Key factors that weigh in on traumatic brain injury care, rehab
On behalf of Harris, Powers & Cunningham, P.L.L.C. posted in Brain Injury on Monday, January 23, 2012
Here is a startling disconnect, as noted by Geoff Manley, a neurological surgery expert at the University of California, San Francisco, and Lisa McGuire of the federal Centers for Disease Control and Prevention: Although the estimated costs to the nation associated with traumatic brain injury (TBI) last year were in excess of $76 billion, the total funding that is available to the National Institutes of Health for TBI research in 2012 is a scant $85 million.
That both perplexes and frustrates researchers and medical practitioners who work with brain-injury victims. Manley calls the dearth of available services and lack of funding “a travesty.”
What medical professionals also find disconcerting are the relative hit-or-miss aspects related to treatment. One patient might be lucky enough to receive exemplary intensive trauma care with long-term rehabilitative treatment thereafter, for example, while another patient receives mediocre care initially and little follow-up over time to address issues concerning cognitive abilities, the emotional aspects of severe head trauma, and related issues.
The severe head injury sustained by Arizona Rep. Gabrielle Giffords last year, and information concerning her rehabilitative therapy, has served to focus a great deal of attention on brain-injury symptoms and care. Giffords has both lauded the care she has received and advocated that it should be standard for every person suffering from a brain injury.
Experts say that Gifford’s high level of care owes less to her congressional status than it does to her insurance carrier and coverage through federal workers’ compensation.
Many factors are involved that influence the type of care ultimately received, say experts. The state a person lives in can have an affect (Texas law, for example, requires that rehabilitation be provided for brain-injury victims). Insurance plans vary widely, as does personal advocacy in any given case.
And hospitals matter. Some — if not most — render merely adequate care for head injuries, says Manley, who adds that there are very few facilities that truly stand out for offering exceptional care.
Source: Pro Publica, “Giffords may get better brain-injury care than most of her constituents” Lena Groeger, Jan. 17, 2012
Tags: Centers for Disease Control and Prevention, TBI, intensive trauma care, rehabilitative therapy, traumatic brain injury
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Archive for dementia
ScienceDaily (Aug. 10, 2010) — Computerized brain fitness programs are known to help seniors improve their memory and focus. Now, a study led by researchers at Albert Einstein College of Medicine of Yeshiva University has found preliminary evidence that such programs may help frail seniors walk faster, potentially preventing disability and improving quality of life. Results appear in the July 19 online edition of the Journal of Gerontology.
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The researchers recruited 20 frail seniors (aged 70 or older) who were sedentary (exercised once a week or less) and walked slowly (a speed of one meter per second or less). Ten of the seniors (the intervention group) participated in the Mindfit brain fitness program three times weekly for eight weeks, with each training session lasting from 45 to 60 minutes. During the sessions, they carried out tasks aimed at sharpening cognitive abilities such as focusing, planning, organizing and problem solving. The other 10 seniors constituted the control group.
Compared with their speeds at the start of the study, the 10 seniors in the intervention group improved their normal-walking velocity, although the gain was not statistically significant. For walking while talking — which requires considerably more concentration than normal walking — the seniors who took computer training notably improved compared with their initial speeds. By contrast, no improvement in walking speed was observed for the control group.
“This was a small study — we’re now preparing to do a larger clinical trial — but the results suggest that brain fitness programs show promise for helping the frail elderly walk better,” says lead author Joe Verghese, M.D., professor in the Saul R. Korey Department of Neurology and the Murray D. Gross Memorial Faculty Scholar in Gerontology at Einstein.
The findings, if duplicated in a larger study, could have important implications since the frail elderly are often in poor health and unable to participate in exercises that build strength and improve balance. Intervening through brain fitness programs could provide a useful alternative.
Here’s a great post by Angela Lunde.
Preventing Alzheimer’s: Exercise still your best bet.
Angela Lunde reported last week from the Alzheimer’s Association. Experts predict that 10 million baby boomers will develop Alzheimer’s disease in the United States — that translates to one out of every eight. For us “baby boomers,” this is frightening to say the least.
There are new treatments on the horizon, but we all wonder whether or not they will be available in time for us or even our children. Let’s keep hoping for a cure or prevention model by supporting research in whatever way we can. Meanwhile, studies continue to point to physical exercise as the most effective therapy today to prevent Alzheimer’s.
Mounting evidence suggests that physical activity may have benefits beyond a healthy heart and body weight. Through the past several years, population studies have suggested that exercise which raises your heart rate for at least 30 minutes several times a week can lower your risk of Alzheimer’s. Physical activity appears to inhibit Alzheimer’s-like brain changes in mice, slowing the development of a key feature of the disease.
In one observational study, investigators looked at the relationship of physical activity and mental function in about 6,000 women age 65 and older, over an 8 year period. They found that the women who were more physically active were less likely to experience a decline in their mental function than inactive women.
Another compelling study, conducted by researchers at the University of Chicago, was highlighted on ABC News last week. The study used mice bred to develop Alzheimer’s type plaque in the brain. In the study, some mice were allowed to exercise and others were not. The brains in the physically active mice had 50 to 80 percent less plaque than the brains of the sedentary mice and they (exercising mice) produced significantly more of an enzyme in the brain that prevents plaque.
Dr. Ronald Petersen, director of the Alzheimer’s Research Center at the Mayo Clinic, said on ABC: “Regular physical exercise is probably the best means we have of preventing Alzheimer’s disease today, better than medications, better than intellectual activity, better than supplements and diet.”
Here’s a great post by Nicholas Brown.
Cognitive Function:
Although the collective scientific analysis of the concept of “brain fitness” — which contends that regular mental exercise leads to better long-term mental health — can be inconclusive, numerous manufacturers are embracing the concept by integrating physical fitness machines with mental exercise components. “Some older-adult and dementia researchers are realizing that cognitive function activities such as crossword puzzles, Sudoku or regular reading can have a positive impact on maintaining neurons,” says Pete McCall, an Exercise Physiologist with the American council of Exercise. “The thinking is, if you don’t use your brain on a regular basis, like any muscle, it will atrophy.”
To that end, makers of brain fitness programs have teamed up with makers of exercise equipment to embrace the mind-body connection. One recumbent bike product, for example, offers users 22 mental exercises — such as memory of names and faces, arithmetic and visual-spatial skills — designed to stimulate different parts of the brain. Users navigate the exercises with a wireless mouse, pedaling all the while. “When you look at the research, it shows that a huge issue on most older adults’ minds is losing their cognitive abilities, right behind losing their independence and health,” says Milner. “Those do go hand in hand.”
McCall cautions facility operators to remember that equipment selection is only one aspect of attracting older adult populations. “They want the equipment to feel comfortable,” he says. “But just as important, they want to feel comfortable in the overall environment. Is the facility clean? Is the equipment in good condition? Are there people to answer questions? Is the music appropriate?”
All of those types of questions, agrees Milner, are important in assessing whether a fitness center is accommodating to older users. “Over the years, the 65-and-up market has been fairly flat — as have the rest of them, by the way,” Colin Milner, from the International Council on Aging, contends. “I would argue that part of the reason it’s flat is because we haven’t presented fitness and fitness equipment in a manner that resonates with enough of this audience.”
Having worked with parkinson’s for over twenty years this article offers great advice for those challenged by Parkinson’s.
From Patrick McNamara, Ph.D., former About.com Guide
Updated June 18, 2009
About.com Health’s Disease and Condition content is reviewed by the Medical Review Board
.
Jasper Greek Golangco/HAAP Media We know exercise is good for us, and people Parkinson’s disease1 (PD) are no exception. Exercise should be considered a standard part of treatment. Beyond the benefits to physical health and mood, new research in animals shows that physical exercise may even protect the health of existing dopamine cells in aniamls — and the same may be true for humans.
Studies in both humans and animals have shown that physical exercise, particularly aerobic exercise, like walking, running, swimming, bicycling promotes the release of neurotrophic factors —- these are chemicals that bathe brain cells in nutrients that HELP brain cells resist degeneration and to make connections with other brain cells. In addition, aerobic exercise increases the amount of blood and oxygen to the brain, thus enhancing virtually all brain functions. Decades of scientific work on exercise and the brain has taught us that (a) intensive physical activity increases the tendency of brain cells to make connections with other brain cells thus enhancing brain function; and conversely (b) reductions in physical activity leads to reductions in brain cell activity and brain cell interconnectivity. That old principle of use it or lose it may apply here. So exercise!
Studies of exercise treatment programs with PD have shown pretty conclusively that exercise improves physical functioning, strength, balance and gait speed. There is also evidence that exercise improves mood and the more general sense that ‘quality of life’ is ‘good.’ A spate of studies have shown that exercise can also improve your thinking and mental abilities2.
So given all of this good news with respect to exercise, how can you start an exercise program that is right for you? The first thing to do is to contact your doctor who can put you in touch with a physical therapist. Your doctor and physical therapist can devise an exercise program that is safe for you and that will give you maximal benefit. In general, all exercises should start with a warm-up and stretching/flexibility session where you systematically and gently stretch all those stiff muscle groups. After the warm-up period, you can begin the exercise session proper. It should consist of some aerobic exercise so that you can get your heart rate up for about 20 minutes or so. There is a set range for heart rate for each age group. You can get this information from your doctor.
Always: Before you begin any exercise therapy, get the approval of your doctor and a prescription to work with a trained, experienced physical therapist.
Exercise programs have been specifically designed for persons with PD. Many national PD organizations have created programs and tools to help you get started with exercise. Check out the Parkinson’s Disease Foundation (PDF) www.pdf.org3 and the American Parkinson Disease (ADPA) www.apdaparkison.org4. These organizations have free booklets on exercise as well as multimedia programs such as videos, DVDs and webcasts that describe detailed exercise programs for persons with PD.
Alzheimer’s disease is known to kick as early as 40s in present times and the reasons for this can be attributed to the lifestyle and stress that we are exposed to. Researchers have found out that the damage to the brain is done in the 20s and 30s silently and what surfaces as we age is an accumulation of how we have been treating the brain. The treatment for Alzheimer’s Disease is still in the nascent stage which is why need to prevent Alzheimer’s.
Eat Vegetables
You may have most nutritionists talking about the fact that we should vegetarian food. Does that mean being non-vegetarian is criminal to the body? Not really. In fact, fish is considered the best source of Omega-3 fatty acids that are vital for the brain’s health. The reason why health experts stress on veggies is because the now vegetarian foods that are being sold on the market these days, are of poor quality. Animals are fed toxic substances, garbage and are bred under poor conditions, so we are just feeding on unhealthy food both directly and indirectly; definitely something that can harm our brain and health.
Exercises
Yoga is not just an exercise but a way of life. Other workout may make your muscles strong but your internal organs stretch and are used better by Yoga. Yoga asanas circulate blood to every part of the body freely, including the brain If you do regular Pranayams, there is a big chance of reducing Alzheimer’s disease.
Play games that increase your focus. Just running on treadmail does not make you think, you need to play sports like tennis where you get to focus. You can also do water aerobics or water exercises where you stand in four feet deep water, you are not only calming your mind but also preventing osteoporosis.
Drink lots of water
Haven’t you realized that you are not able to focus when you are dehydrated. So you need to drink lots of water. Dehydration can spell doom for your body. Do not wait to drink till you are
Keep your diabetes in control
It is always better not to have diabetes but if you have it, make sure you keep it in control. So you should take note of what you are eating an aim to keep sugar levels low. At the 10th International Conference on Alzheimer’s disease and Related Disorders in Spain, there was a link shown between diabetes and Alzheimer’s. While the statistics confirm a link, how exactly are the two connected is not really understood? Likelihood is that diabetes causes accumulation of blood sugar in the brain causing damage to the brain cells. Bottom line: Take note of what you eat and keep sugar levels low
Deep Breathing
There are manifold benefits of deep breathing. Take deep breaths to infuse oxygen which can replenish the brain cells. An observation at the Brain Research Centre at Canada’s University of British Columbia found that low levels of oxygen are connected to the risk of Alzheimer’s.
Take the three minerals: Iron, Phosphorus, zinc
The three types of minerals, when included in everyday diet, aid proper brain functioning and reduce the risk of Alzheimer’s. Sunflower seeds, peas, broccoli, banana, eggs, dairy products, whole-grain cereals, spinach, soy etc. are abundant in zinc, iron and phosphorous . You shouls also drink vegetable and fruit juices regularly. According to the American Journal of Medicine claimed that three glasses of juice per week helps cut down the risk of Alzheimer’s by almost 75 per cent.
Tea and coffee
Tea and coffee lovers, rejoice!A study conducted at the University of Kuopio, Finland closely observed 1409 individuals for a period of 21 years and found out that coffee and tea consumption brings down the risk of Alzheimer’s. You can find the study also in the Journal of Alzheimer’s Disease.
This is awesome information by Bill Hendrick with WebMD Health News.
Exercise, Vitamin D Reduce Risk of Falls in Elderly
Researchers Say Number of Falls, Costs Expected to Rise
By Bill Hendrick
WebMD Health News
Reviewed by Louise Chang, MD
Dec. 20, 2010 — A federal task force’s review finds that for Americans 65 and older, exercise and vitamin D supplements can help reduce the risk of falling.
The U.S. Preventive Services Task Force reviewed findings from 54 clinical trials to determine the benefits and possible harmful effects of interventions aimed at preventing falls in elderly people.
Task Force Findings
The review of research shows:
• Exercise or physical therapy can reduce fall risk by 13%. This includes exercise for strength, balance, and flexibility.
• Vitamin D supplementation was linked to a 17% reduced risk of falls.
• Other interventions may also be helpful: Homes should be carefully examined to determine if impediments that could lead to falls could be removed or modified.
• Behavioral counseling might help older people better understand the risks and potential consequences of falls.
Yvonne Michael, ScD, and colleagues published their review in the Dec. 21 issue of the Annals of Internal Medicine.
The review, an accompanying article, and an editorial all point to the hazards for older people of falling.
Falls Among Elderly Likely to Rise Dramatically
An editorial by Mary E. Tinetti, MD, of the Yale University School of Medicine, notes that falls among elderly people will become even more of a problem than it is now, but that it’s already significant.
Compared with 1984, “today’s typical primary care patient is older, takes more medications, has more chronic conditions, and visits more specialists who perform more tests and procedures and recommend more interventions,” Tinetti writes. “Preventive recommendations are increasingly being imposed on already overburdened providers and patients.”
Falls Lead to Premature Deaths of Elderly
Another report in the Annals of Internal Medicine says recommendations by the task force are needed “because of the anticipated, unprecedented growth of this population in the near future” due to the aging of the 78-million strong baby boom generation.
In the task force review, authors note that between 30% and 40% of community-dwelling people 65 and older fall at least once per year.
“Falls were the leading cause of fatal and non-fatal injuries among persons 65 and older,” cites the task force report. The authors write that estimates indicate falls could lead to medical costs of $43.8 billion by 2020 at the current rate of spending.
This is an awesome post by David Gutierrez.
Arnie
Exercise Improves Health of Elderly with Dementia
by David Gutierrez, staff writer
(NaturalNews) Elderly dementia patients who exercise regularly have better mental and physical health than those who do not, according to the findings of two recent studies.
In the first study, conducted by researchers from Dong-Eui University in Busan, South Korea, and published in the International Journal of Sports Medicine, 30 elderly women who had been diagnosed with senile dementia were divided into two groups. Half of the women exercised for 30 to 60 minutes a day for two or three days a week, while the other half did not undergo any exercise regimen. The average participant age was 80.
Both groups of women were given regular tests of memory recall, object identification and memory, reading, writing, and orientation to place and time. After six months, the scores of the women in the exercise group had improved by an average of 20 percent, and after one year they had improved by 30 percent. In contrast, there was no significant change in the scores of women in the control group.
Women in the exercise group also demonstrated an improved ability to perform daily acts such as getting dressed, bathing and eating. Exercise capacity and muscle strength also improved.
In the second study, researchers from the Alzheimer’s and Memory Program at the University of Kansas School of Medicine used magnetic resonance imaging (MRI) scans to measure the brains of 57 people in the early stages of Alzheimer’s disease. They also evaluated the participants’ fitness by measuring their peak oxygen demand during a treadmill test.
Participants who scored higher on the physical fitness tests experienced significantly less brain shrinkage than those who scored more poorly.
Prior research has demonstrated that the brains of Alzheimer’s patients shrink twice as fast as the normal rate due to aging. The connection between brain shrinkage and Alzheimer’s symptoms is not clear, however.
In the current study, there was no difference in scores on mental performance tests between those who were more and less physically fit.
Sources for this story include: www.reuters.com; www.nola.com.
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