Traumatic brain injury (TBI) is one of the leading causes of disability and death, and is the primary cause of death among people under 45 years of age. Majority of patients who suffer from moderate to severe TBI are often admitted to intensive care units (ICUs).
A lot of randomized controlled trials (RCTs) have been conducted to investigate the efficiency of new treatments, but none seem to exhibit any benefit. Clinical trials in traumatic brain injury pose serious challenges and meeting these require new approaches. These challenges relate to the severity of the brain injury, the optimum analysis of outcome, and the aspects of the design of trials.
The advancement of medical technology in regional trauma services have greatly increased the number of traumatic brain injury survivors, in which the social consequences and medical challenges begin to arise for a growing pool of people with disabilities.
Wider awareness of the scope of the problem and its societal consequences led to a rapid growth in the rehabilitation industry. Because of this, and particularly because clinical rehabilitation strategies vary widely, a lot of organizations are looking into the effectiveness of rehabilitation for traumatic brain injury.
In a Nutshell: Traumatic Brain Injury
Traumatic brain injury, in most cases, is an acute event similar to other injuries. But that is the only thing in common between TBI and other injuries. One moment a person is normal and the next moment, life has abruptly and completely changed.
TBI is very different from other forms of injuries in many aspects. Since the human brain defines who we are, the effects of a brain injury affects all aspects of our lives. It even has a huge impact on one’s personality.
TBI is different compared to a fractured bone or a lacerated liver. An injury in these parts of the body only limits its functions, but your personality and mental abilities remain intact and unchanged. Moreover, these body parts eventually heal and regain their previous function. Brain injuries, on the other hand, do not heal like other injuries. Recovery is functional, one that is based on mechanisms that remain uncertain.
Brain injuries vary from person to person and the consequences of these injuries may be very different. Symptoms could either appear right away or may not be present for days or weeks after the injury.The sad thing is that, in some cases, the person often does not realize that a brain injury has occurred.
Assistive Technology for Patients with Traumatic Brain Injury
The future of traumatic brain injury treatments and aids to patients, including a possible cure, lay in assistive and interactive technology.
Video Games for TBI Patients
One recent innovation comes in the form of a video game.An Arizona-based company called Kinetic Muscles Inc. is currently working on addressing the rehabilitation needs of patients who suffered from stroke and other brain injuries. In 2010, the company received a two-year Phase II Small Business Innovation Research (SBIR) grant from the Department of Defense (DOD)in order to study a new treatment for military veterans who are returning from active duty with TBI.
The first phase of KMI’s research produced promising results that combine both neuropsychological therapy and the technology of the video game. Studies show that the gaming technology could assist patients with TBI in developing their motor and cognitive skills.
This is good news for many soldiers. According to statistics by the Defense and Veterans Brain Injury Center, majority ofsoldiers who are in active army duty are between 18 and 24, which makes this technology popular among those who already own video gaming systems like the Nintendo Wii. The console’s popular game, Wii Fit, can assist not only patients with TBI, but also the healthcare providers who are treating patients because the game creates a baseline, tracks and monitors a patient’s progress over time. This type of game system also comes with an interactive communications feature, an innovation that can be of use to bringing patients and families together during the rehabilitation process, and for patients to get to know and learnfrom other TBI survivors.
Brain Computer Interface
A team of researchers from the Washington University School of Medicine is generating new and exciting information related to a proposed theory about the distinct functions and responsibilities of the brain’s left hemisphere and right hemisphere.
During this process, the team, headed by Eric Leuthardt, PhD, and his graduate students Nick Anderson and Kimberly Wisneski, have applied their findings to a new neuroprosthetic strategy that aims to improve the rehabilitation of stroke and brain trauma patients who have suffered damage to either the left or right half of the brain.
During their research, the team found out that where the left side of the brain was damaged, the opposite side still contained the electrical signals that could be used to initiate right-side body movement. Dr. Leuthardt’s team realized the benefits of this newfound knowledge for victims of stroke and/or brain injuries. Now, they are focusing on the rehabilitation aspect, called the Brain Computer Interface (BCI). In order for this new technology to work, it needs to be adapted to work with signals from one side of the brain. This is certainly one of the most exciting scientific breakthroughs for a new and upcoming technology for TBI patients.
Telehealth
One innovation that has been used for quite some time in the Pacific, particularly at the Tripler Army Medical Center in Hawaii, is “telehealth” (or otherwise known as “telemedicine”).
Telehealth has been in use for more than a decade now, especially in that part of the world due to the expanse of the Pacific Ocean. With the use of Video teleconference (VTC) technology, Otolaryngology, Audiology, and Speech-Language Pathology (SLP), physicians are able to diagnose and treat patients without the need for them to be physically present. This piece of modern technology is now being pushed across the DOD and Veteran Affairs to help in the treatment of patients with TBI and other cognitive disorders.
For years, the technology and its practice have yielded positive results. Doctors have concluded that telehealth has a particular appeal for management of post-TBI cognitive-communication disorders mainly because problems in communication often arise when in the chronic stage post-injury after acute rehabilitation has ended. This is when the patient returns home and attempts to re-enter community life.
Project CampusReader
Supported and funded by the National Science Foundation (NSF) that links technology with education, the CampusReader is an exciting innovation that aims to combine the popular and powerful iPad and other next-generation reading platforms to deliver quality support to improve reading comprehension and retention, with focus on integrating reading strategies with e-books.
CampusReader is a five-year project of the University of Oregon, Tripler Academy Medical Center, and the Portland Veterans Affairs Research Foundation. This project aims to meet the needs of a growing population of active soldiers and veterans who have or are returning from active duty and are not able to meet the reading requirements of post-secondary education.
Project CampusReader aims to assist students who “have cognitive impairments that impact high level text processing skills and result in diverse reading profiles with difficulties in skills such as discerning between relevant and irrelevant information, drawing inferences, connecting background knowledge to new learning and retaining and applying what was learned at a later date.”The goal of this software is to help students with cognitive deficits, sort out the relative information from the irrelevant.
Two tracks encompass the technology behind Project CampusReader. The first track is comprised of the hardware and the software which are also developed by the team behind CampusReader. Every time the technology and software code is changed and updated, the software version is immediately made available for download, which is accomplished through Google’s Code site. The second track is far more complex, as it deals with personalizing CampusReader to each patient and their specific needs. After all, each patient has a unique and different reading strategy.
Project CampusReader continues to explore a means of personalizing a reading device in order to provide effective strategies that fit a user’s reading profile, as well as the changing context of reading for a college-level course.
Robots for Timed and Monitored Medication Dispensing
The US Navy is also working towards a new technology that aims to distribute individual doses of medicine in a scheduled, organized, and monitored environment, with the purpose of reducing the dangers of self-medication by patients.
This is especially useful for patients suffering from TBI.
The US Navy, along with the DOD’s Telemedicine and Advanced Technology Resource Center, is studying robots that dispense medication for patients suffering from either TBI or psychological stress. The US Air Force Center for Excellence in Medical Media hopes that this technology can help improve the lives of TBI victims.
Moving Forward
TBI is a major health and socio-economic problem throughout the world. However, more and more innovations in TBI treatment continue to emerge and there seems to be no stopping or slowing down in the research and treatment areas to assist people who are suffering from this debilitating injury.
Patients who suffer from TBI have lives and families of their own and they all deserve to live their lives to the fullest. It is our sincerest hope that these new and emerging technologies can continue to help diagnose, mitigate, and possibly treat TBI patients everywhere.