Role of Early Inpatient Physiotherapy in Improving Functional Independence after Craniotomy-A Case Study

Background: Craniotomy is a type of surgical procedure to open the cranium to access the brain for surgical repair, and any damage to brain parts or alteration in brain function.The brain surgery is generally the first step of treatment for brain injuries and conditions.The aim of the study was early inpatient physiotherapy to improve the functional outcomes in post craniotomy patient.Functional independence measure (FIM) was the outcome scale that was used to see the progress level of the patient.The patient's score varies from 18 points (the patient is completely dependent) to 126 points (the patient is completely independent).Derivatives of the FIM score include, FIM gain where it is the difference between discharge and admission FIM and measures absolute functional gain.FIM efficiency is the FIM gain divided by the length of stay in rehabilitation and measures the rate of functional improvement.Case Description: A 9-year-old child admitted after a traumatic brain injury with subdural hematoma on 9th November 2017, he underwent craniotomy on 11/11/2017.His GCS level was E2V2M3 and RLA was 2 on 12/11/2017.The child had left hemopneumothorax as associated complication.Intervention done was positioning, chest care, tilt table, activities in bed, balancing, standing and walking.FIM on admission and discharge was taken.Patient was discharged on 2/3/18. Result:The Absolute FIM gain was calculated where Discharge -Admission; 90-18= 72 and FIM efficiency was calculated where FIM gain /by length of stay i.e., 72/90 *100=80% rate of functional improvement.