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NCHPAD - Building Healthy Inclusive Communities

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Case Studies of 3 Men with Acquired Brain Injury


Many individuals who experience a brain injury, regardless of severity, require prolonged rehabilitation and community support services because of the often-complex nature of the deficits resulting from the injury. Three case studies will be reviewed and used as examples for establishing a fitness program:
  1. Rob: ABI from an infection as an adolescent

    Rob developed an acquired brain injury from a severe infection at age 15. He was in a coma for a week. Following his physical recovery, he has suffered from acute bouts of anxiety and stress. Rob could not function in school, and became unmanageable and combative. He spent most of a decade in locked institutional settings before moving into a community-based residential facility for persons with acquired brain injuries. Rob tries to make the right food choices but still ends up with excessive food and poor choices. Rob enjoys the effects that training has on his body, but he continues to struggle with episodes of anxiety and stress.

  2. Sam: TBI from a motor vehicle accident as an adolescent

    Sam was a passenger in a motor vehicle that flipped over. His brain injury resulted in damage to the frontal and temporal lobes of the brain. He initially developed speech and seizure problems. Sam experienced slowed thinking, aggression, depression, and behavior disorders. He spent nearly a decade in an institutional setting before his move to a community-based assisted living facility. Sam smokes two packs of cigarettes daily, drinks six to eight bottles of soda with caffeine, drinks coffee, and eats sparingly throughout the day. His symptoms include anxiety, irritability, periodic bouts of depression, and poor balance. Sam enjoys training once a routine has been established, but if there are any layoff periods, it becomes very difficult to pull him back into the routine.

  3. Don: TBI from a motor vehicle accident as an adult

    Don was injured in a motorcycle accident near the end of his college career. He experiences severe depression from the loss of future plans, which included the chance to become a professional hockey player. In addition, he has other losses in relationships with family and friends as well as marriage plans. Don is unable to carry out the responsibility of caring for himself because of delusional thoughts and the inability to begin or initiate even simple activities. He has spent almost all of his adult life in rehabilitation programs. Six years ago, he elected to move to a community-based assisted living program for persons with acquired brain injury. Don eats sparingly and drinks soda most of his waking hours. Unless going out for a leisure activity, he remains sedentary most of the day. Damage to his left knee from the motorcycle accident limits the exercises he can complete. He is not motivated to exercise, smokes two packs of cigarettes daily, and is sometimes overwhelmed by bouts of depression and anger.

    All these men are on comprehensive medication programs for controlling seizures, problems with thinking, anxiety, depression, or other medical problems.

    People working on the development of a fitness plan should consult with the participant's physician in order to avoid any negative impact from a medication program. Being familiar with the side effects of these medications will help prepare the coach for obstacles such as lowered motivation and balance problems.


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