Introduction:
None of the health or social care professions can handle the diverse burden of managing the sequela of traumatic brain injury alone since the complexity is so extreme and dynamic. As a result, cooperation is one of the most essential aspects of traumatic brain injury rehabilitation. It is crucial to provide patients with complete treatment and a better overall experience, including higher patient survival rates. A multi-professional team with a suitable spectrum of abilities and experience, respect and confidence, a desire to share information and expertise, and open communication is the best team to care for patients with complex needs during neurological rehabilitation. A rehabilitation medicine consultant frequently leads this team.
What Is Traumatic Brain Injury?
A traumatic brain injury (TBI) can happen due to a violent impact on the head or body and from a foreign object breaching the skull and entering the brain. A TBI is not always the consequence of strikes or jolts to the head. Depending on the type of TBI, there may be temporary or short-term issues with a person's ability to think, comprehend, move around, interact, and perform. Severe and lasting disabilities, as well as death, can result from more severe TBI.
Some wounds are regarded as primary since the harm occurs right away. Other TBI effects may be secondary, developing gradually over several hours, days, or weeks. The response mechanisms following the initial head trauma cause these subsequent brain damage.
What Are the Types of Traumatic Brain Injury?
Penetrating and non-penetrating head injuries are the two main categories.
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Penetrating TBI, or open TBI, occurs when an object penetrates the skull (for example, a bullet, shrapnel, bone fragment, or a tool such as a hammer or a knife) and reaches the brain tissue. In most cases, penetrating TBI only affects a portion of the brain.
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Non-penetrating traumatic brain injury (TPI), a closed head injury, is caused by an external force sufficient to shift the brain inside the skull. Some causes include object hits, injuries sustained in sports, explosion injuries, falls, and vehicle crashes.
Explosions, natural disasters, and other extreme occurrences can result in mishaps that leave one with penetrating and non-penetrating TBI.
Which Experts Should Participate in the Multidisciplinary Approach to Treating Traumatic Brain Injury?
People who have had traumatic brain injuries frequently exhibit a variety of medical, physical, sensory, cognitive, linguistic, behavioral, and social issues, necessitating the expertise of numerous medical and allied health experts, including the following.
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Medical Specialists: Depending on the needs of each patient, medical specialists may include a pain management physician, ophthalmologist, neurosurgeon, geriatrician, orthopedic doctor, neurosurgeon, neuropsychiatrist, endocrinologist, and others.
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Rehabilitation Trained Nurse or Professional Care Staff: Provide the foundation for neurorehabilitation through the application of multifaceted team or interdisciplinary team approaches and programs, look after patients' medical needs like seizures and skin viability, but also collaborate with a treatment team with 24-hour posture-related management program, splinting regime, etc.
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Physiotherapist: To prevent other co-morbidities and support the management of idleness, tiredness, state of mind, and other traumatic brain injury-related issues, physiotherapists facilitate movement retraining, mobility and balance retraining, verticalization, general well-being, and developing a tolerance for physical challenge. They also offer advice on physical activity, including participating in recreational activities like the gymnasium, practicing swimming, golf, and games.
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The Occupational Therapist: An occupational therapist supports home modifications and environment organization, helps to enhance mental and executive functions rehabilitation, driving abilities, vocational training, getting back to work, and aids in fatigue management. They also facilitate independence in everyday activities like dressing, washing, cooking, leisure, budgeting, and planning.
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Speech-Language Therapist: Assessment of swallowing difficulties (dysphagia) and advice on safe swallowing management, including the kind of diet, fluid thickening, environment organization, etc., is provided by speech and language therapists who also facilitate communication skills re-education, which includes comprehending and expressing spoken as well as written language and enhancing speech precision.
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Neuropsychologist: Following traumatic brain injury, neuropsychologists assess and treat mental, emotional, and intellectual issues; they can guide minimally conscious state conduct, challenging behavior, and coping mechanisms for shortcomings like diminished memory or emotions like depression or rage.
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Social Workers: Social workers offer helpful guidance on benefits, housing, transportation, at-home assistance, and other aspects of an individual's welfare and wellness.
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Vocational Therapist: A vocational therapist who promotes a return to work may have training as an occupational therapist or a vocational psychologist.
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Therapy Assistants: Therapy assistants, such as occupational or physiotherapy assistants, help with individual therapy.
What Are the Team Based Care Models?
1. Multidisciplinary Teams (MDT):
The multidisciplinary paradigm uses the expertise of physicians from various fields, but they collaborate side by side and in clearly defined roles. MDTs are characterized by a hierarchy paradigm, with the doctor playing a clear leadership role in organizing the specific patient's care. With each clinical specialty determining its goals and treatment plan, the multidisciplinary team allows for a high degree of autonomy. In case conferences, which may or may not include the patient, topics connected to the patient's findings, goals, and treatment plan are shared and discussed.
2. Interdisciplinary Team Approach:
The interdisciplinary paradigm shows a more integrated method of cooperating toward jointly established goals. With shared patient history taking, assessment, diagnosis, and management, along with shared goal setting involving various physicians, the patient, and their family, the interaction within the interdisciplinary team is noticeably closer.
Conclusion:
Each patient will require a particular kind of therapy depending on the type of brain injury and the area of the brain that was harmed. Physicians conduct a thorough physical exam to evaluate the patient's strength, balance, memory, and cognition and discuss the patient's goals. From this information, they develop an individualized program for care and recovery. Patients benefit greatly from the therapy in the first six months following injury, when improvements are most noticeable. This is due to the brain's enhanced adaptability during this stage. This is the capacity of the brain's neuronal networks to expand and rearrange in reaction to harm. After that, progress becomes sluggish or even seems to stall. Although they can be frustrating, plateaus are frequently transient and necessary for healing. Progress can be made incrementally over time. The primary objective of treating individuals with TBI is to maximize improvement and function.
