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Rehabilitation After a Brain Injury

By

Salvador E. Portugal

, DO, New York University, Robert I. Grossman School of Medicine

Last full review/revision Aug 2021| Content last modified Aug 2021
Click here for the Professional Version

If a stroke or head injury damages but does not destroy brain tissue, the tissue can gradually recover its function. Recovery can take 6 months to several years, but rehabilitation Overview of Rehabilitation Rehabilitation services are needed by people who have lost the ability to function normally, often because of an injury, a stroke, an infection, a tumor, surgery, or a progressive disorder ... read more can speed recovery and make it more complete. Brain tissue that is destroyed cannot recover its function, but other parts of the brain sometimes learn to take over some of the duties of the destroyed area. Rehabilitation can help this learning process. The amount and rate of recovery of function cannot be predicted with certainty. Thus, rehabilitation is begun as soon as people are medically stable. Early rehabilitation also helps prevent complications such as shortened muscles (contractures), weakened muscles, and depression Depression A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more .

A detailed evaluation of the person, including psychologic testing, helps the rehabilitation team identify the type and severity of damage. Members of the team then assess which lost functions may benefit from rehabilitation therapy and create a program focusing on the person's specific needs. The success of rehabilitation depends on the person's general condition, range of motion, muscle strength, bowel and bladder function, functional ability before the brain injury, social situation, learning ability, motivation, coping skills, and readiness to participate in a rehabilitation program.

If brain injury results in weakened or paralyzed limbs, therapists move the affected limbs or encourage the person to move them. Moving the affected limbs helps prevent or relieve contractures and maintain the joints’ range of motion. Usually, the unaffected limbs should also be exercised regularly to maintain muscle tone and strength. The person is expected to practice other activities, such as moving in bed, turning, changing position, and sitting up. Being able to get out of bed and transfer to a chair or wheelchair safely and independently is important to a person's physical and mental health.

Coordination exercises may also be needed. Sometimes therapists restrain the unaffected limb (called constraint-induced movement therapy). For example, people with a partially paralyzed arm may wear a mitt or sling on their unaffected arm as they repeatedly practice daily activities, such as eating, washing, grooming, writing, and opening doors. This strategy helps rewire the brain to use the weakened or paralyzed limb.

Some problems due to brain injury require specific therapies—for example, to help with walking (gait or ambulation training), to improve coordination and balance, to reduce spasticity (involuntary contraction of muscles), or to compensate for vision or speech problems. For example, people who are having trouble walking may be taught how to prevent falls. Occupational therapy Occupational Therapy (OT) Occupational therapy, a component of rehabilitation, is intended to enhance a person's ability to do basic self-care activities, useful work, and leisure activities. These activities include... read more may improve coordination. Heat Heat therapy Professional rehabilitation therapists treat pain and inflammation. Such treatment makes movement easier and enables people to participate more fully in rehabilitation. Techniques used include... read more or cold therapy Cold therapy (cryotherapy) Professional rehabilitation therapists treat pain and inflammation. Such treatment makes movement easier and enables people to participate more fully in rehabilitation. Techniques used include... read more may temporarily decrease spasticity in muscles and allow muscles to be stretched. People with one-sided blindness may be taught how to avoid bumping into door frames or other obstacles—for example, by turning the head toward the affected side.

A stroke or another brain injury, especially concussion Concussion A concussion is an alteration in mental function or level of awareness caused by a head injury. A concussion may involve a loss of consciousness, can occur without obvious damage to brain structures... read more , can impair the ability to think (cognition). People may have problems with orientation, attention and concentration, perception, comprehension, learning, organization of thought, problem solving, memory, and speech. Which problems people have depends on the injury. Cognitive rehabilitation is a very slow process, has to be tailored to each person's situation, and requires one-on-one treatment. The goals are to retrain the brain and to teach ways to compensate for problems. For example, tasks, such as tying a shoe, are broken down into simple parts and practiced. Verbal, visual, and tactile (touch) cues, such as verbal hints, gestures, and color-coding items, also help people learn and remember how to do the task.

More Information

The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

NOTE: This is the Consumer Version. DOCTORS: Click here for the Professional Version
Click here for the Professional Version
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Rehabilitation After Limb Amputation
After arm amputation, most people are fitted for an artificial arm. Which of the following components of an artificial arm enables a person to control movements with more precision?
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