Therapies for recovery from TBI
Traumatic brain injuries can be resistant to treatment if not approached in the correct manner. TBIs are serious injuries, and there are several stages of recovery.
Many patients might become frustrated with a seeming lack of progress, so they might turn to alternative therapies that are not considered the norm. However, those who have experienced TBIs should make sure that the treatment they choose is valid and backed by scientific evidence. Below we’ll outline the typical traumatic brain injury treatment timeline of activities.
Traumatic brain injury treatment in stages
Immediately after a brain injury
Let’s use a hypothetical example and walk ourselves through the stages of traumatic brain injury treatment. Our patient’s name is Linda. She fell down some concrete steps, smashing her head against the ground. An ambulance was called, and Linda was transported to ABC Medical Center’s emergency room.
In the aftermath of a brain injury, doctors will need to determine whether Linda needs surgery. Her brain might be bleeding or swelling, which will likely necessitate surgical intervention. A trauma surgeon will evaluate Linda along with a team of medical professionals, all of them monitoring vital systems. The trauma surgeon might need to consult with a neurosurgeon if a spinal cord injury was involved, as well as an orthopedic surgeon if any bones were broken.
Linda’s lungs might need assistance in directing what were previously automatic movements; by placing her on a ventilator, the body does less work and less pressure builds in the head. Linda might also be put into a medically-induced coma by doctors or put on medications in order to reduce the chance of secondary injuries.
Once immediate issues are dealt with – fractures, brain swelling, bleeding – the patient will be stabilized and then sent to a rehabilitation center for further care and observation.
Treatment a little while after a brain injury
Linda has recovered enough that her doctors feel comfortable sending her to the We Heart Patients Rehab Center, a long-term care facility. The purpose of living here for a period of time is to stabilize the medical and rehabilitative issues related to her traumatic brain injury and to prevent further complications. She also has to relearn certain key skills like talking, eating and even thinking clearly.
Linda is confused, frightened and forgetful; she needs assistance using the restroom and dressing herself. That’s why, at WHP Rehab, the name of the game is therapy.
While there are predictors, nothing can say for certain when or why someone will recover from a TBI. Another area of the brain might take over a damaged function, or the patient may learn new strategies to compensate for what was lost.
As part of her traumatic brain injury treatment here, a rehabilitation team will be devoted to Linda’s care. This includes a physiatrist – a physician who specializes in rehabilitation and physical medicine. A neuropsychologist can also monitor changes in Linda’s thinking or behavior. We already know that she’s disoriented and anxious, and her memory is poor. Other changes, like impulsivity or poor concentration, can be assessed by this type of doctor.
Rehabilitation nurses monitor everything from nutrition to bladder incontinence as she progresses through therapy for her traumatic brain injury. Every physical function is provided for, including the functions that are impaired. If Linda needs to learn adaptive skills or relearn how to care for herself, this nurse can help her do it.
A physical therapist will help Linda compensate for the effects of her injury by treating the musculoskeletal and neuromuscular problems caused by her fall. They help by building balance, posture and strength; if Linda needs to use a walker or cane, a physical therapist would provide instruction for proper body mechanics.
An occupational therapist focuses on the movement of the upper body and the ideal way to perform daily activities, such as dressing, showering, and more. An OT will also prepare a patient for the demands of daily living, like relearning how to cook.
Linda might not understand why she is in a rehabilitation center or why she needs to stay there until she is well enough to go home. A rehabilitation team will help both the patient and the family comprehend how the traumatic brain injury will affect their lives.
Later traumatic brain injury treatments
Everyone, rightfully so, is desperate to know what their prognosis will be after a traumatic brain injury. Linda really wants to know. While there are predictors, nothing can say for certain when or why someone will recover from a TBI. Another area of the brain might take over a damaged function, or the patient may learn new strategies to compensate for what was lost. Sometimes it can take years for new pathways to be built in the brain.
TBI recovery indicators do exist, though, such as:
- How long the patient was in a coma (the shorter, the better)
- How old the patient is (it’s best to be older than 2 and younger than 60)
- How long they experienced post-traumatic amnesia (the shorter, the better)
Just like the phase right after her injury, Linda will need to participate in traumatic brain injury therapy so she can be her old self again. She might need:
- Speech therapy
- Movement therapy
- Assistive technologies (walker, cane, wheelchair, specialized keyboard, etc.)
- Additional physical therapy
Linda might become extremely frustrated and try alternative TBI therapies. Many exist, though some lack evidence as to their efficacy.
- Acupuncture: Practitioners of this traditional Chinese medicine use needles to stimulate specific points on the body in an effort to rebalance energy pathways.
- Massage: This type of therapy can help to restore joint function of the spine and release muscle tension, which can relieve pressure on the head.
- Cranio-sacral therapy: Also known as cranial osteopathy, this therapy is manual manipulation of the cranial bones so that cerebral spinal fluid flows properly.
- Lymphatic drainage: The lymphatic system plays a large part in relieving pressure in the body. A TBI can result in limited lymphatic circulation, so “draining” that system in the neck, mouth and face via manual manipulation allows for more movement.
- Reiki: This energy therapy is very popular in alternative medicine. Very often, hands are not even placed on the patient, but several inches above the body. When energy is “blocked,” practitioners use their intent to unblock it.
- Aquatic therapy: The gentle pressure of the water allows a person to exercise in a supportive environment and retrain proper body mechanics.
- Hippotherapy: This actually refers to horses, not hippos. Equine therapy helps to improve motor control, and caring for a lovely horse is therapeutic as well.
- Hyperbaric oxygen: Hyperbaric pressure is controlled when undergoing this treatment and a patient breathes 100% oxygen. This allows oxygen to dissolve in all the body’s fluids – red blood cells, plasma, etc. This lets areas of the body oxygenate that normally would not be able to.
- Neurobiofeedback: Sensors are placed on the body, which allows for immediate feedback of bodily processes. This lets a patient retrain him- or herself in proper mechanics.
- Visceral manipulation: This treatment, pioneered by French osteopath Jean-Pierre Barral, is a gentle manual therapy that aids the internal organs (or “viscera”) in releasing restrictions and fixes unhealthy compensations.
It will likely be a long road, but there are many treatment options for Linda. As long as she has her family and friends to support her, the journey won’t be so difficult.