Traumatic brain injuries, or TBIs, can take time to recover from, with cerebral functioning development being complicated. Another frequently used classification tool to outline and differentiate the course of head trauma rehabilitation with TBI is called the Rancho Los Amigos Scale.
Generally recognized and used by healthcare practitioners, the Rancho Los Amigos Scale comprises four significant levels. These stages are only loose approximations. No single survivor will go through each stage of injury in a precisely identical manner, and the same applies within the timeframe.
Stages of Traumatic Brain Injury Recovery
Stage 1. Coma (No Response, Total Assistance)
Comas are defined as the initial stage in the recovery process after a traumatic brain injury which in fact facilitates the healing process of the brain. One way a person can be in a coma is if they sustain a brain injury. Still, it is also possible for doctors to put them in a coma so that swelling and intracranial pressure are reduced after any trauma to the brain.
It is the stage of unresponsiveness, commonly referred to as the deepest state of unconsciousness, during which a person in a coma remains for prolonged periods without an ability to respond to either the surroundings or to be awake when aroused, even with strong stimuli.
Stage 2. Vegetative State (Generalized Response, Total Assistance)
During comas, full unresponsiveness occurs in the individuals. In the vegetative state, the survivor's functioning has some reflexes returned.
The survivors locked in a vegetative state may sometimes attempt to be alert. The patients may open and shut their eyes and respond to pain and loud sounds. But, they cannot be considered conscious in the real sense.
When individuals start making purposeful responses and interactions, they have progressed to the next stage of recovery: The minimally conscious stage.
Stage 3. Below a-MCS. (Maximal assistance, Localized Response)
Things are different with the state; they are minimum consciousness from vegetative states. The patients are unresponsive most of the time. Although their patients optimize therapeutic positions during low levels of arousal, unlike the vegetative state, patients in this stage are not aware of the surroundings.
In this phase, the doctor for head trauma rehabilitation may introduce certain medications to induce some activity in the brain of the survivor which would facilitate the initiation of the complete consciousness state.
Stage 4. Post-Traumatic Amnesia (Confused/Agitated, Maximal Assistance)
This stage, which is usually referred to simply as Post-traumatic amnesia, is the stage of recovery whereby the patient’s brain remains in some sort of coma or stupor with minimal functioning.
It is about both loss from memory of activities before the incident/injury (retrograde amnesia) and loss of ability to remember events after the injury (anterograde amnesia). In other words, the person cannot keep track of where he is, how he came there, or the events of the previous days.
Also, during this phase, people can be in a disorganized way with episodes of irritability and violent or socially unacceptable behaviors. This is because, upon regaining consciousness, they become very agitated. This is more commonly seen in patients with injuries to the frontal lobe.
It is considered that post-traumatic amnesia is over when a patient can remember most of the daily occurrences coherently. By this time, doctors usually advise the survivors to transfer to a Brain Injury Recovery Services or be discharged home with a view of rehabilitation.
Stage 5. Confused/Inappropriate, Non-agitated (Maximal Assistance)
Here a person cannot direct attention to abiding confusion and is still trying to make sense of the environment. Responses to questions and commands are incorrect and nonsensical.
Stage 6. Confused/Appropriate (Moderate Assistance)
In this phase of recovery, survivors can comply with simple commands and engage in basic conversation, even though issues with memory and attention are still present. They do not recognize their safety or the limitations posed by their impairments.
Stage 7. Automatic/Appropriate (Minimal Assistance)
At this recovery phase, the learners can respect a set timetable and accomplish the body tasks mandated with supervision. However, the students can hardly start and service any future body task. However, older adults cannot be independent at this point.
Stage 8. Purposeful / Appropriate (Standby Assistance)
By this stage, survivors have significantly improved self-awareness and memory. They still have limitations with social engagement and reaction times, and they experience difficulties with novel scenarios but are working through them. They can even live independently with very little help from other people.
Stage 9. Purposeful / Appropriate (Standby Assistance on Request)
At this level, survivors can address and attend to the needs of others. In general, they are willing and capable of performing both routine and novel types of daily living activities, in which assistance may be required.
Stage 10. Purposeful / Appropriate (Modified Independent)
By this final stage of recovery, survivors are functionally independent and almost have reverted to their normal state. They can multitask, begin new assignments, forecast, and cope with the changes with calm assurance. Their cognition remains slower than usual, but they have learned coping methods. Head Trauma Rehabilitation is helpful at this stage.
Sadly, not every brain injury survivor can complete all the stages of recovery outlined. Some TBI patients can languish within levels 7 and 8 or any other, depending on the extent of their injury. Nevertheless, there are ways to speed up the recovery span following an injury to the brain.
How to Move On to the Next Phase of TBI Recovery
The key to progressing through the ten stages of brain injury recovery relies on the activation of neuroplasticity. Brain Injury Recovery Services are central to recovery after an injury, hastening neural recovery so that a patient can regain lost functions or derive new ones.
Head Trauma Rehabilitation uses repetition of therapeutic activities and exercises to stimulate healing during the early years. Occupational therapy is usually encouraged. Many of them will receive therapy and possibly physical, occupational, and speech therapy for speech and language pathology, considering all aspects of rehabilitation.
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