Brain injury patients now turning to alternative medicine for treatment

April 01, 2003

HONOLULU, HAWAII -- More patients than ever before with traumatic brain injuries are turning to complementary and alternative medicine (CAM) therapies to supplement conventional medical care for their injuries. But the majority of these patients are not discussing their use of CAM therapy with their physicians, a new study finds.

This new research further revealed that more than 80 percent of the traumatic brain injury patients interviewed believed that CAM therapy, ranging from massage to herbal medicine, were effective, even though there has been very little medical assessment of CAM's efficiency and safety in treating traumatic brain injuries.

The findings, gathered by researchers in the University of Michigan Health System's Department of Physical Medicine and Rehabilitation, will be presented on April 1 at the American Academy of Neurology's (AAN) annual meeting in Honolulu, Hawaii.

An estimated 5.3 million Americans currently live with disabilities resulting from traumatic brain injury - damage to the brain caused by a sudden physical assault on the head - according to the Centers for Disease Control. And the recovery process can take months or years, depending on the severity of the injury. Often, patients with a traumatic brain injury experience chronic motor and cognitive impairment, in addition to seizures, and sensory and visual deficits, which affect mental and physical functioning.

The chronic nature of traumatic brain injury symptoms, in addition to the lack of definitive treatments for the injury, have turned more patients toward CAM therapies in recent years, says investigator Sharon McDowell, M.D., a lecturer in the U-M Department of Physical Medicine and Rehabilitation.

"It really underlines the high level of frustration that traumatic brain injury patients feel about the chronicity of their problems and the few proven therapies available to them," McDowell explains. "However, while there are some good CAM therapies available. Many of which we even recommend such as meditation and manual muscle therapies. But a lot of therapies are not good for patients with this type of injury. So, it was important for us to find out what CAM therapies patients are turning to, especially if they were not doctor-recommended."

In order to assess the prevalence and spectrum of CAM use among individuals with traumatic brain injuries, McDowell and co-investigator Asma Rafeeq, a student at the U-M Medical School, surveyed 130 patients who were randomly selected from a group of patients treated at the U-M Trauma Burn Center for a traumatic brain injury.

During a telephone interview, the patients were asked if they had used any of 16 specific CAM therapies, or any others, for reasons related to their injury. Specifically, they were questioned about the injury-related factors that lead to their use of CAM therapies and their perceived effectiveness of CAM.

Of those surveyed, more than half of the subjects interviewed said that they had used at least one CAM therapy, with more than one-third using two or more CAM therapies.

The patients revealed that the CAM therapies they most commonly utilized were massage therapy, meditation, herbal medicine and chiropractic care. Both massage therapy and chiropractic care were used by patients to treat pain, while meditation was practiced for affective disorders and herbal medicine was taken for cognitive deficits.

Although there were trends in the CAM therapy for certain chronic symptoms resulting from their injury, it did not necessarily dictate which CAM therapies a patient would turn to for their specific type of injury.

McDowell also points out that there was very little evidence found that could predict which factors - severity of brain injury, time after injury, gender or ethnicity - would determine if a patient with a traumatic brain injury was more likely to use CAM therapies to supplement his or her conventional care. However, younger patients with higher education levels were more likely to use CAM.

While the majority of the patients surveyed felt that CAM therapies were effective, only half had discussed the topic with their physicians, which is a concern for McDowell.

"A lot of patients are embarrassed to tell their doctors, while others don't even realize that the vitamin supplements and other substances they are using can be as active as drugs, which can affect their medical treatment," she says. "As a physician, this makes me more aware of the fact that I need to ask my patients about any possible CAM use."

Nevertheless, McDowell stresses that although traumatic brain injury patients have found CAM to be effective, controlled studies are still needed to assess the efficiency and safety of CAM therapies for these patients.
-end-
The U-M Traumatic Brain Injury Program
Patients seen at the U-M Traumatic Brain Injury Program of the Department of Physical Medicine and Rehabilitation take part in a comprehensive program of cognitive, psycho-social and physical rehabilitation. Intensive services, provided by a core treatment team consisting of physiatrists, occupational therapists, physical therapists, speech pathologists, social workers, neuropsychologists, vocational rehabilitation counselors, rehabilitation engineers and dietitians promote increased independence and accommodation to disability through education and retraining. To learn more, visit www.med.umich.edu/pmr/.

Written by Krista Hopson

Contact:
Krista Hopson, khopson@umich.edu
Kara Gavin, kegavin@umich.edu
(734) 764-2220

University of Michigan Health System

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