Date of Award

2017

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Michelle LaBrecque

Keywords

Brain Injuries, Traumatic -- rehabilitation; Case Reports

Abstract

Background and Purpose Traumatic brain injuries (TBI) are very prevalent throughout the US. They are often caused by a head injury leading to alterations in brain functioning and often result in lifelong disabilities. Current literature is limited on the aspects of rehabilitation following a TBI because of the many factors that differ within each case. This study will explore an atypical pathway for rehabilitation following a TBI.

Case Description The patient was a 32-year-old male who sustained a TBI following a motor vehicle accident (MVA). The Glasgow Coma Scale (GCS) and Rancho Los Amigo Scale (RLAS) were assessed initially and scored at 11/15 and III respectively. A modified version of the Berg Balance Scale (BBS) was only administered once and scored 41148. The patient scored grossly a 1/5 for Manual Muscle Testing (MMT) of bilateral lower extremities and left upper extremity. An abnormal treatment progression occurred due to uumodifiable factors that included the patient's uninsured status, an increased census in the acute care hospital, and limited familial support.

Outcomes and Discussion The patient was treated for a total of 39 sessions over a 44 day period. The GCS score improved to 15/15 and the RLAS improved to IV. The patient also had improvements to 5/5 MMT for all lower extremity motions except right knee extension and dorsiflexion which were both 2/5 MMT. The patient progressed with the treatment provided, however he may have progressed to a greater extent if he had been transferred to a rehabilitation center sooner. Further research needs to be done to determine the ideal path for rehabilitation following a TBl.

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