scholarly journals A Single-center Comparison Using Exoskeleton Rehabilitation for Cerebrovascular Accidents and Traumatic Brain Injury in a Cohort of Hispanic Patients

2020 ◽  
Author(s):  
Lisa R Treviño ◽  
Kristina Vatcheva ◽  
Michael E Auer ◽  
Angela Morales ◽  
Lama M Abdurrahman ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Length Of Stay ◽  
Functional Independence Measure ◽  
Retrospective Chart Review ◽  
The United States ◽  
Functional Independence ◽  
Similar Amount ◽  
Federal Drug Administration ◽  
Robotic Exoskeleton

Abstract Background Traumatic brain injury (TBI) is one of the leading causes of disability in the United States. The EKSO GT Bionics® (EKSO®) is a robotic exoskeleton approved by the Federal Drug Administration (FDA) for rehabilitation following a cerebrovascular accident (CVA or stroke) and recently received approval for use in patients with TBI. The aim of the study was to examine if the use of exoskeleton rehabilitation in patients with TBI will produce beneficial outcomes. Methods This retrospective chart-review reports the use of the (EKSO®) robotic device in the rehabilitation of patients with TBI compared to patients with CVA. We utilized data from a single, private rehabilitation hospital for patients that received post-CVA or post-TBI robotic exoskeleton intervention. All patients that used the exoskeleton were discharged from the hospital between 01/01/2017 to 04/30/2020. Ninety-four percent of patients in the CVA groups and 100% of patients in the TBI group were of Hispanic or Latino ethnicity. Gains in total Functional Independence Measure (FIM), walking and cognition, and length of stay in the rehabilitation facility were measured. Results Patients in the TBI group (n = 11) were significantly younger than the patients in the CVA group (n = 66; p < 0.05). Both groups spent a similar amount of time active, number of steps taken, and the number of sessions in the exoskeleton. Both groups also started with similar admission FIM scores. The FIM gain in the TBI group was similar to that of the CVA group (37.5 and 32.0 respectively). The length of stay between groups was not different either. Conclusions The use of exoskeleton rehabilitation in patients with TBI appear to produce similar outcomes as for patients with CVA, prompting further attention of this intervention for this type of injury. Trial registration: Retrospectively registered on 07/09/2020 in clinicaltrials.gov number NCT4465019.

scholarly journals Predictors of Functional Outcome in a Cohort of Hispanic Patients Using Exoskeleton Rehabilitation for Cerebrovascular Accidents and Traumatic Brain Injury

2021 ◽  
Vol 15 ◽  
Author(s):  
Lisa R. Treviño ◽  
Peter Roberge ◽  
Michael E. Auer ◽  
Angela Morales ◽  
Annelyn Torres-Reveron
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Functional Outcome ◽  
Retrospective Chart Review ◽  
The United States ◽  
Functional Independence ◽  
Clinical Trial Registration ◽  
Federal Drug Administration ◽  
Cerebrovascular Accidents ◽  
Diabetes Status

Traumatic brain injury (TBI) and cerebrovascular accidents (CVA) are two of the leading causes of disability in the United States. Robotic exoskeletons (RE) have been approved for rehabilitation by the Federal Drug Administration (FDA) for use after a CVA, and recently received approval for use in patients with TBI. The aim of the study was to determine which factors predict the improvement in functional independence measure (FIM) score after using RE rehabilitation in a population of patients with CVA or TBI. We carried out a retrospective chart-review analysis of the use of the RE (Ekso® GT) in the rehabilitation of patients with TBI and CVA using data from a single, private rehabilitation hospital for patients admitted and discharged between 01/01/2017 and 04/30/2020. From the medical records, we collected presentation date, Glasgow Coma Scale score (GCS) on the date of injury, rehabilitation start date, age, diabetes status on presentation (Yes or No), injury category (TBI or CVA), and both admission and discharge FIM scores. Matching algorithms resulted in one TBI patient matched to three CVA patients resulting in a sample size of 36. The diabetic and non-diabetic populations showed significant differences between age and days from injury to the start of rehabilitation. A multivariate linear regression assessed predictors for discharge motor FIM and found admission motor FIM score and total RE steps to be statistically significant predictors. For each point scored higher on the admission motor FIM the discharge FIM was increased by 1.19 FIM points, and for each 1,000 steps taken in the RE, the discharge motor FIM increased by three points. The type of acquired brain injury (CVA or TBI) was not found to affect functional outcome. The presented results show that key clinic-biologic factors including diabetic status, together with start to rehabilitation play key roles in discharge FIM scores for patients using RE.Clinical Trial Registration: ClinicalTrials.gov, NCT04465019

Epidemiology, neurological and functional outcome of concomitant traumatic brain and spinal cord injury: An Oswestry experience

Trauma ◽  
2017 ◽  
Vol 19 (1_suppl) ◽  
pp. 30-32
Author(s):  
Poornashree Ramamurthy ◽  
Naveen Kumar ◽  
Aheed Osman
Keyword(s):  
Traumatic Brain Injury ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Brain Injury ◽  
Length Of Stay ◽  
Severe Traumatic Brain Injury ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Functional Independence Measure Score ◽  
Cord Injury

Background Concomitant traumatic brain injury with spinal cord injury is likely to worsen prognosis and increase hospital length of stay. This study assessed the duration of in-patient rehabilitation and outcome in patients with both traumatic brain injury and spinal cord injury. Methods Retrospective study of all patients with concomitant traumatic brain injury and spinal cord injury over a 3-year period who had 5 years of subsequent follow-up at the Midlands Centre for Spinal Injuries. Results Twenty-seven patients had concomitant injuries of which five had severe traumatic brain injury, nine had moderate traumatic brain injury and the remaining thirteen had mild traumatic brain injury with spinal cord injury of grades A–D; commonest mechanisms of injury were motor vehicle collision (55%) and falls (37%). Thirteen (48%) had tetraplegia and 14 (52%) had paraplegia. Mean functional independence measure score at admission was 52.1 and 103.4 at 5 years. Patients with mild traumatic brain injury gained a mean functional independence measure score of 67.1; the moderate and severe traumatic brain injury patients gained mean functional independence measure score of 60.1 and 69.2, respectively. The mean length of stay was 138.3, 139.4 and 153.4 days for mild, moderate and severe traumatic brain injury, respectively. Conclusion Hospital length of stay and patient’s functioning at 5 years were not affected by traumatic brain injury severity in this subgroup; however, functional independence measure on its own may not be very sensitive to cognitive deficits.

scholarly journals Overview of Traumatic Brain Injury Patients at a Tertiary Trauma Centre

2005 ◽  
Vol 32 (2) ◽  
pp. 186-193 ◽  
Author(s):  
Elaine de Guise ◽  
Mitra Feyz ◽  
Joanne LeBlanc ◽  
Sylvain-Luc Richard ◽  
Julie Lamoureux
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Care ◽  
Scale Score ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Term Care ◽  
Traumatic Amnesia ◽  
Post Traumatic

ABSTRACT:Objective:The goal of this study was to provide a general descriptive and cognitive portrait of a population with traumatic brain injury (TBI) at the time of their acute care stay.Material and methods:Three hundred and forty-eight TBI patients were assessed. The following data were collected for each patient: age, level of education, duration of post-traumatic amnesia, Galveston Orientation Amnesia Test score, Glasgow Coma Scale score, results of cerebral imaging, Neurobehavioral Rating Scale score, the Functional Independence Measure cognitive score and the Glasgow Outcome Scale score.Results:The clinical profile of the population revealed a mean age of 40.2 (±18.7) and a mean of 11.5 (±3.6) years of education. Most patients presented with frontal (57.6%) and temporal (40%) lesions. Sixty-two percent had post-traumatic amnesia of less than 24 hours. Seventy percent presented with mild TBI, 14% with moderate and 15% with severe TBI. The cognitive deficits most frequently observed on the Neurobehavioral Rating Scale were in the areas of attention, memory and mental flexibility as well as slowness and mental fatigability. Most patients had good cognitive outcome on the Functional Independence Measure and scores of 2 and 3 were frequent on the GOS. Forty-five percent of the patients returned home after discharge, 51.7% were referred to in or out patient rehabilitation and 3.2% were transferred to long-term care facilities.Conclusion:Because of the specialized mandate of acute care institutions, the information provided here concerning characteristics of our TBI population is essential for more efficient decision-making and planning/programming with regards to care and service delivery.

scholarly journals Rehabilitation Outcomes in Subjects with West Nile Neuro-Invasive Disease

2021 ◽  
Vol 11 (10) ◽  
pp. 1253
Author(s):  
Komal Patel ◽  
Brian D. Greenwald ◽  
Rosanna C. Sabini
Keyword(s):  
Brain Injury ◽  
Assisted Living ◽  
Functional Decline ◽  
Skilled Nursing Facility ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
The United States ◽  
Functional Independence ◽  
West Nile ◽  
Rehabilitation Facility

West Nile Virus (WNV) is the most common mosquito borne cause of viral encephalitis in the United States. Physical and neuro-cognitive recovery from WNND may be prolonged or incomplete leading to chronic cognitive inefficiencies and functional decline. There continues to be no effective treatment of WNV and current management is primarily supportive. The objective of this review is to evaluate the functional outcomes and role of rehabilitation services in subjects with WNND. The charts of five subjects admitted to an acute inpatient brain injury rehabilitation facility from June to December 2012 were retrospectively reviewed. (Mean, Range)-Age (64.8, 43–78 years), Admission Functional Independence Measure (FIM) (45.2, 14–63), Discharge FIM (82.2, 61–100), FIM score gain (37, 24–60), Cognitive FIM gain (7, 1–18), Mobility FIM gain (17.4, 13–20), ADL FIM gain (12.6, 4–23); acute brain injury inpatient rehabilitation facility length of stay (LOS) (17.8, 14–21 days); acute hospital LOS (15, 10–22 days). Of the five subjects, three were discharged home, one was discharged to a skilled nursing facility, and one was discharged to an assisted living facility. Subjects with WNND have significant functional decline across all FIM subcategories and may benefit from a course of brain injury-specific acute inpatient rehabilitation.

scholarly journals Outcome in Women with Traumatic Brain Injury Admitted to a Level 1 Trauma Center

2014 ◽  
Vol 2014 ◽  
pp. 1-9
Author(s):  
Elaine de Guise ◽  
Joanne LeBlanc ◽  
Jehane Dagher ◽  
Simon Tinawi ◽  
Julie Lamoureux ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Centre ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Discharge Destination ◽  
Confounding Variables ◽  
Mcgill University ◽  
Research Findings ◽  
Level 1 Trauma Center

Background. The aim of this study was to compare acute outcome between men and women after sustaining a traumatic brain injury (TBI). Methods. A total of 5,642 patients admitted to the Traumatic Brain Injury Program of the McGill University Health Centre-Montreal General Hospital between 2000 and 2011 and diagnosed with a TBI were included in the study. The overall percentage of women with TBI was 30.6% (n= 1728). Outcome measures included the length of stay (LOS), the Extended Glasgow Outcome Scale (GOSE), the functional independence measure instrument (FIM), discharge destination, and mortality rate. Results. LOS, GOSE, the FIM ratings, and discharge destination did not show significant differences between genders once controlling for several confounding variables and running the appropriate diagnostic tests (P<0.05). However, women had less chance of dying during their acute care hospitalization than men of the same age, with the same TBI severity and following the same mechanism of injury. Although gender was a statistically significant predictor, its contribution in explaining variation in mortality was small. Conclusion. More research is needed to better understand gender differences in mortality; as to date, the research findings remain inconclusive.

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