Академический Документы
Профессиональный Документы
Культура Документы
Outline of presentation
Background information on ABI
Acute management
Long term sequelae of ABI
Long term management
Implications for Physiotherapy
Case studies
BRAIN INJURY
congenital brain injury
prebirth
during birth
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Cerebral oedema
Hypoxia
Haemorrhage/haematoma
Seizures
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hallux valgus
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Neuroplasticity
Plasticity = to form, ability to be moulded
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Neuroplasticity
Repetition
Intensity
Neuroplastic
Change
Timing
Difficulty
Specificity
Salience
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Respiratory
- dysfunction of autonomic nervous
Dysautonomia
system
Post traumatic epilepsy
Other MS injury
Heterotopic ossification
Complex Regional Pain Syndrome
Outcomes of TBI
Cognitive disability more frequent and pervasive outcome of
brain injury than motor disability (Eiben et al, 1984 Jaffe et al, 1995)
Increased physical disability following severe TBI than mild TBI
(Jaffe et al, 1992; Fay et al,1994)
Children with severe TBI (and non TBI) who have limited recovery
of physical skills at 12 months post injury have significant chance
of non recovery of these skills in the long term (Hancock et al 2011)
Motor dysfunction affects integration into home and school
(Hayley et al, 1990)
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Health Condition
activity limitations:
what is this child need to be able to do?
Body Functions
and Structures
Activity
Environmental
Factors
Physical
Participation
Personal
Factors
balance difficulties
ataxia
impaired coordination
impaired motor planning
muscle weakness
spasticity
dystonia
tremor
dyspraxia
cognitive fatigue
organisational skills/planning
problem solving
inflexibility of thinking
self monitoring
social reasoning
insight
cognitive fatigue
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personality changes
poor behavioural control
egocentricity
social problems
emotional difficulties
impulsivity
poor judgement and anticipation of consequences of actions
impaired memory
difficulty with multi tasking
on your assessment?
what are you actually assessing?
on your intervention:
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Further Information
Kids Rehab, the Childrens Hospital at Westmead
www.schn.health.nsw.gov.au
Brain Injury Association NSW www.biansw.gov.au
Ministry of Health www.health.nsw.gov.au/birp
Working with people with traumatic brain injury, Liverpool BIRU and NSW
BIRD http://www.tbistafftraining.info
www.physiotherapyexercises.com
www.d-ability.org
jan.hancock@health.nsw.gov.au
References
Ada and Canning (eds) (1990) Physiotherapy Foundations for Practice. Keys issues in Neurological
Physiotherapy. Butterworth-Heinmann Limited.
Anderson et al (2011) Do children recover better? Neurobehavioural plasticity after early brain insult. Brain, 125.
Bland et al (2011) Effectiveness of physical therapy for improving gait and balance in individuals with a
traumatic brain injury: a systematic review. Brain Injury 25(7-8): 664-679.
Campbell S, Vander Linden D and Palisano R (2012) Physical Therapy for Children. 4th ed. W.B.Saunders
Company, Philadelphia
Carr and Shepherd, Ada L (1995) Spasticity: Research findings and implications for intervention.
Physiotherapy, 81, 421-429.
Carr and Shepherd (1998) Neurological Rehabilitation Optimising Motor Performance. ButterworthHeinmann Limited.
Hancock J et al (2011) Balance, Mobility and Community Participation Outcomes in Children and Adolescents
with an Acquired Brain Injury. Waiting publication.
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References
Hassett L et al (2012) Circuit class therapy can provide a fitness training stimulus for adults with a sever traumatic
brain injury: a randomised trail with an observational study. Journal of Physiotherapy 58 (2) 105112.Physiotherapy for the Acute Care Management of Traumatic Brain Injury An Information Package.
Publication of Brain injury Rehabilitation unit, Liverpool health Service.
Hassett L (2005) Physiotherapy for the Acute Care Management of Traumatic Brain Injury An Information
Package. Publication of Brain injury Rehabilitation unit, Liverpool health Service.
Hellweg s and Johannes S (2008) Physiotherapy After Traumatic Brain injury: a systematic review of the
literature. Brain injury 22 (5) 365-373
Hellweg S (2012) Effectiveness of physiotherapy and occupational therapy after traumatic brain injury in the
intensive care unit. Critical care research and Practice Apr 5 (768456) Epub
Katz-Leurer M et al (2009) The effects of a home-based task-orientated exercise program on motor and
balance performance in children with spastic cerebral palsy and severe traumatic brain injury. Clinical
rehabilitation 23 (8) 714-724.
Kleim J (2008) Principles of experience-dependent neural plasticity: implications for rehabilitation after brain
damage. Journal of Speech Lang Hear Res. 51(1):S225-39
Marshall S et al (2007) Motor Impairment Rehabilitation Post Acquired Brain Injury. Brain Injury 21 (2) 133-160.
References
OFlaherty S et al (2000) The Westmead Paediatric TBI Multidisciplinary Outcome Study: Use of functional
outcomes data to determine resource prioritisation. Archives of Physical Medicine and Rehabilitation. 81
(6) 723-729.
Patradoon H-P et al (2005) Obesity in Children and Adolescents with Acquired Brain Injury. Paediatric
Rehabilitation 8 (4) 303-308.
Rosenbaum P and Gorter J.W (2011) The F words in childhood disability: I swear this is how we should think!
Child: Care, Health and Development
Shepherd, R (1995) Physiotherapy in Paediatrics. Third Ed. Butterworth-Heinmann Limited.
Teasall R et al (2007) A Systematic Review of the Rehabilitation of Moderate to Severe Acquired Brain Injuries.
Brain injury 2007 21 (2) 107-112
Teplicky et al (2002) The effectiveness of casts, orthoses and splints for children with neurological disorders.
Infant and Young Children, Jul15 (1):42-50.
Zhu et al (2001) Does an intensive Rehabilitation improve the functional outcome of patients with traumatic
brain injury? Interim results of a randomized controlled trial. British Journal of Neurosurgery 15 (6) 464473
Zhu et al (2007) Does Intensive Rehabilitation improve the functional outcome of patients with traumatic brain
injury (TBI)? A randomized controlled trial. Brain Injury 21 (7) 681-690
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