Residency Course

Traumatic Brain Injury – From Adolescence Across the Lifespan

Faculty: Karen McCulloch, PT, PhD, MS, FAPTA Board Certified in Neurologic Physical Therapy (Emeritus) Professor, Division of Physical Therapy, Department of Allied Health Sciences, School of Medicine, UNC-Chapel Hill, Chapel Hill, NC

Course Description

Traumatic brain injury is a condition that affects individuals across the lifespan, with peaks of injury for very young children, adolescents/young adults and older adults. This course focuses on injuries that are moderate to severe in nature that can result in a myriad of physical, cognitive and behavioral impairments that limit the ability of the survivor to resume their typical life activities. The course will be divided into units that include an introduction to the injury, acute medical management, disorders of consciousness, common cognitive/behavioral impairments, rehabilitation management, community-based care, and long-term issues. Throughout the units, case examples will provide illustration of key concepts, addressing all levels of the International Classification of Function, Disability and Health. Evidence-based physical therapy evaluation, outcome measurement, and treatment strategies will be presented in the context of international best practice standards and treatment delivery models in the US health system. Interventions will include discussion of methods of managing common impairments including increased muscle tone, evidence for intervention to improve gait, balance, and higher-level mobility, as well as the physical therapist’s role in facilitating return to school, work and play.

Learning Objectives

At the conclusion of this course, participants will be able to:

  1. Describe the incidence and prevalence of moderate to severe TBI in the US, including prognostic indicators, risk factors and common injury mechanisms based on stage of the lifespan.

  2. Describe particular challenges of moderate to severe TBI in the older adult, as it relates to prognosis.

  3. Describe primary and secondary injury factors that are critical in acute management and influence PT intervention as well as prognosis.

  4. Summarize imaging and other diagnostic procedures used in acute management of TBI.

  5. Describe measures used to manage intracranial pressure and optimize cerebral perfusion pressure, and their implications for acute PT.

  6. Identify clinical signs of and effective interventions for common medical complications including heterotopic ossification, paroxysmal sympathetic hyperactivity, and increased muscle tone.

  7. Correctly identify responses and behaviors representative of coma, unresponsive wakefulness, minimally conscious state and post-injury confusional state.

  8. Describe common behavioral and cognitive impairments observed following TBI and suggest appropriate therapeutic approaches to manage these issues.

  9. Identify appropriate evaluation tools and outcome measures to address disorders of consciousness, functional mobility, gait, balance and vestibular impairments, and higher-level mobility in individuals post-TBI.

  10. Identify evidence-based treatment strategies to address the following domains in people with TBI: functional mobility at all levels, motor control, flexibility, and aerobic conditioning.

  11. Describe international best practice standards for physical therapy evaluation and treatment of people with TBI.

  12. To design physical therapy delivery plans for case examples of people moderate to severe TBI in acute, rehabilitation, community based and long-term care settings.

  13. Identify long term concerns for individuals with TBI and their families or available support systems that may be managed with community resources.

The online course will be launched in Aug, 2019

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