goal of rehabilitation is to help regain the highest level of
independent functioning as possible whilst learning how to perform
tasks and activities differently when functions cannot return
to pre-injury levels.
No two brain injuries are alike and their impact on unique individuals'
means that treatments and therapies are specific to the individual
and they alter over time according to the individual's changing
needs and circumstances. Timing of an intervention is important
since the many dynamic underlying processes occurring during
the recovery phase of a brain injury means that the timing of
the intervention, choice of the intervention, can determine that
intervention's likelihood of success.
In rehabilitation, many therapies attempt to improve specific
functional abilities or activities based upon the assumption
and agreement of the patient that those activities are a major
source of life satisfaction and increasing that activity leads
to an improved quality of life.
The quality of life satisfaction depends on the unique and personal
individual values of the patient. Life satisfaction after TBI
is associated with a better physical function, increased independence
and gainful employment. In addition, patients' global improvement
in quality of life is reported to increase with an early discharge
to their home and to be able to participate in meaningful leisure
activities including visiting friends and family as well as entertaining.
Patients have reported unhappiness in their limitations of independent
travel beyond walking distance and limited ability and frequency
for overnight trips; they desired greater community mobility
and self-care independence. An improvement and ease in nursing,
mobilisation, physiotherapy, pain relief, walking ability, seating
position all help to provide better comfort for the patient.
Intrathecal baclofen therapy is one such interventional therapy
that allows the multidisciplinary rehabilitation team, in appropriate
patients, to manage severe spasticity and spasms that may compromise
the patients' ability to fully improve their function allowing
the opportunity to realise better life satisfaction.
The brain injury was
a result of a motor vehicle accident in 1988. Brent experienced severe spasticity in his left arm and leg as a result of the brain injury. He also
experienced strong, unexpected kicking and jerking (spasms) in his leg.
OUTCOME AFTER RECEIVING ITB THERAPY: Spasticity significantly reduced; has 90% control of his leg; able to walk with quad canes and climb stairs by himself; has returned to drawing, playing the drums, and socialising; has enrolled in college.
COMMENT: “Before the pump, I was a mess. I just thought life was useless. Now my head's clearer, I'm walking better, and I'm doing things I want to do.”