Effect of early rehabilitation in patients with severe traumatic brain injury

Abstract

Objective To investigate the clinical effect of early rehabilitation treatment on patients with severe traumatic brain injury (sTBI).Methods Forty sTBI patients were divided into treatment group (n =20) and control group (n =20) according to the random number table.Conventional treatment was performed on all patients including dehydration to decrease intracranial pressure,hemorrhage control,neurotrophic treatment,antiinflammation therapy,and gastric acid control.In addition to these interventions,patients in treatment group received hyperbaric oxygen treatment,median nerve stimulation,fastigial nucleus stimulation,and bedside motor therapy in the early period.Intracranial pressure and partial pressure of brain tissue oxygen (PbtO2) were continuously monitored during the process of treatment.GCS was measured before and 15 days after treatment and single-photon emission computed tomography (SPE-CT) was used to evaluate cerebral perfusion.Results There was no statistical difference between the two groups with respect to GCS in advance of treatment (P ＞ 0.05),but GCS differed between treatment group and control group after treatment [(10.18 ± 3.75) points vs (8.33 ±2.36) points,P ＜0.05],with substantial improvement in treatment group.Significantly improved cerebral perfusion was seen in treatment group.On day 5 after treatment,intracranial pressure in treatment group lowered significantly compared with that in control group (P ＜ 0.05).On day 6 after treatment,PbtO2 was significantly higher in treatment group than in control group (P ＜ 0.05).Conclusion Early rehabilitation treatment leads to improved outcome and acts a positive effect on nerve function recovery. Key words: Brain injuries ; Rehabilitation; Hyperbaric oxygen