Posts Tagged alternative medicine

[ARTICLE] Functional Medicine Approach to Traumatic Brain Injury – Full Text

Abstract

Background: The U.S. military has seen dramatic increases in traumatic brain injuries (TBIs) among military personnel due to the nature of modern-day conflicts. Conventional TBI treatment for secondary brain injuries has suboptimal success rates, and patients, families, and healthcare professionals are increasingly turning to alternative medicine treatments.

Objective: Effective treatments for the secondary injury cascades that occur after an initial brain trauma are unclear at this time. The goal of successful treatment options for secondary TBI injuries is to reduce oxidative stress, excitotoxicity, and inflammation while supporting mitochondrial functions and repair of membranes, synapses, and axons.

Intervention: A new paradigm of medical care, known as functional medicine, is increasing in popularity and acceptance. Functional medicine combines conventional treatment methods with complementary, genetic, holistic, and nutritional therapies. The approach is to assess the patient as a whole person, taking into account the interconnectedness of the body and its unique reaction to disease, injury, and illness while working to restore balance and optimal health. Functional medicine treatment recommendations often include the use of acupuncture, Ayurveda, chiropractic manipulation, detoxification programs, herbal and homeopathic supplements, specialized diets, massage, meditation and mindfulness practices, neurobiofeedback, nutritional supplements, t’ai chi, and yoga. At present, some of these alternative treatments appear to be beneficial, but more research is needed to validate reported outcomes.

Conclusions: Few clinical studies validate the effectiveness of alternative therapies for TBIs. However, further clinical trials and empirical studies warrant further investigation based on some reported positive results from research studies, case histories, anecdotal evidence, and widespread popularity of some approaches. To date, only nutritional therapies and hyperbaric oxygen therapy have shown the most promise and potential for improved outcomes for the treatment of secondary TBI injuries.

Introduction

The u.s. military has seen a dramatic increase in traumatic brain injuries (TBIs) among military personnel during conflicts in recent years. According to estimates by the Department of Defense (DoD) and the Defense and Veteran’s Brain Injury Center, the majority of military TBIs are sustained during motor vehicle accidents, gunshot wounds, blasts, or a combination of these. An estimated 22% of all combat casualties are thought to be caused directly by TBIs. Compared to civilian populations, veterans are disabled for longer periods of time with symptoms of cognitive and behavioral impairments. Veterans frequently experience additional symptoms of post-traumatic stress disorder (PTSD) and chronic pain, and are at increased risk for suicide and substance abuse.

When the brain is injured, brain metabolism is altered and neurons are highly susceptible to damage from free radicals and mitochondrial dysfunction. Thus begins a pathologic process that can sometimes take years to repair. Conventional TBI treatment for these secondary brain injuries has had suboptimal success rates. Because of this, TBI victims, their families, and some healthcare professionals are increasingly exploring new treatment options that are perceived to be less injurious to health, more beneficial, and sometimes their only hope. As Joel Goldstein—whose son sustained a severe TBI in an automobile accident—the founder of the Bart Foundation, and author of No Stone Unturned: A Father’s Memoir of His Son’s Encounter with Traumatic Brain Injury—states: “Unconventional therapies are not merely a reasonable option, they are a necessity.” These “new” treatments include cell-based, genetic, holistic, integrative, nutritional, and hyperbaric oxygen therapies. Emerging treatment options for the treatment of secondary brain injuries is the focus of this article.

A literature review of alternative treatment options for patients with TBI was completed for this article with a focus on research reported between the years 1980 and 2017. Search criteria included TBI in the military; alternative and functional medicine therapies for brain injury; blogs and foundations for patients with TBI; and supplements, nutrition, and alternative therapies for the treatment of TBI. Because there are few clinical studies validating the effectiveness of alternative treatments for TBIs to date, promising therapies were selected for discussion based on reported objective evidence found in research settings, subjective therapies reported by patients with TBI and their families, and subjective clinician case reports.

Numerous clinical studies involving individual nutrients for brain injury treatment in animal models was found and 10 articles summarizing the most prominent of these studies were focused on. The Institute of Medicine (IOM) book about nutrition and TBI was also relied upon for a summary of research in this area. Three specific case reports are highlighted in this article because they represent the most successful alternative treatment approaches for patients with TBI to date. The Brain Trauma Foundation, Brain Health Education and Research Institute, Brainline.orgTraumaticBrainInjuryatoz.org, the National Center for PTSD [post-traumatic stress disorder], and Harch Hyperbarics also supplied information about therapies and treatments that patients with TBI and their families are finding helpful for recovery.

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Continue —-> Functional Medicine Approach to Traumatic Brain Injury

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[Systematic Review] Complementary and alternative interventions for fatigue management after traumatic brain injury: a systematic review – Full Text

We systematically reviewed randomized controlled trials (RCTs) of complementary and alternative interventions for fatigue after traumatic brain injury (TBI).

We searched multiple online sources including ClinicalTrials.gov, the Cochrane Library database, MEDLINE, CINAHL, Embase, the Web of Science, AMED, PsychINFO, Toxline, ProQuest Digital Dissertations, PEDro, PsycBite, and the World Health Organization (WHO) trial registry, in addition to hand searching of grey literature. The methodological quality of each included study was assessed using the Jadad scale, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. A descriptive review was performed.

Ten RCTs of interventions for post-TBI fatigue (PTBIF) that included 10 types of complementary and alternative interventions were assessed in our study. There were four types of physical interventions including aquatic physical activity, fitness-center-based exercise, Tai Chi, and aerobic training. The three types of cognitive and behavioral interventions (CBIs) were cognitive behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), and computerized working-memory training. The Flexyx Neurotherapy System (FNS) and cranial electrotherapy were the two types of biofeedback therapy, and finally, one type of light therapy was included. Although the four types of intervention included aquatic physical activity, MBSR, computerized working-memory training and blue-light therapy showed unequivocally effective results, the quality of evidence was low/very low according to the GRADE system.

The present systematic review of existing RCTs suggests that aquatic physical activity, MBSR, computerized working-memory training, and blue-light therapy may be beneficial treatments for PTBIF. Due to the many flaws and limitations in these studies, further controlled trials using these interventions for PTBIF are necessary

Fatigue is a common phenomenon following traumatic brain injury (TBI), with a reported prevalence ranging from 21% to 80% [Ouellet and Morin, 2006Bushnik et al. 2007Dijkers and Bushnik, 2008Cantor et al. 2012Ponsford et al. 2012], regardless of TBI severity [Ouellet and Morin, 2006Ponsford et al. 2012]. Post-TBI fatigue (PTBIF) refers to fatigue that occurs secondary to TBI, which is generally viewed as a manifestation of ‘central fatigue’. Associated PTBIF symptoms include mental or physical exhaustion and inability to perform voluntary activities, and can be accompanied by cognitive dysfunction, sensory overstimulation, pain, and sleepiness [Cantor et al. 2013]. PTBIF appears to be persistent, affects most TBI patients daily, negatively impacts quality of life, and decreases life satisfaction [Olver et al. 1996Cantor et al.20082012Bay and De-Leon, 2010]. Given the ubiquitous presence of PTBIF, treatment or management of fatigue is important to improve the patient’s quality of life after TBI. However, the effectiveness of currently available treatments is limited.

Although pharmacological interventions such as piracetam, creatine, monoaminergic stabilizer OSU6162, and methylphenidate can alleviate fatigue, adverse effects limit their usage and further research is needed to clarify their effects [Hakkarainen and Hakamies, 1978Sakellaris et al.2008Johansson et al. 2012b2014]. Therefore, many researchers have attempted to identify complementary and alternative interventions to relieve PTBIF [Bateman et al. 2001Hodgson et al. 2005Gemmell and Leathem, 2006Hassett et al. 2009Johansson et al. 2012aBjörkdahl et al. 2013Sinclair et al. 2014]. In this study, we aimed to systematically review randomized controlled trials (RCTs) that evaluated treatment of PTBIF using complementary and alternative medicine (CAM) to provide practical recommendations for this syndrome. […]

 

Continue —>  Complementary and alternative interventions for fatigue management after traumatic brain injury: a systematic review – Gang-Zhu Xu, Yan-Feng Li, Mao-De Wang, Dong-Yuan Cao, 2017

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[REVIEW] Post-Stroke Depression | EBRSR – Evidence-Based Review of Stroke Rehabilitation – Full Text PDF

Abstract

Depression is a common complication post-stroke affecting approximately one-third of patients. The presence of post-stroke depression has been associated with decreases in functional recovery, social activity and cognition. In addition, the presence of mental health disorders following stroke may be associated with increased mortality. The present review discusses the prevalence, natural history and risk factors for post-stroke depression as well as issues around its assessment and impact on rehabilitation outcomes. Strategies for the prevention and management of post-stroke depression are reviewed. Recommendations for assessment and treatment are provided based on current guidelines. A discussion of post-stroke emotionalism, its impact and treatment is also included.

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via Post-Stroke Depression | EBRSR – Evidence-Based Review of Stroke Rehabilitation.

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