Traumatic Brain Injury: A Review of Practice Management and Recent Advances

Department of Physical Medicine and Rehabilitation, University of Missouri-Columbia, DC046.00, One Hospital Drive, Columbia, MO 65212, USA.
Physical Medicine and Rehabilitation Clinics of North America (Impact Factor: 0.93). 12/2007; 18(4):681-710, vi. DOI: 10.1016/j.pmr.2007.06.005
Source: PubMed


This review of traumatic brain injury encompasses its impact on society, pathophysiology, and rehabilitative management. Topics include mild traumatic brain injury, outcomes, prognosis, cognitive rehabilitation, behavioral management, and neurologic and medical complications. Emphasis is placed on clinically relevant topics that have had recent developments or have been historically difficult to treat. Neurologic complications discussed include seizure, balance, visual dysfunction, and spasticity. Medical complications discussed include neuroendocrine and pain issues.

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    • "Approximately 7.8 million persons live in Europe with some level of disability caused by TBI [1] [2]. Impairment, activity limitations and participation restrictions are ubiquitous and very important consequences of moderate and severe TBI [3] [4] [5]. "
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    ABSTRACT: To identify the most frequently used outcome measurement instruments reported in clinical studies on TBI and to provide a content comparison in the framework of the International Classification of Functioning, Disability and Health (ICF). A systematic literature review of clinical studies in TBI was performed using Medline, EMBASE and PsychINFO. The items of the measurement instruments present in more than 20% of the studies were linked to the ICF language. 193 papers fulfilled the eligibility criteria. The frequency analysis identified six instruments: Functional Independence Measure (50%), Glasgow Outcome Scale (34%), Disability Rating Scale (32%), Wechsler Adult Intelligence Scale (29%), Trail Making Test (26%) and Community Integration Questionnaire (22%). The analysed instruments focus on different aspects of body functions (especially DRS, WAIS and TMT) and aspects of activities and participation in life (especially CIQ and FIM). Inter-researcher agreement for the ICF linking process was 0.83. Translating the items of different measurement instruments into the ICF language provides a practical tool to facilitate content comparisons among different outcome measures. The comparison can assist clinical researchers to integrate information acquired from different studies and different tools.
    Clinical neurology and neurosurgery 01/2012; 114(6):645-50. DOI:10.1016/j.clineuro.2011.12.038 · 1.13 Impact Factor
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    • "Research should be strongly supported with a focus on rehabilitation programmes assessment, assessment of long-term community reintegration and outcomes in terms of activity and participation, as well as long-term outcome into adulthood, using specific and sensitive ecological outcome measures (Crooks et al. 2007; Engberg 2007). "
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    ABSTRACT: Acquired brain injury (ABI) is a leading cause of death and lifelong acquired disability in children and remains a significant public health issue. Deficits may only become fully apparent when developmental demands increase and once cognitive processes are expected to be fully developed. It is therefore necessary to provide organized long-term follow-up for children post ABI. Despite these recommendations, it has been shown that only a small proportion of children received specialized rehabilitation and adequate follow-up after ABI. The aims are: (i) to describe a comprehensive model of care devoted to children with acquired brain injuries; and (ii) to provide descriptive data analysing the characteristics of children followed up, the type/amount of services provided and general outcomes. PROGRAMME DESCRIPTION: The programme features an in- and outpatient rehabilitation facility, where multidisciplinary rehabilitation and specialized schooling are provided. The ultimate goal of the programme is to promote each child's successful reintegration in school and in the community. Adequate preparation of discharge is essential, long-term follow-up is organized, and an outreach programme has been developed to deal with the complex delayed psychosocial issues. Overall outcome, as measured by the Glasgow Outcome Scale, improved dramatically between admission (3.3; SD = 0.45) and discharge (2.15; SD = 0.74). Most of the children were discharged home with an adequate personalized plan for ongoing rehabilitation and school adaptations. Analysis of the outreach programme underlines the more challenging issues arising in late adolescence-early adulthood. Given the specificities of childhood ABI, long-term specific care must be organized and co-ordinated, regardless of injury severity.
    Child Care Health and Development 06/2009; 36(1):31-43. DOI:10.1111/j.1365-2214.2009.00949.x · 1.69 Impact Factor
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    • "Individuals TBI can experience a myriad of symptoms which include, but are not limited to: headaches, dizziness (vertigo), poor balance, forgetfulness, slowed thinking, impaired concentration, decreased executive function, fatigue, forgetfulness, irritability, visual impairment, or sensitivity to light or noise, any of which can adversely affect the ability to drive (Crooks et al., 2007; Heegaard & Biros, 2007). "
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    ABSTRACT: Research has shown that traumatic brain injury (TBI) is a common condition that affects numerous individuals within the United States. Driving is a coveted occupation that gives identity and independence to many. Determining an individual's capacity to drive is crucial to the rehabilitative process for an individual after a traumatic brain injury. Unfortunately, there is not a standard method for determining fitness to drive and it is left to the evaluator’s discretion. Therapists may use assessments that have been commonly used but do not yield the appropriate information for accurate assessment. This project reviewed the standardized assessments and recommendations geared to evaluate driving capabilities for this particular population with the goal of developing a comprehensive, evidence-based driving evaluation program for individuals with traumatic brain injuries. By having a program that allows for a trained professional (DRS) to determine a person's fitness to drive, the burden is taken off loved ones and physicians.
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