Traumatic Brain Injuries

TBI

• The brain is altered functionally or there is other evidence an external force has caused pathology.

Mechanism of Injury

• Contact directly with an object to skull possibly penetrating. There may be a rapid acceleration/deceleration force and a TBI may occur from blast waves from an explosion.

3 Classifications of TBI

• Open head Injury-Penetration of the skull has occurred, meninges exposure exposes brain.
• Closed Head Injury-There is no skull fracture. Brain tissue becomes forcefully in contact with the skull.Examples are hemorrhages (coup-same side or contrecoup-opposite side)
• Acquired-Obstruction of airway, Near drowning experience, Exposure to toxins or Electric shock

Primary Impairments

• Neuromuscular (ie dysautonomia, paresis, motor function, abnormal muscle tone and postural control)
• Cognitive (i.e. arousal, focus, memory, learning ability, executive functioning).
• Neurobehavioral (i.e. disinhibition, apathy, agitation or aggression, emotional lability, impulsiveness.
• Communication (i.e. disinhibited (socially inappropriate, retrieval of words)).
• Seizures are also impairments with TBI.

Secondary Impairments Complications

• Secondary Impairments: Pressure ulcer,DVT,Heterotropic ossificans,pneumonia,chronic pain, decreased endurance,contractures, muscle atrophy,fractures,peripheral nerve damage,vestibular problems,visual disturbances.
• Medical Complications:Gastrointestinal problems,genititourinary problems, respiratory problems,dermatological problems and cardiovascular problems.

The Role of the Caregiver

• A patient who has experienced a TBI may experience many different impairments.
• The caregiver has an important role in the care of a loved one who has experienced a TBI.

The Role of the Caregiver

• The caregiver of a loved one who has experienced a TBI can offer support, encouragement, and guidance.
• The caregiver plays an important role in the treatment plan.
• There are many services available for a caregiver including in home assistance, support groups, and short-term counseling.
• Having a consistent schedule planned for your family member will be beneficial.
• Post-it notes, lists, and cue cards are a great way to help your family member once they return home.

The Role of the Caregiver

• The caregiver may feel very overwhelmed or exhausted from their responsibilities.
• It is important for the person caring for a loved one who has experienced a TBI to remember to take care of themselves during the process.

Treatment Interventions Video To Link Below TBI and shoulder amputation From Case Study 7 Chapter 19 & 22-O'Sullivan 7e TBI and shoulder amputation From Case Study 7 Chapter 19 & 22

Traumatic Brain Injury:Gait Training
Summary: The sample of the study was 102 individuals with TBI. This study suggested that there are not always consistent abnormal gait patterns in persons who have experienced a TBI. From computer analysis the article mentioned that the most common gait abnormalities are related to trunk and pelvic movement as well as excessive knee flexion when the foot is at initial contact. The article did use computerized 3D gait analysis when available as well as other techniques. The article noted that the majority of patients with severe TBI were able to successfully recover independent ambulation within 3 months post injury. Lastly the study mentioned that after conducting a five year follow up with the patients; greatest gains were achieved within the first year, however notable gains were made in patients two years after the injury.

References

• Palmer, E. (2014). Traumatic Brain Injury:Gait Training (S. Richman, Ed.). Retrieved October 10, 2015, from http://web.b.ebscohost.com.libproxy.ws.edu/rrc/detail?sid=29cb8919-84d5-46e...
• Power Point slides Via Nancy Clark "Traumatic Brain Injuries TBI"
• Sullivan, S., & Schmitz, T. (2014). Physical rehabilitation (6th ed.). Philadelphia: F.A. Davis. Chapter 19 http://davisplus.fadavis.com/ProductDetail/ProductDetail?urls=physical-ther...
• (n.d.). Welcome to the Brain Injury Association of America. Brain Injury Family and Caregivers - BIAA. Retrieved from http://www.biausa.org/brain-injury-family-caregivers.htm
• (n.d.). VA Caregiver Support Home. Retrieved from http://www.caregiver.va.gov/pdfs/FamilyCaregiversGuideToTBI.pdf
• (n.d.). Family Caregiver Alliance. Traumatic Brain Injury | Family Caregiver Alliance. Retrieved from http://caregiver.org/traumatic-brain-injury
• (n.d.). Traumatic Brain Injury - TBI & Head Injury Resource | BrainLine.org. Caregiving & Brain Injury - Brain Injury Resource | BrainLine.org. Retrieved from http://www.brainline.org/landing_pages/categories/caregiving.html