The Road Back

Therapy is Key to Recovery After Traumatic Brain Injury

Physical Therapist Carlene Tauzer assists a patient.

The road to recovery following a traumatic brain injury begins almost immediately after the patient is stabilized, says Doug Hinton, manager of rehabilitation services for NorthBay Healthcare. Whether the brain injury is the result of stroke, auto accident, fall or prolonged loss of consciousness because of heart attack or near-drowning, the protocol is the same.

“We will get a physician order to see the patient on the first or second day they are in the hospital,” Doug says. During that visit, rehabilitation therapists evaluate the level of potential neurological damage. “We assess the patient’s cognitive abilities. Are they able to participate in a conversation and follow commands? We’ll do a physical assessment to see if the patient has balance issues, is able to walk, or get into and out of a chair.”

Therapists also examine the patient’s muscle strength and tone. “Some brain injuries affect muscle tone by over-relaxing the muscles, others by stiffening them, and that can greatly impact an ability to get in and out of bed, to walk or perform the activities of daily living.”

Therapists will also see if the patient has difficulty swallowing. If the patient can’t safely swallow, that can pose a choking hazard.

The patient or family members also will be asked about how the patient was performing activities of daily living before coming to the hospital. Did he or she need any form of assistance, use a cane, were they wheelchair-bound or completely independent? All questions, answers and assessments will be used to help the therapists determine what kind of follow-up care the patient receives, and where: at home, in a nursing home or acute rehabilitation facility.

The path to recovery following a traumatic brain injury can be as unique as the individual and the injury itself, Doug says. “Some patients who have had a small stroke may find their symptoms resolve in a few days. However, if many bodily or cognitive functions have been affected, it’s an indication of greater brain damage and the patient may have residual effects for months, or for the rest of their life. How the brain heals depends on the level of damage to begin with.”

Successful recovery also depends on the patient’s age. “The brain can start creating new pathways and nerve connections early after an injury, and it happens more extensively for younger patients and young adults, vs. those who are in their 50s or 60s, or older,” Doug says.

The greatest strides toward healing the brain and returning to familiar activities of daily living usually occur in the first three to six months following a traumatic brain injury, Doug says, but progress can still be seen up to
a year after the incident.

While therapists can do a lot to help brain-injured patients return to various levels of a normal life, it helps to have lots of support from friends and family, Doug stresses. “It’s very important to have family members reinforce what has been taught in therapy. It takes a team approach.”

It also takes patience and understanding on everyone’s part. “Recovering from a stroke or other brain injury takes time,” which can be frustrating for the patient and their family members. For any who may be struggling with the journey, Doug recommends talking with a social worker or attending a support group.

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