Rolf B. Gainer, Ph.D., Diplomate ABDA, is the Chief Executive Office at Brookhaven Hospital and the Vice President of Rehabilitation Institutes of America. Dr. Gainer has been involved in the design and operation of treatment programs since 1977.

 

 

Michael Mason is author of the book Head Cases: Stories of Brain Injury and Its Aftermath, and is a Brain Injury Projects Manager at the Neurologic Rehabilitation Institute.

Penny Rott, MS, is a brain injury case manager for the Neurologic Rehabilitation Institute at Brookhaven Hospital..

July 31, 2007, 7:44 am

Hidden Epidemic: A Film About Post-Concussion Syndrome

I predict that in the oncoming years, there's going to be an increasing interest and response to PCS, post-concussion syndrome. It's going to be a major concern among athletes, and sports like football and boxing are going to have to take the matter into serious consideration as a result.

One of the first films to ever address the topic is now available for purchase. "The Hidden Epidemic," written and directed by Bill Brown, is an educational film that addresses the consequences of post concussion syndrome–call it important viewing for caregivers, survivors, coaches, and everyone else affected by PCS.

Click here to view The Hidden Epidemic site.

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July 25, 2007, 10:45 am

Sports, Concussion and Depression

In a forthcoming study to appear in the Journal of the American College of Sports Medicine of 595 football players who experienced three or more concussions, 20.2% were found to have depression. The National Football League has refuted the survey results and attacked the methodology of the study. The facts speak louder than the attack in the form of professional football athletes who have shared their personal stories like former Patriots Linebacker, Ted Johnson who reported depression and cognitive problems. Certainly, the suicide death of former Philadelphia Eagles player, Andre Waters, also carries the story home. A neuropathologist who examined Mr. Waters brain concluded that repeated concussions caused the problems which resulted in Mr. Waters taking his own life.The debate between the NFL and the American College of Sports Medicine will carry on for some time as there is much at stake for the NFL and for the players.

For those of us who work in traumatic brain injury, we know that repeated concussion can result in cognitive and psychological changes. A concussion is a brain injury and multiple concussions are multiple brain injuries.Coaches, players and parents need to be mindful of the risks of repeated concussive injuries. They can result in significant problems which can be life changing. As schools gear up for fall training, let's remember to follow the guidelines for evaluation prior to returning players to the game if concussion is suspected.

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, 10:22 am

Falling Between the Cracks in Healthcare: Reading and Wellness

In 2003 the U.S. Department of Education identified that 14% of the nation or 30 million people cannot read or understand basic information presented in short, simple statements. In another study 12% of the adults could not read or understand information in simple documents, including basic maps. Recently the issue of literacy has entered into our examination of healthcare. David Williams at Harvard observed that economics and social status are directly linked to "wellness". He further noted that poor health practices related to cognitive abilities. Dr. Williams, in his 2006 study, found that obesity, hypertension, depression and diabetes occurred at higher rates in individuals with reduced health literacy.

For individuals with cognitive problems related to disability or other conditions, the issue of health literacy as the cause of healthcare disparities is alarming.Could a person remember to take medication as directed, find a physician's office and follow the requirements of a diet or medication regime to battle an illness or chronic condition? Many of the forms that are used in healthcare and directions for treatment are written at the 8th grade level. Will individuals with reading or cognitive problems eventually be shunned by physicians and clinics as reimbursement moves towards as "pay for performance" model? How will this impact individuals living with disabilities who may have the "double whammy" of reduced health literacy and social status. While the focus is on improving the health of our nation, we are missing a large segment of the population who, for clear reasons, will fall through the crack unless changes occur to address health literacy problems.

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July 24, 2007, 12:34 pm

Goodbye Clunky MRI, Hello Funky Helmet

Technology Review suggest that traditional brain scanning may be on its way out thanks to a strange looking helmet that shines a little light on the skull's inner workings.

The device, worn on the head, may be able to quickly diagnose brain-related problems like Alzheimer's and epilepsy. Even medical giant Siemens is taking a serious look.

Click here to see the helmet and read about MIT's research.

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July 20, 2007, 12:14 pm

Neurological Abuse Markers Save Babies

Brain injury in infants is a silent epidemic, especially if the cause of the brain trauma is abuse. Infants who are injured cannot speak for themselves and parents who have caused the injury are unlikely to come forward. Axela Biosensors, a Toronto based company, has developed a test to determine the presence of two proteins that are markers of brain injury. Currently the technology is being tested in Pittsburgh and Salt Lake City as part of a five year trial involving 1000 children. The new technology will enable physicians to find the "smoking gun" to detect abuse which has resulted in brain injury. Recent literature on brain injury and child abuse indicate that 1 in 3000 children are the victims of severe and sometimes fatal brain injuries. The new technology offers an opportunity to protect vulnerable children during their initial visit to an emergency room and perhaps to save them from a cycle of abuse with potentially life threatening results.

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July 17, 2007, 12:13 pm

Homicidal Marine May Have Blast Injuries

In three tours of duty, Cpl. Trent D. Thomas suffered over 25 different incidents of blast injury–and now he strands trial at Camp Pendleton for the murder of an Iraqi man.

Many of us know that brain injuries can unleash violent behavior, and Cpl. Thomas may indeed have a severe neurobehavioral problem on his hands. What is most disconcerting about the revelations is that Cpl. Thomas was permitted to return to the battlefield following each blast. One question naturally arises: how many other blast-affected soldiers are still serving in Iraq?

Read more here.

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July 12, 2007, 2:26 pm

New Post at Second Chance to Live

For those of you who have enjoyed Craig Phillips' posts about living with a brain injury, he has some wonderful new writing up at his website, Second Chance to Live. Click here to visit.

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, 10:23 am

Robotics and Rehabilitation

The life of stroke patients can be improved with new rehabilitation technology in the form of robotics. A new device, worn as a brace, senses weak electrical activity in an individual's arm muscle and provides assistance to the arm to complete activities like extending and flexing the arm and performing simple functional skills, like flipping on a light switch and lifting a box. Through repetition and practice, the neurological pathway can be rebuilt and strengthened over time. The designers of the device, John McBean and Kailas Narendran, refer to the technology application as a way to "get patients over the functional hump". Other robotic devices are also entering into medical rehabilitation. These devices are both free-standing or "strapped-on" like the robotic arm.Dr. Hermano Krebs, at M.I.T. and one of the first scientists working in robotic assisted therapy, called the area of applied research in this area as "exploding". He expects to see these devices in rehabilitation clinics and even patient homes in the next 5-10 years. Dr. Krebs notes that repeated practice with an impaired limb can foster plastic change within the brain, strengthening neural connections and forging new ones. For individuals with brain injuries this technology offers new hope. The work of Dr. Paul Bach-y-Rita in the area of brain plasticity and rebound heralded much of the technology we are seeing today. Applied neuromotor scientist, Avi Nativ, Ph.D., working in Ottawa at NeuroGym (neurogym.com) is active in developing new equipment and applications in the area of neuromotor rehabilitation. Dr. Nativ's work involves the use of EMG-biofeedback equipment interacting with computer games to encourage the individual to maintain practice and repetition as motor relearning is accomplished over time.

The goal of making neurons talk to each other is at the core of this advancement in rehabilitation which is based on motor learning theory.A complelling article in the New York Times of July 10, 2007 tells the story of Mary O'Regan who fell from a dirt bike in 1986 and later suffered a stroke resulting in left sided weakness and numbness and the loss of use of her left arm.. Ms. O'Regan has been participating in a clinical trial of a robotic arm called the Myomo e100. After a six week training program Ms. O'Regan saw improvement including the spontaneous response of her paralyzed arm to grab at falling mail she was carrying at work. Clinical trials of the device were conducted at Spaulding Rehabilitation Hospital and published in the April edition of The American Journal of Physical Medicine and Rehabilitation. Further studies were conducted at Braintree Rehabilitation Hospital with stroke patients. Individuals with spinal cord injuries and traumatic brain injuries, including returning Iraq was veterans, are entering into a study at the James A. Haley Veterans' Hospital in Tampa.

This area of advancement is of great importance to the rehabilitation of individuals with neurologic injuries.

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July 10, 2007, 8:02 am

Everything You Want to Know About Brain Drugs

In an impressive and laudable display of foreward thinking and action, the American College of Neuropsychopharmacology has put an entire textbook online that compiles all we currently know about how drugs affect the brain. The tome is a wealth of information, and now it's freely available as PDF files.

Over 131 chapters detail the history and development of a variety of different medications and discuss how their effects on brain physiology, cognition and behavior. Best of all, you don't have to be a neurosurgeon to understand the text.

It's recommended reading for anyone curious about the medications involved in treating brain injury.

Find it here.

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July 3, 2007, 2:26 pm

Coma Documentary Debuts Tonight

For all of our neuroscientific advances, comas remain one of the most mysterious phases of traumatic brain injury. The HBO documentary "Coma" is an exploration into the enigmatic state. It follows the lives of four brain injury survivors and, from the looks of things, the show should be realistic and heartwrenching.

Read more about HBO's Coma here.

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