Brain Injury Rehabilitation
How can Therapy First help?
An Occupational Therapist can work with you to solve the problems that interfere with activities that are important to you.
They may work with a person in a coma to help with positioning the body to prevent long term contractures (muscle tightness) and to provide sensory stimulation. They can work with you throughout their recovery process to help with wheelchair mobility, physical and mental exercises for recovery, home safety devices and teaching the individual new techniques to be successful in their daily tasks (at work, school and home).
What is a brain injury?
A brain injury is a traumatic injury to a person's brain. This can be caused by trauma directly to the brain or by anoxic damage.
Anoxic brain injury is caused by lack of oxygen to the brain. The extent and type of symptoms depend on the amount of brain tissue damage and part of the brain where the injury occurred.
How a brain injury can affect function?
To better understand how the individual will be affected by a brain injury, it is important to know which parts of the brain affect which functions. There are three main areas of the brain, the cerebral cortex, the brain stem and the cerebellum.
How each person is affected by a brain injury is determined by the area of the brain that was damaged and the severity of damage.
Within the cerebral cortex are different lobes: The frontal lobe, the parietal lobe, the occipital lobe and the temporal lobe.
The frontal lobe (under the forehead) helps us know what we are doing in our environment. The frontal lobe helps us with focus/attention, judgment, planning, problem solving. It controls our emotions, personality, our ability to express ourselves in language and to understand the meanings of words. It also helps with our memory for habits and motor activities.
A person with an injury to the frontal lobe might have difficulty with initiating tasks, movement, planning a multi-step task, interacting with others and focusing. They may perseverate (persistently think of a single thought), be emotional, have difficulty problem solving and have a different personality. They may also have difficulty expressing themselves verbally and have behavioural difficulties.
The temporal lobe (at the sides of the head) helps us with hearing, memory and categorizing items.
Difficulties that a person might have with an injury to the temporal lobe may be recognition of faces, understanding speech, attending to what is seen or heard, and identifying and verbalizing objects. They may also have difficulty with categorizing objects, with short term memory loss and possible interference with long-term memory. They may have the tendency to talk persistently or be more agitated or aggressive, as well.
The parietal lobe (at the back, top of the head) helps us to pay attention to visual items, to understand where we are being touched and how to manipulate objects. It also helps with voluntary movements and understanding our senses.
A person with an injury to the parietal lobe may have difficulty with focusing, naming objects, writing, reading, drawing, doing mathematics and with hand eye coordination.
The occipital lobe is at the back of the head and helps us with vision.
A person with an injury to the occipital lobe may have difficulty seeing one side of their visual field, may have difficulty locating items visually, identifying colours or inaccurately seeing objects. For these reasons, they may have difficulty with reading and writing.
The brain stem is deep in the brain and leads to the spinal cord. It's role is to control breathing, heart rate, swallowing, certain reflexes, sweating, blood pressure, digestion, temperature regulation, alertness and ability to sleep. Balance is also controlled.
A person with an injury to their brain stem may have difficulty with breathing, swallowing, balance, dizziness, sleep and other vital functions.
The cerebellum (at the base of the skull) is in charge of coordination, balance and equilibrium. It also helps with memory for reflex motor actions.
A person with cerebellar damage may have difficulty coordinating fine movements; have difficulty walking or balancing or trouble with reaching and grabbing objects. They may have dizziness, tremors, difficulty with rapid movements and/or slurred speech.
The left and right side of the brain also have different general functions.
The left side is generally in charge of sequencing, logical interpretation of information including symbols, language and mathematics. Abstract thinking and reasoning and language memory.
The right side is generally in charge of processing and using sensory stimuli to understand the environment including visual spatial skills and physical demands (such as dancing and gymnastics). Auditory (hearing), Visual (seeing) and spatial memories are stored in the right hemisphere.
These descriptions were used in part from:
http://www.neuroskills.com/brain.shtml and http://www.waiting.com/brainfunction.html
Therapy First therapists are trained in the use of the Saebo orthoses and treatment programs for clients with limited hand and arm function following a stroke, brain injury or spinal cord injury.