Tag: uraz czaszkowo-mózgowy

Differences of opinion between patients aroused from prolonged coma and their caregivers in respect to the feeling of quality of life

Anna Pufal

Anna Pufal – Differences of opinion between patients aroused from prolonged coma and their caregivers in respect to the feeling of quality of life. Fizjoterapia Polska 2004; 4(3); 209-217

Abstract

Background. In recent years the problem of quality of life (QOL) has become increasingly important, especially in rehabilitation. In the case of patients aroused from prolonged coma, this issue is all the harder to resolve, because many patients experience a major change of life perspective, personality, etc. after their brain injury. This often leads to conflict between patients and their caregivers, caused by differences of opinion regarding QOL. The purpose of the present study was to evaluate these differences. Material and methods. The research involved 30 patients treated in 2002-03 in the Rehabilitation Clinic at the Rydygier Academy of Medicine in Bydgoszcz, Poland after brain and brainstem injury accompanied by coma, and their caregivers. Clinical interviews and the Pachalska-MacQueen QOL Scale were used. Differences in the scores obtained by patients and their caregivers were analyzed statistically. Results. The strongest correlation was found between the opinions of patients and caregivers in respect to the more physical parameters on the scale. There was no correlation in respect to psycho-social functions. The exception to this general rule was locomotion, a physical function that produced significant differences of opinion.Conclusions. Differences were found in the evaluation of QOL between patients and their caregivers in respect to some parameters, though not all. These differences of opinion often lead to conflict and disturbed family functioning. Training and therapy is necessary in this respect, for both patients aroused from prolonged coma and their caregivers.

Key words:
traumatic brain injury, brainstem, psychosocial disturbances
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Circadian rhythms of blood pressure variability in ill people after cranio-brain trauma

Paulina Wyrzykowska, Jan Talar, Maria Wyrzykowska

Paulina Wyrzykowska, Jan Talar, Maria Wyrzykowska – Circadian rhythms of blood pressure variability in ill people after cranio-brain trauma. Fizjoterapia Polska 2006; 6(1); 32-36

Abstract

Βackground. The aim of this paper was to evaluate 24-hour changes in arterial blood pressure in patients after craniocerebral injuries hospitalized in Rehabilitation Clinic in Bydgoszcz. Material and methods. The investigation involved 30 patients after craniocerebral injuries with brain stem damages hospitalized in Rehabilitation Clinic in Bydgoszcz between August 2003 and April 2004. The 24-hour monitoring of arterial blood pressure was performed with Mobil-O-Graph equipment supplied by I. E. M. GmbH Deutshland Margot Medical Polska. The measurment was noninvasive and based on oscillometric method. Results. Twenty-four hour variablity of arterial blood pressure in patients after craniocerebral injuries was demonstrated. Morning increase was obserwed in 22 of 30 patients. Nocturnal decrease in comparison to day (up to 15% changeability was considered as normal) was observed in 3 patients. Arterial pressure load in people after injuries increased significantly during the night. Conclusions. In examined patients after craniocerebral injuries 24-hour changeability of arterial blood pressure is maintained, but not significant. Variation in measurements performed during day and night disappears. Increase of pressure exceeding arbitrally accepted boderline arterial pressure values is intensified during night. Morning increase and noctrurnal decrease of arterial pressure are blunted.

Key words:
blood pressure variability, circadian rhythm, cranio-brain trauma
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Application of the Polysensory Stimulation and the General Movement Patterns in Patients with the Serious Traumatic Brain Injury

Wojciech Kiebzak, Anna Wysocka, Arkadiusz Żurawski, Marek Kiljański, Justyna Pogorzelska

W. Kiebzak, A. Wysocka, A. Żurawski, M. Kiljański, J. Pogorzelska – Application of the Polysensory Stimulation and the General Movement Patterns in Patients with the Serious Traumatic Brain Injury. FP 2015; 15(2); 6-20

Abstract

Introduction. Traumatic brain injuries are among the major causes of disabilities and deaths in children. They cause motor performance disorders and neuropsychological dysfunctions. All the above require the maximum reduction of any iatrogenic effects.
Goal. The goal of this paper is to present a rehabilitation program for the patient after severe traumatic brain injury.
Case Study. As the result of a traffic accident, the 15 years old boy had suffered a severe overall trauma, including the traumatic brain injury. He was deeply unconscious, his score in the Glasgow Coma Scale – 4 points. The patient had undergone a 2 months rehabilitation program, while hospitalized. The polysensory stimulation and elements of the following methods had been applied: Vojta method (Reflex locomotion), NDT-Bobath, PNF, Castillo-Morales and Kinesiology Taping. A high degree of the patient’s self-reliance had been achieved, including the ability to walk, with only a slight support.
Discussion. Within the recent – dozen or so – years, numerous studies regarding the physiotherapy treatment in patients with the traumatic brain injury have been published. More often than not, success of the rehabilitation process depends on the early start and the proper orientation of the rehabilitation treatment. Still, in available research, there is very few studies dedicated to the formalized early treatment methods. Hence the need to define the best possible physiotherapy procedures.
Conclusions. The most important issue in the physiotherapy treatment, in patients after the traumatic brain injury, is the interdisciplinary rehabilitation, based on the polysensory stimulation and on the general movement patterns, which combines the techniques of the various methods. Planning of a physiotherapy program should be founded on the basic principles of continuity, comprehensiveness and regularity, but most of all – on the early start of the rehabilitation process. The competent physiotherapy treatment plays an important role in restoration of the cognitive-emotional functions and an achievement of the optimum level of the patient’s psychomotor performance.

Key words:
traumatic brain injury, craniocerebral injury, physiotherapy treatment, polysensory stimulation, general movement patterns

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