, NS). Because of somnolence, the hypoglycemic state could only be stopped with i.v. administration of glucose in 25 supine patients (66%). In contrast, none of the 18 patients (0%) tested in a sitting position got somnolent or was in need of i.v. application of glucose (P!0.001). Conclusions: In patients with brain injury, posture might affect rates of diagnosing GHD and hypocortisolism and sympathetic symptoms in the ITT. These findings are exploratory and need replication in a standardized setting.

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“…Once hospital-based rehabilitation has been completed the person may require a community-based program or ongoing outpatient rehabilitation services. Recovery from brain injury depends on the areas of the brain that were injured and the extent of the injury [22] (Greenwald &, Rigg, 2009). Rehabilitation helps stimulate the brain to retrain other neurons to take the place of those that have died (Neurologic Rehabilitation Institute of Ontario, 2008) .Often a person must relearn physical skills as well as functional skills.…”

Section: Treatment Pathways For Abimentioning

confidence: 99%

“…The first step is to get an appropriate assessment by a qualified specialist, such as a Neuropsychologist or Psychiatrist. A person with an ABI and Psychiatric illness should have a care plan in place if being discharged from a hospital facility that outlines the supports and services to assist the person back in the community [22] (Greenwald &, Rigg, 2009).This is important for preventing relapse and re-admission into a psychiatric facility. Case Management should be provided to co-ordinate any mental health and ABI services the person is to be receiving.…”

Section: Treatments and Supports For Abi And Mental Illnessmentioning

confidence: 99%

A Contemplation on Rehabilitation Models for Adult Clients with Dual Diagnosis of Acquired Brain Injury and Mental Illness in Australia

Radhamony¹

2016

ujph

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Acquired Brain Injury (ABI) of different forms represents one of the major public health problems for the world. Numerous neuropsychiatric disorders are associated with brain Injury including depression, anxiety disorder, irritability and aggression and mania which makes the presentation of these patients complex. The dual diagnosis of ABI and mental illness is often missed making the management of these patients difficult. Review of literature, websites and case study examples are used to illustrate the implications on care needs and discharge planning of these patients post rehabilitation phase. Majority of the models reviewed in Australia have advanced approaches for rehabilitation of clients with brain injury but none of them other than the brain disorders programme in Victoria offers rehabilitation services to clients with dual diagnosis of acquired brain injury and mental illness. Despite of the evidence that ABI can often result in ongoing mental health problems, there are a few facilities that provide for this dual diagnosis and there is not even a single model of rehabilitation which can cater for the needs of these patients. Current and existing models offer alternative approaches that are particularly applicable to person with disabilities. These include the strength-based and empowerment approaches as well as case management and independent living models.

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Neurorehabilitation in traumatic brain injury: does it make a difference?

Cited by 26 publications

References 18 publications

A fight for life and dignity: A case of massive traumatic brain injury and the paths for treatment and neurorehabilitation

A fight for life and dignity: A case of massive traumatic brain injury and the paths for treatment and neurorehabilitation

Differences in the insulin tolerance test in patients with brain damage depending on posture

A Contemplation on Rehabilitation Models for Adult Clients with Dual Diagnosis of Acquired Brain Injury and Mental Illness in Australia

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