Community Reintegration Following Acquired Brain Injury
30/11/09 20:45 Filed in: Module#13
Community reintegration is the ultimate goal of brain injury rehabilitation. However, the evidence supporting many widely held beliefs about outcomes in this domain is limited. The evaluation of clinical work in this domain may not lend itself well to the rigors of a randomized controlled trial, as the situations, circumstances, deficits, and supports are as complex and varied as the individuals themselves.
DownloadPaediatric Interventions in Acquired Brain Injury Rehabilitation
29/11/09 20:45 Filed in: Module#14
The nervous system is in a dynamic state of development throughout childhood, thus treating a child with a brain injury is distinctly unique from treating an adult. Brain injury in children may disrupt established functions, as well as functions that are in the process of developing or those that have yet to emerge. With respect to general functioning, most children less than seven years of age have not achieved independence in their activities of daily living. Baseline functions are therefore variable and constantly changing. Children are growing between 5 – 8cm per year, learning to control basic impulses, and rapidly acquiring information within their school programme. A brain injury interrupts this complex pattern of growth and development, leading to increased variability in baseline skills, the need for age/stage appropriate testing and rehabilitation programming, as well as longitudinal follow-up to address the increasing gap between the skills of the child and age appropriate peers. Unlike the stroke population, children and adolescents comprise a significant portion of the traumatic brain injury population [Crowley & Miles, 1991]. It has been suggested that young children are particularly vulnerable to brain injury as many skills are in the developmental stages [Didus et al. 1999]. Furthermore, the notion that rehabilitation following brain injury does not simply expedite recovery, but helps to improve functional outcomes beyond that expected from spontaneous recovery has been posed [Greenspan and MacKenzie 2000].
DownloadFatigue and Sleep Disorders Post Acquired Brain Injury
28/11/09 20:45 Filed in: Module#15
Fatigue has been and remains one of the more common symptoms associated with and reported on by those who have sustained a brain injury [Elovic et al. 2005]. Over the years, researchers, physicians and psychologists have all tried to define fatigue: What is it? How do we measure it? How do we treat it? It is believed that fatigue is a subjective experience and thus not easily assessed by objective measures [Lewis and Wessely 1992]. It is also believed that because fatigue is common with all who sustain a brain injury, it is therefore not related to damage within a specific area of the brain [Lezak 1978].
DownloadAcute Interventions for Acquired Brain Injury
27/11/09 20:45 Filed in: Module#16
During the initial stages of a brain injury, there are variable degrees of irreversible damage to the central nervous system commonly known as the primary injury. Subsequently, a chain of events is put into motion leading to ongoing injury to the brain caused by edema, hypoxia, and ischemia which occurs as a result of increased ICP, the release of toxic amounts of excitatory neurotransmitters like glutamate, and impaired ionic homeostasis. Acute brain injury treatment therefore focuses on preventing or minimizing the extent of secondary injury by targeting intracranial hypertension, oxygenation and ion homeostasis in order to reduce cellular injury.
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