THE IMPACT OF THERAPY AND REHABILITATION ON COGNITIVE FUNCTIONS IN PATIENTS AFTER TRAUMATIC BRAIN INJURY
Notice bibliographique
Résumé
Abstract. The effectiveness of an individual physical therapy program in children with the consequences of traumatic brain injury (TBI) was analyzed. According to statistics, only 50–60% of patients after inpatient treatment fully recover or have minimal neurological disorders. In 63–75% of children who have suffered TBI, a delay in physical and mental development is observed. Mild TBI, as a rule, passes without complications, but in approximately 3% of cases, a sudden deterioration of the condition is possible, which requires timely detection to prevent the development of serious neurological dysfunctions. Purpose of the research: to analyze the dynamics of cognitive function indicators in children after TBI at the inpatient rehabilitation stage. Materials and methods of the research. The study was conducted on the basis of the Faculty of Medicine of the Lesya Ukrainka Volyn National University and the Volyn Regional Territorial Medical Association for the Protection of Motherhood and Childhood. The study involved 10 children aged 8–17 years who had suffered TBI. All patients and their parents were informed about the study conditions and provided informed consent to participate. Medical history analysis, somatic and neurological examination were performed. Comprehensive rehabilitation with the use of physical therapy was carried out in inpatient conditions during the subacute stage of recovery. The Montreal Cognitive Assessment (MoCA) scale, the Clock Drawing test, and the Rancho Los Amigos Scale were used to assess effectiveness. Results. Analysis of the results showed a statistically significant improvement in cognitive functions in patients after a comprehensive therapy and rehabilitation program, in particular in the areas of memory, attention, and executive functions. According to the results of the assessment of cognitive functions according to the Montreal scale (MoCA), the average value at the end of the study was 24.2±1.78, which confirms a statistically significant improvement (p<0.001). The Clock Drawing Test showed a mean score of 6.7±0.45 with significant progress compared to baseline (p<0.001). A comprehensive assessment of cognitive-behavioral functions using the Rancho Los Amigos scale showed improvement in all patients. Conclusions. Despite modern advances in neurosurgery and intensive care, TBI remains one of the leading causes of mortality and disability in the world. About a third of patients die in the prehospital stage, and another 20–30% in the hospital. Successful rehabilitation is based on the principles of evidence-based medicine, in particular, maintaining adequate brain perfusion, norm ventilation, prevention of hypoxemia, hypercapnia and intracranial hypertension. At the same time, an important component is secondary prevention of complications such as hyperthermia, hyponatremia, hyperglycemia and impaired water-salt balance. A comprehensive physical therapy program for children with TBI should be individual, flexible and dynamic, adapted to the functional state of the patient and the dynamics of his recovery. Its structure includes elements of physical activity, cognitive therapy, speech and social-psychological interventions. The proposed weekly program demonstrated effectiveness in restoring not only motor but also cognitive functions of children, which was confirmed by the results of standardized tests - the Montreal Cognitive Assessment Scale, the Clock Drawing Test and the Rancho Los Amigos Scale. The study confirmed the importance of a comprehensive approach in the rehabilitation of children with TBI, which includes physical therapy as the main component of restoring cognitive functions.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».