Specialized rehabilitation nursing interventions: from dependence to functionality after traumatic brain injury

Abstract

Introduction: Traumatic brain injury (TBI) is one of the leading causes of disability and mortality worldwide, significantly affecting young individuals and the working-age population. The importance of this condition lies in its considerable impact on the quality of life of affected individuals, as well as the social and economic consequences it imposes on families and healthcare systems. Objective: To develop specialized rehabilitation interventions based on Dorothea Orem’s Self-Care Theory through the application of the Nursing Care Process in a person with sequelae of traumatic brain injury. Methodology: An experimental case study was conducted following the Nursing Care Process guided by Dorothea Orem’s Self-Care Theory in an older adult with sequelae of traumatic brain injury. The patient received continuous follow-up and home-based care over a seven-month period. Results: A favorable clinical evolution and a remarkable improvement in the patient’s functional capacities within the musculoskeletal and motor domains were observed. Progressive increases in muscle strength were demonstrated in the affected hemibody according to the Daniels scale. The right upper extremity reached a final score of 3+/5, while the right lower extremity showed even greater recovery, progressing to a level of 4/5, with isolated peaks of 4+/5 during follow-up sessions. This neuromuscular strengthening, combined with postural hygiene training, enabled the patient to transition from an almost nonexistent standing ability (maintained for only 7 seconds) to assisted, coordinated, and safe ambulation using a walking aid (walker). Improvements in both static and dynamic balance were quantitatively confirmed through the Tinetti Scale, with the patient’s score increasing substantially to a final value of 14 points.Conclusions: The sequelae of TBI, particularly in older adults, tend to be more complex and have a greater impact on quality of life due to advanced age and the presence of comorbid health conditions. Therefore, timely intervention and a multidisciplinary rehabilitation approach can improve functional outcomes and reduce the emotional and physical burden on both the individual and their caregivers.