International Medical Journal, Vol. 20., Iss. 4, 2014, P. 54−57.
DEFINITION OF QUALITY OF LIFE IN PATIENTS WITH SEQUELLAE OF MILD TRAUMATIC BRAIN INJURIES BEFORE AND AFTER NEUROMETABOLIC THERAPY
Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
In recent years, mild traumatic brain injury (MTBI) has emerged as a leading public health concern. The study involved 75 patients with sequellae of mild traumatic brain injuries (52 men and 23 women), aged 25−33 years. The duration of the disease was 3−5 years. All patients were examined in standard clinical neurological conditions. The patients were divided into two groups: group 1 included 38 patients (26 men and 12 women), who received palliative treatment consisting of vasoactive drugs, vitamins, light sedation. The course of treatment lasted for 2 months. Group 2 consisted of 37 patients (26 men and 11 women), who received symptomatic therapy and simultaneously the course of neuroprotective therapy with Phenibut at a dose of 250 mg 3 times a day for 2 months. The controls included 30 sex− and age−matched healthy subjects without any TBI. The quality of life in the patients with sequellae of mild traumatic brain injuries was assessed using detection of state and trait anxiety with Spielberger − Hanin Test. Quality of life was evaluated by using the questionnaire MOS SF−36. In the group of patients with brain concussion the quality of life according to the Scale of Pain was 66.3±3.9 before the treatment with metabolic therapy and 82.5±3.6 points after treatment. According to the questionnaire by Spielberger − Hanin, moderate state anxiety and trait anxiety of the patients were registered. The average meaning of state anxiety was 47.5±1.5 points (in the controls − 11.2±2.8 points) and the average value of trait anxiety was 38.2±8.7 points (in the controls − 12.3±1.7 points). After the metabolic treatment, the level of reactive anxiety was 33.5±2.1 points, personal anxiety was 31.4±3.2 points (p > 0.0001). The quality of life reduced according to all scales of SF−36 questionnaire. According to the scale of physical functioning the quality of life was in average 65.2±4.2 points and as to role functioning, it was 65.5±2.5 points before the treatment. After the metabolic treatment, the level of physical functioning of the quality of life was 83.7±3.2 and as to role functioning, it was 79.5±2.1. The impact of pain reduced daily activity to 65.7±1.7 points and the common state of health was evaluated as 66.2±3.8 points. After the metabolic treatment, daily activity was 81.2±1.7 points and the common state of health was evaluated as 82.2±3.8 points. The quality of life according to the scale of social functioning and emotional functioning before the treatment was 63.7±2.5 points and 65.1±1.8 points, respectively. After the metabolic treatment it was 79.8±3.5 points and 85.1±5.1 points, respectively. The mental health of patients with mild traumatic brain injuries was evaluated as 68.3±3.1 points before the treatment and 79.2±2.5 after the metabolic treatment. Integral evaluation of quality of life according to the questionnaire SF−36 showed reduction in quality of life according to the scales of pain intensity, social functioning and mental health. The treatment of patients with sequellae of mild traumatic brain injuries with neurometabolic therapy improves quality of life.
Key words: mild traumatic brain injury, sequellae of mild traumatic brain injuries, quality of life, metabolic therapy.