Physical Therapy & Rehabilitation Science
DPT (Doctor of Physical Therapy)
Session and Year of Graduation
Frey Law, Laura
Background: Traumatic brain injuries (TBI) can be devastating events that can completely transform individuals’ lives. Determining prognosis after a brain injury can be difficult to discern due to the countless variations in injuries and contributing factors that affect rehabilitation. There is no standard physical therapy treatment for addressing TBI’s due to the complex integration of the motor cortex with many regions of the brain that impact recovery. Case Description: A 62-year-old male sustained a severe TBI resulting from a fall down the stairs. He was found to have a subarachnoid hemorrhage, subdural hematoma, right posterior cephalohematoma and resulting encephalopathy. He spent 4 weeks in acute care and 39 days in an inpatient rehabilitation hospital to improve his functional mobility. Interventions in inpatient rehab utilized neuromuscular electrical stimulation, the Ekso bionic walking device, and task-oriented functional mobility training to work towards his goal of discharging home with his wife. Outcome Measures: The Center for Medicare and Medicaid Services GG Codes for Functional Abilities and the Swedish Modified Version of Postural Assessment Scale for Stroke Patients were utilized to demonstrate the functional improvements made during this patient’s inpatient rehabilitation stay. Discussion: Recovery progression from TBI is difficult to study and predict due to the significant fluctuations in injuries and length of recovery. Neuroplasticity following brain injuries is dependent on timing, the environment, and other concurrent therapies as well as the motivation and attention level of the patient. Multifaceted treatment approaches should be taken to increase likelihood of success. This case demonstrates that despite the low functional initial presentation after a severe TBI, patients can still make dramatic improvements.
Physical Therapy; inpatient rehabilitation; traumatic brain injury; recovery; neuromuscular electrical stimulation; bionic walking device; task-oriented functional mobility training
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