Brain-Injured Patients Turn to Alternative Medicine
...and their Physicians Often Remain Unaware

Sharon McDowell and Asma Rafeeq consult with patient Thomas Kulback as he receives massage therapy from therapist Robert Ferguson in the inpatient physical therapy gym. Photo: Gregory Fox

Over 80 percent of patients with traumatic brain injuries interviewed for a recent U-M study said they used complementary or alternative medicine therapies — ranging from massage to herbal treatments —to supplement conventional medical care for their injuries. Most patients did not discuss use of such therapies with their physicians.

Even though there have been few medical studies testing the effectiveness and safety of alternative therapies for traumatic brain injuries, patients in the U-M study said they believed they were working for them.

“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,” says Sharon McDowell, M.D., a lecturer in physical medicine and rehabilitation. “There are some good complementary and alternative therapies available, such as meditation and manual muscle therapies, which we recommend. 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 therapies patients were using, especially if they were not doctor-recommended.”

McDowell and co-investigator Asma Rafeeq, a U-M medical student, 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.

In a telephone interview, the patients were asked if they used complementary or alternative medicine for reasons related to their injury. More than half of the subjects interviewed said they used at least one such therapy, and an additional one-third of study subjects used two or more. Therapies used most commonly were therapeutic massage, meditation, herbal medicine and chiropractic care. Both massage therapy and chiropractic were used to treat pain, while meditation was practiced for affective disorders and herbal medicine was taken for cognitive deficits.

While most of the patients surveyed felt that complementary and alternative 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 realize that the vitamin supplements and other substances they use can affect their medical treatment,” she says. “As a physician, this makes me more aware that I need to ask my patients about their use of alternative therapies.”

U-M researchers presented the results of the study in April at the American Academy of Neurology’s annual meeting.

—KH

Information on the U-M Traumatic Brain Injury Program:
www.med.umich.edu/pmr/clinical.htm