- Email: [email protected]
Bladder-sphincter disorders and quality of life of traumatic brain injury: Tunisian experience
e134
Light to moderate traumatic brain injuries / Annals of Physical and Rehabilitation Medicine 59S (2016) e131–e137
Kozlowski O, Pollez B, Thevenon A. Outcome and quality of life in a cohort of patients with severe traumatic brain injury. Ann Phys Rehab Med 2002;45:466–73.
∗
http://dx.doi.org/10.1016/j.rehab.2016.07.299
Objective To determine factors influencing long-term functional and professional outcomes in patients post severe traumatic brain injury (STBI). Material/patients and methods A descriptive analytical transversal and cross-sectional study involving patients with STBI dated more than 1 year and managed in rehabilitation department on an outpatient basis. Described parameters were: coma duration, posttraumatic amnesia duration (PTA), duration of hospitalization in intensive care unit, rehabilitation delay management, brain imaging findings, motor impairment, neuropsychological impairment assessed with Neurobehavioral Rating Scale-Revised (NRS-R), functional outcomes assessed with Functional Independence Measure (FIM) and disability assessed with Glasgow Outcome Scale (GOS). Results Three years post-STBI, motor impairment was severe in 34% of cases. Neuropsychological impairments were common: memory disorders (89.6%), attention-deficit disorder (81.2%), irritability (64.6%). Dependency in activities of daily living according to FIM was severe and total in 44% of cases and disability was severe in 44% of cases according to GOS. Factors significantly associated with bad functional outcomes (FIM and GOS) were: coma duration (P: 0.014), PTA (P < 0.001) and hospitalization duration (P < 0,001). We noticed that patients with brain injuries, such as cerebral contusion; cerebral oedema and subarachnoid hemorrhage have a poor recovery. The vocational reintegration rate was at 22%. Patients who failed to return to work had mainly severe motor impairment and an altered FIM or GOS. APT duration and the length of hospitalization in intensive care unit were correlated to return to work. Discussion–conclusion It is important to determine and to understand factors influencing patient’s prognosis after severe traumatic brain injury allowing us to improve functional and professional outcomes of this population. The current study confirmed the impact of APT and coma duration on functional recovery and professional activities resumption. Disclosure of interest The authors declare that they have no competing interest.
PO0119
Bladder-sphincter disorders and quality of life of traumatic brain injury: Tunisian experience
Mariem Rekik , Khaoula Achour , Anouer Abdallah , Sonia Lebib ∗ , Imen Miri , Fatima Zahra Ben Salah , Catherine Dziri Institut Med Kassab d’orthopédie, médecine physique et réadaptation fonctionnelle, Manouba, Tunisia ∗ Corresponding author. E-mail address: [email protected] (S. Lebib) Objective The aim of our study was to assess the bladder and sphincter function after brain injury (BI) and to review their association with quality of life (QOL). Material/patients and methods We conducted a cross-sectional study, including patients referred to physical and rehabilitation medicine department at the Med Kassab Institute of Orthopedics. The initial gravity data were collected. The bladder-sphincter assessment included evaluation of the urine drain mode, the irritative disorders, obstructive disorders, disorders of transit and the existence of secondary anal lesions. The assessment of QOL was conducted by visual analog scale (VAS). We sought an association between the bladder-sphincter disorders (BSD) and QOL. Results Thirty-two patients, 24 men and 8 women, mean age 23.93 years assessed after BI. Most patients (90%) had spontaneous urination, three performed intermittent self-catheterization, six had an overactive bladder syndrome, and three had dysuria. Two of the evaluated subjects had constipation and one patient had chronic diarrhoea. Secondary anal lesions were external haemorrhoids for one patient and an anal fissure for another. The mean VAS of QOL was 5.59/10. Patients with added BSD had a poorer QOL and a more pronounced impact on daily life with a statistically significant difference (P < 0.05). Discussion–conclusion After BI, the bladder-sphincter profile of patients appears heterogeneous. Their presence alters more QOL. All BI patients having a rehabilitation care should have a screening of these problems in order to preserve the upper urinary tract and to improve the autonomy and the QOL. Keywords Brain injury; Quality of life; Bladder and sphincter disorders Disclosure of interest The authors have not supplied their declaration of competing interest. Further reading Spinal cord/brain injury and the neurogenic bladder. Urol Clin North Am 2010;37(4):537–46. Youngson HA, Alderman N. Fear of incontinence and its effects on a community-based rehabilitation programme after severe brain injury: successful remediation of escape behaviour using behaviour modification. Brain Inj 1994;8(1):23–36. Treating urinary incontinence in a head-injured adult. Brain Inj 1990;4(2):203–7. http://dx.doi.org/10.1016/j.rehab.2016.07.300 PO016
Predictors of functional and professional outcomes in patients with severe traumatic brain injury
Soumaya Boudokhane ∗ , Hichem Ben Brahim , Aymen Haj Salah , Houda Migaou , Anis Jellad , Zohra Ben Salah Frih CHU Fattouma Bourguiba de Monastir, faculté de médecine, université de Monastir, médecine physique et réadaptation fonctionnelle, Monastir, Tunisia
Corresponding author. E-mail address: [email protected] (S. Boudokhane)
http://dx.doi.org/10.1016/j.rehab.2016.07.301 PO017
Neuropsychological and behavioral disorders and their correlations with the severity of the traumatic brain injury
Sameh Ghroubi ∗ , Islem Feki , Hedi Chelly , Mohamed Habib Elleuch CHU Habib Bourguiba, service service de médecine physique, rééducation et réadaptation fonctionnelle, unité de recherche de l’évaluation des pathologies de l’appareil locomoteur UR12ES18, université de Sfax, route de l’Aéroport 0,5 km, BP 1169, 3029 Sfax, Morocco ∗ Corresponding author. E-mail address: [email protected] (S. Ghroubi) Objective The goal of this study was to evaluate the different neuropsychological and behavioral disorders of patients with traumatic brain injury (TBI) and to study their correlations with the epidemiological and neurotraumatic characteristics. Material/patients and methods It was a cross-sectional study including 30 patients with TBI conducted in the physical medicine and rehabilitation department. The analysis of memory impairment was performed by the (MMS) and the (GOAT) tests. The psychological profile was evaluated by the HAD scale. Behavioral disorders were tested by the agitated behavior scale. Otherwise, the
Light to moderate traumatic brain injuries / Annals of Physical and Rehabilitation Medicine 59S (2016) e131–e137
Kozlowski O, Pollez B, Thevenon A. Outcome and quality of life in a cohort of patients with severe traumatic brain injury. Ann Phys Rehab Med 2002;45:466–73.
∗
http://dx.doi.org/10.1016/j.rehab.2016.07.299
Objective To determine factors influencing long-term functional and professional outcomes in patients post severe traumatic brain injury (STBI). Material/patients and methods A descriptive analytical transversal and cross-sectional study involving patients with STBI dated more than 1 year and managed in rehabilitation department on an outpatient basis. Described parameters were: coma duration, posttraumatic amnesia duration (PTA), duration of hospitalization in intensive care unit, rehabilitation delay management, brain imaging findings, motor impairment, neuropsychological impairment assessed with Neurobehavioral Rating Scale-Revised (NRS-R), functional outcomes assessed with Functional Independence Measure (FIM) and disability assessed with Glasgow Outcome Scale (GOS). Results Three years post-STBI, motor impairment was severe in 34% of cases. Neuropsychological impairments were common: memory disorders (89.6%), attention-deficit disorder (81.2%), irritability (64.6%). Dependency in activities of daily living according to FIM was severe and total in 44% of cases and disability was severe in 44% of cases according to GOS. Factors significantly associated with bad functional outcomes (FIM and GOS) were: coma duration (P: 0.014), PTA (P < 0.001) and hospitalization duration (P < 0,001). We noticed that patients with brain injuries, such as cerebral contusion; cerebral oedema and subarachnoid hemorrhage have a poor recovery. The vocational reintegration rate was at 22%. Patients who failed to return to work had mainly severe motor impairment and an altered FIM or GOS. APT duration and the length of hospitalization in intensive care unit were correlated to return to work. Discussion–conclusion It is important to determine and to understand factors influencing patient’s prognosis after severe traumatic brain injury allowing us to improve functional and professional outcomes of this population. The current study confirmed the impact of APT and coma duration on functional recovery and professional activities resumption. Disclosure of interest The authors declare that they have no competing interest.
PO0119
Bladder-sphincter disorders and quality of life of traumatic brain injury: Tunisian experience
Mariem Rekik , Khaoula Achour , Anouer Abdallah , Sonia Lebib ∗ , Imen Miri , Fatima Zahra Ben Salah , Catherine Dziri Institut Med Kassab d’orthopédie, médecine physique et réadaptation fonctionnelle, Manouba, Tunisia ∗ Corresponding author. E-mail address: [email protected] (S. Lebib) Objective The aim of our study was to assess the bladder and sphincter function after brain injury (BI) and to review their association with quality of life (QOL). Material/patients and methods We conducted a cross-sectional study, including patients referred to physical and rehabilitation medicine department at the Med Kassab Institute of Orthopedics. The initial gravity data were collected. The bladder-sphincter assessment included evaluation of the urine drain mode, the irritative disorders, obstructive disorders, disorders of transit and the existence of secondary anal lesions. The assessment of QOL was conducted by visual analog scale (VAS). We sought an association between the bladder-sphincter disorders (BSD) and QOL. Results Thirty-two patients, 24 men and 8 women, mean age 23.93 years assessed after BI. Most patients (90%) had spontaneous urination, three performed intermittent self-catheterization, six had an overactive bladder syndrome, and three had dysuria. Two of the evaluated subjects had constipation and one patient had chronic diarrhoea. Secondary anal lesions were external haemorrhoids for one patient and an anal fissure for another. The mean VAS of QOL was 5.59/10. Patients with added BSD had a poorer QOL and a more pronounced impact on daily life with a statistically significant difference (P < 0.05). Discussion–conclusion After BI, the bladder-sphincter profile of patients appears heterogeneous. Their presence alters more QOL. All BI patients having a rehabilitation care should have a screening of these problems in order to preserve the upper urinary tract and to improve the autonomy and the QOL. Keywords Brain injury; Quality of life; Bladder and sphincter disorders Disclosure of interest The authors have not supplied their declaration of competing interest. Further reading Spinal cord/brain injury and the neurogenic bladder. Urol Clin North Am 2010;37(4):537–46. Youngson HA, Alderman N. Fear of incontinence and its effects on a community-based rehabilitation programme after severe brain injury: successful remediation of escape behaviour using behaviour modification. Brain Inj 1994;8(1):23–36. Treating urinary incontinence in a head-injured adult. Brain Inj 1990;4(2):203–7. http://dx.doi.org/10.1016/j.rehab.2016.07.300 PO016
Predictors of functional and professional outcomes in patients with severe traumatic brain injury
Soumaya Boudokhane ∗ , Hichem Ben Brahim , Aymen Haj Salah , Houda Migaou , Anis Jellad , Zohra Ben Salah Frih CHU Fattouma Bourguiba de Monastir, faculté de médecine, université de Monastir, médecine physique et réadaptation fonctionnelle, Monastir, Tunisia
Corresponding author. E-mail address: [email protected] (S. Boudokhane)
http://dx.doi.org/10.1016/j.rehab.2016.07.301 PO017
Neuropsychological and behavioral disorders and their correlations with the severity of the traumatic brain injury
Sameh Ghroubi ∗ , Islem Feki , Hedi Chelly , Mohamed Habib Elleuch CHU Habib Bourguiba, service service de médecine physique, rééducation et réadaptation fonctionnelle, unité de recherche de l’évaluation des pathologies de l’appareil locomoteur UR12ES18, université de Sfax, route de l’Aéroport 0,5 km, BP 1169, 3029 Sfax, Morocco ∗ Corresponding author. E-mail address: [email protected] (S. Ghroubi) Objective The goal of this study was to evaluate the different neuropsychological and behavioral disorders of patients with traumatic brain injury (TBI) and to study their correlations with the epidemiological and neurotraumatic characteristics. Material/patients and methods It was a cross-sectional study including 30 patients with TBI conducted in the physical medicine and rehabilitation department. The analysis of memory impairment was performed by the (MMS) and the (GOAT) tests. The psychological profile was evaluated by the HAD scale. Behavioral disorders were tested by the agitated behavior scale. Otherwise, the