Brain Injury Physical Therapy

A traumatic brain injury (TBI) is an injury experienced during a fall or a blow or jolt to the head that interrupts the normal function of the brain. TBIs typically result from a sports injury, a fall, an act of violence or from a car accident. While some TBIs are grave, life-threatening injuries that may or may not penetrate the skull, the great majority of TBIs are concussions or other forms of mild TBI.

In many TBI cases, physical therapy is required to increase the chances of a full recovery.

Risk Factors and Leading Causes of TBI

According to the Centers for Disease Control and Prevention (CDC), TBI-related hospital stays are highest among adults 75 years of age and older. TBI-related emergency room visits are highest for those 75 years of age and older, followed by high rates among infants and children from birth to 4 years of age.

Falls are a leading cause of TBI, accounting for nearly half of all TBI-related emergency room visits. Over 80% of all TBI-related ER visits occurring in older adults (age 65 years and older) are due to falls, and nearly half of all TBI-related ER visits among children (birth to age 17) result from falls. For ages 5 to 14, being struck by or against an object is the leading cause of TBI-related ER visits.

Falls are also the leading cause of all TBI-related hospitalizations (52%), and 20% of all TBI-related hospitalizations are due to impact from motor vehicle accidents. The CDC reports that in 2014, approximately 2.87 million emergency room visits, hospital stays, and deaths were related to traumatic brain injuries.

Symptoms of TBI

TBI symptoms generally fall into four categories:

Difficulties in thinking and remembering
Physical difficulties
Emotional and mood difficulties
Difficulties with sleep

TBI symptoms in thinking and memory, including difficulty concentrating and thinking clearly, and trouble remembering new information, often leading to a general feeling of being slowed down.

Emotional and mood symptoms of TBI include sadness, nervousness, anxiety, irritability, and feeling more emotional than usual.

Physical symptoms of TBI include headache or blurred vision, nausea, or vomiting (soon after the injury), sensitivity to light or noise, difficulties with balance, and feeling tired. There may be difficulty with sleep – sleeping more or less than usual, which can contribute to or worsen the above-mentioned emotional and mood symptoms.

Some of these symptoms may be noticeable right away, while others may not appear for days or months after the brain injury. Some individuals may not understand the difficulties they are experiencing and how their symptoms are impacting their everyday activities.

When to Seek Immediate Medical Attention for a Head Injury

In rare instances, a dangerous blood clot can form after a TBI, crowding the brain against the skull. You or a loved one should go right away to the nearest emergency department with any of these symptoms:

A lasting headache that gets worse
Numbness, weakness, or a decrease in coordination
Nausea or vomiting that reoccurs
Slurred speech
Difficulty waking up or looking very drowsy
One pupil (the black center of the eye) is larger than the other
Unable to recognize familiar people or places
Increasing confusion, restlessness, or agitation
Loss of consciousness
Convulsions or seizures
Unusual behavior

Take an infant or child to the nearest emergency room right away if they have received a bump or blow to the head or body and have any of the above signs, if they cannot stop crying and are inconsolable, and/or if they will not nurse or eat.

If you’re not sure how severe a bump or blow to the head or body is, don’t wait to get to the hospital. Play it safe and get checked by a physician just in case. It is always best to err on the side of caution.

How Physical Therapy Helps with Brain Injuries

Physical therapists (PTs) are educated and trained to assist patients in recovering from TBIs. Patients may have difficulty lying down in bed or turning over, as well as difficulty maintaining balance while sitting, standing, or walking. Physical therapists help TBI patients regain their physical function by relearning daily tasks, and restoring fitness and wellness.

Your PT can assist you or your loved one in improving balance, coordination, and stability, helping to increase muscle strength and flexibility for overall improvements in movement patterns and mobility. If there are limitations that prevent the return to pre-injury activities, physical therapists provide help in mastering the use of equipment for improving mobility, such as an ankle brace, cane, walker, or a wheelchair. Various PT rehabilitation approaches include:

Specialized stretching and exercise programs tailored to the individual for improving and maintaining range of motion, flexibility, coordination, and physical function
Manual manipulation for those who cannot currently participate in an exercise program
Hydrotherapy
Acupuncture
Dry needling
Therapeutic massage