Towards a state of play: A case study exploring insight-oriented musical experiences with a woman with severe brain injury

This article presents an improvisational approach to insight-oriented therapy in music therapy with a woman with severe cognitive impairments following haemorrhagic stroke. Analysis of five clinical excerpts across 40 sessions demonstrates how a prepared improvised musical experience can facilitate meaningful self-exploration in dialogue, leading to a renewed self-identity in life after brain injury. The therapist’s reflective processing is integral to the therapeutic outcomes; these are examined alongside the casework material. This article suggests that insight-oriented musical experiences may be one way of supporting the emotional health of individuals living with the enduring consequences of severe brain injury in slow-stream rehabilitation or long-term neurological care.

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Long-term and delayed functional recovery in patients with severe cerebrovascular and traumatic brain injury requiring tracheostomy

Journal of Neurosurgery ◽

10.3171/2018.2.jns173247 ◽

2019 ◽

Vol 131 (1) ◽

pp. 114-121 ◽

Cited By ~ 4

Author(s):

Rafael Wabl ◽

Craig A. Williamson ◽

Aditya S. Pandey ◽

Venkatakrishna Rajajee

Keyword(s):

Brain Injury ◽

Functional Recovery ◽

Tube Feeding ◽

Severe Brain Injury ◽

Eligibility Criteria ◽

Severe Stroke ◽

Icu Discharge ◽

Significant Difference

OBJECTIVEData on long-term functional recovery (LFR) following severe brain injury are essential for counseling of surrogates and for appropriate timing of outcome assessment in clinical trials. Delayed functional recovery (DFR) beyond 3–6 months is well documented following severe traumatic brain injury (sTBI), but there are limited data on DFR following severe cerebrovascular brain injury. The objective of this study was to assess LFR and DFR in patients with sTBI and severe stroke dependent on tracheostomy and tube feeding at the time of discharge from the intensive care unit (ICU).METHODSThe authors identified patients entered into their tracheostomy database 2008–2013 with sTBI and severe stroke, encompassing SAH, intracerebral hemorrhage (ICH), and acute ischemic stroke (AIS). Eligibility criteria included disease-specific indicators of severity, Glasgow Coma Scale score < 9 at time of tracheostomy, and need for tracheostomy and tube feeding at ICU discharge. Assessment was at 1–3 months, 6–12 months, 12–24 months, and 24–36 months after initial injury for presence of tracheostomy, ability to walk, and ability to perform basic activities of daily living (B-ADLs). Long-term functional recovery (LFR) was defined as recovery of the ability to walk or perform B-ADLs by the 24- to 36-month follow-up. Delayed functional recovery (DFR) was defined as progression in functional milestones between any 2 time points beyond the 1- to 3-month follow-up.RESULTSA total of 129 patients met the eligibility criteria. Functional outcomes were available for 129 (100%), 97 (75%), 83 (64%), and 80 (62%) patients, respectively, from assessments at 1–3, 6–12, 12–24 and 24–36 months; 33 (26%) died by 24–36 months. Fifty-nine (46%) regained the ability to walk and 48 (37%) performed B-ADLs at some point during their recovery. Among survivors who had not achieved the respective milestone at 1–3 months, 29/58 (50%) were able to walk and 28/74 (38%) performed B-ADLs at 6–12 months. Among survivors who had not achieved the respective milestone at 6–12 months, 5/16 (31%) were able to walk and 13/30 (43%) performed B-ADLs at 12–24 months. There was no significant difference in rates of LFR or DFR between patients with sTBI and those with severe stroke.CONCLUSIONSAmong patients with severe brain injury requiring tracheostomy and tube feeding at ICU discharge, 46% regained the ability to walk and 37% performed B-ADLs 2–3 years after injury. DFR beyond 1–3 and 6–12 months was seen in over 30% of survivors, with no significant difference between sTBI and severe stroke.

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Long-Term Outcome from Severe Brain Injury

Neurorehabilitation and Neural Repair ◽

10.1177/154596839601000406 ◽

1996 ◽

Vol 10 (4) ◽

pp. 259-265

Author(s):

P. J. Wisdom ◽

H. Jones ◽

J. R. Couch ◽

R. L. Bayles

Keyword(s):

Brain Injury ◽

Severe Brain Injury ◽

Term Outcome ◽

Long Term Outcome

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Children and young adults in a prolonged unconscious state after severe brain injury: Long-term functional outcome as measured by the DRS and the GOSE after early intensive neurorehabilitation

Brain Injury ◽

10.1080/02699050601151795 ◽

2007 ◽

Vol 21 (1) ◽

pp. 53-61 ◽

Cited By ~ 20

Author(s):

H. J. Eilander ◽

R. B. W. Timmerman ◽

J. G. M. Scheirs ◽

C. M. Van Heugten ◽

P. L. M. De Kort ◽

...

Keyword(s):

Young Adults ◽

Brain Injury ◽

Functional Outcome ◽

Severe Brain Injury ◽

Children And Young Adults ◽

Unconscious State

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The Impact of Physiotherapy in the Water Assisted by Dolphins for Motor Skills of Patient after Haemorrhagic Stroke (Case Analysis)

Reabilitacijos mokslai slauga kineziterapija ergoterapija ◽

10.33607/rmske.v1i20.783 ◽

2019 ◽

Vol 1 (20) ◽

Author(s):

Evelina Rimkutė ◽

Eglė Radzevičienė ◽

Brigita Kreivinienė

Keyword(s):

Muscle Strength ◽

Motor Skills ◽

Haemorrhagic Stroke ◽

The Status ◽

Animal Interaction ◽

Therapeutic Activities ◽

The Impact

Background. Stroke is one of the leading causes of morbidity, mortality and long-term disability worldwide. In terms of innovative technologies which help to recover from stroke one of the newest and least researched methods is physiotherapy in the water assisted by dolphins. Such an innovative case study was conducted in Lithuania. A great variety of scientifc literature on animal assisted therapies and interventions can be found worldwide, however, concerning research on human-animal interaction mechanisms a scientifc gap is still existing as presented in various journals of diﬀerent felds (Beetz et al., 2012). The aim of the study was to determine the eﬀectiveness of healing exercises in the water assisted by dolphins for motor skills of patients with haemorrhagic stroke. Methods. The study was carried out at the Dolphin Therapy Centre of the Lithuanian Sea Museum. The study lasted two weeks. The sample was a man diagnosed with a haemorrhagic stroke. The research data was collected on motor skills in the water, leg muscle strength, coordination, balance and gait. The patient participated in ten therapeutic activities in the water, assisted by dolphins (length of one activity – 30 minutes). The physiotherapist working with the patient applied balance and coordination exercises in the water. The status of the patient was evaluated four times: before activities with dolphins, after fve activities with dolphins, after ten activities with dolphins, and follow up in three weeks after ending the activities with dolphins. Results. The muscle strength of legs increased signifcantly in the foot group and slightly in the lower limb muscle group. The greatest result in balance was registered after ten therapeutic activities with dolphins in the water. The greatest improvement in coordination and walking occurred later. Assessing motor skills in the water, a signifcant positive change in equilibrium was observed. Conclusions. The results of the study showed that physiotherapy exercises in the water assisted by dolphins might help to achieve improvements in motor skills.Keywords: haemorrhagic stroke, motor skills in the water, balance, gait, therapeutic activities for assisting dolphins, physiotherapy in water.

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Long-term Outcome Regarding Linguistic and Nonlinguistic Functions in Two Cases of Acquired Aphasia Due to Severe Brain Injury in Childhood.

The Japan Journal of Logopedics and Phoniatrics ◽

10.5112/jjlp.43.261 ◽

2002 ◽

Vol 43 (3) ◽

pp. 261-269

Author(s):

Fumi Tamai ◽

Yoji Tokunaga ◽

Kimitaka Kaga

Keyword(s):

Brain Injury ◽

Severe Brain Injury ◽

Term Outcome ◽

Long Term Outcome

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Recovery of consciousness through the prism of psychology: psychological work with children after severe brain injury

Counseling Psychology and Psychotherapy ◽

10.17759/cpp.2018260207 ◽

2018 ◽

Vol 26 (2) ◽

pp. 104-124

Author(s):

V.I. Bykova ◽

A.N. Harkovskiy ◽

E.V. Fufaeva ◽

V.I. Lukyanov ◽

Y.G. Sidneva

Keyword(s):

Brain Injury ◽

Proximal Development ◽

Severe Brain Injury ◽

Rehabilitation Team ◽

Communication Signals ◽

Complex Approach ◽

The Family ◽

And Behavior ◽

Recovery Of Consciousness

The paper discusses psychological work with children after severe brain injury. We present the method of clinical anthropocentrism which lets the rehabilitation team sample the patient’s capabilities and determine his/her areas of proximal development at each stage of recovery, and also find the nearest and set out long-term tasks of psychological rehabilitation. We present the results of the comparative analysis of the recovery of two children in the state of reduced consciousness who were rehabilitated with the use of different methods: clinical anthropocentrism and standard complex approach (psychological support of the family, therapeutic physical training, massage, physiotherapy, pharmacotherapy, etc.). Conclusions: the method of clinical anthropocentrism used in work with children after severe brain injury raises the quality and intensity of his/her communication signals and expands the potential for movement and behavior.

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International prospective study on long-term clinical evolution of patients with severe brain injury and disorders of consciousness

Journal of the Neurological Sciences ◽

10.1016/j.jns.2021.117666 ◽

2021 ◽

Vol 429 ◽

pp. 117666

Author(s):

Anna Estraneo ◽

Alfonso Magliacano ◽

Salvatore Fiorenza ◽

Rita Formisano ◽

Antonello Grippo ◽

...

Keyword(s):

Brain Injury ◽

Prospective Study ◽

Disorders Of Consciousness ◽

Severe Brain Injury ◽

Clinical Evolution

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Motor Control Recovery After a Severe Brain Injury: Applications of Quantitative Surface Electromyography

Biofeedback ◽

10.5298/1081-5937-41.2.03 ◽

2013 ◽

Vol 41 (2) ◽

pp. 50-55 ◽

Cited By ~ 3

Author(s):

Jeffrey E. Bolek ◽

Jennifer Yost

Keyword(s):

Motor Control ◽

Brain Injury ◽

Motor Skill ◽

Visual Processing ◽

Surface Electromyography ◽

Severe Brain Injury ◽

Head Control

In this case study, surface electromyography (SEMG) was used to help a severely brain-damaged adolescent regain head control. In addition to relearning a lost motor skill, the patient, because of the extensiveness of the injury, had to overcome deficits in memory, visual processing, and cognitive tone. The process of quantitative SEMG was used to teach the patient to use a targeted series of muscles, which, in 14 weeks, brought her to the point that for many activities a headrest was no longer needed.

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