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British Medical Bulletin 55:927-943 (1999)
© 1999 The British Council

research-article

Rehabilitation after traumatic brain injury

Michael P Barnes

Academic Unit of Neurological Rehabilitation, University of Newcastle upon Tyne Newcastle upon Tyne, UK

Correspondence to Prof. M P Barnes, Hunters Moor Regional Neuro rehabilitation Centre, University of Newcastle upon Tyne, Hunters Road, Newcastle upon Tyne NE2 4NR, UK

Abstract

Head injury is a common disabling condition but regrettably facilities for rehabilitation are sparse. There is now increasing evidence of the efficacy of a comprehensive multidisciplinary rehabilitation team compared to natural recovery following brain injury. This chapter outlines some basic concepts of rehabiltation and emphasises the importance of vaild and reliable outcome measures. The evidence of the efficacy of a rehabilitation programmes is discussed in some detail. A number of specific rehabilitation problems are outlined including the management of spasticity, nutrition, pressure sores and urinary continence. The increasingly important role of assistive techology is illustrated, particularly in terms of communication aids and environmental control equipment. However, the major long-term difficulties after head injury focus around the cognitive, intellecutal, behavioural and emotional problems. The complex management of these disorders is briefly addressed and the evidence of the efficacy of some techniques discussed. The importance of recognition of the vegetative state and avoidance of misdiagnosis is emphasised. Finally, the important, but often neglected, area of employment rehabilitation is covered.


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