Balance and mobility problems in patients with Mild Traumatic Brain Injury MTBI

Reliability, validity, and responsiveness of the High–Level Mobility Assessment Tool (HiMAT) in Mild Traumatic Brain Injury MTBI was looked at in Physical Therapy, 05/08/2013. The research was conducted by

Kleffelgaard I et al from the Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Norway together with the Department of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Norway. The group concluded that the above measure is a reliable outcome measure for balance and mobility in Mild Traumatic Brain Injury MTBI.

 

Home therapy to improve arm and hand function after brain injury in New Zealand

Over 30,000 New Zealanders have a traumatic brain injury (TBI) each year. Added to this only 11 per cent of people with stroke receive any rehabilitation therapy after they leave hospital.

Because of this the Health Research council of New Zealand have awarded two grants to physical therapists from  The University of Auckland who will use technologies to treat and support brain injury patietns including stroke after discharge from in patient therapy. Firstly, Dr Kersten and her team will train people in the community who have had a TBI in the past to act as mentors or peer mentors for people with a recent moderate to severe TBI. Participation is considered a fundamental outcome of rehabilitation for people with TBI,” Dr Kersten says.

A second project lead by Dr Stinear will evaluate a new home-coach model of therapy for stroke survivors. In New Zealand, only 11 per cent of people with stroke receive any rehabilitation therapy after they leave hospital. This is despite research that shows rehabilitation therapy is capable of improving hand and arm function months or years after stroke. Dr James Stinear from The University of Auckland says “There are tens of thousands of people living with stroke in our community who have an untapped capacity to recover,” explains Dr Stinear and the objective of this study is to test and design a ‘home-therapy’ protocol.”

After a physiotherapist has assessed the therapy needs of a person with stroke a family member, carer, friend or other volunteer will act as a ‘home-coach’ to deliver daily therapy in the home.

Resting-State fMRI pinpoints changes in brain organization after TBI

Evidence from functional MRI findings show the traumatic effect on brain network function of traumatic brain injury (tbi). Writing in Neurology, 04/26/2013 Zhou Y et al. from New York University Langone Medical Center, New York.USA report that RS-fMRI shows a variety of changes in subjects after mild TBI that may be responsible for both physical deficits and behavioral symptoms following traumatic brain injury.

Telerehabilitation for addressing executive dysfunction after traumatic brain injury

Telerehabilitation allows for the delivery of cognitive training post traumatic brain injury. Writing in Brain Injury, 05/01/2013 Ng EMW et al. from Toronto Rehabilitation Institute, University Health Network , Toronto, ON look at the delivery of the Cognitive Orientation to daily Occupational Performance approach (CO-OP) in a telerehabilitation format. Using the Outcome measures included the Canadian Occupational Performance Measure, the Mayo-Portland Adaptability Inventory-4 Participation Index, and the Dysexecutive Questionnaire the group conclude that Telerehabilitation can be used for addressing executive dysfunction after traumatic brain injury and may help promote community integration of individuals living with TBI.

Patient functioning after traumatic brain injury

Laxe S et al. disucuss International Classification on Functioning in Brain Injury, 05/01/2013.

The group from Brain Injury Unit, Institut Guttmann-Universitat Autónoma de Barcelona Spain report on the use of 23 Brief Core Sets within the International Classification on Functioning, Disability and Health (ICF) as a basic international standard for the multidisciplinary assessment of a TBI patient’s functioning.

 

OT and PT therapeutic goals

The MediTouch system is a state of the art targeted rehabilitation system that hones in on specific therapeutic goals. Through the enjoyment and motivation of video game based rehabilitation which gives immediate feedback to the patient, the HandTutor, ArmTutor, LegTutor and 3DTutor address the challenge of impaired movement ability. The system is used in the clinic and at home and offers motivating customized exercise practice with OT and PT support.

The system benefits patients with movement dysfunction or impaired functional activity caused by neurological disorders, including traumatic brain injury (tbi), stroke, cerebral palsy, spinal cord injury, and multiple sclerosis. In addition the system is used for physical therapy after shoulder, elbow, hip and knee surgery.

Aggressive and comprehensive treatment of older adults following Traumatic brain injury are justified

Looking at Glasgow Outcome Scale scores , among older adults (>60 years) after a traumatic brain injury within one year post-TBI McIntyre A et al from Lawson Health Research Institute, St. Joseph’s Parkwood Hospital, London, ON, Canada discuss pooled data looking at favourable, unfavourable, and fatal outcomes in older tbi patients. They conclude that Aggressive and comprehensive treatment of older adults following Traumatic brain injury are justified.

 

Who benefits from residential intensive neurorehabilitation as opposed to community therapy in the UK

Answering this question Foy CML et al from the Rehabilitation Services, Brain Injury Centre, Banstead, Surrey, UK and Sutton Hospital, look at patient functional ability following rehabilitation at a mixed therapy and educational residential programme. The clients received 5 hours of education and/or physiotherapy and occupational therapy each day.

BothTBI and nonTBI made clinically and statistically significant improvements in their functional abilities during their neurorehabilitation and benefited from a mixed inpatient neurorehabilitation programme. The movement and functional improvements was predicted by the patients functional abilities at admission and the length of stay. Therefore preinjury and injury variables do give insight into functional recovery in traumatic brain injury (TBI) and non traumatic brain injury (nonTBI) patients.

Physical and occupational therapy guidelines for treatment of pediatric Traumatic brain injury (TBI)

The second edition of the Guidelines for the Medical Management of Traumatic Brain Injury in Infants, Children and Adolescents is updated from the first edition published in 2003. This 2012 edition edited by Bell MJ et al appears in Critical Care Clinics, 04/09/2013. The team work at the Department of Critical Care Medicine, Safar Center for Resuscitation Research, University of Pittsburgh, Department of Neurological Surgery, Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA.

 

Quantifying balance and mobility problems after traumatic brain injury (TBI).

Physical therapists from the Department of Physical Medicine and Rehabilitation and department of physiotherapy, Oslo University Hospital Norway, look at measuring the outcome of balance and mobility in patients with mild traumatic brain injury. Dr. Kleffelgaard I et al. show that the High–Level Mobility Assessment Tool (HiMAT) equates to patient considered balance ability in both severe and mild TBI patients. The report was published in Physical Therapy, 04/05/2013.