NeuroRehabilitation - Volume 11, issue 2

Authors: Zasler, Nathan D. | Leon-Carrion, Jose

Article Type: Introduction

DOI: 10.3233/NRE-1998-11201

Citation: NeuroRehabilitation, vol. 11, no. 2, pp. 75-76, 1998

Authors: Jennett, Bryan

Article Type: Research Article

Abstract: Successive wars in Europe and the Far East have taught neurosurgeons the importance of early wound debridement after open head injury to minimise infection even since the availability of antibiotics. Recognition of the importance of secondary brain damage due to systemic hypoxia and hypotension and raised intracranial pressure was the first major post-war development, leading to intensive medical treatment of patients in coma. The Glasgow Coma and Outcome Scales facilitated multi-centre data collection to study the effectiveness of such treatment. In the mid-1970s CT scanning led to earlier detection and treatment of acute intracranial haematomas, with improved outcomes. Pharmacological agents …to prevent or control secondary pathological processes in the brain have so far proved disappointing. Epidemiological studies indicate different causes for mild and severe injuries and indicate how to target preventive measures. Severe head injuries due to road accidents are now less common in developed countries due to legislation to reduce accidents and to protect the brain in accidents. Co-ordinated rehabilitation is an important recent development in improving outcome after severe head injury. Show more

DOI: 10.3233/NRE-1998-11202

Citation: NeuroRehabilitation, vol. 11, no. 2, pp. 77-84, 1998

Authors: DePompei, Roberta | Epps, Adrienne | Savage, Ronald | Blosser, Jean | Castelli, Enrico

Article Type: Research Article

Abstract: When youth with brain injury enter the education system, educators, health care providers and family members are challenged to design and provide school programs that will help these youngsters achieve their greatest potential. Several global issues emerged from the presentations on pediatric educational needs and they form the framework of this article. The key themes presented include: uniformity of data collection regarding injury and outcome, specificity of collaborative approaches, sensitivity to developmental issues and creativity in program design. This article offers specific examples of effective programming and concrete recommendations for implementation. More importantly, it offers hope for the future.

Keywords: Pediatric acquired brain injury, Special education, Educational programming for youth with TBI, Global perspective of educational needs

DOI: 10.3233/NRE-1998-11203

Citation: NeuroRehabilitation, vol. 11, no. 2, pp. 85-100, 1998

Authors: Niemann, George W. | Seaton, J. David | León-Carrión, José | Booth, Victor A. | Perino, Claudio

Article Type: Research Article

Abstract: Several efforts have been made to create national standards for the training and certification of brain injury rehabilitation specialists in post-acute settings in the United States, culminating most recently in the formation of an academy that has developed a basic training curriculum and national certification standards. Despite similar efforts to develop certification standards on an international level, progress has been slower for several reasons. The status of interdisciplinary training in the US and several European countries over the past decade is briefly reviewed. Progress made to date in the US is contrasted to what has been done in Europe. Due …to the vast differences between the American and European models of service delivery, more survey data needs to be collected at the international level to guide planning and determine what needs to be done to advance training in the field of brain injury rehabilitation. The method in which the international academy will proceed with further study of this important issue is described. Show more

Keywords: Certification, Brain injury rehabilitation, Training standards

DOI: 10.3233/NRE-1998-11204

Citation: NeuroRehabilitation, vol. 11, no. 2, pp. 101-106, 1998

Authors: Voogt, Robert D. | Teasdale, Thomas W. | Patrick, Peter D. | Carman, Judith

Article Type: Research Article

Abstract: When establishing a community or family setting where individuals with traumatic brain injury can live, the setting must be sensitive to the individual’s specific needs, as well as basic human needs. All individuals are in need of loving relationships, meaningful work activities, and the ability to enjoy themselves. They also want access to community events, and to be a part of a respectful environment that stimulates growth. Often, return to the family has resulted in disruption, return to work has been the exception, and relationships are forever altered. Reintegration must take place where needs can be met; where individuals are …not simply cared for, but where they enjoy the same opportunities as those who are not disabled. The authors of this article each presented at The Second World Conference on Brain Injury, in Seville, Spain. In this article, they look at the impediments to reintegration and possibilities for creating a rehabilitation environment that values life and allows for reintegration into the community and a return to work and family. Show more

Keywords: Traumatic brain injury, Reintegration, Family, Work, Community

DOI: 10.3233/NRE-1998-11205

Citation: NeuroRehabilitation, vol. 11, no. 2, pp. 107-117, 1998

Authors: Léon-Jimenez, Fernando

Article Type: Research Article

Abstract: Ethical and legal aspects have to be considered in traumatic brain injury (TBI) because they will be a determining factor in the possibility of patient recovery and his/her new life style. Ethically, TBI rehabilitation has to be directed by true specialists in the field of brain injury. This rehabilitation has to be interdisciplinary and the goal must be that of insuring that the patient enjoys quality of life. Rules for the conduct of professionals in the field of brain injury and attorneys alike need to be established.

Keywords: Brain injury, Trial lawyer, Plaintiff’s medical experts, Life care planning, Insurance company, Neuropsychology

DOI: 10.3233/NRE-1998-11206

Citation: NeuroRehabilitation, vol. 11, no. 2, pp. 119-127, 1998

Authors: León-Carrión, José

Article Type: Research Article

Abstract: This article introduces version 0.1 of the Neurologically-Related Changes in Personality Inventory (NECHAPI), an instrument designed as a tool to assess personality factors in neurological patients and to register changes observed in patients after a neurological condition has appeared or following treatment of the same. The NECHAPI consists of 40 statements, easily rated by close family and friends of patients with neurological problems. A total of 135 normal subjects and 32 patients with neurological damage were evaluated. Reliability analysis showed an α = 0.7 for the entire inventory. Factor analysis showed five factors accounting for 45.5% of …the variance: anger, sensation seeking, emotional vulnerability, sociability, and motivation. Show more

Keywords: Neurological disorders, Brain injury, Neuropsychological assessment, Personality inventory, Psychotherapy, Drug therapy

DOI: 10.3233/NRE-1998-11207

Citation: NeuroRehabilitation, vol. 11, no. 2, pp. 129-139, 1998

Authors: Mathiowetz, Virgil | Matuska, Kathleen M.

Article Type: Research Article

Abstract: Objectives: This study examined: the self-care outcomes of a 1-week rehabilitation program for individuals with multiple sclerosis; the frequency of use and effectiveness of adapted equipment prescribed; and the satisfaction with occupational therapy services. Study Design: Self-care abilities of 30 adults with multiple sclerosis were evaluated on admission, at discharge, and 6-weeks post-discharge. Changes in self-care scores were analyzed using one-way ANOVAs of repeated measures. Results: Tub/shower transfers, toileting, feeding, grooming, upper body dressing, and lower body dressing scores improved significantly between admission and discharge. In addition, they continued to improve significantly between discharge and 6-weeks …post-discharge except for feeding. Of the adapted equipment prescribed by the occupational therapists 85% was used and 94% of the equipment used was described as effective. Finally, 100% of the participants were satisfied with occupational therapy services provided. Conclusion: A 1-week inpatient rehabilitation program significantly improved the self-care abilities of participants with multiple sclerosis. Show more

Keywords: Activities of daily living, Functional outcomes, Adapted equipment, Functional assessment

DOI: 10.3233/NRE-1998-11208

Citation: NeuroRehabilitation, vol. 11, no. 2, pp. 141-151, 1998