Rehabilitation & our amazing brains after injury

Following a brain injury, cells inside the brain are damaged or destroyed.  Whilst they are unable to regenerate, dissimilar to most other cells in our body, the brain is essentially able to adapt by reorganising and creating new neural pathways from a damaged area to an undamaged area, regaining any function that has been lost.  This is called functional neuroplasticity.

Rehabilitation is a way of kick-starting these neural pathways that the brain is struggling to use, to create new pathways through repetitive actions and exercises.  Rehabilitation can also be really important to provide support to the patient and their family, as well as to help them adapt to their disabilities.

At Bolt Burdon Kemp, we recognise the important part rehabilitation can play in our client’s recovery following their brain injury.  Early implementation of a rehabilitation programme by a multidisciplinary team (MDT) is crucial for the brain injured person’s needs to be quickly assessed and any areas for development identified.  There are various types of specialist teams that can help but in this series of blogs I will focus on physiotherapists, speech and language therapists and occupational therapists, discussing the important part they each play in rehabilitation after a brain injury.

What is rehabilitation and how can it help?

Rehabilitation helps the brain injured person manage the effect their injury may have had on their functional ability as well as helping to adjust to any physical changes.  The objective is to improve the patient’s ability to function at home and in the community further to their discharge from hospital.  It can have benefits such as:

• Developing their ability to function both at home and in society
• Improving their motor skills and muscle strength
• Assisting with any psychological issues that occur from their injury
• Helping to adapt to any changes during their recovery

Types of rehabilitation can include

• Physical therapy
• Psychological assessments
• Speech and language therapy
• Occupational therapy
• Physical medicine
• Psychiatry sessions
• Social care

Where does rehabilitation take place?

Rehabilitation can take place in a variety of settings:

• As an inpatient: Many hospitals will have intense specialist in-patient neurological rehabilitation and condition management programmes for those not ready to return home
• As an outpatient: If there is no need to stay in hospital, they may go home and receive further rehabilitation either through a local hospital or at a rehabilitation outpatient centre
• At home: Rehabilitation therapists will continue sessions with the patient in their home or their community environment
• At an independent living centre: This enables people to improve their independent living skills so that they can prepare to live by themselves in a place of their own

When should rehabilitation begin?

In complex brain injury cases a rehabilitation programme is likely to begin in hospital in an intensive care unit.  They will then be initially assessed so that their physical and non-physical needs can be identified and they can be provided with a tailored rehabilitation programme.  This programme will then be developed as their needs and abilities change over time during the recovery process.  Once the patient has received emergency treatment and has made a good recovery, they may be transferred to a subacute unit of the hospital or to an independent rehabilitation hospital.

How long will rehabilitation last for?

Every brain injury is unique and there is no set time period for rehabilitation.  The length of rehabilitation differs depending on the severity of the injury and how well the individual responds to the therapy, however it is not a quick process and takes months or years.

Whilst some people may be able to recover well enough to return to the same level of ability they had before the injury, others may need care throughout their lifetime.