Rehabilitation Techniques for Brain Injury Recovery

The human brain controls every body system as well as our senses, thoughts, and emotions. Despite the protection of a cushioning layer of fluid and a bony skull, the brain sometimes suffers injuries with serious impacts on physical and cognitive ability as well as mood, emotion, and behavior. Over 5 million adults in the United States live with disabilities related to traumatic brain injuries (TBI).

An injury to the brain can occur from blunt force trauma to the head or from a strong jolt or violent shaking that causes the brain to bump or twist inside the skull. A brain injury could also come from a penetrating wound from a bullet or blade during a violent assault, or from a piece of broken metal during a car accident. When a portion of the brain sustains damage, the cells may die off. Brain cells do not regenerate. When this occurs, the effects on the individual can impact many areas of function. While recovery is unique to every individual and some injury victims never recover to full independence, many brain injury victims maximize their recovery through various rehabilitation techniques to help the brain form new pathways for sending and receiving signals.

Symptoms of a Traumatic Brain Injury

In cases of severe head trauma, the symptoms of a brain injury may be dramatic and immediate, with loss of consciousness, coma, and sometimes death. In other cases, a blow to the head may cause bruising, bleeding, or swelling in the brain that slowly damages the brain cells leading to the development of symptoms during the hours and days following the initial injury. Symptoms of a TBI include:

• Headache
• Dizziness
• Vision problems
• Confusion
• Difficulty concentrating
• Seizures
• Slurred speech
• Problems with coordination
• Changes in mood and personality
• Insomnia and other sleep problems

According to the CDC, the most common causes of traumatic brain injuries are falls, car accidents, violent assaults, and sports injuries.

Medical Treatment for a Traumatic Brain Injury

Immediately after an accident with a suspected brain injury, a medical team will ensure the patient has an open airway and then work toward stabilizing them by surgically removing any blood clots and draining fluid away from the brain. Once the patient is stable, medical providers begin an acute-care stage of medical treatment where they attempt to manage or minimize secondary injury from swelling, bleeding, and pressure, and apply therapeutic medications and techniques to increase blood flow and oxygenation to encourage healing. Patients are typically given anti-anxiety medications or may be placed into deep sedation or a medically-induced coma to maximize healing.

After the patient recovers consciousness, they’ll begin a series of tests in the acute care hospital or unit to determine the extent of their injury and assess the impacts of the injury on their cognitive function, speech, mobility, and behavior. Once the assessment is complete, medical providers will form a treatment plan and determine the most effective rehabilitation techniques to address any impairments caused by the brain injury. Impacts vary depending on the part of the brain that sustained damage.

Understanding Rehab After a Traumatic Brain Injury

After a brain injury patient has been stabilized, treated, and assessed, they are typically transferred to a rehabilitation hospital for therapies intended to return them to independence or to optimize their function. A care team will determine if home health services or a residence in a long-term care facility is right for them.

Each patient has unique needs after a TBI. Rehabilitation may take place in any of the following settings:

• Inpatient rehab in a hospital
• Outpatient rehab at a hospital
• Home-based rehab
• Comprehensive day programs
• Independent living centers for brain-injured patients

A care team determines the types of rehabilitation each brain injury patient requires in order to maximize their recovery to the greatest extent possible. A patient may receive any or all of the following therapies:

• Speech and language therapy
• Physical therapy
• Occupational therapy
• Psychiatric/Psychological care
• Social support
• Medications

Once a care team puts a rehabilitation program in place for a brain injury patient, they may experience a variety of helpful rehab techniques to aid their recovery.

Helpful Rehabilitation Techniques for Traumatic Brain Injuries

The team approach is typically the best way to manage multiple therapies for rehabilitation after a brain injury. A patient may undergo some or all of the following therapy methods:

• Therapy to redevelop cognitive skills in a quiet environment working with problem-solving, numbers, and relearning life skills such as balancing a bank account and managing daily medications
• Speech and language therapy to relearn language skills in both receptive language and speech and to learn new ways to talk and respond such as with simpler phrases, asking yes/no questions, using gestures, and practicing oral motor skills and techniques
• Therapy to address motor issues and muscle weakness as brain injuries can cause floppiness or stiffness. This may include strength training, stretching exercises, balance exercise, and encouraging neuroplasticity—the “rewiring” of the brain to form new pathways using undamaged areas of the brain to send and receive signals
• Behavior management therapy to address changes in behavior and mood caused by impacts on the region of the brain controlling impulse control, reasoning, inhibition, and judgment

There are many options for rehabilitation therapies after a brain injury, including social support and counseling. Families are encouraged to join support groups and attend family therapy sessions with their injured loved ones.

The amount and length of time undergoing these therapies depend on the severity of the brain injury and how well each patient responds. Some patients return to full function and independence while others require lifelong care. The majority of patients fall somewhere in the middle of this range.

Aftercare and Follow Ups In Brain Injury Patients

It’s essential for brain injury victims to get regular assessments and attend follow-up appointments. Suffering a brain injury can increase an individual’s chances of later developing conditions such as Parkinson’s disease, Alzheimer’s disease, and dementia. Each patient’s primary care physician should have access to all of their records and recommendations from the therapy team for care going forward after a traumatic brain injury in New Haven.