Assessment of Traumatic Brain Injury: Difference between revisions

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Revision as of 22:46, 30 June 2019

Welcome to Traumatic Brain Injury Content Creation Project. This page is being developed by participants of a project to populate the Traumatic Brain Injury Section of Physiopedia. 
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Preparation for Physiotherapy Assessment[edit | edit source]

Physiotherapy assessment commences once the patient is medically stable.

In view of the complexity of many patients with TBI, the assessment is frequently unable to be completed within a single session so is ongoing for the first few physiotherapy sessions. Close liaison with other members of the multidisciplinary team is extremely beneficial, and on occasion joint assessments by 2 or even 3 therapists from different disciplines can be beneficial.


Handling during Ax[edit | edit source]

In the initial stages following TBI, careful handling is essential when assessing patients, especially if they are in a minimally conscious state.


Information required before starting the assessment[edit | edit source]

The following information should be provided by the medical team before beginning the physiotherapy assessment:

  • State of consciousness of the patient - for further information see the Coma Recovery Scale page
  • Areas of the brain injured, including diffuse and secondary injury
  • Site of Decompression Craniotomy, if this has been performed on the patient[1]
  • Any other injuries sustained - patients who have TBI from road traffic accidents frequently also have a range of musculoskeletal, abdominal and chest injuries
  • Any impact on cognition of the patient - neuropsychological assessment is indicated

Areas of Assessment[edit | edit source]

Abnormal Muscle Tone[edit | edit source]

particularly hypertonicity and spasticity.

It is noticeable that, in contrast to Stroke when there is often a period of low tone before high tone develops, in cases of severe TBI hypertonicity and spasticity can develop very quickly. The symptoms may start to occur as sedation is reduced, or as the patient emerges from coma.

Approximately 18% to 30% of TBI patients suffer from spasticity that requires treatment[2].

Muscle Paresis[edit | edit source]

Muscle paresis very common following TBI[3]

Sub Heading 3[edit | edit source]

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References[edit | edit source]

References will automatically be added here, see adding references tutorial.

  1. ↑ Bohman LE, Schuster JM. Decompressive craniectomy for management of traumatic brain injury: an update. Curr Neurol Neurosci Rep. Nov 2013;13(11):392
  2. ↑ Verplancke, D, Snape, S, Salisbury, CF et al. 2005. A randomised controlled trial of botulinum toxin on lower limb spasticity following acute acquired severe brain injury. Rehabil. 19, 117-125
  3. ↑ Ivanhoe, CB, Reistetter, TA, 2004. Spasticity: the misunderstood part of the upper motor neuron syndrome. Am. J. Phy. Med. Rehabil. 83, S3-S9
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