Due to its high incidence, high disability rate, and high mortality rate, traumatic brain injury (TBI) poses a serious threat to human health. This manuscript describes the urgent problems currently existing in China's TBI treatment and proposes a scheme of a nationwide collaboration platform for the treatment of TBI so as to improve the overall level of TBI treatment in China, and reduce disability and mortality rates in TBI patients.
Brain Injuries, Traumatic ; rehabilitation ; therapy ; China ; Humans

For the children who suffer trauma in earthquake, rehabilitation care aims to promote functional recovery, shorten hospital stay, and reduce the incidence of complications or disability by evidence-based, multidisciplinary, and comprehensive early rehabilitation intervention on the basis of first aid and clinical treatment. Children are likely to suffer traumatic brain injury, spinal cord injury, peripheral nerve injury, limb fracture, and amputation in the earthquake disaster, so the clinical rehabilitation care designed considering the characteristics of children should be provided immediately after acute phase of trauma to promote functional recovery.
Amputation, Traumatic ; rehabilitation ; Brain Injuries ; rehabilitation ; Child ; Disasters ; Earthquakes ; Humans ; Peripheral Nerve Injuries ; rehabilitation ; Spinal Cord Injuries ; rehabilitation ; Wounds and Injuries ; rehabilitation

OBJECTIVES: To investigate the correlation of the initial Computerized Tomography(CT) findings of the brain and the functional outcome, and to suggest the initial CT findings as a functional outcome predictor in the traumatic brain injured(TBI) patients. METHODS: Thirty-nine TBI patients were included in this study. Subjects were divided into groups of non-focal or focal TBI, and with or without a depressed skull fracture according to their initial brain CT findings. RESULTS: The non-focal TBI patients were not significantly different from focal TBI patients in the days from onset to rehabilitation, rehabilitation stay, and initial FIM score. However their outcome in FIM gain and FIM efficiency significantly worse than focal TBI patients. The TBI patients with a depressed skull fracture were not significantly different from the patients without a depressed skull fracture in the days from onset to rehabilitation, rehabilitation stay, and intial FIM score. However their outcomes were significantly worse than patients without a depressed skull fractrue in FIM efficiency. CONCLUSION: The initial brain CT findings were generally useful for the prediction of functional outcomes in TBI patients.
Brain Injuries ; Brain* ; Humans ; Rehabilitation ; Skull ; Skull Fracture, Depressed

OBJECTIVE: The purposes of this study were to estimate the incidence and complications of the tracheostomy and after decannulation, and to compare the functional outcomes between tracheostomy and non-tracheostomy groups in the severe traumatic brain injury (TBI) patients. METHOD: One hundred and fifteen severe TBI patients were included in this study and the functional outcomes were measured by the Functional Independence Measure (FIM) scores retrospectively. RESULTS: The incidence of tracheostomy was 45.2% and the average duration of tracheostmy was 69.7 days. Twenty seven complications associated with the tracheostomy (51.9%) were reported and a pneumonia was the most common complication. Fourteen complications (26.9%) were reported after the decannulation and a tracheal granuloma was the most common complication. Complications mostly occurred during the first two weeks of tracheostomy. The duration of rehabilitation treatment for the patients with tracheostomy was longer than the patients without tracheostomy. TBI patients with tracheostomy had significantly lower initial and discharge FIM scores, FIM gain, and FIM efficiency than the patients without tracheostomy. CONCLUSION: The complications of tracheostomy were mostly occurred early in the acute stage. Functional outcomes were lower in severe TBI patients with tracheostomy, thus early comprehensive and aggressive rehabilitation treatments would be necessary.
Brain Injuries* ; Granuloma ; Humans ; Incidence ; Pneumonia ; Rehabilitation ; Retrospective Studies ; Tracheostomy*

PURPOSE: This study was conducted to develop a comprehensive cognitive rehabilitation program that can be easily applied to brain injured patients by family members or nurses in community or hospital settings. METHODS: A Systemic literature review design was used. Thirty-three related studies were reviewed. RESULT: Based on the results of the literature review, the training tasks for attention were designated to enhancing 4 hierarchical areas, i.e., focused, selective, alternating, and divided attention. On the other hand, the memory rehabilitation tasks mainly consisted of mnemonic skills, such as the association method which helps patients memorize given information by linking together common attributes, the visual imagery method, and self-instruction method. The problem solving rehabilitation program included a task of games or plays which stimulated the patients' curiosity and interest. The training tasks for problem solving were to encourage the process of deriving reasonable solutions for a problematic situation resembling real problems that the patients were faced with in their everyday life. CONCLUSION: It is expected that the cognitive rehabilitation program developed from this study could help patients having difficulty in their every day life, due to a reduced cognitive ability resulting from brain injury, to effectively adapt to every day life.
Problem Solving ; Memory ; Humans ; *Cognitive Therapy ; Cognition Disorders/etiology/*rehabilitation ; Brain Injuries/complications/nursing/*rehabilitation

Virtual reality (VR) therapy has many benefits to promote neurological and functional recovery in the field of neurorehabilitation after brain injury. VR-assisted neurorehabilitation can be applied in motor, sensori-motor, cognitive, activities of daily living (ADL), and telerehabilitation. Recent reports found that VR therapy appears to be a safe intervention that is effective at improving arm function and ADL function following stroke. Greater improvements were seen at a higher VR therapeutic dose. There has been insufficient evidence that VR therapy improved lower extremity gait speed, balance, and cognitive function after brain injury. As a result, the number of commercially available devices have increased and large-scale controlled trials have reported positive effects recently. Interface devices, various feedback methods, and the advancement of augmented reality technology are quickly developing, therefore, the potential value of VR therapy in neurorehabilitation will be high and its clinical application will be diversified.
Activities of Daily Living ; Arm ; Brain Injuries ; Cognition ; Gait ; Lower Extremity ; Neurological Rehabilitation* ; Rehabilitation ; Stroke ; Telerehabilitation

The higher cognitive functions of human brain are hypothesized to be selectively distributed across large-scale neural networks interconnected cortical and subcortical areas. Recently, advances in functional imaging made it possible to visualize the brain areas activated by certain cognitive function in vivo. Out of several technologies currently available for brain activation study, functional magnetic resonance imaging (fMRI) is increasingly being used because of its superior time resolution and finer spatial resolution. The technique is non-invasive without radiation hazard, which allow to take repeated multiple scans within the same individual. The most common approach to fMRI of brain is the one using 'blood-oxygen level dependent (BOLD)' contrast, which based on the localized hemodynamic changes following neural activities in the certain areas of brain. With functional imaging techniques including fMRI, neural networks subserving for higher cognitive functions such as language, memory, attention, and visuospatial functions could be visualized. Neural substrates of human emotion and motivation behaviors also begin to be unveiled. Brain mapping with functional imaging is a very useful method for detecting eloquent areas in a neurosurgical setting to prevent the residual disabilities. One of the issues recently having attention in the field of functional imaging is the reorganization of neural network following brain injuries. Much research results using fMRI identified intra- and/or interhemispheric reorganization of neural networks accompanied with functional recovery after brain injury. Effects of learning and rehabilitation on the extent and pattern of neural reorganization was also delineated. fMRI will be a very useful tool for developing of various rehabilitation treatments, which promote successful functional recovery by maximizing the plasticity of brain.
Brain ; Brain Injuries ; Brain Mapping ; Hemodynamics ; Humans ; Learning ; Magnetic Resonance Imaging* ; Memory ; Motivation ; Plastics ; Rehabilitation*

OBJECTIVE: To survey the utilization status of public health and medical rehabilitation services by the persons with disabilities in community. METHOD: The subjects were 118 patients who were admitted to National Rehabilitation Center from January 1998 to December 2001 and agreed with home-visit. The subjects were assessed of disability level with functional scales, utilization rate of public health and medical rehabilitation services, utilization facilities, and service contents. RESULTS: The subjects included 78 pesons with stroke, 20 persons with spinal cord injury, 9 pesons with traumatic brain injury, and 11 persons with other diseases. Only 28.0% of the low-functional group used public health and medical rehabilitation services, showing a low utilization rate than the high-functional group (43.2%). 17 out of 24 persons who used rehabilitation clinics were in the low-functional group and 9 out of 13 persons who used welfare agency were in the high-functional group (p=0.012). In two groups, most frequent utilization out of the service contents was the exercise therapy. CONCLUSION: The utilization rate of public health and medical rehabilitation services in communities was 32.8%. It is necessary to supply the persons with disabilities in community with the rehabilitation service for the continuum of rehabilitation.
Brain Injuries ; Disabled Persons* ; Exercise Therapy ; Humans ; Public Health* ; Rehabilitation Centers ; Rehabilitation* ; Spinal Cord Injuries ; Stroke ; Weights and Measures

OBJECTIVE: To study the effect of early intervention and rehabilitation in the expression of aquaporin-4 and ultrastructure changes on cerebral palsy pups model induced by intrauterine infection. METHODS: 20 pregnant Wistar rats were consecutively injected with lipopolysaccharide intraperitoneally. 60 Pups born from lipopolysaccharide group were randomly divided into intervention group (n=30) and non-intervention group (n=30); intervention group further divided into early intervention and rehabilitation group (n=10), acupuncture group (n=10) and consolidate group (n=10). Another 5 pregnant rats were injected with normal saline intraperitoneally; 30 pups born from the normal saline group were taken as control group. The intervention group received early intervention, rehabilitation and acupuncture treatment. The motor functions of all pups were assessed via suspension test and modified BBB locomotor score. Aquaporin-4 expression in brain tissue was studied through immunohistochemical and western-blot analysis. Ultrastructure changes in damaged brain and control group were studied electron-microscopically. RESULTS: The scores of suspension test and modified BBB locomotor test were significantly higher in the control group than the intervention and non intervention group (p<0.01); higher in the intervention group than the non-intervention group (p<0.01). The expression of Aquaporin-4 was lower in intervention and non intervention group than in the control group (p<0.01); also lower in non-intervention group than the intervention group (p<0.01). Marked changes were observed in ultrastructure of cortex and hippocampus CAI in brain damaged group. CONCLUSION: Early intervention and rehabilitation training can improve the motor function in offspring with brain injury and reduce the expression of aquaporin-4 in damaged brain.
Acupuncture ; Animals ; Brain Injuries ; Brain* ; Cerebral Palsy ; Early Intervention (Education)* ; Hippocampus ; Rats ; Rats, Wistar ; Rehabilitation*

OBJECTIVE: To identify possible clinical predictors of intermittent oro-esophageal (OE) tube feeding success, and evaluate the clinical factors associated with OE tube treatment. METHODS: A total of 135 dysphagic patients were reviewed, who received OE tube treatment and were hospitalized in the department of rehabilitation medicine between January 2005 and December 2014. The 76 eligible cases enrolled were divided into two groups, based on the OE tube training success. Clinical factors assessed included age, cause of brain lesion, gag reflex, cognitive function and reasons for OE tube training failure. RESULTS: Of the 76 cases enrolled, 56 study patients were assigned to the success group, with the remaining 20 in the failure group. There were significant differences between these two groups in terms of age, gag reflex, ability to follow commands, and the score of Korean version of Mini-Mental Status Examination (K-MMSE). Location of the brain lesion showed a borderline significance. Multivariable analysis using logistic regression revealed that age, cause of brain lesion, gag reflex, and K-MMSE were the main predictors of OE tube training success. CONCLUSION: A younger age, impaired gag reflex and higher cognitive function (specifically a K-MMSE score ≥19.5) are associated with an increased probability of OE tube training success in dysphagic patients.
Brain Injuries* ; Brain* ; Cognition ; Deglutition Disorders* ; Enteral Nutrition* ; Humans ; Logistic Models ; Multivariate Analysis ; Reflex ; Rehabilitation