Discovering new rehabilitation options for patients with traumatic brain injury

Sheital Bavishi, DO, is a physician whose interest is in caring for patients who have acquired traumatic brain injury (TBI) or stroke. Along with other physicians and researchers in Physical Medicine and Rehabilitation at the Neurological Institute within The Ohio State University Wexner Medical Center, she is anticipating bringing new technology and treatment options to the inpatient rehabilitation setting.

"We are currently developing a Disorders of Consciousness Program at Ohio State," Dr. Bavishi, who is fellowship trained in TBI and poly-trauma, explains. The new program, expected to be available in 2016, will focus on caring for patients whose brain injury results in coma, persistent vegetative state or minimally conscious state.

"Because there are currently no evidence-based treatment guidelines for helping patients with disorders of consciousness predictably recover, we have a special interest in new, recently published protocols – including for transcranial direct current stimulation (tDCS) – that show great promise in the literature and with which we have had some success," she notes.

Disorders of consciousness include:

• Coma – patients have no signs of sleep/wake cycle; eyes do not open
• Persistent vegetative state (also known as persistent unresponsive wakefulness syndrome) – patients are awake, but have no awareness
• Minimally conscious state – patients show signs of awareness, respond to verbal commands, but do not communicate

Clinical trials to investigate the effectiveness of tDCS in helping patients emerge from a minimally conscious state are being developed at Ohio State's Dodd Hall Rehabilitation Hospital.

"I always want to treat patients as I want to be treated," she says. "This means seeing them as a whole person – not just their injury, disorder or disease. I work to find ways to enhance and restore their functional ability and quality of life so they may return to their families and their lives."