By GORDON MUIR GILES AND JO CLARK-WILSON
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Additional resources for Brain Injury Rehabilitation: A neurofunctional approach
The best responses in the three categories of motor response, verbal response and eye opening are assigned a numerical value which are summed to produce a Glasgow Coma Scale score (Chapter 8). A severe injury may be defined as a GCS of 8 or less, a score of 9-12 indicates brain injury of moderate severity and of 13-15 a mild brain injury. Duration of coma may be used as an indicator of severity of injury, 0-20 minutes indicating mild injury, 20 minutes to one hour indicating moderate injury and one hour and above indicating severe injury.
Shaw et al. (1985) describe two patients who became disruptive in a nursing home setting and who were transferred to a rehabilitation centre. When given appropriate training, the improvement of these two patients was so rapid that it suggests that some stimulation is necessary to ensure that patients function at the level permitted by their neurological recovery. There is no evidence that one specific form of interaction has a greater effect at this early stage on potentiating recovery than 36 Theories of recovery following brain injury another.
Rather than the 'top down' models described above, it is a 'bottom up' model in which the aim and method of rehabilitation is the development of real functional skills. Central to the intervention is an understanding of the neuropsychiatric, neuropsychological and neurophysiological 40 Theories of recovery following brain injury limits placed on the individuals by the brain trauma. Some of these may be addressed by neuropharmacological interventions but all need to be taken into account when designing intervention programmes.
Brain Injury Rehabilitation: A neurofunctional approach by GORDON MUIR GILES AND JO CLARK-WILSON