THE IMPACT OF THERAPY AND REHABILITATION ON COGNITIVE FUNCTIONS IN PATIENTS AFTER TRAUMATIC BRAIN INJURY
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".