Assessment of Traumatic Brain Injury: Difference between revisions
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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. | 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 === | === Handling during Ax === | ||
<div align="justify"> | <div align="justify"> | ||
In the initial stages following TBI, careful handling is essential when assessing patients, especially if they are in a minimally conscious state. | 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 === | === Information required before starting the assessment === | ||
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<div align="justify"> | <div align="justify"> | ||
== Areas of Assessment == | == Areas of Assessment == | ||
==== Abnormal Muscle Tone ==== | ==== Abnormal Muscle Tone ==== | ||
particularly hypertonicity and spasticity. | particularly hypertonicity and spasticity. | ||
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==== Muscle Paresis ==== | ==== Muscle Paresis ==== | ||
Muscle paresis very common following TBI<ref>Ivanhoe, CB, Reistetter, TA, 2004. Spasticity: the misunderstood part of the upper motor neuron syndrome. Am. J. Phy. Med. Rehabil. 83, S3-S9</ref> | Muscle paresis very common following TBI<ref>Ivanhoe, CB, Reistetter, TA, 2004. Spasticity: the misunderstood part of the upper motor neuron syndrome. Am. J. Phy. Med. Rehabil. 83, S3-S9</ref> | ||
==== Movement Disorders ==== | ==== Movement Disorders ==== | ||
Ataxia, dyspraxia, dyskinesia, or reduced motor control | Ataxia, dyspraxia, dyskinesia, or reduced motor control | ||
Revision as of 07:57, 9 July 2019
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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]
Movement Disorders[edit | edit source]
Ataxia, dyspraxia, dyskinesia, or reduced motor control
Balance and vestibular dysfunction[edit | edit source]
This is very common in TBI, and varies enormously in degree[4]
Sub Heading 3[edit | edit source]
Add text here...
References[edit | edit source]
- ↑ Bohman LE, Schuster JM. Decompressive craniectomy for management of traumatic brain injury: an update. Curr Neurol Neurosci Rep. Nov 2013;13(11):392
- ↑ 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
- ↑ Ivanhoe, CB, Reistetter, TA, 2004. Spasticity: the misunderstood part of the upper motor neuron syndrome. Am. J. Phy. Med. Rehabil. 83, S3-S9
- ↑ Kleffelgaard I, Soberg H, Bruusgaard K, Tamber A, Langhammer B. Vestibular Rehabilitation After Traumatic Brain Injury: Case Series. Physical Therapy. 2015
