Traumatic brain disease has a phase character: 3 days – the most acute phase; 3 weeks – acute phase; after 3 weeks – intermediate period. The most optimal start of rehabilitation is 1 month from the moment of injury.
- What recovery methods are the most effective?
- How to adapt to life with limited functional abilities?
- How to restore the lost functions as much as possible?
Rehabilitation after a traumatic brain injury not only prolongs life, but also significantly improves its quality!
1. In numbers
- 50,000 people in Russia annually receive brain injury of varying degrees.
- Young people are more likely to become victims of traumatic brain disease.
- The probability of returning to an active life increases many times if a person recovers under the supervision of specialists from a rehabilitation center and follows clinical recommendations for concussion.
2. The most common disorders after brain injury
- Violation of motor functions – coordination, balance, gait, hand function.
- Sensory disturbances – taste, touch, hearing, sight, touch.
- Sleep disturbance – insomnia, fatigue, low energy levels.
- Medical complications – spasticity, post-traumatic epilepsy, soft tissue ossification, hydrocephalus.
- Cognitive disorders – disorders of memory, speech, attention, learning ability, impaired thinking.
- Changes in personality and behavior – apathy, irritability, aggression, lack of motivation.
Cognitive deficits, personality changes and behavioral disorders are more pronounced than physical incapacity.
3. Methods of rehabilitation after a head injury, recognized worldwide
For cognitive disorders:
- Neuropsychological correction (training of memory, attention, pragmatics, emotional control).
- Medical therapy.
- Lessons with a speech therapist.
- Psychotherapy (music therapy, group, Gestalt therapy, behavioral, feedback).
For movement disorders:
- Stabilometry (coordination, balance).
- PNF therapy.
- Aquatherapy.
For somatic disorders:
- Medical therapy.
- Physiotherapy (magnetotherapy, transcranial therapy).
- Diets.
- Protective mode (anti-decubitus mattress, nursing care).
- Family counseling.
The sooner rehabilitation begins, the higher its effectiveness!
4. Time periods in the recovery process after TBI
Traumatic brain disease has a phase character: 3 days – the most acute phase; 3 weeks – acute phase; after 3 weeks – intermediate period. The most optimal start of rehabilitation treatment is 1 month from the moment of injury. The next 1.5–2 years after discharge from the hospital is the most effective period for recovery. Subsequently, the progress of maximum recovery is less active.
5. Financial costs
$1 for rehabilitation today or $17 for life support tomorrow?
These are the official statistics on investing in recovery from traumatic brain injury. Investing in early rehabilitation saves significant funds that will have to be invested in the future due to developing incapacity and functional limitations (buying a wheelchair, babysitting services, etc.).
6. Family support
The support of relatives and friends plays an important role in the restoration of a person.
That is why relatives are encouraged to know as much as possible about the features of the post-traumatic state and to master the skills of caring for the patient. For his speedy recovery, it is extremely important to create a comfortable atmosphere.
7. How long should rehabilitation last?
Ideally, for maximum progress in recovery, acute rehabilitation treatment should coincide with the healing and reorganization of the nervous tissue of the brain – this is the early post-hospital period. The presence of functional progress, its speed is the best indicator for rehabilitation. The functional “plateau” can come at any time. 3 months – active rehabilitation, the first 1-2 years – maximum rehabilitation, in the next 3 years the process is more passive.
8. Multidisciplinary approach
A multidisciplinary approach is the best method of rehabilitation, recognized all over the world, and includes motor rehabilitation, adaptive-everyday and psycho-emotional (speech, cognitive).
The rehabilitation process is provided by a team of specialists, which includes:
- doctor-surgical assistant, his main task is the treatment of present and prevention of future complications inherent in the disease, drug therapy;
- a physical therapist is responsible for the restoration of motor functions and selects individual methods depending on the patient’s condition (PNF, Bobath, exarta, kinesthetics, pool exercises, etc.);
- occupational therapist restores the social component of life (dressing, personal hygiene, cooking, hobbies);
- speech therapist – functions of speech and swallowing;
- neuropsychologist – fight against depression, apathy, memory recovery;
- the nurse monitors the timely intake of medicines, physiotherapy, accompaniment, care.
9. How to measure the quality of rehabilitation?
The world community of rehabilitation specialists has defined the FIM indicator (TheFunctionalIndependenceMeasure) as the most appropriate scale that makes it possible to digitize the functional capabilities of a person. Makes it possible to measure the rehabilitation service, its progress and payment by insurance companies.
FIM includes indicators that characterize self-care skills (dressing, washing, using a comb, etc.), motor characteristics (walking, balance, walking up stairs, etc.) and cognitive indicators (memory, speech, communication, etc.). In general, FIM consists of 18 main sections – functions, organized on a scale from 1 to 7 points, where 1 is absolute dependence, and 7 points are complete independence. The use of a highly standardized international scale makes it possible to predict the course of the disease with sufficient accuracy and evaluate the effectiveness of treatment and rehabilitation therapy. FIM assessment is carried out at the time of admission of the patient and at the time of discharge. An indicator of the quality of rehabilitation is the change in FIM per day. In the best rehabilitation centers in the United States, this figure is 1.5, i.e. FIM increments by 1,
10. The need for rehabilitation and an example of positive coping
Serious traumatic brain injuries often cut a person’s life into “before” and “after”, the psychological state of patients is accompanied by depression, apathy, and emotional disorders. The person seems to be doomed. However, entrusting the recovery process to the surgical technologists of the rehabilitation center, in addition to professional medical care, he receives the support of people who find themselves in a similar situation. There is nothing more encouraging than seeing another person’s positive experience of coping with trauma that provides hope and encourages action.
The lack of rehabilitation under the supervision of specialists pushes patients and their relatives onto the path of self-treatment, which leads to inevitable complications, a decrease in the quality of life, and subsequently may even lead to death (hydrocephalus, deep venous thrombosis, neuroendocrine disorders).
