The Rehabilitation Process of Traumatic Brain Injuries

Introduction

Traumatic Brain Injury (TBI), also called intracranial injury or simply head injury, occurs when a sudden trauma causes brain damage. The trauma may result from a brain injury or closed head injury occurs from a penetrating head, and is one of the two types of acquired brain injury. The other subtype is the non-traumatic brain injury (e.g. stroke, meningitis, and anoxia); parts of the brain that can be damaged include the cerebral hemispheres, the cerebellum, and the spinal cord (High, pp. 228). Symptoms of a TBI can be mild, moderate, or severe, depending on the extension of the damage to the brain. The outcome can vary from complete recovery of all duties until the disability or the permanent death.

Discussion

Rehabilitation can be defined in various ways. The newest definition used is that of the World Health Organization (WHO): “Rehabilitation of people with disabilities is a process aimed at enabling them to reach and maintain their optimal physical, sensory, intellectual, psychological and social functional levels. Rehabilitation provides disabled people with the tools they need, to attain independence and self-determination” (Chestnut, pp. 333).

Neither this nor any other definition of rehabilitation further delimits and determines the content of the technology (brain injury rehabilitation), since the definitions do not describe in detail the services, methods and processes included in rehabilitation. The definition, however, outlines an objective in relation to achieving and maintaining functioning in a broad sense, and rehabilitation includes a process for attaining independence and self-determination. In this sense, the definition provides a broad framework for the content of this report, and the five analyses mentioned previously emphasize the report's broad starting-point in assessing brain injury rehabilitation.

WHO has created the International Classification of Functioning, Disability and Health (ICF) for assessing people's health status in relation to rehabilitation. The ICF is based on WHO's biopsychosocial model (ibid). The components of this model include functioning and contextual and personal factors. This conceptual framework together with other perspectives comprises the framework for assessing brain injury rehabilitation.

Rehabilitation Interventions

Multidisciplinary Rehabilitation of People with Acquired Brain Injury

Strong evidence indicates 1) moderate to great effects from hospital-based, specialized, multidisciplinary rehabilitation of everyone with a stroke; 2) that early discharge to continuing home-based multidisciplinary rehabilitation provided by a hospital-based multidisciplinary team improves the prognosis further for people with mild to moderate stroke; 3) that continuing outpatient multidisciplinary rehabilitation after discharge from hospital has a positive effect; and 4) that the best way for multidisciplinary rehabilitation to achieve positive results is to strive towards activity-based objectives that are determined jointly with the person with acquired brain injury and his or her relatives (High, pp. 228). The positive effects of multidisciplinary rehabilitation among people with stroke have not been demonstrated beyond the first year after the onset of disease.

For people with other types of moderate to severe acquired brain injury, strong evidence indicates that sub acute, intensive, hospital-based, multidisciplinary rehabilitation has positive effects, but the long-term effects have been inadequately investigated. Despite such ...