Physiotherapy Management of Traumatic Brain Injury

Introduction:

Traumatic brain injury is a life-threatening yet life-changing moment, distressing the person and the family. Unfortunately, about sixty-nine million people sustain a traumatic brain injury per annum. And the complications are debilitating, from immediate emergency care within seconds to paralysis and other consequences for months. Rehabilitation is also a crucial part of the whole intervention as the reinforcement of the brain, neural system, and muscles is achieved. So, the early commencement of physiotherapy will contribute.

How Can Physiotherapy Help in Traumatic Brain Injury?

Though traumatic brain injuries follow trauma such as a mishap, blow, fall, or injury, no two brain injuries are the same. They hold dissimilar signs and accompanied sequelae. Hence, the intervention for rehabilitation should concentrate on neuroadaptive fixates, motor control systems, motor learning, patient-based, psychological elements, and overall recovery. Recovery from traumatic brain injury is quite an extensive process that requires physical performance for sound stimulation. Therefore, physiotherapy is an essential component of any rehabilitation, while neurological physiotherapy is for neurological rehabilitation. But, in cases of traumatic brain injury, physiotherapeutic rehabilitation is relatively challenging and may take longer days to recover than other neurological conditions.

How Does Physiotherapy Work in the Recovery of Traumatic Brain Injury?

Physiotherapeutic rehabilitation has been a crucial part of recovery on the basis of maximum potential attainment. Moreover, physiotherapy contributes to the enhancement of neuroplasticity. Brain plasticity, also known as neuroplasticity, is the ability of the brain’s neural system to entitle changes and activities from the injured networks when internal or external stimuli are given. Physiotherapy is the external stimulus here. In simpler words, re-programming or rewiring of the brain activity and nervous pathways. It could bring about functional improvement, like relearning the skills, motor movements, and cognitive aspects when the structural connections become perfect. So, the appropriate stimuli are given early after injury in neurological physiotherapy intending to restrain the neuroplasticity.

Principles: The rehabilitation leans primarily on recovery, but it also holds certain principles.

• Providing education for the patient, caretakers, and family members regarding traumatic brain injury, treatment goals, care plan, health regimen, and exercises.

• To bring about neuroplasticity and neuroadaptive changes.

• However, the foremost principle is to enhance recovery.

• The initial intervention phase is focused on preventing additional neurological damage.

• The intervention should count on the contracture, cognition, weaknesses, motor control abilities, and other concerns.

• The definite treatment goal of rehabilitation should meet the patient’s desires, likes, goals, beliefs, considerations, and expected outcomes.

• Physiotherapy treatment should advance a patient-centered approach for the involvement of patients intending to bring out the desired change and recovery.

What Are the Physiotherapy Interventions for Traumatic Brain Injury?

Physiotherapy intervention comprises meaningful exercises organized to enhance neuroadaptive changes and plasticity. Besides, consistency matters. So, persistent practices of physiotherapist-aided rehabilitation of the following targeted activities would attain the outcome.

• Neuromuscular Re-Education: Neuromuscular is the link between the brain and the muscles as the way they act in response to each other. However, the connection is distorted in patients with traumatic brain injury. So, the exercises enhance neuroplasticity and new networks, and thus the link between the brain and muscles is reinforced with neuromuscular re-education. The commands for sitting, moving, drinking, or walking will work.

• Gait Training: Gait training is employed to improve the walk. Firstly, The therapist will guide the patient with walking aids, robotics, orthotics, or parallel bars to regain the potential to walk. For instance, he will advise walking on the treadmill at low frequency. Then, with improvement, the training continues the following cane and self-aided walking. In addition, it incorporates task-specific gait training to reinforce neuroplasticity.

• Vestibular Training: Through vestibular training, the patient will receive a sound regain of balance. In addition, it prevents further injury by diminishing the risk of assault and falls. Vestibular training is manifested as the person encounters balance issues after brain injury. So, the therapist will assess the vestibular concerns through a specific range of vision and balance tests. If so. Then, the activities are designed as such addressing the vestibular problem.

• Constraint-Induced Movement Therapy (CIMT): Individuals after traumatic brain injury are more likely to develop learned non-use by depending consistently on unaffected healthy arms or limbs. It could culminate in the deterioration of affected extremities when not raised and used over time. So, constraint-induced movement therapy forces the person to engage in affected arms while preventing such learned non-use.

• Aquatic Therapy: The buoyancy of water is utilized for the therapy. The person can walk in the pool with the therapist or aides. So, the person could lift their legs with decreased pressure on joints. Subsequently, the viscosity of water defies the movement resulting in muscle mass and strength reinforcement.

• Passive Activities: Sometimes, the individuals will have paralysis, impaired movement, and sensation in affected areas. And they can not involve in active exercises as the actions are limited. Therefore, physiotherapists move the affected limbs and muscles for you to stimulate them. So, passive activities would regain movement and enhance neuroplasticity.

• Home-Based Training: Limiting daily sessions does not enhance reinforcement over mobility and neuroadaptive changes. So, the activities should be applied at home, even when the therapist is not around. Subsequently, rehabilitation tools are accessible to help out.

What Are the Benefits of Physiotherapy Over Traumatic Brain Injury?

Subsequently, with consistency, the physiotherapeutic approach for rehabilitating and recovering from traumatic brain injury provides the following benefits.

• Reinforcement of muscle strength, muscle mass, and joint stability.

• Improvement of balance and coordination.

• It diminishes further spasms, contractures, stiffness, and pain.

• Regain over walking, functional tasks, and other elements of daily living.

• Rebuilt independence.

• Reduces the likelihood of falls.

• Improvement in overall quality of life.

Conclusion:

The physiotherapeutic approach is pivotal in the comprehensive treatment plan for traumatic brain injury (TBI). This technique aims to address and manage the functional, physical, and cognitive impairments associated with traumatic brain injury. The techniques include gait training, vestibular rehabilitation, functional training, pain management, and education. Consult with a specialized physiotherapist experienced in TBI management to get tailored care.