Traumatic Brain Injury Physiotherapy Management

A traumatic brain injury is a condition that can affect the life of an individual adversely. A person’s life will never be the same after a traumatic brain injury. Traumatic brain injuries are unfortunately rather frequent these days. So, taking care of a patient is the most important process for a speedy recovery.

Physiotherapy management can have a positive impact on the individual. Physiotherapy services can create a change in the individual and help them recover from TBI. Let us first learn more about traumatic brain injuries before diving into post-TBI physiotherapy management.

A blow, bump, or shock to the head; the head hitting an object fast and strongly; or an object piercing the skull and penetrating brain tissue and when some one injured by speeding trucks or buses affecting head are all examples of traumatic brain injury (TBI). Any of the clinical indicators listed below implies a disruption in normal brain function:

  1. Loss or diminution of consciousness
  2. Memory loss for events that occurred before or after the event (amnesia)
  3. Focal neurological problems include muscle weakness, loss of vision, and alterations in speech.
  4. Mental state alterations include disorientation, delayed thinking, and difficulty concentrating.

Depending on the severity of the brain damage, TBI symptoms can range from mild to severe. A momentary shift in mental state or consciousness may occur in minor cases. Severe cases can lead to comas, death, or extended unconsciousness.


The degree of the head injury determines the symptoms. Any of the following might be included in them:

  1. Concerns about dizziness and balance
  2. Breathing difficulties
  3. A slow heartbeat
  4. Vomiting
  5. Lethargy
  6. Headache
  7. Confusion
  8. A rise in blood pressure with a slower breathing rate
  9. Hearing loss or ringing in the ears
  10. Eyelid drooping or facial weakness
  11. Not being able to control the bowel movements
  12. Inability to control the bladder
  13. Vomiting
  14. Lethargy
  15. Headache
  16. Confusion
  17. Paralysis
  18. Coma
  19. Problems with cognition
  20. Inappropriate emotional responses
  21. Slurred speech, difficulty interpreting and/or enunciating words are examples of speech issues.
  22. Swallowing problems
  23. Numbness or tingling across the body
  24. Consciousness loss
  25. Pupils Dilate
  26. The way you view things shifts (blurred vision or seeing double, unable to tolerate bright light, loss of eye movement, blindness).
  27. CSF, cerebrospinal fluid, (clear or blood-tinged) discharges from the ears or nose.

If a TBI is suspected, contact the national emergency number right away or take the victim to the nearest hospital emergency department.

Injuries and their types

TBIs can result in “mass lesions,” which are areas of localised damage such as hematomas and contusions that raise brain pressure. The following are some of the numerous forms of TBI sequelae

Diffuse Injuries

TBIs can cause minute alterations in the brain that do not show up on CT scans and are dispersed throughout the brain. This type of brain injury, known as diffuse brain injury, can occur with or without a mass lesion.

Skull Fractures

TBIs can cause linear skull fractures as well as simple breaks or “cracks” in the skull. The underlying brain might be damaged by pressure powerful enough to shatter the skull. If a patient’s skull fractures are discovered during an examination, this might be concerning.

Fractures near the base of the skull are dangerous because they can damage nerves, arteries, and other systems. A leak of cerebrospinal fluid (CSF) from the nose or ears is possible if the fracture continues into the sinuses. Depressed skull fractures, in which a piece of the bone pushes on or into the brain, are also possible.

Diffuse axonal damage

Axonal injury is defined as a decrease in axon function over time. Due to these lengthy extensions, nerve cells can interact with each other. If enough axons are damaged in this way, the nerve cells’ capacity to communicate and integrate their functions may be lost or severely hindered, potentially leaving a person with a severe disability.


A hematoma is a blood clot within or on the surface of the brain. Hematomas can develop in any part of the brain. A blood clot between the dura mater (the brain’s protective covering) and the interior of the skull is known as an epidural hematoma. A subdural hematoma is a blood clot that forms between the dura mater and the arachnoid layer, which lies immediately on the brain’s surface.


The term “cerebral contusion” refers to the bruising of brain tissue. When studied under a microscope, cerebral contusions are similar to bruises in other sections of the body. They are made up of wounded or enlarged brain tissue combined with blood from arteries, veins, or capillaries. Contusions are most frequent at the base of the front sections of the brain, although they can happen elsewhere.


Ischemia, or a lack of blood flow to particular areas of the brain, is another kind of diffuse damage. A considerable proportion of TBI patients may have a drop in blood supply to dangerously low levels. This is critical because a brain that has just suffered a traumatic injury is extremely sensitive to even small changes in blood flow. Blood pressure fluctuations during the first few days following a head injury might potentially be harmful.

Intracerebral haemorrhage

An intracerebral haemorrhage (ICH) is a type of brain bleeding that can be caused by various types of brain trauma, such as contusions. The size and location of the haemorrhage have a role in determining whether it can be surgically removed.

Subarachnoid haemorrhage

Subarachnoid bleeding into the subarachnoid space causes subarachnoid haemorrhage (SAH). After a TBI, it looks like diffuse blood is scattered thinly over the surface of the brain.

What to do after a TBI?

The brain, on the other hand, is extremely responsive, and physiotherapy can help you regain control of your body. Patients have recovered from injuries in as little as a year by sticking to a rigid treatment plan. As a result, it is suggested that you begin physiotherapy as quickly as possible to minimise your hospital stay and continue it until you are completely recovered.

With regular physiotherapy, you may restore as much movement and function as possible. Neurological physiotherapy can help you regain your balance and improve your walking by reducing muscular spasms, pain, and stiffness while also allowing you to perform modest tasks like sitting and standing, rolling over in bed, and moving. Physiotherapy aims to increase a patient’s physical strength while also helping them relearn their normal movement patterns.

What is Neurological Physiotherapy?

The assessment, treatment, and care of individuals with traumatic brain injuries are all entwined in a single string known as neurological physiotherapy. Their relatives or caregivers are also engaged in the process to get the best results.

Treatment generally begins at the same time as or within a few days of discharge. Physiotherapists begin by evaluating the patient’s condition, identifying prospective requirements, and commencing therapy by properly educating the patient and his relative or carer. Short-and long-term rehabilitation goals are set and updated regularly.

The use of therapeutic activities by therapists contributes to a patient’s total recuperation. Manual therapies like mobilisations and manipulations may also be employed. Mobility aids such as orthotic or prosthetic devices, as well as wheelchairs, may be required for some individuals. Few people suffer from respiratory problems, so airway clearing treatments are indicated in those cases.

Rehabilitation after a severe injury takes place in one of two ways, depending on the type of damage and the patient:

  1. Following a brain injury, spontaneous recovery refers to the early repair of the central nervous system and the regression of diaschisis.
  2. Function-induced recovery, as seen in the Constraint-Induced Movement Therapy training regimen, is a process that focuses on establishing neuroplasticity in response to activity and environmental stimuli, resulting in behavioural change.

Many people who have had a traumatic brain injury (TBI) are left with serious disabilities. The brain, on the other hand, is extremely adaptive, and with the right therapies, recovery can take years. Following a TBI, people frequently experience a quick period of recovery in the first few weeks, followed by gradual recovery during the following years. Physiotherapy treatment should be continued as soon as possible after you leave the hospital until you have attained your full potential.

When you are medically stable, you will be released from the hospital. Being released from the hospital does not imply that you will not continue to improve. As soon as you leave the hospital, you should begin your therapy. You still have a lot of room to develop in the next few years with the right PT input and counsel.

Your short and long-term recovery objectives will be discussed at your initial exam. These objectives will subsequently be the focal point of your recovery.

Physiotherapy will help you restore as much movement and function as possible after your injury. Sitting balance, standing balance, walking, using your afflicted arm/hand, and controlling any changes in muscle tone, discomfort, or stiffness are all common treatment goals.

Physiotherapy for TBI can help:

  • Improve your walking ability and balance.
  • Increase your ability to roll around in bed, sit, and stand to reduce muscle spasms, soreness, and stiffness.
  • Increase strength, retrain natural movement patterns, improve impaired arm and leg function, boost energy levels, improve independence and quality of life, and lower the risk of falling.

Physiotherapy Management Post-TBI

Many people have difficulty executing things that were previously uncomplicated after a TBI. This can make day-to-day living difficult for you and those closest to you. To make your life simpler, physiotherapists and the home physiotherapy Dubai services will come to your residence to advise you on the use of walking aids, splints, supports, and home equipment. Neurological physiotherapists should guide you through a gradual programme of functional exercises to improve your mobility and muscle control throughout treatment sessions.

Caretakers and family members should be given manual handling training classes provided by medical experts. This course will educate people caring for you about safe therapeutic handling and positioning practices that will encourage normal mobility and postural alignment. It is also possible to learn how to use particular hoists and slings for therapeutic purposes. Professional physiotherapists can do postural, bed, sitting, and wheelchair exams as needed. Following this evaluation, a physiotherapist might recommend you to relevant NHS or private services for additional medical advice.

A TBI is a life-altering experience. Personality changes, impatience, and a lack of confidence are all possible side effects of TBIs. Choosing the finest home physiotherapy services will help you recover faster and reduce the length of your treatment. To avoid this, individuals seek the help of professional organisations that provide home health care services to patients and their families that require support and care for sick people.

Physiotherapy management can help TBI survivors with proper exercises and counselling. This, together with enhanced function and independence, enables our patients to live the happiest lives possible.

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