Research in rehabilitation treatment for patients with severe traumatic Brain Injury: Mapping complex therapeutic procedures and developing measures of adherence and treatment outcome. Exemplified by swallowing problems and Facial Oral Tract Therapy

 

The therapeutic rehabilitation of patients with traumatic brain injury (TBI) has a limited evidence-based foundation. The current rehabilitation approaches have been developed mainly through clinical practice. They often consist of many components that are defined in incomplete ways, making it difficult if not impossible to investigate treatment outcome. This thesis has dealt with one of the widely used rehabilitation approaches used for, among others, swallowing difficulties: Facial Oral Tract Therapy (FOTT) ^©. The studies in this thesis show that swallowing difficulties often occur in patients with severe TBI admitted for subacute rehabilitation (93%), pneumonia was found in 12%. The many components of FOTT are defined in a treatment manual; we developed and tested a method that can measure whether therapist uses FOTT appropriately. In addition, we developed and validated a FOTT clinical evaluation of swallowing difficulties. These studies pave the way for effectiveness studies of FOTT and thus an evidence-based foundation for the rehabilitation of swallowing difficulties in TBI patients.