早期リハビリテーション

Early Rehabilitation

Point

・頭部外傷に対する早期リハビリテーションとは，多方面にわたる機能を維持・改善・再獲得するために，48時間以内に開始される治療アプローチである．

・廃用を予防し，早期のADL向上を図るため，早期離床や早期からの積極的な運動を行うように勧められるが，十分なリスク管理が必要である．

・早期リハビリテーションは，多職種で構成されたチームで継続的に展開することが重要となる．

　Bed rest after brain injury may result in disuse syndrome, making it difficult for the patient to reintegrate into society. Early mobilization and exercise intervention are important for preventing disuse syndrome and promoting early improvement of activities of daily living. However, there are problems with controlling the intracranial pressure and cerebral perfusion pressure after severe traumatic brain injury. Recently, the effect of rehabilitation for acute brain injury has been reported. Rehabilitation is a therapeutic approach to assist patients with disabilities in maintaining, improving, and regaining optimal functioning within their environments. In acute head injury cases, pulmonary rehabilitation and dysphagia rehabilitation are important in addition to exercise therapy. Although the evidence is not yet well established, it is important to provide early multidisciplinary rehabilitation to patients with traumatic brain injuries regularly. Moreover, rehabilitation needs to be conducted safely with adequate risk management. In the future, it is necessary to conduct a large-scale systematic cohort study on early rehabilitation to examine patient strength and the optimal time to begin exercising.