Abstract
A 33-year-old male with a moderate to severe traumatic brain injury was seen for physical therapy treatment for three sessions over one week in the intensive care unit of an inpatient hospital. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist. The patient’s injury was caused by a collision with a motor vehicle while riding a bicycle without a helmet. The patient initially presented to the emergency department with a Glasgow Coma Scale score of 11. Computed tomography revealed skull fractures and supratentorial and infratentorial subarachnoid hemorrhages without midline shift. The patient was seen for his initial physical therapy visit when he was able to participate meaningfully at four weeks following the injury. The patient was evaluated with the Rancho Los Amigos Level of Cognitive Functioning Scale, the Moss Attention Rating Scale, and the Activity Measure for Post-Acute Care “6-Clicks” Basic Mobility Short Form. Based on the findings of these measures, observation, and required assistance levels during transfers, a plan of care was established. Goals were for the patient to improve attention, arousal, cognition, bed mobility, transfers, balance, vi ambulation, and overall functional mobility. The physical therapy treatment provided emphasized task-specific functional training and the principles of neuroplasticity. The patient’s attention, arousal, cognition, bed mobility, transfers, balance, and functional mobility improved over the duration of care. The patient was transferred to the service of another physical therapist for continued rehabilitation in the acute setting.