More than 3.5 million children and adults sustain an acquired brain injury each year, according to the Brain Injury Association of America. A brain injury can result from numerous incidents, including falls, motor vehicle accidents, assaults and being struck by or against another object.
Brian injuries are typically not only traumatic for the patients, but also for family, friends and caregivers whose lives may also shift dramatically – and while the aftermath of a brain injury may be overwhelming, physical therapy can play an integral role in the recovery process toward a “new normal.”
In honor of Brain Injury Awareness Month, we spoke with Danielle C. Bonner, PT, DPT, NCS, in the Shepherd Center’s Acquired Brain Injury Unit, to discuss her experiences with patients recovering from brain injuries. And, according to Danielle, a “successful” recovery from a brain injury comes down to time, patience and hard work – which may be a tough road for patients and their families.
In her five years with the Shepherd Center, Danielle has treated patients with a variety of brain injuries – both traumatic and non-traumatic. The most common characteristic of these patients is that there isn’t much commonality. No two injuries present the same, regardless of the obvious similarities. And because of this, no two treatment plans look the same. Brain injuries are always unique, as are their treatment and recoveries.
When treating an individual with a brain injury, the process begins with an assessment by the full medical team to determine medical stability, identify physical and cognitive impairments and then set priorities. For a recently injured but medically stable patient, this may look different from a patient who has had an extended stay in the ICU. In these cases where the patient has minimal activity in his or her time in the ICU, it is imperative to make sure their heart and blood pressure are stable enough to handle a more active environment.
The physical therapy team then works together to determine a patient’s cognitive and communication abilities to identify the best types of assistance and cues necessary in his or her case – like whether or not a patient is able to follow verbal physical commands or requires more hand-on support. This is partially determined by a standardized assessment is called the Rancho Level of Cognitive Functioning Scale.
Strength, range of motion and balance are then taken into account to determine the best course of treatment – which can look dramatically different depending upon the patient. For some, this means an extended in-patient stay. Others are better suited for an out-patient or day program. And many patients may not even recognize the need for PT until much later in the recovery process when persistent pain or headaches appear. For more patients, cognitive improvements later in recovery may provide them with the insight to know that therapy is necessary to continue to increase independence.
Beyond the initial shock of the injury, the most difficult element of the recovery process, according to Danielle, is often the time it may take to achieve the best “new normal” possible. For many people, it may take years of returning to physical therapy to address a new element of recovery.
What are the most important things to keep in mind while you or a loved one is recovering from a brain injury?
Patience and hard work.
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