What are the solutions for rehabilitation after traumatic brain injury?
(Baonghean) - Along with treating diseases such as polyarthritis, herniated disc, autism..., recently, Nghe An Rehabilitation Hospital has received many patients for effective recovery after traumatic brain injury.
Unforeseen consequences
The case of Ms. Le Thi Vy (65 years old) in Dien Ky commune (Dien Chau) suffered a traumatic brain injury after a traffic accident in August 2018. Mr. Tran Xuan Luong - Ms. Vy's husband said that the accident caused Ms. Vy to completely lose her memory, not knowing who she was, and not having any reflexes. During the treatment process at the Central Hospital and the Provincial Hospital, the family had to provide full support. However, what Mr. Luong's family was most excited about was that since the day she was admitted to the rehabilitation hospital, Ms. Vy recognized her relatives.
The tragic accident caused my wife to lose all her memory, not knowing who she was, and not having any reflexes.
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| Ms. Le Thi Vy (65 years old) in Dien Ky commune (Dien Chau) suffered a traumatic brain injury and is currently being treated at Nghe An Rehabilitation Hospital. Photo: Duc Anh |
Patient Nguyen Thi Loi (65 years old) in Nghi Hop commune (Nghi Loc) also suffered a traumatic brain injury due to a car accident. After undergoing two surgeries at provincial and central hospitals, after 6 months of treatment, Ms. Loi was transferred to Nghe An Rehabilitation Hospital for recovery and post-surgery care. Before coming to Nghe An Rehabilitation Hospital, Ms. Loi did not feel anything when others called her; she had to be fed through a feeding tube.
Upon returning to Nghe An Rehabilitation Hospital, Ms. Nguyen Thi Loi was directly examined by Prof. Dr. Nguyen Van Chuong - Head of Neurology Department - Hospital 103, Neurologist of Military Medical Institute, Member of Executive Committee of Vietnam Neurology Association, Chairman of Hanoi Pain Relief Association and given a specific rehabilitation regimen. Therefore, Ms. Loi's health has improved a lot, such as she can feel when hearing others call her name, feel pain in her hands and feet when her family touches her... the family is very excited.
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| Acupuncture - one of the treatment methods for patients with paralysis of arms and legs at Nghe An Rehabilitation Hospital. Photo: Duc Anh |
The rehabilitation process for patients with traumatic brain injury requires comprehensiveness, ensuring the correct principles and good coordination among members of the treatment team. A good rehabilitation program will help patients recover quickly, regain maximum functional activities and improve quality of life.
Prof. Dr. Nguyen Van Chuong said: Traumatic brain injury is a condition of brain damage caused by trauma, leading to disorders of perception, cognition, movement, sensory perception and language. Traumatic brain injury can be divided into two main groups based on pathophysiology: primary injury and secondary injury: Common types of primary injury: epidural hematoma, subdural hematoma, subarachnoid hemorrhage, intraventricular hemorrhage, intracerebral hemorrhage, cerebral contusion, diffuse axonal injury, deep gray matter injury.
Common secondary injuries include: brain herniation, cerebral edema, cerebral infarction or post-traumatic cerebral ischemia. In addition, clinical symptoms as well as impairments and reduced capacity caused by traumatic brain injury are very diverse. Therefore, the rehabilitation process for patients with traumatic brain injury must be comprehensive, ensure proper principles and have good coordination among members of the treatment team. A good rehabilitation program will help patients recover quickly, regain maximum functional activities and improve quality of life.
Treatment
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| To restore health for patients after traumatic brain injury, Nghe An Rehabilitation Hospital has many different treatment regimens, especially combining physical therapy and oriental medicine. Photo: Duc Anh |
Rehabilitation experts have proven that early mobilization of patients not only helps limit secondary injuries but also helps patients improve motor and cognitive functions faster.
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| Doctors and nurses take care of patients recovering from traumatic brain injury. Photo: Duc Anh |
Applied exercises include:
- Exercise according to joint range of motion;
- Instruct the patient to turn themselves or help them change position if perception is still poor;
- Let the patient sit up early, move to a recliner next to the bed, practice standing and walking as soon as possible if hemodynamic status, perception and motor function allow;
- Instruct patients on breathing and coughing exercises to prevent respiratory complications; Continue to maintain a nutrition program, care for and prevent secondary injuries;
- Maintain mobility and functional joint integrity;
- Increase contact and talk with patients to improve perception, cognition and language;
- Instruct and support patients to perform functional exercises in bed, beside the bed and walking function; Control muscle tone, balance and coordination, and correct gait;
- Provide orthopedic devices such as wrist splints and AFO splints to prevent or treat limb contractures;
- Instruct patients on how to use mobility aids such as wheelchairs, walkers, crutches, canes, etc.
The exercises applied include: Exercises according to the range of motion of the joints; Instructing patients to turn themselves or help them change their posture if their perception is still poor; Letting patients sit up early, move to a recliner next to the bed, practice standing and walking as soon as possible if their hemodynamic status, perception and motor function allow; Instructing patients in breathing and coughing exercises to prevent respiratory complications; Continuing to maintain the nutrition program, care and prevention of secondary injuries;Maintain mobility and functional joint integrity; Increase contact and conversation with patients to improve perception, cognition and language; Instruct and support patients in performing functional movement exercises in bed, beside the bed and walking function; Control muscle tone, balance and coordination, correct gait; Provide orthopedic devices such as wrist and hand splints, AFO splints to prevent or treat limb contractures; Instruct patients in using mobility aids such as wheelchairs, walkers, crutches, canes, etc.
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| Nurse is practicing hand joint movement for a patient with traumatic brain injury. Photo: Duc Anh |
In addition to physical therapy, it is necessary to apply a parallel occupational therapy program to help patients achieve the maximum possible level of functional independence in daily activities.
How to recover from injury
When brain damage occurs, daily activities are also greatly affected. To recover from a traumatic brain injury, patients and their families need to follow the instructions of doctors. For patients with severe injuries, the recovery process is slow, and caution must always be exercised to avoid problems such as joint mobility, skin ulcers, infections, and other physiological functions.
Once the patient has recovered from the acute condition, a rehabilitation program can be guided through its stages. In the final stage, rehabilitation will help the patient achieve maximum independence when returning to their family, possibly returning to their old job or approaching a new career that is appropriate to their current functional status.
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| Helping patients walk is one of the solutions to help patients recover quickly. Photo courtesy of Thanh Cuong |
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