10 Oct Neurological Rehabilitation – Traumatic Brain Injury

Posted at 15:48h in Treated by Physio by
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Rehabilitative Management

  1. Behavioural Deficits

These are the most enduring and disabling disorders and deficits associated with a traumatic brain injury. Amongst the issues are:

  • Depression
  • Anxiety
  • Aggression
  • Sexual disinhibition
  • Apathy

To ensure the correct assessment and long-term management of these issues it is important to get a thorough picture of the persons premorbid personality, the landscape of their social environment as well as the physical, cognitive and emotional effects of the injury.

  1. Sensorimotor Deficits

This is a primary area where physiotherapists must complete a thorough and comprehensive evaluation, forming a picture of deficits and causes as well as areas of strength that can be progressed and a treatment and rehabilitation program including short, medium and long-term goals. The scope of the assessment will depend on the person’s ability to co-operate.

A. General deconditioning

This is a very common aspects of post traumatic brain injury rehabilitation in that even for people with relatively uncomplicated recoveries there almost certainly has been some from of blood loss, lung issue, changes in diet and activity, healing and recovery demands. This must be analysed, and form part of the rehabilitative process.

B. Hemiparesis

If there has been unilateral trauma to the cortex either via the actual trauma or bleeding, hypoxia or other issue this can lead to hemiparesis or one-sided paralysis. The symptoms and deficits are very similar in presentation to the impairments seen in a cerebrovascular accident or stroke. This can also however become bilateral hemiparesis which can involve the impairment of all 4 extremities, can be asymmetric, voluntary movement may be absent and can be dominated by reflex activity.

C. Balance Deficits

Almost every person who suffers a traumatic brain injury will have balance and proprioceptive issues and deficits. The assessments and therefore plans should range from the lowest level of balance work to high level skills required for sport and recreation. We may also see ataxia, incoordination, intention tremor etc.