Traumatic Brain Injury

1. Traumatic Brain Injury Timothy R. Elliott, Ph.D.

2. 5.3 million Americans (just over 2% of the population) currently live with a disability resulting from a TBI 1.5 million people sustain an TBI each year 50,000 die due to TBI each year Every 21 seconds a person in the US sustains an TBI TBI facts

3. �an injury to the brain, occurring after birth�.not hereditary, congenital, degenerative, or induced by birth trauma commonly results in a change in neuronal activity, which affects the physical integrity, the metabolic activity, or the functional ability � an acquired brain injury

4. May result in mild, moderate, or severe impairments in one or more areas Injuries can range from very mild to very severe, and depending on the location of the brain injury, impairments may include �. Levels of Injury

5. Closed head injury occurs when an outside force impacts the head hard enough to cause the brain to move within the skull Open head injury can occur from motor vehicle crashes, gun shot wounds, falls, shaking (a baby), sports, and physical violence, such as hitting or striking with an object Types of brain injury

6. Airway obstruction Near-drowning, throat swelling, choking, strangulation, crush injuries to the chest Electrical shock or lightening strike Trauma to the head and/or neck Traumatic brain injury with or without skull fracture, blood loss from open wounds, artery impingement from forceful impact, shock Vascular Disruption Causes of brain injury

7. Lack of coordination Slowness or confusion in the planning and sequencing of movements Muscle spasticity Speech disorders Seizures, paralysis Chronic, persistent pain (nerve damage, fractures) Sensory impairments (e.g., vision and hearing loss Impairments may include�

8. Mood swings Depression, blunted affect Lack of motivation, decreased initiative Agitation Impulse control Interpersonal difficulties, impaired empathy Social, emotional, and behavioral impairments

9. Short and/or long term memory loss Poor attention, judgment, and concentration Communication disorders related to speech, writing, and reading Cognitive impairments

10. Closed head injury occurs when an outside force impacts the head hard enough to cause the brain to move within the skull Open head injury can occur from motor vehicle crashes, gun shot wounds, falls, shaking (a baby), sports, and physical violence, such as hitting or striking with an object Types of brain injury

11. Severity loss of consciousness Posttraumatic Amnesia Glasgow Coma Scale Mild scores 13 � 15 Moderate scores 9 � 12 Severe < 8 Gross predictor of outcomes at 6 months

12. Post-Concussive Syndrome History of head trauma Evidence of difficulty in attention or memory Significant impairment in role functioning Three of these Fatigue, disordered sleep, headache, anxiety/depression, apathy, change in personality, irritability/aggression, vertigo or dizziness

13. Veterans and ABI By some estimates, as many as 10% of the 1.5 million soldiers may have some form of traumatic brain injury Over 60% of soldiers recently wounded in action in Operation Iraqi Freedom sustained blast injuries Perhaps 60% and 80% of these blast-injured soldiers have TBI

14. Veterans and ABI The average age of a soldier stationed in Iraq and Afghanistan is 19 years old Estimating conservatively,�the cost of�caring for veterans with TBI from these wars could be $14 billion over 20 years, and $35 billion over their lifetimes

15. A brain injury is unpredictable A person with a brain injury is a person first No two brain injuries are exactly the same The effects are complex and vary greatly from person to person The effects may depend on such factors as cause, location, and severity

16. Rehabilitation Strategies Compensatory Written instructions, date books, calendars, pagers, electronic or other assistive devices Restoration visual & auditory exercises, practice/performance, reinforcement, monitoring, problem-solving strategies, goal setting

17. Indicators of Adjustment Severity of injury Pre-injury personal and social adjustment Social support structures (e.g., family, church, work history)

18. Health and Adjustment Normal life expectancy People with ABI generally have a greater propensity towards poor health habits as well as having poor health profiles At risk for secondary complications including social (e.g., poverty, arrests)

19. Health-risk behaviors Smoking Alcohol misuse Dietary problems or habits Lack of exercise, Prolonged inactivity Sedentary lifestyle Obesity Medications that may be debilitating over time Indifference, lack of initiation Negative moods

20. An Agenda for Public Health Healthy People 2010 calls for behavioral and social initiatives to promote the health and quality of life of persons with traumatic brain injury

21. Benefits of Exercise and Healthy Lifestyles Improved stamina and strength Enhanced mood management Sense of confidence, competence Possible benefits to sense of balance Weight management, improved cardio fitness

22. Benefits of a Stretching Program Increased range of motion For some, there will be an increase in muscular strength Promoted relaxation Stretched muscle tissue, flexibility Positive effects on balance

23. Benefits of a Strength Program Increased muscle endurance Reduction of body fat Increased metabolic rate Increased body awareness

24. Benefits of a Cardiovascular Program Reduction of specific risk factors for conditions (e.g., heart disease, stroke) Increased cardio efficiency More calories burned (weight loss) Improved circulation Decreased harmful cholesterol

25. Recreation and Leisure Benefits Brainstorming activities

26. Online Resources