The use of ergotherapeutic techniques in the rehabilitation after severe traumatic brain injury at the stage of confusion syndromes
Keywordsergotherapy, traumatic brain injury, post-coma disturbance of consciousness, reintegration of consciousness, dyspraxia, praxis, ideation, motoric planning.
AbstractThe work is based on the results of diagnosis, rehabilitation and restorative treatment of 220 patients with post-coma long-term consciousness disorders after severe traumatic brain injury. The main attention is given to the actual topic — the possibility of using ergotherapeutic techniques after severe traumatic brain injury at the stage of confusion in line with the stages of classification according to Dobrokhotova T. A. in the course of the rehabilitation route. This is the identification of sensitivity to ergotherapy, each of its techniques and ascertaining the practical feasibility of their use at each of the stages (6A, 6B, 6C). The research reveals that, although patients within their groups at the stages 6A, 6B, 6B had almost identical (with individual fluctuations) physical capabilities, social skills, similar in their main features neurological status, but differed in the results of restoration the skills acquired through living. Despite the fact that during migration of syndromes of consciousness reintegration from stage to stage, new physical skills appeared and previous achievements were strengthened, but tasks and techniques aimed at improving the language and higher cortical functions were at the forefront, thanks to which the social activity of patients increased. The study emphasized that the combination of ergotherapeutic and psychotherapeutic techniques connected to the rehabilitation program precisely at the time of the stages migration, from confusion with aspontaneity to speech-motor confusion and, subsequently, amnestic confusion, had a great prognostic significance. The importance of selection of ergotherapeutic techniques and their combinations at each link in the chain of consciousness recovery was revealed, and the dynamics of changes indicated the reserves of restoration of each patient's praxis.
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