Rehabilitation of Persons With Traumatic Brain Injury

Ragnarsson, Kristjan T.; Clarke, William R.; Daling, Janet R.; Garber, Susan L.; Gustafson, Carl; Holland, A; Jordan, Barry; Parker, Jerry C.; Riddle, M. A.; Roth, Elliot J.; Seltzer, Marsha Mailick; Simpson, Kit N.; Therrien, Barbara; Wexler, Bruce E.; Yawn, Barbara P.; Banja, John D.; Cardenas, D D; Chesnut, Randall M.; Cope, D. Nathan; Corrigan, John; DeJong, Gerben; Greenough, William T.; Heinemann, Allen W.; Johnston, Mark V.; Kraus, Jess F.; Kreutzer, Jeffrey S.; Levin, H. S.; McIntosh, Tracy K.; Ottenbacher, Kenneth J.; Povlishock, J. T.; Prigatano, George P.; Rankin, Theresa; Rosenthal, Mitchell; Ruff, Ronald M.; Stuss, Donald T.; Thurman, David J.; Whyte, John; Ylvisaker, Mark; Alexander, D.; Ansel, Beth M.; Cheung, Gordon; Cheung, Mary Ellen; Coopey, M.; Elliott, John; Ferguson, Jamie; Fuhrer, Marcus J.; Hall, William H.; Henderson, Christopher E.; Heppel, David; Krotoski, D.; Lawrence, Tania; Lehmkuhl, Don; Salazar, Andres M.; Sherman, C. R.; Sigmon, H. D.; Tuel, Stephen M.; Vitiello, Benedetto; Whalen, Jim; Zitnay, George; Batley, J F Jr; Hyman, Susan; Fischbach, G D; Grady, Patricia; Wb, Jonas; Pinn, V. W.; Eisenberg, J. M.; Koplan, Jeffrey P.

doi:10.1001/jama.282.10.974

Cited by 611 publications

(18 citation statements)

References 190 publications

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“…A consensus conference sponsored by the National Institutes of Health in 1999 determined that further research was necessary to identify specific factors affecting long-term functional outcomes in people with TBI [4]. Identification of factors predictive of improvement could have important implications for intervention development, cost projection, allocation of funding for TBI treatment, and family counselling.…”

Section: Traumatic Brain Injury (Tbi)mentioning

confidence: 99%

Changes in cognition and continence as predictors of rehabilitation outcomes in individuals with severe traumatic brain injury

Kushner¹,

Johnson-Greene²

2014

J Rehabil Res Dev

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Abstract-The study objective was to examine postacute changes in bowel and bladder continence and cognition after severe traumatic brain injury (TBI) in persons with long-term functional recovery to full independence. This case series included nine patients initially admitted to inpatient rehabilitation (IR) with severe TBI who had returned to prior responsibilities and functional independence by 8 to 15 mo. Patients had initial Glasgow Coma Scale scores of 3 to 6, posttraumatic amnesia durations of 18 to 70 d, time-to-follow-commands of 16 to 56 d, initial abnormal brain computed tomography scans, and initial pupil abnormalities. IR Functional Independence Measure (FIM) cognitive and sphincter score improvements were compared with national TBI FIM data from Uniform Data Systems for Medical Rehabilitation (UDSMR) for 2010 (n = 16,368). All patients had IR improvements in cognitive and sphincter FIM scores approximately twice the national UDSMR data for 2010. All patients had combined IR discharge sphincter FIM scores that were 12 or greater, indicating independence to modified independence with bowel and bladder function with no incontinence. Five participants (55%) were admitted to IR with sphincter FIM scores of 11 to 12, indicating recovery of continence during acute care. These findings suggest potential usefulness of IR cognitive FIM score changes and of the recovery of bowel and bladder continence for predicting favorable functional outcomes following severe TBI.

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Section: Traumatic Brain Injury (Tbi)mentioning

confidence: 99%

Changes in cognition and continence as predictors of rehabilitation outcomes in individuals with severe traumatic brain injury

Kushner¹,

Johnson-Greene²

2014

J Rehabil Res Dev

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“…Even if they were correct, of course, it would not be the whole story; rough calculations based on the figures given in the statement suggest that approximately 50% of PVS patients have been in that state for less than six months, 70% for less than a year [13]. Thus, on that assumption, the number of long-term PVS patients would be somewhere between 3,500 and 10,000 [15,16]. …”

Section: Introductionmentioning

confidence: 99%

“…The 1994 American Multi-Society Task Force estimated the PVS patient in a nursing facility as costing from USD 126,000 to 180,000 per year; a rough approximation of the total annual costs in the United States for the care of all adults and children in a PVS is USD 1-7 billion [15,16]. It has been estimated the average lifetime cost of care for a person in VS ranges from USD 600,000 to 1,875,000 [15,16].…”

Section: Introductionmentioning

confidence: 99%

“…It has been estimated the average lifetime cost of care for a person in VS ranges from USD 600,000 to 1,875,000 [15,16]. These figures may grossly underestimate the economic burden to family and society because they do not include lost earnings, costs to social service systems, and the value of the time and foregone earnings of family members who care for persons in PVS [17].…”

Section: Introductionmentioning

confidence: 99%

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Neuromodulation of Vegetative State through Spinal Cord Stimulation: Where Are We Now and Where Are We Going?

Pepa

Fukaya

Rocca

et al. 2013

Stereotact Funct Neurosurg

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Background: Vegetative state (VS) is a complex condition that represents a challenging frontier for medicine and neuroscience research. Nowadays there is no scientifically validated treatment for VS patients, and their chronic long-term assistance is very demanding for healthcare systems worldwide. Objectives: The present paper is a systematic review of the role of spinal cord stimulation (SCS) as a treatment of patients with VS. Methods: Published literature on this topic was analyzed systematically. Clinical and epidemiological characteristics of VS, present therapeutic options and social costs of VS were also evaluated. Results: Only 10 papers have been published since 1988, and overall 308 VS patients have been treated with SCS worldwide; 51.6% displayed a clinical improvement and an amelioration of the environmental interaction. These effects are probably mediated by the stimulation of the reticular formation-thalamus-cortex pathway and by cerebral blood flow augmentation induced by SCS. Conclusions: The experience on this topic is still very limited, and on this basis it is still hard to make any rigorous assessment. However, the most recent experiments represent significant progress in the research on this topic and display SCS as a possible therapeutic tool in the treatment of VS.

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“…In response to this need, the experimental Familiar Auditory Sensory Training (FAST) protocol was developed for examination in a double-blind randomized clinical trial (RCT). We chose to develop a sensory stimulation treatment protocol because, despite the scarcity of evidence regarding therapeutic efficacy, sensory stimulation is customarily provided to patients in states of seriously impaired consciousness [8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery

Pape¹,

Rosenow²,

Harton³

et al. 2012

JRRD

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Abstract-Since there remains a need to examine the nature of the neural effect and therapeutic efficacy/effectiveness of sensory stimulation provided to persons in states of seriously impaired consciousness, a passive sensory stimulation intervention, referred to as the Familiar Auditory Sensory Training (FAST) protocol, was developed for examination in an ongoing, double-blind, randomized clinical trial (RCT). The FAST protocol is described in this article according to the preliminary framework, which is a synthesis of knowledge regarding principles of plasticity and capabilities of the human brain to automatically and covertly process sensory input. Feasibility issues considered during the development of the intervention are also described. To enable replication of this intervention, we describe procedures to create the intervention and lessons learned regarding the creation process. The potential effect of the intervention is illustrated using functional brain imaging of nondisabled subjects. This illustration also demonstrates the relevance of the rationale for designing the FAST protocol. To put the intervention within the context of the scientific development process, the article culminates with a description of the study design for the ongoing RCT examining the efficacy of the FAST protocol.

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Rehabilitation of Persons With Traumatic Brain Injury

Cited by 611 publications

References 190 publications

Changes in cognition and continence as predictors of rehabilitation outcomes in individuals with severe traumatic brain injury

Changes in cognition and continence as predictors of rehabilitation outcomes in individuals with severe traumatic brain injury

Neuromodulation of Vegetative State through Spinal Cord Stimulation: Where Are We Now and Where Are We Going?

Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery

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