摘要:

The rehabilitation of traumatic brain injury (TBI) has undergone tremendous development over the past 20 years. A much more aggressive, extended and comprehensive approach is now common and clinically accepted. Multiple new forms and sites of treatment are utilized such as cognitive, behavioural, sub-acute and post-acute rehabilitation programmes. While there has been widespread clinical acceptance of these treatments the appearance of well-designed experimental or quasi-experimental studies actually evaluating the results of such treatment have been, until recently, generally lacking. This review article selects, analyses, and critiques the most salient of recent studies published regarding the overall clinical benefit, and to some extent the cost benefit, of TBI treatment programmes in their multiple forms. A conclusion which is reached following this survey is that while truly randomized controlled studies still have not been achieved, an impressive variety of studies of quasi-experimental design have been completed. The overall conclusion from these studies is that the efficacy (and cost-effectiveness) of TBI rehabilitation is strongly supported.

ISSN:0269-9052    

DOI:10.3109/02699059509008224

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

The perceptual and physiological features of the dysarthric speech of five severely closed-head-injured (CHI) subjects were examined in a case-by-case analysis. The five male CHI subjects included in the study were selected to reflect the range of severity and types of dysarthria evident in the CHI population. The perceptual profiles of each subject consisted of the findings of a perceptual speech analysis, the Frenchay Dysarthria Assessment (FDA) and the Assessment of the Intelligibility of Dysarthric Speakers (ASSIDS). The subjects' physiological profiles included the results of instrumental assessments of the respiratory, laryngeal, velopharyngeal and articulatory subsystems of the speech-production mechanism. The case studies highlighted the variability among the individual subjects with respect to the location, physiological nature, and severity of the impairment in their speech-production mechanisms. In addition, the interdependence of the various speech subsystems in determining speech outcome, the presence of differential subsystem impairment in dysarthria following CHI, and the varied therapeutic requirements of the individual subjects were identified. Clinically, the case studies highlighted the importance of developing individual treatment programmes based on comprehensive perceptual and physiological evaluations of the speech mechanism in each CHI subject with dysarthric speech.

ISSN:0269-9052    

DOI:10.3109/02699059509008225

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

A total of 74 brain-injured patients and 46 non-neurologically matched controls consecutively admitted to a specialist medical rehabilitation unit, were administered the 'Headley Court psychosocial rating scale' and four questionnaires examining personality traits of 'locus of control', 'use of humour', 'optimism' and 'easy-going disposition'. Both pre- and post-injury personality ratings were obtained. The relatives of all participants were sent the same scales. Personality changes are reported in each of the four areas; however, time post-injury appears to be a significant factor in the type of change reported; in this cross-sectional study, at 6 and 12 months post-injury, changes are noted in all variables except locus of control, whereas at 18 months post-injury only 'easy-going disposition' showed significant change, at 24 months post-injury changes were noted in all variables except optimism, and at 30 months post-injury no changes were noted. In the present study, examining a period of 2-5 years post-injury, the personality changes remain static once they have occurred. Despite widespread reports in the literature on the importance of pre- and post-trauma personality to good psychosocial functioning, the present study found that it was only an 'easy-going disposition' post-trauma that was consistently related to good psychosocial functioning. Reasons for this are discussed.

ISSN:0269-9052    

DOI:10.3109/02699059509008226

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

The aim of this follow-up study was to examine the long-term disabilities and handicaps caused by severe head injuries and their effects on the everyday life of patients and their relatives. The group studied consisted of 19 subjects who had suffered a severe closed-head injury during 1984 and had been rehabilitated in the KäpyläRehabilitation Center. In 1989 a thorough functional assessment of these patients was carried out. In addition, information concerning the quality of life, activities of daily living (ADL) and social situation was gathered by means of questionnaires filled in by the patient and, if possible, by a close relative. The results indicated the importance of changes in cognitive functions, personality and emotional reactions. Changes in personality and emotional reactions were especially emphasized by the relatives. We also correlated the patients' and their relatives' estimates of the occurrence of memory problems in everyday life with the results of objective memory tests. We found that verbal memory tests reached significant correlations with the estimates of everyday memory problems, whereas tests of visual memory, though able to discriminate the brain-injured from normal subjects, did not correlate on a statistically significant level with the estimates of patients and relatives. The implications of the results for methods of assessment and the planning of rehabilitation programmes are discussed.

ISSN:0269-9052    

DOI:10.3109/02699059509008227

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

A case study is presented of confusion in a head-injured man, lasting for more than 2 years, when intermittent treatment with physostigmine resulted in progressive improvement in both confusion and usable cognitive functions. Aetiological mechanisms and implications for treatment plans are discussed.

ISSN:0269-9052    

DOI:10.3109/02699059509008228

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Rehabilitation services for patients with brain injury have been slower to develop than those with other disabilitites, but have rapidly improved over the past 10-15 years. A range of different, specialized brain injury programmes has evolved. The literature is reviewed and the author describes and discusses the relative merits of these models from personal experience and observation in Australia and other countries. The importance of an integrated network of specialized brain injury rehabilitation services is emphasized.

ISSN:0269-9052    

DOI:10.3109/02699059509008229

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Traumatic brain injuries and spinal cord injuries occur in a variety of accidents which may become the subject of civil litigation. A new field of medical jurisprudence, called neurolaw, is emerging to join health-care professionals and attorneys in a common quest to employ legal remedies to enhance the quality of life for individuals with neurological injury and their families. Presented here is a review of the underpinnings of this developing area of inquiry.

ISSN:0269-9052    

DOI:10.3109/02699059509008230

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

ISSN:0269-9052    

DOI:10.3109/02699059509008231

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor