Оценка факторов, влияющих на восстановление когнитивных функций в течение ранней реабилитации лиц с травматическим повреждением головного мозга

Abstract

An objective of the study was to specify the factors influencing the recovery of cognitive functions in subjects with moderate or severe traumatic brain injury (TBI) in the early stage of rehabilitation. One hundred and thirty-one patients with moderate or severe TBI have been studied. The early rehabilitation comprised two phases: acute and subacute. Cognitive dysfunction and its recovery at the end of early rehabilitation as well as efficacy of rehabilitation have been assessed using the Functional Independence Measure. According to this test, patients were assigned into 3 groups: high efficacy, moderate efficacy and no significant efficacy of rehabilitation. Subjects with moderate or severe TBI had significant cognitive dysfunction at the beginning of the acute period of TBI: these patients required maximum assistance in understanding and memorizing of the tasks. The assessment of cognitive functions at the end of early rehabilitation revealed that most of patients with moderate or severe TBI were independent, although they still needed assistance to understand, memorize and express their thoughts, and some patients required minimum assistance in the actions related to cognitive functions. The assessment of recovery of cognitive functions at this period showed that 41,3% of patients performed independently the actions related to cognitive functions, 17,5% could perform in the presence of other people, 41,3% needed help from others. Speech and perceptions disorders, sleep disorders, brain injury localized in the temporal areas were significantly associated (p < 0,05) with low efficacy of rehabilitation.