Neurological Physiotherapy and Rehabilitation

The following case study describes a hypothetical patient who has sustained a Traumatic Brain Injury (TBI). Head Injury or Traumatic Brain Injury (TBI) is a complex condition affecting the Central Nervous System (CNS). The management of patients with TBI can be demanding and presents a challenge to all members of the rehabilitation team. Many factors need to be taken into consideration as the sequelae of TBI may affect lifestyle, aspirations, health and social status. It is therefore vital that the physiotherapist comprehends the complex nature of TBI and is aware of a number of management issues.

Name – Mrs Tania Thomson
Age – 72
Occupation – retired Art Teacher
Current History – Sustained a Traumatic Brain Injury (TBI), right colles fracture, multiple bruising and skin lacerations after road traffic accident in which she was knocked off her bike 10 weeks ago. This caused a closed head injury mainly affecting her right frontal lobe and to a minor extent right temporal lobe. Initially admitted to a neurological intensive care unit, but transferred to neurology ward after 2 weeks and has been in the neurological rehabilitation unit for the past 4 weeks. Colles fracture treated with cast – worn for 6 weeks, now wears tubigrip
Past Medical History – Mild, bilateral OA knees, has had physiotherapy in past, finds swimming eases pain
Mild asthma – managed with Ventolin and occasional course of low dose steroids.
Hospital admission for R lower lobe pneumonia 18 months ago
Social history – Married, lives with husband who worked full-time as Solicitor, retired 6 months ago. Husband has history of hypertension and diabetes and was investigated 3 years ago for transient left arm and leg weakness – no abnormalities found on scans / routine tests and symptoms resolved in 12 hours.
They live in a 4 bedroom detached villa on 2 storeys.
Bedrooms and bathrooms on both levels
2 grown up sons, 1 living in Glasgow (married with 2 teenage children and works 4 days a week), 1 in San Francisco.
Hobbies – plays piano and cello, treasurer and lead soprano in local choral society, volunteers at church groups, takes childrens art classes for Sunday School; walking, gardening and painting

On current assessment
At this stage in the neuro rehabilitation unit, Tania is receiving regular rehabilitation from:
the physiotherapist
the occupational therapist
the speech therapist
the clinical psychologist
A multi-disciplinary team meets weekly to determine rehabilitation goals.
During the time since admission to the neurological rehabilitation unit Tania has made continuous progress and assessment now shows the following abilities:

Sample Solution