Why Physical Therapy After a Brain Injury is Important

By: Lindsey McCants, PT, DPT, NCS, CBIS

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After a brain injury, your brain must heal in order to return to your prior level of function and maximize mobility. That is the goal of physical therapy, which combines intensity, repetition, and desired goals. It enhances your ability to produce neuroplastic change. In other words, you must rebuild connections among nerve cells and “re-wire” your brain.

However, not all injuries are the same, and thus, the approach to physical therapy for a brain injury should be:

  • Tailored to the individual
  • Based on the type of brain injury
  • Based on the severity of the brain injury

Types of Brain Injuries

There are various types of brain injuries. Each requires different treatments. They include:

  • Stroke
  • ​Aneurysm
  • Infection to the brain
  • Anoxia (lack of oxygen to the brain)
  • Tumor
  • Traumatic brain injury (TBI)
    • Closed Head Injury: A closed head injury (CHI) is when your head receives impact or injury, but the skull is not penetrated. A very common outcome of a CHI is a concussion.
    • Penetrating Head Injury: A penetrating head injury is when impact or injury to the head allows penetration through the skull and directly to the brain.

Types of Impairments Treated Through Physical Therapy

Physical therapy can help treat several impairments that are common after a brain injury, including:

  • Spasticity
  • Pain
  • Muscle weakness
  • Impaired coordination
  • Loss of balance, dizziness, and/or vertigo
  • Cognition and mobility integration

Physical therapy and mobility can also help prevent secondary complications such as:

  • Blood clot formation
  • Contractures
  • Skin breakdown and pressure injuries
  • Cardiovascular and respiratory dysfunction

Types of Treatment Through Physical Therapy

Depending on the location of the injury, a brain injury presents differently. It is important for you to have a thorough physical therapy assessment to identify all impairments. Based on the assessment, your physical therapist will create a plan of care. It might include:

  • Gait training
  • Intensity and endurance training  
  • Balance training
  • Therapeutic activities such as transfers and bed mobility training
  • Neuromuscular re-education
  • Strength training and stretching
  • Manual therapy

Types of Facilities

There are a variety of rehabilitation settings where physical therapy for brain injuries is offered, including:

  • Acute inpatient rehabilitation: An intensive rehabilitation center where patients receive three or more hours of therapy per day, including physical, occupational, and speech therapy. Patients stay at the facility and are under the medical supervision of a physician who specializes in rehabilitation and physical medicine. Patients also are provided 24-hour nursing care.
  • Home health therapy: This is for patients who are well enough to return home, but are unable to be physically transported to an outpatient facility due to physical or medical needs. A therapist comes to the home, performs an evaluation, and assess the need for skilled physical therapy services.
  • Outpatient therapy: A facility for patients who are well enough to be discharged home and can be safely transported to an outpatient rehabilitation facility via caregiver support or medical transport. Therapists perform an examination and evaluation to determine the most appropriate physical therapy services to address present impairments.

To seek help from a qualified brain injury rehabilitation professional, click here.

References:

Brain Injury Association of America. 2023, Brain Injury Association of America | BIAA (biausa.org). Accessed 22 May 2023.

MSKTC. Model Systems Knowledge Translation Center. 2023, Understanding Traumatic Brain Injury | MSKTC. Accessed 22 May 2023.

Sheltering Arms Institute. (2019). Moderate to Severe Traumatic Brain Injury Clinical Practice Guideline. Traumatic Brain Injury CPG.docx

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