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admin@neurovita.com.au or 1300 034 812
Author: Rickey Hickman (Snr Occupational Therapist)
700,000 Australian's have a brain injury that impacts their ability to manage everyday activities and participate in social and community activities.
As occupational therapists (OT) we play a key role in recovery after brain injury. Helping survivors to regain cognitive and physical skills and adapting to life after a brain injury. Brain injury is a specialised and complex area of occupational therapy so it's important to work with someone with the required knowledge and skills. Here we will cover what a brain injury is, the typical symptoms, the OT role in brain injury recovery and common ways OTs can help.
If you'd like to work with our expereinced Gold Coast OTs get in touch!
A brain injury is any injury that causes damage to the cells within the brain this can range from something like a mild concussion from bumping your head or a severe traumatic brain injury from a car accident or fall.
The severity and location of an injury significantly influences the recovery process and post-injury abilities. Our brain and body function like a highly advanced computer system connected to a complex robot—where the brain sends signals, and the body executes actions, providing real-time feedback. When a part of the brain is injured it can impair or complete stop the brains ability to send messages to different parts of the body or receive feedback from the body. Since different parts of the brain control specific functions (thinking, moving, talking, bladder management etc.), understanding the location of the injury helps us anticipate which functions may be affected. This insight is crucial for developing personalised care plans that address each individual's unique needs.
Acquired Brain Injury is a damage to the brain that occurs after birth and is not due to genetic or developmental reasons and is not from physical trauma. This type of brain injury can be caused by many factors some common causes include:
Traumatic Brain Injury is also damage to the brain after birth that isn't associated to genetic or developmental reasons, but in this type it is from a physical trauma to the brain. Such as a sudden jolt or impact to the head. Common causes of traumatic brain injury include sports accidents, falls, car accidents and physical altercations.
Concussions are typically a short term form of traumatic brain injury and those who experience these especially in mild forms will typically recovery within days to weeks after the injury.
However some people will experience Post Concussion Syndrome where symptoms will continue for months to years following a concussion.
In the acute stages after a brain injury the the medical team are working hard sley focussed on life preservation. Once the individual is stable that is when an OT may begin to see the client. They will perform assessments to understand the the functional impact of the brain injury and will begin providing appropriate therapy as soon as feasible.
Once medically stable the cleint will move to a rehabilitation ward or facility to begin intensive rehab in a multidisciplinary team (MDT). The MDT work together to help the client regain cognitive and physical function and improving daily living skills.
Evidence suggests that providing intensive therapy as soon as feasible after a brain injury and with as much frequency and intensity as can be tolerated leads to the best outcomes.
Specifically OTs will work with clients 1-to-1 or in group settings to focus on improving hand and upper limb function, cognitive abilities (attention, memory, problem solving etc.) and daily living skills.
When your progress in the intensive therapy stage slows the hospital team will start to work on a transition to the community plan. An OT will help you figure out how you will manage your daily life and make sure that you are going to be safe and as independent as possible when you return home.
This might involve showing you different ways of doing your everyday tasks, using special equipment and technology, organising home modifications or helping you access formal support. At this point you may have 2 OTs working together the hospital OT and a community OT that will help you once you leave the hospital.
Just because your progress slowed it doesn't mean you've reached your full potential, your community OT will continue to support you to recover cognitive, physical and daily living skills.
As opposed to your hospital OT who are more concerned with your safety, your community OT will help you work on goals that build you social, recreational, work and community skills and help you do the things you want and need to.
This will usually involve a combination of therapy, equipment prescription and training and modifications.
Occupational therapy is a holistic practice with a focus on the client and their goals, we support our clients by using our expert understanding of therapy, assistive technology, environmental modification and the clients function to help them be as safe and independent as possible in all facets of life.
Its important that health professionals utilise evidence-based practice, which essential means using therapies and strategies that have been thoroughly tested and found to be safe and effective.
Task Specific Training (TST) in brain injury rehab focuses on improving motor skills by practicing specific, meaningful movements. This method involves repeatedly performing functional movements like walking, standing from sitting, putting food away, buckling a seatbelt, hitting/kicking a ball and much more. Hubbard et al (2009) highlighted that evidence supports task specific training for brain injury. By practicing specific tasks improvements in motor control, coordination and strength could be achieved and ultimately lead to enhanced daily activity performance. The best part about Task Specific Training is that it is a highly motivating therapy strategy, what is more motivating than practicing the task you want to improve.
Constraint-induced movement therapy (CIMT) is a method for recovery after Brain Injury, with clinical literature showing significant improvements following short, intense bouts of the technique (Shaw et al, 2005). This strategy works by temporarily restricting the use of the unaffected arm, which pushes the client to rely on and strengthen the affected arm through lots of practice. CIMT can be really effective in boosting motor function and making daily tasks easier by encouraging the brain to adapt and reorganize. The draw backs are that it can be quite demanding and requires a strong commitment from clients, and some may find the intensity challenging or frustrating.
Cognitive Rehabilitation OTs use specific exercises to help improve your memory and thinking skills. The aim is to make everyday challenges less of a hassle and help you manage cognitive difficulties more effectively.
Virtual reality (VR) therapy is a cutting-edge method for recovery after brain injury that immerses patients in digital worlds to help them get better. By using interactive VR simulations, therapists can design customised exercises that focus on improving the specific motor skills and cognitive functions affected by a brain injury. Calderone et al (2023) completed a systematic review finding that VR is effective for improving motor and cognitive skills in people with a brain injury. The great thing about VR therapy is that it’s engaging and can be tailored to fit individual needs, potentially speeding up and boosting recovery.
Mirror therapy is a fascinating and promising method for stroke rehab that uses visual feedback to help improve motor function. In this approach, a mirror is placed between the patient’s two arms, hiding the affected limb and showcasing the unaffected one. As the patient moves their unaffected arm, the mirror creates the illusion that the affected arm is moving too, which can help stimulate the brain’s motor pathways and encourage recovery. Gandhi et al (2020) established that Mirror Therapy is a feasible method for motor, sensory and perceptual deficits in acute, sub-acute and chronic phases of stroke, as brain injury occurs after a stroke it is practical to assume that similar improvements would be seen for those with a acquired or traumatic brain injury.
Home Modification To make your home safer and more accessible, OTs might recommend minor or complex home modifications, like adding grabrails or installing a ramp. These tweaks help you move around more comfortably and tackle everyday tasks with greater ease.
Assistive Technolog OTs might suggest some handy tools to help you out. This could be a four-wheeled walker or wheelchair to help you get around, or a button hook and dressing stick to make dressing easier. These aids are all about boosting your independence.
Task Adaption is a core occupational therapy strategy where an OT will analyse a tasks and identify the keys steps to complete the task and identify the aspect of the task the client finds challenging. They will then modify how the task is used, adapt the environment or use special equipment to help the client to be able to complete the task independently. For example, if you can hold and onion still and cut it at the same time using a special chopping board with spikes might help or if you find it hard to get in and out of the shower some rails might boost your independence.
OTs create personalised exercises to help rebuild your strength, coordination, and range of motion. This not only helps you get back to doing the things you love but also makes daily activities feel more manageable.
With our focus on neurological conditions we have seen many clients with brain injuries and have had the privilege of achieving great outcomes.
Mr. Man was discharged from hospital after 6 months of inpatient therapy, he had made great progress in that time but continued to have challenges. Most importantly to him was being independent with his toileting. Because of his hemiparesis he struggled with getting on and off the toilet and wiping. Working together we had installed grabrails in the bathroom, completed tasks specific training and obtained a wiping aid. This combination of intervention and Mr. Man's dedication was the perfect combination and HE DID IT! Mr. Man achieved his goal and the sense of joy it brought him was priceless!
Occupational therapy can be a powerful service in your brain injury rehab, but It's important to remember that each person's recovery journey is unique, and outcomes will vary. While we cannot guarantee specific results, our focus is on working together to achieve the best possible progress for each person.
Living with a brain injury presents unique challenges, but Occupational Therapy offers valuable support in achieving a more independent and fulfilling life. Through personalised approaches and dedicated therapy, you can make significant progress in managing your condition. While recovery may be gradual, each step forward is a testament to your resilience and determination. Embrace the resources available, stay committed to your therapy, and continue striving towards your goals. Your journey to greater independence starts now.
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