At least TBI patients have something, Stroke survivors have nothing but doctors flailing in the dark, knowing nothing about how to get their patients to 100% recovery. You are once again fucking screwed.
http://tirr.memorialhermann.org/journal/2016-summer/tbi-action/
The work of a research team led by principal investigator Mark
Sherer, Ph.D., ABPP, FACRM, has resulted in the development of a
web-based resource created to help clinicians working with persons with
traumatic brain injury (TBI) develop case conceptualizations and
consider treatment options. Practitioners can access TBI ACTION
(Traumatic Brain Injury Assessment Conceptualization Therapeutic
Intervention Options Narrative) at http://tbiaction.tbindsc.org.
“The
typical TBI ACTION user is a psychologist or neuropsychologist who
conducts cognitive testing in a rehabilitation setting,” says Dr.
Sherer, senior scientist and associate vice president for research at
TIRR Memorial Hermann and a clinical professor of physical medicine and
rehabilitation at Baylor College of Medicine and at McGovern Medical
School at UTHealth. “Once clinicians have the results of a client’s
cognitive processing, memory and verbal fluency tests, they can enter
the scores on the website. There are 12 questionnaires on the site,
which can be completed by the client in 30 to 40 minutes. An algorithm
combines the test and questionnaire scores to describe the dimensions
that represent key indicators of recovery from TBI, including cognitive
processing speed, verbal fluency, self-reported cognitive symptoms,
independence and self-esteem, resilience, emotional distress,
post-concussive symptoms, physical symptoms, physical functioning and
economic and family support.”1
The website grew out of a
research project funded by the 2010 Rehabilitation Research and
Training Center grant on Developing Strategies to Foster Community
Integration and Participation for Individuals with Traumatic Brain
Injury. The $4.2 million grant awarded to researchers at TIRR Memorial
Hermann by the National Institute on Disability and Rehabilitation
Research funded three research projects and five training projects.
Among them was Dr. Sherer’s study, “Development and Validation of a
Classification System of Symptoms and Characteristics to Guide Treatment
Assignments for Persons with TBI Living in the Community.” The ultimate
aim of the study was the creation of a web-based classification system
that can be used to recommend the type of treatment most likely to
provide the greatest benefit to persons with TBI. Participants for the
study were recruited from three centers following discharge from
neurosurgery and inpatient rehabilitation programs: TIRR Memorial
Hermann, Rehabilitation Institute of Michigan at Wayne State University,
and Spain Rehabilitation Center at the University of Alabama at
Birmingham.
After identifying the dimensions, the researchers
conducted a cluster analysis to determine the number of groups they
could derive from a large cohort of 504 people with TBI. Five groups
emerged.2 In May 2014, they assembled a consensus group of 17
experts from around the country and Australia at the Galveston Brain
Injury Conference to review draft descriptions of the five groups and
develop lists of therapeutic options. The experts’insights form the
basis of the website, which allows practitioners to apply data gained
from research directly to their clinical practice.
Dr. Sherer
views the website as an assist to clinical judgment. “Clinicians can use
the website to get a description of their client, treatment options,
the average profile of group members and an individual profile of their
client, allowing them to compare the characteristics of their client to
people assigned to the group,” he says. “Each client is an individual
who won’t necessarily fit precisely into any of the five groups. In the
end, clinicians have to use their judgment in applying the information
available on the website.”
Use of the website is free, secure and
HIPAA compliant. “Clinicians have a good idea of what’s going on with
their clients,” he says. “The site allows them to compare their own
measures with those of a team of expert researchers. We hope the
information we’ve provided will spur some new ways of thinking that
ultimately will improve outcomes for people with TBI.”
1Sherer
M, Sander AM, Nick TG, Melguizo MS, Tulsky DS, Kisala P, Hanks R,
Novack TA. Key Dimensions of Impairment, Self-Report, and Environmental
Supports in Persons with Traumatic Brain Injury. Rehabilitation
Psychology 2015 May;60(2):138-46.
2Sherer M, Nick TG,
Sander AM, Melguizo M, Hanks R, Novack TA, Tulsky D, Kisala P, Luo C,
Tang X. Groupings of Persons with Traumatic Brain Injury: A New Approach
to Classifying Traumatic Brain Injury in the Post-Acute Period. Journal
of Head Trauma Rehabilitation. 2015 Dec 24. [Epub ahead of print]
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