Early neurorehabilitation after severe brain trauma

A, brain injury, whether isolated or accompanied with polytrauma, is one of the most common forms of injury sustained in road accidents, accidents at work or during leisure time. Immediate and systematic applications of adequate rehabilitation are the most important factors for restitution of the impaired brain function. The integration of these applications makes it possible to start rehabilitation therapy directly after the brain injury, without any interruption. The aim of the first part of the study was to observe the efficiency of early rehabilitation after a severe head trauma at the Neurosurgical Intensive Care Unit. 50 survivors after a severe brain injury (GCS < 8 for at least 24 hours) with or without polytrauma were investigated. Early rehabilitation treatment lasted for the average of 18 days. The therapy was adapted to the individual capability and was performed for 4-5 hours each day. At the time of discharge from the early rehabilitation about 50% of patients were independent in their every-day activities. The second part of the study evaluates 1-year's outcome of patients after a severe brain injury. The data have revealed that in one year more than 90% of patients were completely or restrictedly independent on care and capable to carry out their every-day activities after the early-onset continuous rehabilitation although they were often still suffering from marked behavioral and certain sensorimotor deficits. Less than 50% of patients were obviously able to work without restrictions or returned to work.