Traumatic Brain Injury Timothy R. Elliott, Ph.D. TBI facts

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Traumatic Brain Injury

• Timothy R. Elliott, Ph.D.

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TBI facts

• 5.3 million Americans (just over 2 of the
  population) currently live with a disability
  resulting from a TBI
• 1.5 million people sustain an TBI each year
• 50,000 die due to TBI each year
• Every 21 seconds a person in the US sustains an
  TBI

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an acquired brain injury

• an injury to the brain, occurring after
  birth.not hereditary, congenital, degenerative,
  or induced by birth trauma
• commonly results in a change in neuronal
  activity, which affects the physical integrity,
  the metabolic activity, or the functional ability

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Levels of Injury

• May result in mild, moderate, or severe
  impairments in one or more areas
• Injuries can range from very mild to very severe,
  and depending on the location of the brain
  injury, impairments may include .

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Types of brain injury

• Closed head injury
• occurs when an outside force impacts the head
  hard enough to cause the brain to move within the
  skull
• Open head injury
• can occur from motor vehicle crashes, gun shot
  wounds, falls, shaking (a baby), sports, and
  physical violence, such as hitting or striking
  with an object

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Causes of brain injury

• Airway obstruction
• Near-drowning, throat swelling, choking,
  strangulation, crush injuries to the chest
• Electrical shock or lightening strike
• Trauma to the head and/or neck
• Traumatic brain injury with or without skull
  fracture, blood loss from open wounds, artery
  impingement from forceful impact, shock
• Vascular Disruption

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Impairments may include

• Lack of coordination
• Slowness or confusion in the planning and
  sequencing of movements
• Muscle spasticity
• Speech disorders
• Seizures, paralysis
• Chronic, persistent pain (nerve damage,
  fractures)
• Sensory impairments (e.g., vision and hearing
  loss

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Social, emotional, and behavioral impairments

• Mood swings
• Depression, blunted affect
• Lack of motivation, decreased initiative
• Agitation
• Impulse control
• Interpersonal difficulties, impaired empathy

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Cognitive impairments

• Short and/or long term memory loss
• Poor attention, judgment, and concentration
• Communication disorders related to speech,
  writing, and reading

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Types of brain injury

• Closed head injury
• occurs when an outside force impacts the head
  hard enough to cause the brain to move within the
  skull
• Open head injury
• can occur from motor vehicle crashes, gun shot
  wounds, falls, shaking (a baby), sports, and
  physical violence, such as hitting or striking
  with an object

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Severity loss of consciousness

• Posttraumatic Amnesia
• Glasgow Coma Scale
• Mild scores 13 15
• Moderate scores 9 12
• Severe lt 8
• Gross predictor of outcomes at 6 months

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Post-Concussive Syndrome

• History of head trauma
• Evidence of difficulty in attention or memory
• Significant impairment in role functioning
• Three of these
• Fatigue, disordered sleep, headache,
  anxiety/depression, apathy, change in
  personality, irritability/aggression, vertigo or
  dizziness

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Veterans and ABI

• By some estimates, as many as 10 of the 1.5
  million soldiers may have some form of traumatic
  brain injury
• Over 60 of soldiers recently wounded in action
  in Operation Iraqi Freedom sustained blast
  injuries
• Perhaps 60 and 80 of these blast-injured
  soldiers have TBI

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Veterans and ABI

• The average age of a soldier stationed in Iraq
  and Afghanistan is 19 years old
• Estimating conservatively, the cost of caring for
  veterans with TBI from these wars could be 14
  billion over 20 years, and 35 billion over their
  lifetimes

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A brain injury is unpredictable

• A person with a brain injury is a person first
• No two brain injuries are exactly the same
• The effects are complex and vary greatly from
  person to person
• The effects may depend on such factors as cause,
  location, and severity

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Rehabilitation Strategies

• Compensatory
• Written instructions, date books, calendars,
  pagers, electronic or other assistive devices
• Restoration
• visual auditory exercises, practice/performance,
  reinforcement, monitoring, problem-solving
  strategies, goal setting

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Indicators of Adjustment

• Severity of injury
• Pre-injury personal and social adjustment
• Social support structures (e.g., family, church,
  work history)

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Health and Adjustment

• Normal life expectancy
• People with ABI generally have a greater
  propensity towards poor health habits as well as
  having poor health profiles
• At risk for secondary complications
• including social (e.g., poverty, arrests)

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Health-risk behaviors

• Smoking
• Alcohol misuse
• Dietary problems or habits
• Lack of exercise, Prolonged inactivity
• Sedentary lifestyle
• Obesity
• Medications that may be debilitating over time
• Indifference, lack of initiation
• Negative moods

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An Agenda for Public Health

• Healthy People 2010 calls for behavioral and
  social initiatives to promote the health and
  quality of life of persons with traumatic brain
  injury

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Benefits of Exercise and Healthy Lifestyles

• Improved stamina and strength
• Enhanced mood management
• Sense of confidence, competence
• Possible benefits to sense of balance
• Weight management, improved cardio fitness

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Benefits of a Stretching Program

• Increased range of motion
• For some, there will be an increase in muscular
  strength
• Promoted relaxation
• Stretched muscle tissue, flexibility
• Positive effects on balance

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Benefits of a Strength Program

• Increased muscle endurance
• Reduction of body fat
• Increased metabolic rate
• Increased body awareness

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Benefits of a Cardiovascular Program

• Reduction of specific risk factors for conditions
  (e.g., heart disease, stroke)
• Increased cardio efficiency
• More calories burned (weight loss)
• Improved circulation
• Decreased harmful cholesterol

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Recreation and Leisure Benefits

• Brainstorming activities

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Online Resources
http//www.braininjuryresources.org/rec_hobbies.ht
ml http//www.birf.info/home/library/recreation/r
ec-fitness.html http//www.bobwoodrufffamilyfund.
org/about_brain_injury.shtml http//www.biausa.or
g/