Department of Rehabilitation Medicine

any individuals who sustain a SCI may also have a traumatic brain injury (TBI). The rehabilitation of individuals with concomitant SCI/TBI must take into account the cognitive, behavioral, and physical impairments often associated with TBI. Persons with cognitive impairments present special challenges to clinicians, including deficits in attention, concentration, memory and problem solving.

Because the Department of Rehabilitation Medicine has nationally recognized expertise in rehabilitating individuals with TBI, the MS-SCI MS is able to provide individualized services to person with concomitant SCI and TBI. The SCI/TBI program provides the proper rehabilitation environment for all individuals, from those who are emerging from coma to those who have minor cognitive deficits and learning impairments in addition to their SCI. Highly structured classes are scheduled, and a strong program of cognitive remediation is emphasized. Advantage is taken of preserved cognitive strengths, while techniques are taught to compensate for areas of weakness. Because agitated and aggressive behaviors are frequent sequelae of brain injury, weekly meetings attended by all team members are held to analyze and discuss interventions for behaviorally impaired individuals. When indicated, the attending physiatrists may choose a pharmacological agent for either cognitive enhancement or behavior control.

If individuals with a concomitant SCI/TBI have suffered severe cognitive impairments that interfere significantly with learning, they may be admitted to the brain injury unit on KCC3 to address the cognitive issues. Once these have been adequately addressed, the patients may be transferred to the SCI unit for intensive SCI rehabilitation. If the brain injury is not deemed severe, the patients are admitted to the SCI unit, but may attend some of the cognitive remediation classes to complement their SCI rehabilitation.

After discharge from the inpatient unit, patients may be referred to the brain injury rehabilitation outpatient program, Phase II, for additional services.