Traumatic Brain Injury

WHAT IS A BRAIN INJURY?

There are 2 types of acquired brain injury: traumatic and non-traumatic brain injuries

A traumatic brain injury or TBI happens when there are forces exert on the brain which causes damages. Common causes are: falls, car accidents, blows to the head (gunshot wounds, violence/abuse, sport injuries etc). There are two types: close head injury and penetrating injury.

A non-traumatic brain injury happens when there is internal damage to the brain, such as lack of oxygen, exposure to toxins, pressure from a tumor. Common causes are: stroke, brain tumor, infectious disease, meningitis (inflammation of the lining of the brain), drug overdose, neurotoxin poisoning.

SEVERITY OF BRAIN INJURY

Mild Brain Injury

  • Brief, if any, loss of consciousness
  • Vomiting & Dizziness
  • Lethargy
  • Memory loss

Moderate Brain Injury

  • Unconsciousness up to 24 hours
  • Signs of brain trauma
  • Contusions or bleeding
  • Signs of injury on neuroimaging

Severe Brain Injury

  • Unconsciousness over 24 hours
  • No sleep/wake cycle during loss of consciousness
  • Signs of injury on neuroimaging

SIGNS & SYMPTOMS

Physical symptoms

  • Weakness of the arm, leg, trunk, head
  • Difficulty with functional movements like transferring, walking, balancing
  • Abnormal muscle tone or posturing

Cognitive/Behavioral symptoms:

  • Memory loss or difficulty
  • Behavioral changes
  • Difficulty with concentration
  • Poor safety awareness
  • Difficulty controlling emotions
  • Personality changes

Sensory symptoms:

  • Vision changes
  • Hearing difficulty
  • Loss or decreased sensation
  • Off balance
  • Headaches

HOW CAN A PHYSICAL THERAPIST (PT) HELP?

Through multiple modes of treatment, a PT can help someone with brain injury with:

  • Increase alertness
  • Improve flexibility to gain or maintain normal range of motion
  • Ability to move around in bed, get in and out of bed
  • Ability to get in and out of different surfaces
  • Ability to walk
  • Improve strength
  • Improve balance and coordination
  • Fitting and prescribing customized wheelchair
  • Prescribing assistive device and adaptive equipment
  • Return to sport and recreational activities

Treatment for brain injury includes, but not limited to:

  • Balance & Postural training
  • Gait training, include High intensity gait training and body weight support walking training
  • Strength training
  • Endurance training
  • Use of functional electrical stimulation
  • Neuro muscular re-education

HOW CAN AN OCCUPATIONAL THERAPY (OT) HELP?

OT can help in various aspects of independent living for those with a brain injury. They are instrumental in providing tools and treatments to maximize independence. OT treatments for brain injury includes, but not limited to:

  • Coping skills when it comes to emotional and behavioral problems.
  • Activities of Daily Living (dressing, bathing, grooming, feeding, home management, medications management etc.)
  • Memory strategies (checklists, planners, specialized apps)
  • Caregiver education and training
  • Recommendation of adaptive equipments to improve safety around the home & maximize independence
  • Social skills
  • Vocational rehab to get the person to return to work, school or other community activities
  • Driving rehab
  • Home modifications