Massage & Bodywork

September/October 2008

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pathology perspectives BY RUTH WERNER POTENTIAL FOR RECOVERY IN CENTRAL NERVOUS SYSTEM INJURIES According to statistical averages, a stroke, traumatic brain injury, or spinal cord injury will radically change the lives of 116 Americans this hour. Injuries to the central nervous system (CNS) can be devastating to the injured person and his or her loved ones and caregivers. The brain and spinal cord, so carefully protected by the three layers of meninges and the bony shells of the cranium and spinal canal, are extraordinarily vulnerable to damage if those protective layers are breeched by a blood clot, a gunshot wound, a motor vehicle accident, or other trauma. This article will address the consequences of the most common kinds of CNS injuries, along with some new paradigms that are shaping the future of treatment strategies and the long-term prognoses for these events. Because some of these shifts involve muscle reflexes and proprioceptors, this puts the recovery process at least partly within the scope of practice for massage therapists, so we will also look at how bodyworkers can apply their skills in this context. TRAUMATIC BRAIN INJURY Traumatic brain injury (TBI) is an insult to the brain that is not brought about by congenital or degenerative conditions. This damage can lead to altered states of consciousness, cognitive impairment, and disruption of physical, emotional, and motor function. TBI is usually due to external force. Falls, gunshot wounds, motor vehicle accidents, physical violence, and sports are leading causes. About 1.5 million TBIs are reported every year, and 270,000 are classified as moderate to severe injuries; the rest are considered to be mild (although even mild injuries carry some significant risks).1 Most TBI patients are people between 15 and 25, or over 75 years old. Younger patients are injured in motor vehicle accidents, sports injuries, and personal violence; older patients are injured most often in falls. massagetherapy.com—for you and your clients 111

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