Traumatic Brain Injury Rehabilitation: Services, treatments and outcomes PDF
Preview Traumatic Brain Injury Rehabilitation: Services, treatments and outcomes
Traumatic Brain Injury Rehabilitation Services, treatments and outcomes Edited by M.A. Chamberlain Charterhouse Professor of Rehabilitation Medicine Rheumatology and Rehabilitation Research Unit Leeds University, UK V. Neumann Consultant, Chapel Allerton Hospital, Leeds, UK and Senior Lecturer in Rehabilitation Medicine Rheumatology and Rehabilitation Research Unit Leeds University, UK A. Tennant Charterhouse Principal Research Fellow Rheumatology and Rehabilitation Research Unit Leeds University, UK Springer-Science+Business Media, B.V. First edition 1995 ISBN 978-1-56593-307-1 ISBN 978-1-4899-2871-9 (eBook) DOI 10.1007/978-1-4899-2871-9 © 1995 Springer Science+Business Media Dordrecht Originally pub1ished by Chapman & Hall in 1995. Typeset in Palatino by Florencetype Ltd., Stoodleigh, Devon. Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act, 1988, this publication may not be reproduced, stored, or transrnitted, in any fonn or by any means, without the prior pennission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the tenns of the licences issued by the Copyright Licensing Agency in the UK, or in accordance with the tenns of licences issued by the appropriate Reproduction Rights Organization outside the UK. Enquiries conceming reproduction outside the tenns stated here should be sent to the publishers at the London address printed on this page. The publisher makes no representation, express or implied, with regard to the accuracy of the infonnation contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. A catalogue record for this book is available from the British Library Library of Congress Catalog Card Number: 95--69154 Printed on permanent acid-free text paper, manufactured in accordance with ANSI/NISO 239.48-1992 and ANSI/NISO 239.48-1984 (Pennanence of Paper). Contents List of contributors VI Foreword IX Preface xi Acknowledgements xiii Part One Aspects of service delivery 1 1 Head injury - the challenge: principles and practice 3 of service or organization M. Anne Chamberlain 2 The epidemiology of head injury 12 Alan Tennant 3 A national service: coma to community 25 ~eev (;roswasser 4 A regional service: developing a head injury service 37 Mike Barnes 5 A rural service: developing rehabilitation in the community 51 Chris Evans 6 An urban community service: head injury - using occupational therapy to meet the challenge of community reintegration 66 David Hughes, Elizabeth Ward, Heather Warnock, Ruth Hunter, Alan Tennant and M. Anne Chamberlain 7 A home-based service: a community rehabilitation programme 84 Miroslav Paltit and Miroslav Paltit Jr 8 A clinically and neurophysiologically led postacute rehabilitation programme 88 Anne-Lise Christensen and Thomas Teasdale iv Contents Part Two Recent initiatives in traumatic brain injury rehabilitation 99 9 Principles and practice of treatment 101 Vera C. Neumann 10 Evaluation of memory rehabilitation: many questions and some answers 119 Ina J. Berg, Betto G. Deelman and Marthe Koning-Haanstra 11 Slow information processing and the use of compensatory strategies 141 Luciano Fasotti and Feri Kovacs 12 Introduction to behavioural techniques for rehabilitation of brain-injured adults 153 Ann Goodman-Smith 13 He's no longer the same person: how families adjust to personality change after head injury 167 Michael Oddy 14 Making group work work 180 Debora Prichard and Eric Berard 15 Developing coiiUp.unications skills: a group therapy approach 193 Janet Cockburn and Jacqueline Wood Part Three Measurement 205 16 The principles and practice of measuring outcome 207 Alan Tennant and M. Anne Chamberlain 17 Disability - the Functional Independence Measure 213 Alex Chantraine and Eric Berard 18 Handicap as a measure of outcome following head injury 225 Alan Tennant, David Hughes, Elizabeth Ward, Heather Warnock and M. Anne Chamberlain 19 A score of zero? Assessment of functional skills after severe head injury 234 Agnes Shiel, Sandra Horn, Martin Watson·, Lindsay McLellan and Barbara Wilson 20 Choosing outcome measures 245 Richard Body and Maggie Campbell Contents v Part Four Reflections 259 M. Anne Chamberlain, Vera C. Neumann and Alan Tennant Index 264 Contributors Mike Barnes M. Anne Chamberlain Professor of Neurology, Charterhouse Professor of Hunters Moor Rehabilitation Rehabilitation Medicine, Centre, Newcastle upon Tyne, UK University of Leeds, Leeds, UK Alex Chantraine Eric Berard Professor of Physical Medicine Medical Director, and Rehabilitation, Geneva L' Argentiere Medical Centre, Medical School, Geneva, France Switzerland Ina J. Berg Anne-Lise Christensen University Lecturer, Professor of Neuropsychological Department of Neuropsychology Rehabilitation, Centre for and Gerontology, Rehabilitation of Brain Injury, University of Groningen, University of Copenhagen, The Netherlands Copenhagen, Denmark Janet Cockburn Richard Body Senior Research Fellow and Specialist Communication Neuropsychologist, Department Therapist, Head Injury of Psychology, University of Rehabilitation Centre, Reading, UK Sheffield, UK Betto G. Deelman Maggie Campbell Professor of Gerontology, Lead Clinician Physiotherapist, Department of Neuropsychology Head Injury Rehabilitation and Gerontology, University of Centre, Sheffield, UK Groningen, The Netherlands Contributors vii Chris Evans Feri Kovacs Consultant in Rehabilitation Neuropsychologist, Institute for Medicine, City Hospital, Truro, Rehabilitation Research, Cornwall, UK Hoensbroek, The Netherlands Luciano Fasotti Neuropsychologist, Institute for Lindsay McLellan Rehabilitation Research, Europe Professor of Hoensbroek, Rehabilitation, University of The Netherlands Southampton, UK Ann Goodman-Smith Vera C. Neumann Director, Brain Injury Services, Consultant and Senior Lecturer in Partnerships in Care Ltd, Rehabilitation, University of Northampton, UK Leeds, Leeds, UK Zeev Groswasser Michael Oddy Professor and Chairman, Director of Head Injury Department for Brain Injury Rehabilitation Unit, Rehabilitation, Tel-Aviv Ticehurst House Hospital University, Ra' anana, Israel Wadhurst, UK Miroslav Paltit Sandra Horn Associate Professor, Head of Lecturer in Health Psychology, Department of Rehabilitation University of Southampton, UK Medicine, Industrial Health Centre, Bratislava, David Hughes Slovakia Manager in Disability Services, Leeds City Council, Department Miroslav Paltit Jr of Social Services, Leeds, UK Assistant Physician, Institute for Holistic Medicine, Bernried Ruth Hunter Starnberger See, Germany Community Occupational Therapist, Leeds City Council, Debora Prichard Department of Social Services, Psychologist, L' Argentiere Leeds, UK Medical Centre, Aveize, France Marthe Koning-Haanstra Clinical Neuropsychologist, Agnes Shiel Department of Neuropsychology Research Fellow, Rehabilitation and Gerontology, University of Research Unit, University of Groningen, The Netherlands Southampton, Southampton, UK v111 Contributors Thomas W. Teasdale Ileather Warnock Psychologist, Centre for Occupational Therapist, Leeds Rehabilitation of Brain Injury, City Council, Department of University of Copenhagen, Social Services, Leeds, UK Denmark Martin Watson Lecturer in Physiotherapy, Alan Tennant University of East Anglia, UK Charterhouse Principal Research Fellow, University of Leeds, Barbara Wilson Leeds, UK Senior Scientist (Special Appointment), MRC Applied Psychology Unit, Cambridge, UK Elizabeth Ward Principal Occupational Jacqueline Wood Therapist, Leeds City Council Chief Speech and Language Department of Social Services, Therapist, Royal Hospital and Leeds, UK Home, Putney, London, UK Foreword In 1986 the Trustees of the Nuffield Provincial Hospitals Trust decided to develop a major core programme of studies concerned with the organization, development and improvement of services for physically disabled and frail elderly people. This programme developed rapidly due to the enthusiastic response of those in the field; and by 1992 the total value of the programme was in excess of £2 million and currently totals over £3.2 million. It comprised a cohesive matrix of grants commissioned throughout the United Kingdom for work in identified areas which, taken in conjunction with existing grants, formed a comprehensive programme of much-needed studies and research in this field. The whole was to be underpinned by a major study planned and financed by the Trust but conducted by the Royal College of Physicians to survey the existing services being provided by some 180 health authorities. This study, together with concern for the handicapped schoolleaver, information about the availability of disability services and the care of mild/moderate head-injured persons, formed the prime initial thrust of the programme. In the case of head injury, the Trust was particularly concerned that there was discontinuity of care for many patients and little evidence as to which treatments were effective. Once patients had stabilized in hospital they were discharged into the community under the care of their general practitioner often without a continuing responsibility from the hospital. The general practitioner was frequently inexperienced and in many districts services for assistance and rehabilitation were rudi- mentary, fragmented and poorly coordinated. These patients were frequently suffering not just from physical disabilities - in themselves often devastating to a fit young person - but also from personality changes that affected family relationships and the ability to return to
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