1. TBI Model Systems of Care: -established in 1987 by the US department of educations
national institute on disability and rehab research, which moved to theadministration for
community living in 2015 as the national institute on disability, independent living, and rehab
research
-conducts prospective, longitudinal research to demonstrate the course of recoveryand
outcomes following TBI at 16 centers
-maintains the model systems knowledge translation center
2. mTBI: mild traumatic brain injury
-traumatically induced physiological disruption of brain function
-alteration of mental state (dazed, confused, difficulty answering questions, unclearthinking,
unable to describe what happened prior to or after injury)
3. mTBI incidence: -represents 75% of all TBI's that occur in the US
-true incidence may be higher as 16-25% of those injured do not see medical care
4. mTBI symptoms:
5. How to reduce disability from mTBI: early intervention and management isthe most
effective way to reduce disability
-rest and slow resumption of normal activities
6. PPCS: persistent post-concussive symptoms
7. PPCS incidence: 10-15% have slow or incomplete resolution of symptoms
8. PPCS treatment plan: should:
-begin asap
-be symptom focused
-be based off careful diagnosis
-emphasize both functional resolution and compensatory strategies
-provide an optimistic outlook and clear path for the patient to improve
-be multidisciplinary
9. CTE: chronic traumatic encephalopathy
-rare and progressive degenerative condition
-DAI causes the release of Tau proteins and chronic inflammation
-still working to identify who is at risk for CTE after mTBI
,-most do not develop CTE
10. and compose the CNS: brain and spinal cord
11. brain: -cerebrospinal fluid
-meninges
-composed of neurons (communicating) and glial (support/maintain neurons) cells
12. neurons communicate via : synapses
13. brain stem: -three components (midbrain, pons, medulla)
-located at the top of the spinal column
-central point for all incoming and outgoing info and basic life functions
14. midbrain: -smallest part of the brain stem
-involved in elementary forms of vision and hearing
-plays a pivotal role in alertness and arousal
15. Acquired brain injury (ABI): injury to the brain that is not hereditary, congenital,
degenerative, or induced by birth trauma
16. Traumatic Brain injury: an alteration in brain function or other evidence of brain
pathology caused by an external force
17. Mild brain injury: -AKA concussion
-brief or no loss of consciousness
-its presentation may demonstrate vomiting, lethargy, dizziness, and inability to recallwhat just
happened
18. Moderate brain injury: -marked by unconsciousness for any period of time up to24 hrs
-will have neurological signs of brain trauma (skull fractures with contusion orbleeding and
may have focal findings on and EEG/CT scan)
19. Severe brain injury: marked by a period of loss of consciousness of 24 hrs orgreater
20. Incidence/prevalence: -13.5 million americans, 4.5% of population are living withbrain
injury
-TBI is a contributing factor to a third of all injury-related deaths in the US
-75% of TBI's that occur each year are mild TBI
-2.5 million people sustain a TBI yearly
21. Chronic conditions caused or accelerated by a TBI: -aspiration pneumonia
-seizures
-septicemia
, -circulatory problems
22. Continuum of care: -acute rehab
-post-acute rehab
-long term home and community
23. acute rehab: -emergency department
-icu
-acute medical/surgical unit
-specialty neuro trauma polytrauma
24. post-acute rehab: -comprehensive inpatient rehab hospital
-sub-acute rehabilitation
-transitional residential programming
25. Long term home and community: -home
-snf
-long term residential programming
-outpatient and day treatment services
-home and community based services
-school and/or vocational rehab
26. standards for rehabilitation facilities: -person centered practices that focuson their health
and safety
-a robust performance measurement, management, and improvement system thatfocuses on
continuous improvement of both clinical business practices
-delivery of quality services by competent ad well trained personnel
-accountability to persons served, payers, and regulators
27. Olmstead decision: -in 1999 the supreme court ruled that the plaintiffs must begranted the
option to live in the community
-uses title II of the american disabilities act to assert that states must administer their services,
programs, and activities "in the most integrated setting appropriate to the needs of qualified
individuals with disabilities"
-resulted in multiple federal and state initiatives that make living in the community a reality for
more persons with disabilities