presented by Mary Beth Osborne
This course covers physical therapy management of people following brain injury in the rehabilitation phase after medical stability is achieved. Participants will be challenged to identify strategies to address cognitive and behavioral issues and to apply them clinical practice. Students will also identify common impairments underlying functional deficits, and will design effective treatment plans to address areas of need. Cognitive deficits, behavior issues and common complications will be illustrated by case studies detailing common manifestations during this phase of recovery.
Mary Beth Osborne PT, DPT, NCS earned her BS and doctorate in physical therapy from the University of North Carolina at Chapel Hill. Her area of clinical expertise is in adult neurologic rehabilitation including working with people following brain injury, stroke, spinal cord injury, and neurologic diseases. She has over 25 years of clinical experience in both inpatient and outpatient settings. Dr. Osborne has served as adjunct faculty at UNC Chapel Hill assisting with online and traditional classroom courses focusing on neurologic physical therapy and evidence based practice. She is currently working as a clinician at Duke University Medical Center on the outpatient team in adult neurology. Dr. Osborne is the current chair of the Brain Injury Special Interest Group for the Neurology Section of the American Physical Therapy Association and is a past member of the practice committee. She also has interest and expertise in using hippotherapy (using movements of a horse) as a treatment strategy for children and adults with neurologic conditions.
This chapter covers patients as they move out of the DOCs phase and are gaining awareness, but continue to struggle with cognitive deficits. The Ranchos Los Amigos Levels of Cognitive Recovery (RLA) will help illustrate how patients often progress following a brain injury. The issues of confusion and agitation will be explored and learners will become familiar with clinical tools to utilize when measuring progress in this area.
This chapter goes into more depth regarding the impact behavioral and cognitive deficits can have on physical therapy sessions and strategies to best structure sessions and concepts to apply when interacting with individuals exhibiting these issues in the clinic. Learners will gain knowledge surrounding common complications often seen following brain injury including communication deficits, changes in tone and heterotopic ossification.
This chapter looks at in depth evaluation of people in the rehab phase of treatment including management of contractures and tonal abnormalities, wheelchair seating and orthotics, balance and gait. Participants will have a strong working knowledge of the many components of a thorough physical therapy evaluation following brain injury and the need for referral to other professionals to fill needs not covered in physical therapy practice.
This chapter addresses evidence-based physical therapy intervention choices for people following brain injury and how to structure treatment sessions for optimal outcomes.