Acquired Brain Injury (ABI)

Question 1

Who is the least likely to sustain a moderate-severe brain injury?

A. Everest, a 3 year old, typically-developing pre-schooler
B. Lucy, a 74 year old grandmother
C. Tarun, an 18 year old snowboarder (man)
D. April, an 18 year old skateboarder (woman)

Answer 1

D. April - young children and males are high risk too, statistically April is lowest risk, Tarun would be the highest risk

Question 2

Which of the following is not true about decorticate posturing?

A. Indicates damage to the brainstem
B. Involves disinhibition of red nucleus causing facilitation of rubrospinal tract
C. Involves disruption of the lateral corticospinal tract
D. Upper extremities are flexed, lower extremities extended

Answer 2

A. indicates damage to the brainstem - decorticate = above the brainstem level

Question 3

Which of the following is not typically a primary goal of PT during the acute stage of moderate-severe brain injury?
A. Prevent secondary complications
B. Functional skills training
C. Mobilization (when medical clearance received)
D. Patient & family education

Answer 3

B - No functional skills training YET –> If ready to do functional skills training – they are also ready to go to inpatient rehab
* Prioritize education for pt and family and preventing secondary complications
* Typically max assist at this stage
* Monitoring vitals

Question 4

The Community Balance & Mobility Scale is best described as a measure of:

A. High-level gait
B. High-level balance control
C. Low- and high-level balance control
D. Coordination

Answer 4

B. high-level balance control

Question 5

What classification tool is used for individuals with a TBI?

Answer 5

Glasgow Coma Scale (GCS)

Question 6

If Jeff has a GCS score of 10, what does this mean?

Answer 6

Jeff would be categorized as having a moderate TBI
- mild = 13-15
- moderate = 9-12
- severe = <9

Question 7

What are the primary impairments of ABI?

Clinical Presentation

Answer 7

• Neuromuscular (paresis, abnormal tone, postural control, motor function)
• Cognitive (arousal level, memory, inattention, learning etc)
• Neurobehavioral (agitation/agression, apathy, disinhibition, emotional lability etc)
• communication
• swallowing
• dysautonomia
• abnormal tone (spasticity)
  → Decorticate Posturing = UE flexed, LE extended
  → Decebrate posturing = UE & LE extended

Question 8

What does the Rancho Los Amigos Levels of Cognitive Functioning (LOCF) measure?

Answer 8

• cognition
• appropriate for early stages of ABI

Question 9

Name 2 relevant outcome measures appropriate for the rehab stage of ABIs.

Answer 9

The Community Balance & Mobility Scale, Timed Walking Tests

Question 10

What would be an important assessment for a pt in inpatient rehabilitation?

Answer 10

Gait with dual task performance
- important to measure dual task performance to evaluate the impact of cognitive load on gait performance & safety
e.g., saying the months backwards, engage them in a conversation

Question 11

What are important topics of education you would provide a family/client/caregiver of a pt with ABI?

Answer 11

• Important that family & caregiver understands that client cannot control their behaviour
• How to assist client with mobilization safely