array:22 [
  "pii" => "S1130147307703032"
  "issn" => "11301473"
  "doi" => "10.1016/S1130-1473(07)70303-2"
  "estado" => "S300"
  "fechaPublicacion" => "2007-01-01"
  "aid" => "70303"
  "copyright" => "Sociedad Española de Neurocirugía"
  "copyrightAnyo" => "2007"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Neurocirugia. 2007;18:5-15"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1928
    "formatos" => array:3 [
      "EPUB" => 23
      "HTML" => 1150
      "PDF" => 755
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1130147307703044"
    "issn" => "11301473"
    "doi" => "10.1016/S1130-1473(07)70304-4"
    "estado" => "S300"
    "fechaPublicacion" => "2007-01-01"
    "aid" => "70304"
    "copyright" => "Sociedad Española de Neurocirugía"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Neurocirugia. 2007;18:16-27"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1938
      "formatos" => array:3 [
        "EPUB" => 17
        "HTML" => 1226
        "PDF" => 695
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Perspectivas en el tratamiento del vasospasmo cerebral inducido por hemorragia subaracnoidea"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "16"
          "paginaFinal" => "27"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Perspectives in the treatment of subarachnoid-hemorrhage-induced cerebral vasospasm"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J. Fandino, A.R. Fathi, T. Graupner, S. Jacob, H. Landolt"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "J."
              "apellidos" => "Fandino"
            ]
            1 => array:2 [
              "nombre" => "A.R."
              "apellidos" => "Fathi"
            ]
            2 => array:2 [
              "nombre" => "T."
              "apellidos" => "Graupner"
            ]
            3 => array:2 [
              "nombre" => "S."
              "apellidos" => "Jacob"
            ]
            4 => array:2 [
              "nombre" => "H."
              "apellidos" => "Landolt"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147307703044?idApp=UINPBA00004B"
    "url" => "/11301473/0000001800000001/v1_201305151301/S1130147307703044/v1_201305151301/es/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "titulo" => "Rehabilitation outcome after traumatic brain injury"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "5"
        "paginaFinal" => "15"
      ]
    ]
    "autores" => array:2 [
      0 => array:4 [
        "autoresLista" => "J. Irdesel, S.B. Aydiner"
        "autores" => array:2 [
          0 => array:3 [
            "nombre" => "J."
            "apellidos" => "Irdesel"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "S&#46;B&#46;"
            "apellidos" => "Aydiner"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Depart&#46; of Physical Medicine &#38; Rehabilitation&#46; Uludag University&#46; School of Medicine&#46; Bursa&#46; Turkey"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding Author&#58; Uludag University&#46; School of Medicine&#46; Department of Physical Medicine &#38; Rehabilitation&#46; 16059 Gorukle&#46; Bursa&#46; Turkey&#46;"
          ]
        ]
      ]
      1 => array:3 [
        "autoresLista" => "S&#46; Akgoz"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Akgoz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:3 [
            "entidad" => "Depart&#46; of Biostatistics&#46; Uludag University&#46; School of Medicine&#46; Bursa&#46; Turkey"
            "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
            "identificador" => "aff0010"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Resultados de la rehabilitacion despues de sufrir un traumatismo craneoencef&#225;lico"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2005-08-19"
    "fechaAceptado" => "2006-01-03"
    "PalabrasClave" => array:2 [
      "en" => array:2 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec159492"
          "palabras" => array:3 [
            0 => "Traumatic brain injury"
            1 => "Rehabilitation"
            2 => "Complication"
          ]
        ]
        1 => array:4 [
          "clase" => "abr"
          "titulo" => "Abreviaturas"
          "identificador" => "xpalclavsec159493"
          "palabras" => array:11 [
            0 => "CT"
            1 => "DRS"
            2 => "DVT"
            3 => "FIM"
            4 => "GCS"
            5 => "HO"
            6 => "ICU"
            7 => "LOS"
            8 => "RLA"
            9 => "ROM"
            10 => "TBI"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec159491"
          "palabras" => array:3 [
            0 => "Traumatismo craneoencef&#225;lico"
            1 => "Rehabilitaci&#243;n"
            2 => "Complicaci&#243;n"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Summary"
        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Rehabilitation goals after traumatic brain injury are improving function&#44; increasing the level of independence as high as possible&#44; preventing complications and providing an acceptable environment to the patient&#46; Several complications can be encountered during the rehabilitation period which lead to physical&#44; cognitive and neurobehavioral impairments that cause major delay in functional improvement&#46; This prospective study was designed in order to investigate the complications and their relations with functional recovery in patients that were included in the acute phase of a rehabilitation program&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Thirty traumatic brain injured patients admitted to the Intensive Care Units of Uludag University School of Medicine were included in the study&#46; Rehabilitation program consisted in appropriate positioning&#44; range of motion exercises&#44; postural drainage and respiratory exercises&#46; Complications that were encountered during intensive care rehabilitation program were recorded&#46; All patients were evaluated by Functional Independence Measure&#44; Disability Rating Scale and Ranchos Los Amigos Levels of Cognitive Function Scale at admission and discharge&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Improvement was observed in patients in terms of functional outcome and disability levels&#46; Pneumonia&#44; athelectasis&#44; anemia and meningitis were the most frequent complications&#46; Deterioration in functional outcome and disability levels was noted as the number of these complications increased&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In conclusion&#44; rehabilitation has an important role in the management of traumatic brain injured patients&#46; Reduction of frequency of complications and improvement in functional outcome and disability levels can be achieved through rehabilitation programs&#46; Long-term controlled studies with large number of patients are needed in order to obtain accurate data on factors associated with rehabilitation outcomes&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Entre los objetivos de la rehabilitaci&#243;n despu&#233;s de un traumatismo craneoencef&#225;lico est&#225; la mejor&#237;a de la funci&#243;n cerebral el aumento del grado de independencia la prevenci&#243;n de complicaciones y la obtenci&#243;n de un ambiente acceptable para el paciente&#46; Durante el per&#237;odo de la rehabilitaci&#243;n pueden producirse varias complicaciones que conducen a discapacidades f&#237;sicas&#44; cognitivas y otras neurol&#243;gicas que causan un importante retraso en la mejor&#237;a funcional&#46; Este estudio ha sido dise&#241;ado para investigar las complicaciones observadas en los pacientes que se incluyeron en un programa de rehabilitaci&#243;n en fase aguda&#44; sus relaciones con el estado funcional y los factores que tienen impacto en los resultados de la rehabilitaci&#243;n&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se incluyen en el estudio treinta pacientes con traumatismo craneoencef&#225;lico admitidos en la Unidad de Cuidados Intensivos de la Escuela de Medicina de la Universidad de Uludag&#46; El programa de rehabilitaci&#243;n consisti&#243; en rehabilitaci&#243;n postural&#44; una serie de ejercicios de movimiento&#44; y ejercicios respiratorios&#46; Se registraron las complicaciones que se encontraron durante el programa de rehabilitaci&#243;n de cuidados intensivos&#46; Todos los pacientes fueron evaluados por una Medida de Independencia Funcional&#44; por el grado de invalidez y mediante los niveles de funci&#243;n cognitiva de la Escala Rancho Los Amigos tras la admisi&#243;n&#44; y en el momento del alta&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La mejoria se observ&#243; en los pacientes en t&#233;rminos de resultados funcionales y niveles de invalidez&#46; Las complicaciones m&#225;s frecuentes fueron la neumon&#237;a&#44; atelectasia&#44; anemia y meningitis&#46; Se observ&#243; una disminuci&#243;n en los niveles de los resultados funcionales y de invalidez a medida que aument&#243; el n&#250;mero de complicaciones&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En conclusi&#243;n&#44; la rehabilitaci&#243;n tiene un papel principal en la recuperaci&#243;n de pacientes con traumatismo craneoencef&#225;lico&#46; La reducci&#243;n de la incidencia de complicaciones y la mejora de los niveles de los resultados funcionales y de invalidez se pueden lograr con programas de rehabilitaci&#243;n&#46; Estudios controlados a largo plazo con un gran n&#250;mero de pacientes son necesarios para obtener datos exactos sobre los factores asociados a los resultados de la rehabilitaci&#243;n&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Irdesel&#46; J&#46;&#59; Aydiner&#44; S&#46;B&#46;&#59; Akgoz&#44; S&#46;&#58; Rehabilitation outcome after traumatic brain injury&#46; Neurocirug&#237;a 2007&#59; 18&#58; 5&#8211;15&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:47 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of mortality in severely head-injured patients with civilian gunshot wounds&#58; a report from the NIH Traumatic Coma Bank"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;F&#46; Aldrich"
                            1 => "H&#46;M&#46; Eisenberg"
                            2 => "C&#46; Saydjari"
                            3 => "M&#46;A&#46; Fowlkes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Surg Neurol"
                        "fecha" => "1992"
                        "volumen" => "38"
                        "paginaInicial" => "418"
                        "paginaFinal" => "423"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1298106"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Functional outcome following traumatic brain injury&#58; the Turkish experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46;D&#46; Aras"
                            1 => "A&#46; Kaya"
                            2 => "A&#46; Cakc&#305;"
                            3 => "K&#46;O&#46; Gokkaya"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Rehabil Res&#46;"
                        "fecha" => "2004"
                        "volumen" => "27"
                        "paginaInicial" => "257"
                        "paginaFinal" => "260"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15572987"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Brain Injury Rehabilitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Boake"
                            1 => "G&#46; Francisco"
                            2 => "C&#46; Ivanhoe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Physical Medicine and Rehabilitation&#46;"
                        "paginaInicial" => "1073"
                        "paginaFinal" => "1116"
                        "serieFecha" => "2000"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interrater reliability on a Modified Aschworth scale of muscle spasticity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;W&#46; Bohannon"
                            1 => "M&#46;B&#46; Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Phys Ther"
                        "fecha" => "1987"
                        "volumen" => "67"
                        "paginaInicial" => "206"
                        "paginaFinal" => "207"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3809245"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation of a model for evaluating outcome after traumatic brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46;A&#46; Bush"
                            1 => "T&#46;A&#46; Novack"
                            2 => "J&#46;F&#46; Malec"
                            3 => "A&#46;Y&#46; Stringer"
                            4 => "S&#46;R&#46; Millis"
                            5 => "A&#46; Madan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "2003"
                        "volumen" => "84"
                        "paginaInicial" => "1803"
                        "paginaFinal" => "1807"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14669187"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Introduction&#58; The traumatic brain injury model systems of care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Bushnik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/apmr.2003.50123"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "2003"
                        "volumen" => "84"
                        "paginaInicial" => "151"
                        "paginaFinal" => "152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12601643"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Etiology of traumatic brain injury&#58; characterization of differential outcomes up to 1 year postinjury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46; Bushnik"
                            1 => "R&#46;A&#46; Hanks"
                            2 => "J&#46; Kreutzer"
                            3 => "M&#46; Rosenthal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/apmr.2003.50092"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "2003"
                        "volumen" => "84"
                        "paginaInicial" => "255"
                        "paginaFinal" => "262"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12601658"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Summary report&#58; Evidence for the effectiveness of rehabilitation for persons with traumatic brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;M&#46; Chesnut"
                            1 => "N&#46; Carney"
                            2 => "H&#46; Maynard"
                            3 => "N&#46;C&#46; Mann"
                            4 => "P&#46; Patterson"
                            5 => "M&#46; Helfand"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Head Trauma Rehab"
                        "fecha" => "1999"
                        "volumen" => "14"
                        "paginaInicial" => "176"
                        "paginaFinal" => "188"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chest physical therapy for patients in the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "N&#46;D&#46; Ciesla"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Physical Therapy"
                        "fecha" => "1996"
                        "volumen" => "76"
                        "paginaInicial" => "609"
                        "paginaFinal" => "625"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8650276"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early detection of heterotopic ossification in young patients with traumatic brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;J&#46; Citta"
                            1 => "M&#46;A&#46; Alexander"
                            2 => "N&#46;L&#46; Steg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1992"
                        "volumen" => "73"
                        "paginaInicial" => "258"
                        "paginaFinal" => "262"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1543430"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of early variables in traumatic brain injury on Functional Independence Measure scores and rehabilitation length of stay and charges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46; Cowen"
                            1 => "J&#46; Meythaler"
                            2 => "M&#46; DeVivo"
                            3 => "C&#46; Ivie"
                            4 => "J&#46; Lebow"
                            5 => "T&#46; Novack"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1995"
                        "volumen" => "76"
                        "paginaInicial" => "797"
                        "paginaFinal" => "805"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7668948"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Profiles of functional recovery in fifty traumatically brain injured patients after acute rehabilitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46;H&#46; Davis"
                            1 => "L&#46; Fardanesh"
                            2 => "D&#46; Rubner"
                            3 => "R&#46;L&#46; Wanlass"
                            4 => "C&#46;M&#46; McDonald"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Phys Med Rehabil"
                        "fecha" => "1997"
                        "volumen" => "76"
                        "paginaInicial" => "213"
                        "paginaFinal" => "218"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9207707"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Kafa travmal&#305; hastalarda komplikasyonlar&#305;n kognitif ve fonksiyonel geli&#351;im &#252;zerine etkisi"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46;&#214;&#46; Demir"
                            1 => "G&#46; Ayd&#305;n"
                            2 => "Z&#46; Boyac&#305;o&#287;lu"
                            3 => "S&#46; Tomruk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Turk Fiz T&#305;p Rehab Derg"
                        "fecha" => "2001"
                        "volumen" => "47"
                        "paginaInicial" => "15"
                        "paginaFinal" => "19"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for acute care transfer among traumatic brain injury patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Deshpande"
                            1 => "S&#46;R&#46; Millis"
                            2 => "R&#46;D&#46; Zafonte"
                            3 => "F&#46;M&#46; Hammond"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1997"
                        "volumen" => "78"
                        "paginaInicial" => "350"
                        "paginaFinal" => "352"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9111452"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pressure Ulcer prevention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "R&#46;F&#46; Edlich"
                            1 => "K&#46;L&#46; Winters"
                            2 => "C&#46;R&#46; Woodard"
                            3 => "R&#46;M&#46; Buschbacher"
                            4 => "W&#46;B&#46; Long"
                            5 => "J&#46;H&#46; Gebhart"
                            6 => "E&#46;K&#46; Ma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Long-Term Effects Medical Implants"
                        "fecha" => "2004"
                        "volumen" => "14"
                        "paginaInicial" => "285"
                        "paginaFinal" => "304"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Periarticular heterotopic ossification in head injury adults&#46; Incidence and location"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;F&#46; Garland"
                            1 => "G&#46;E&#46; Blum"
                            2 => "R&#46;L&#46; Waters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Joint Surg"
                        "fecha" => "1980"
                        "volumen" => "62"
                        "paginaInicial" => "1143"
                        "paginaFinal" => "1146"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6776126"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preliminary outcome analysis of a long term rehabilitation program for severe acquired brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;S&#46; Gray"
                            1 => "R&#46;S&#46; Burnharm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/apmr.2000.16343"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "2000"
                        "volumen" => "81"
                        "paginaInicial" => "1447"
                        "paginaFinal" => "1456"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11083347"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Levels of cognitive functioning&#46; Downey &#40;CA&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Hagen"
                            1 => "D&#46; Malkmus"
                            2 => "P&#46; Durham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Rancho Los Amigos Hospital"
                        "fecha" => "1972"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A uniform national data system for medical rehabilitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;B&#46; Hamilton"
                            1 => "C&#46;V&#46; Granger"
                            2 => "F&#46;S&#46; Sherwin"
                            3 => "M&#46; Zielezny"
                            4 => "J&#46;S&#46; Tashman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Rehabilitation outcomes analysis and measurement&#46;"
                        "paginaInicial" => "137"
                        "paginaFinal" => "150"
                        "serieFecha" => "1987"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Descriptive findings from the Traumatic Brain Injury Model Systems National Data Base"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Harrison-Felix"
                            1 => "C&#46;N&#46; Newton"
                            2 => "K&#46; Hall"
                            3 => "J&#46; Kreutzer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Head Trauma Rehabil"
                        "fecha" => "1996"
                        "volumen" => "11"
                        "paginaInicial" => "11"
                        "paginaFinal" => "14"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence and management of complications during posttraumatic early rehabilitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46; Hoffmann"
                            1 => "K&#46;R&#46; von Wild"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Neurochir"
                        "fecha" => "2002"
                        "volumen" => "79"
                        "numero" => "Suppl"
                        "paginaInicial" => "25"
                        "paginaFinal" => "29"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Length of stay effect on outcome for stroke and brain injured patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; John"
                            1 => "T&#46; Mayer"
                            2 => "A&#46; Eberstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1999"
                        "volumen" => "80"
                        "paginaInicial" => "1133"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medical problems encountered during rehabilitation of patients with head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Z&#46; Kalisky"
                            1 => "D&#46;P&#46; Morrison"
                            2 => "C&#46;A&#46; Meyers"
                            3 => "A&#46; Von Laufen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1985"
                        "volumen" => "66"
                        "paginaInicial" => "25"
                        "paginaFinal" => "29"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3917661"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relationship between cognition and functional independence in adults with traumatic brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;P&#46; Kaplan"
                            1 => "J&#46;D&#46; Corrigan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1994"
                        "volumen" => "75"
                        "paginaInicial" => "643"
                        "paginaFinal" => "647"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8002762"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Traumatic brain injury&#58; predicting course of recovery and outcome for patients admitted to rehabilitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Katz"
                            1 => "M&#46; Alexander"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Neurol"
                        "fecha" => "1994"
                        "volumen" => "51"
                        "paginaInicial" => "661"
                        "paginaFinal" => "670"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8018038"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medical complications of head injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46;H&#46; Kaufman"
                            1 => "G&#46; Timberlake"
                            2 => "J&#46; Voelker"
                            3 => "T&#46;G&#46; Pait"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Clin North Am"
                        "fecha" => "1993"
                        "volumen" => "77"
                        "paginaInicial" => "43"
                        "paginaFinal" => "60"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8419723"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Travmatik beyin yaralanmas&#305;nda rehabilitasyon sonu&#231;lar&#305;&#58; Kognitif fonksiyonlar&#305;n rehabilitasyon sonu&#231;lar&#305;na etkisi"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Kaya"
                            1 => "M&#46; Dalyan"
                            2 => "H&#46; &#220;lker"
                            3 => "M&#46; Aky&#252;z"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Turk Fiz T&#305;p Rehab Derg"
                        "fecha" => "2001"
                        "volumen" => "47"
                        "paginaInicial" => "7"
                        "paginaFinal" => "14"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prediction of discharge status of persons with brain injury in rehabilitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;F&#46; Lau"
                            1 => "D&#46;W&#46; Man"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.mrr.0000102051.48781.82"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Rehabil Res&#46;"
                        "fecha" => "2003"
                        "volumen" => "26"
                        "paginaInicial" => "251"
                        "paginaFinal" => "255"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14634358"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of medical comorbidities and complications on FIM change and length of stay during rehabilitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46;L&#46; Lew"
                            1 => "E&#46; Lee"
                            2 => "E&#46;S&#46; Date"
                            3 => "H&#46; Zeiner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Phys Rehabil"
                        "fecha" => "2002"
                        "volumen" => "81"
                        "paginaInicial" => "830"
                        "paginaFinal" => "837"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome of prolonged coma following severe traumatic brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Lippert-Gruner"
                            1 => "C&#46; Wedekind"
                            2 => "N&#46; Klug"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Brain Inj"
                        "fecha" => "2003"
                        "volumen" => "17"
                        "paginaInicial" => "49"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12519647"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization and correlates of medical and rehabilitation charges of traumatic brain injury during acute rehabilitation hospitalization"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46;H&#46; Mayer"
                            1 => "S&#46; Pelensky"
                            2 => "S&#46; Whyte"
                            3 => "R&#46; Fidler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/apmr.2003.50101"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "2003"
                        "volumen" => "84"
                        "paginaInicial" => "242"
                        "paginaFinal" => "248"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12601656"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Meray"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Kafa Travmas&#305; ve Rehabilitasyonu"
                        "paginaInicial" => "1951"
                        "paginaFinal" => "1962"
                        "serieFecha" => "2000"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rehabilitation of patients admitted to a respiratory intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Nava"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1998"
                        "volumen" => "79"
                        "paginaInicial" => "849"
                        "paginaFinal" => "854"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9685104"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "No authors listed&#46; Consensus conference&#46; Rehabilitation of persons with traumatic brain injury&#46; National Institutes of Health Consensus Development Panel on Rehabilitation of persons with traumatic brain injury&#46; JAMA 1999&#59; 282&#58; 974&#8211;983&#46;"
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outcome after traumatic brain injury&#58; pathway analysis of contributions from premorbid&#44; injury severity and recovery variables"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;A&#46; Novack"
                            1 => "B&#46;A&#46; Buh"
                            2 => "J&#46;M&#46; Meythaler"
                            3 => "K&#46; Canupp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/apmr.2001.18222"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "2001"
                        "volumen" => "82"
                        "paginaInicial" => "300"
                        "paginaFinal" => "305"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11245749"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib36"
              "etiqueta" => "36&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prescribed versus actual length of stay and inpatient neurorehabilitation outcome for brain dysfunctional patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;P&#46; Prigatano"
                            1 => "J&#46;L&#46; Wong"
                            2 => "C&#46; Williams"
                            3 => "K&#46;L&#46; Plenge"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1997"
                        "volumen" => "78"
                        "paginaInicial" => "621"
                        "paginaFinal" => "629"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9196470"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib37"
              "etiqueta" => "37&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complications of traumatic brain injury patients during the period of early rehabilitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46; Ranka"
                            1 => "M&#46; Teofilovski"
                            2 => "B&#46; Djurovic"
                            3 => "V&#46; Potic"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1999"
                        "volumen" => "80"
                        "paginaInicial" => "1131"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib38"
              "etiqueta" => "38&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disability rating scale for severe head trauma&#58; coma to community"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Rappaport"
                            1 => "K&#46;M&#46; Hall"
                            2 => "H&#46;K&#46; Hopkins"
                            3 => "T&#46; Belleza"
                            4 => "D&#46;N&#46; Cope"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1982"
                        "volumen" => "63"
                        "paginaInicial" => "118"
                        "paginaFinal" => "123"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7073452"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib39"
              "etiqueta" => "39&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Retrospective assessment of rehabilitation outcome after traumatic brain injury&#58; development and utility of the functional independence level"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Schatz"
                            1 => "F&#46;G&#46; Hillary"
                            2 => "S&#46;T&#46; Moelter"
                            3 => "D&#46;L&#46; Chute"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Head Trauma Rehabil&#46;"
                        "fecha" => "2002"
                        "volumen" => "17"
                        "paginaInicial" => "510"
                        "paginaFinal" => "525"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12802242"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib40"
              "etiqueta" => "40&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Traumatic brain injury&#58; efficacy of multidisciplinary rehabilitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;K&#46; Semlyen"
                            1 => "S&#46;J&#46; Summers"
                            2 => "M&#46;P&#46; Barnes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "1998"
                        "volumen" => "79"
                        "paginaInicial" => "678"
                        "paginaFinal" => "683"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9630149"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib41"
              "etiqueta" => "41&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development of complications during rehabilitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46;L&#46; Siegler"
                            1 => "M&#46;G&#46; Stineman"
                            2 => "G&#46; Maislin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "1994"
                        "volumen" => "154"
                        "paginaInicial" => "2185"
                        "paginaFinal" => "2190"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7944839"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib42"
              "etiqueta" => "42&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Tan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Kafa travmas&#305; ve rehabilitasyonu"
                        "paginaInicial" => "83"
                        "paginaFinal" => "99"
                        "serieFecha" => "2000"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib43"
              "etiqueta" => "43&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of coma and impaired consciousness&#58; A practical scale"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; Teasdale"
                            1 => "B&#46; Bennett"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1974"
                        "volumen" => "2"
                        "paginaInicial" => "81"
                        "paginaFinal" => "84"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2567876"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib44"
              "etiqueta" => "44&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in hospitalization associated with traumatic brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Thurman"
                            1 => "J&#46; Guerrero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "1999"
                        "volumen" => "282"
                        "paginaInicial" => "954"
                        "paginaFinal" => "957"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10485680"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib45"
              "etiqueta" => "45&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rehabilitation of the patient with traumatic brain injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Whyte"
                            1 => "T&#46; Hart"
                            2 => "A&#46; Laborde"
                            3 => "M&#46; Rosenthal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Rehabilitation Medicine&#58; Principles and practice&#46;"
                        "paginaInicial" => "997"
                        "paginaFinal" => "1013"
                        "serieFecha" => "1998"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib46"
              "etiqueta" => "46&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship between Glasgow coma scale and functional outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;D&#46; Zafonte"
                            1 => "F&#46;M&#46; Hammond"
                            2 => "N&#46;R&#46; Mann"
                            3 => "D&#46;L&#46; Wood"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Phys Med Rehabil"
                        "fecha" => "1996"
                        "volumen" => "75"
                        "paginaInicial" => "364"
                        "paginaFinal" => "369"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8873704"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib47"
              "etiqueta" => "&#91;47&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Severe Penetrating Head Injury&#58; A study of outcomes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;D&#46; Zafonte"
                            1 => "D&#46;L&#46; Wood"
                            2 => "C&#46;L&#46; Harrison"
                            3 => "S&#46;R&#46; Millis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/apmr.2001.18226"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Phys Med Rehabil"
                        "fecha" => "2001"
                        "volumen" => "82"
                        "paginaInicial" => "306"
                        "paginaFinal" => "310"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11245750"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/11301473/0000001800000001/v1_201305151301/S1130147307703032/v1_201305151301/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/11301473/0000001800000001/v1_201305151301/S1130147307703032/v1_201305151301/en/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147307703032?idApp=UINPBA00004B"
]
Compartir
Información de la revista
Vol. 18. Núm. 1.
Páginas 5-15 (enero 2007)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 18. Núm. 1.
Páginas 5-15 (enero 2007)
Rehabilitation outcome after traumatic brain injury
Resultados de la rehabilitacion despues de sufrir un traumatismo craneoencefálico
Visitas
1909
J. Irdesel
, S.B. Aydiner
Depart. of Physical Medicine & Rehabilitation. Uludag University. School of Medicine. Bursa. Turkey
S. Akgoz*
* Depart. of Biostatistics. Uludag University. School of Medicine. Bursa. Turkey
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas
Summary

Rehabilitation goals after traumatic brain injury are improving function, increasing the level of independence as high as possible, preventing complications and providing an acceptable environment to the patient. Several complications can be encountered during the rehabilitation period which lead to physical, cognitive and neurobehavioral impairments that cause major delay in functional improvement. This prospective study was designed in order to investigate the complications and their relations with functional recovery in patients that were included in the acute phase of a rehabilitation program.

Thirty traumatic brain injured patients admitted to the Intensive Care Units of Uludag University School of Medicine were included in the study. Rehabilitation program consisted in appropriate positioning, range of motion exercises, postural drainage and respiratory exercises. Complications that were encountered during intensive care rehabilitation program were recorded. All patients were evaluated by Functional Independence Measure, Disability Rating Scale and Ranchos Los Amigos Levels of Cognitive Function Scale at admission and discharge.

Improvement was observed in patients in terms of functional outcome and disability levels. Pneumonia, athelectasis, anemia and meningitis were the most frequent complications. Deterioration in functional outcome and disability levels was noted as the number of these complications increased.

In conclusion, rehabilitation has an important role in the management of traumatic brain injured patients. Reduction of frequency of complications and improvement in functional outcome and disability levels can be achieved through rehabilitation programs. Long-term controlled studies with large number of patients are needed in order to obtain accurate data on factors associated with rehabilitation outcomes.

Key words:
Traumatic brain injury
Rehabilitation
Complication
Abreviaturas:
CT
DRS
DVT
FIM
GCS
HO
ICU
LOS
RLA
ROM
TBI
Resumen

Entre los objetivos de la rehabilitación después de un traumatismo craneoencefálico está la mejoría de la función cerebral el aumento del grado de independencia la prevención de complicaciones y la obtención de un ambiente acceptable para el paciente. Durante el período de la rehabilitación pueden producirse varias complicaciones que conducen a discapacidades físicas, cognitivas y otras neurológicas que causan un importante retraso en la mejoría funcional. Este estudio ha sido diseñado para investigar las complicaciones observadas en los pacientes que se incluyeron en un programa de rehabilitación en fase aguda, sus relaciones con el estado funcional y los factores que tienen impacto en los resultados de la rehabilitación.

Se incluyen en el estudio treinta pacientes con traumatismo craneoencefálico admitidos en la Unidad de Cuidados Intensivos de la Escuela de Medicina de la Universidad de Uludag. El programa de rehabilitación consistió en rehabilitación postural, una serie de ejercicios de movimiento, y ejercicios respiratorios. Se registraron las complicaciones que se encontraron durante el programa de rehabilitación de cuidados intensivos. Todos los pacientes fueron evaluados por una Medida de Independencia Funcional, por el grado de invalidez y mediante los niveles de función cognitiva de la Escala Rancho Los Amigos tras la admisión, y en el momento del alta.

La mejoria se observó en los pacientes en términos de resultados funcionales y niveles de invalidez. Las complicaciones más frecuentes fueron la neumonía, atelectasia, anemia y meningitis. Se observó una disminución en los niveles de los resultados funcionales y de invalidez a medida que aumentó el número de complicaciones.

En conclusión, la rehabilitación tiene un papel principal en la recuperación de pacientes con traumatismo craneoencefálico. La reducción de la incidencia de complicaciones y la mejora de los niveles de los resultados funcionales y de invalidez se pueden lograr con programas de rehabilitación. Estudios controlados a largo plazo con un gran número de pacientes son necesarios para obtener datos exactos sobre los factores asociados a los resultados de la rehabilitación.

Palabras clave:
Traumatismo craneoencefálico
Rehabilitación
Complicación

Artículo

Opciones para acceder a los textos completos de la publicación Neurocirugía
Socio
Socio de la Sociedad Española de Neurocirugía

Si es la primera vez que accede a la web puede obtener sus claves de acceso poniéndose en contacto con Elsevier España en suscripciones@elsevier.com o a través de su teléfono de Atención al Cliente 902 88 87 40 si llama desde territorio español o del +34 932 418 800 (de 9 a 18h., GMT + 1) si lo hace desde el extranjero.

Si ya tiene sus datos de acceso, clique aquí.

Si olvidó su clave de acceso puede recuperarla clicando aquí y seleccionando la opción "He olvidado mi contraseña".

Suscriptor
Suscriptor de la revista

Si ya tiene sus datos de acceso, clique aquí.

Si olvidó su clave de acceso puede recuperarla clicando aquí y seleccionando la opción "He olvidado mi contraseña".
Suscribirse
Suscribirse a:

Neurocirugía

Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 19,34 €

Comprar ahora
Contactar
Teléfono para suscripciones e incidencias
De lunes a viernes de 9h a 18h (GMT+1) excepto los meses de julio y agosto que será de 9 a 15h
Llamadas desde España
932 415 960
Llamadas desde fuera de España
+34 932 415 960
Email
Idiomas
Neurocirugía
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?