Rehabilitation following traumatic brain injury

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  • WATANABE Shu
    Department of Rehabilitation Medicine, The Jikei University School of Medicine

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  • 外傷後のリハビリテーション（身体的および高次脳機能）の発達
  • ガイショウ ゴ ノ リハビリテーション(シンタイテキ オヨビ コウジ ノウ キノウ)ノ ハッタツ

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Abstract

With advances in emergency and intensive care medicine, the number of survivors with severe traumatic brain injury（TBI）tends to increase. In most cases, they are left with physical, cognitive and psychosocial problems. Cognitive rehabilitation focuses on the recovery of functions such as memory, attention, motor skills and instrumental ADL as well as other functions and a therapy program should be specifically constructed for the individuals. In the rehabilitation unit, individual and group programs are composed of specific categories such as social skill training（activities of daily living, activities parallel to daily living, transitional living）, driving skill training, vocational rehabilitation including supported employment, occupational therapy, physical therapy, speech therapy, cognitive retraining and psychological counseling. Cognitive improvement after TBI is most dramatic in the first six months after injury, but this recovery is continued for a long time through cognitive rehabilitation. Therefore, the long-term support is necessary for TBI patients to facilitate reintegration into society. In this paper, I reported changes in cerebral blood flow to ischemic areas after cognitive rehabilitation by ECD-Tc 99m single photon emission computed tomography（SPECT）brain scanning. These results shows a potential beneficial effects of cognitive rehabilitation on cognitive disorders in patients with TBI which is substantiated by neural changes observed in SPECT imaging.

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