Methodist Rehabilitation Center - Areas of Expertise

Eight months after suffering a traumatic brain injury when a freight train hit the 18-wheeler he was driving, 41-year-old Vernon Walters was back behind the wheel, running his first post-accident route. Walters was among a 170 brain injury patients treated last year at Methodist Rehabilitation Center in Mississippi’s only comprehensive TBI Program.

In 2006, the most experienced TBI staff in the state treated more patients than any other Mississippi hospital and nearly more patients than the 14 largest Mississippi hospitals combined. And since its opening in 1975, the physiatrists, neuropsychologists, neuroscience researchers, certified rehabilitation nurses and physical, occupational and speech therapists at Methodist have treated thousands of people with brain injuries.

This number, coupled with the hospital's participation in the Traumatic Brain Injury Model System, gives Methodist the proven expertise brain injury patients deserve.

Our Patients

Patients in the TBI Program at Methodist Rehabilitation Center have acquired brain injuries due to trauma, cerebral hemorrhage, infection, tumors or lack of oxygen.

A brain injury can cause physical changes to the brain, affecting the ability to think, behave properly, move or feel. Some of the resulting problems are apparent, others are less obvious. The complex needs of a person with brain injury demand the intervention of specialized rehabilitation professionals, an intensive brain injury treatment program and state-of-the-art rehabilitative medicine—all of which can be found at Methodist.

Methodist plays a lead role in brain injury research—a definite advantage for our patients who often participate in scientific studies. The knowledge gained from that research is immediately applied to patient care. That’s a benefit that can’t be found at any other hospital in the state and few in the nation. Current research programs are in rehabilitation medicine as well as in behavior management and long term lifestyle changes.

TBI patients at Methodist are hospitalized on a separate floor which is secured for safety with their own therapy gym and a staff dedicated solely to the treatment of brain injuries. No other Mississippi hospital provides brain injury survivors with this level of specialized care.

Our Team

TBI patients receive treatment from a multi-disciplinary team led by the program’s medical director, Dr. Stuart A. Yablon, a board-certified physiatrist (specialist in physical medicine). Before joining Methodist, Dr. Yablon was co-director of the Brain Injury Program at The Institute for Rehabilitation and Research in Houston, and assistant professor in the department of physical medicine and rehabilitation at The University of Texas Medical School at Houston, and Baylor College of Medicine.

The TBI team also includes certified rehabilitation registered nurses, physical therapists, occupational therapists, therapeutic recreation specialists, respiratory therapists, vocational rehabilitation counselors, dieticians, neuropsychologists and biomedical engineers. A patient’s referring physician is invited to stay involved in their care and other medical specialists are consulted, as needed.

Together, this comprehensive team works to meet the complex physical, emotional and behavioral needs of brain-injured patients through counseling, medication, behavior modification and psychiatric consultation. The team is trained to recognize the mental, personality and emotional changes caused by brain injury. These areas are strengthened using memory retention and decision-making techniques.

Our Program

The treatment program includes medical care, cognitive retraining, emotional and behavioral treatment, communication, mobility, life skills, therapeutic recreation, patient and family education, nutrition and respiratory care. The program also helps patients and their families cope and adapt to physical and emotional changes through extensive adjustment and education sessions.

Each patient has a treatment plan tailored to meet their individual needs. Patients may require or benefit from a variety of therapies.

Sensory stimulation in the early critical stage of recovery involves consistent interaction with a patient, stimulating all five senses. Our team works with patients on maintaining general positioning for improved alignment, preventing complications due to immobility, encouraging patients to respond as well as follow one-step commands.

The team also works with patients to improve respiratory strength, coordination, lung volume, cough force and endurance. They are also skilled in providing rehabilitative care to ventilator-dependent patients.

A brain injury often affects movement, balance and coordination resulting in difficulties with sitting, transferring and walking. To assist with mobility, our team implements a program consisting of muscle reeducation and strengthening as well as bed and wheelchair positioning. These provide a basis from which to perform functional training activities such as balance training, turning in bed, transfers and retraining patients to walk. Coordination and endurance training are also provided. Assistive devices and/or wheelchairs may be recommended.

Cognition initially involves being awake, able to pay attention, knowing who you are, where you are, the time and date and current place. It requires accurate sensory perception. Memory and language are a part of all phases of cognitive recovery. The highest levels of cognition are social behavior and executive functioning which includes reasoning, judgment, insight, plus planning and evaluation based on correct perception of the feedback received. Cognition affects a persons behavior, emotional responses, social skills and all relationships. Based on the patients needs following cognitive evaluation, the team may assist patients with memory enhancement and decision making, using a variety of tools including reality orientation, cognitive therapy, computer tasks, memory aids, films, games and academic training.

Mood swings, anxiety, personality disorders and decreased inhibitions are often experienced by those with brain injuries. Our team treats these emotional and behavioral problems with counseling, medication, behavior modification programs and psychiatric consultation.

Most people with a brain injury experience some difficulty with communicating. The staff evaluates communication skills related to listening, thinking, speaking, reading, writing and works with the patient to develop the most effective and appropriate communication system possible.

A brain injury may also affect nutritional status, causing swallowing problems, eating disorders and metabolic changes. The team evaluates patients and implements an appropriate dietary program. Patients with swallowing problems (dysphagia) may receive a videofluroscopy (an x ray video of their swallowing) evaluation and attend therapy sessions to improve swallowing.

Because a brain injury creates sudden and complex changes, adjustment and education sessions help patients and their families understand the characteristics and consequences of brain injury and how roles, responsibilities, relationships and behaviors are affected. The team helps both patient and family adjust to these changes.

Accomplishing everyday tasks can be quite difficult for people with brain injuries. Individual and group treatment programs involve re-learning or management of daily tasks including personal self-care, bowel and bladder management, home management, driving, recreation and community, work and school reintegration.

Quest

After discharge, TBI patients transition to Quest—Mississippi’s only comprehensive outpatient program designed to help them reintegrate into society. A team of physical, occupational and speech therapists work with physicians and neuropsychologists to help patients improve in a setting that’s more tailored to their individual needs than a hospital environment.

Patients who have difficulty with mobility, cognition, behavior, academics and independent living skills benefit from the program. The goal is to provide a supportive environment to assist patients in their transition back to work, school and their communities. Working in a structured setting, the staff teaches patients how to continue the new skills they’ve learned and help them achieve community re-entry goals.

Research

TBI patients at Methodist have opportunities to participate in and benefit from clinical trials and other research through the hospital’s Center for Neuroscience and Neurological Recovery. A team of CNNR physician-scientists translate basic neuroscience research into useful therapies that benefit patients suffering from traumatic brain injuries. By building on the hospital’s reputation and strong commitment to research, this team is able to quickly move research findings from the laboratory to the patient’s bedside, thus bridging the gap between biomedical discoveries and their clinical application.

This commitment to neuroscience research is a crucial component of a comprehensive TBI program. Our research team’s mission is to provide objective evidence about what works for whom, when and why, whether evaluating new promising therapies or challenging embraced clinical practices. The goal is to provide clinicians with the best possible evidence to consider when evaluating or modifying practices in TBI rehabilitation.

In this endeavor, patients and investigators form a partnership, with our patients contributing to knowledge by electing to participate in studies that they hope will benefit themselves or others like them.

Methodist TBI News

Numerous news releases and feature stories have been written about traumatic brain injury patients who’ve had successful outcomes or made significant gains following treatment at Methodist Rehabilitation Center. To read those stories, go to the patient profiles section and click “brain injuries.” Many more TBI news releases and links to news coverage about Methodist’s TBI program are available by entering the keywords "brain" or "TBI" in the search box at the top of this page.

More About Methodist

Brain Injury Program Manager
Susan B. Greco, RN, MSN, CRRN
sgreco@mmrcrehab.org
601-364-3480 or 601-497-2070a

Brain Injury Nurse Manager
Lauren Dukes , RN, BSN
ldukes@mmrcrehab.org
601-364-3438

»	How many brain injury patients does Methodist treat in a typical year?

In 2006, Methodist Rehabilitation Center treated 170 patients with traumatic brain injuries. That's 49 percent of all TBI patients treated in Mississippi last year. This number of patients gives us experience no other hospital has. In fact, the 14 largest Mississippi hospitals combined treated only 174 patients in 2006.