Physiotherapy After Traumatic Brain Injury
Traumatic brain injury (TBI) ranges from mild concussion to severe, life-changing injury. Moderate to severe TBI can cause a wide range of physical, cognitive, and emotional changes that require comprehensive rehabilitation. Physiotherapy addresses the physical effects — weakness, balance problems, coordination difficulties, and changes in muscle tone.
The physical effects of TBI depend on the areas of the brain damaged and the severity of the injury. Common problems include: hemiparesis (weakness on one side), ataxia (uncoordinated movements), spasticity (increased muscle tone), balance impairment, and fatigue. These physical changes are often accompanied by cognitive changes affecting attention, memory, and executive function, which must be considered in rehabilitation.
Rehabilitation after TBI follows a progressive path. In the acute phase, the focus is on medical stabilisation, preventing complications, and beginning gentle mobilisation. As the patient stabilises, intensive rehabilitation begins — addressing movement, balance, strength, and functional tasks. The brain's capacity for neuroplasticity means that recovery can continue for months or years.
Physiotherapy treatment is tailored to the individual's specific impairments. For weakness, progressive strengthening exercises rebuild muscle power. For balance and coordination, specific exercises challenge and improve stability. For spasticity, stretching and positioning manage increased muscle tone. For fatigue, energy management strategies and graduated exercise programmes build tolerance.
Cognitive factors influence rehabilitation delivery. Patients with attention or memory problems may need shorter sessions, more repetition, and simplified instructions. Family involvement is valuable, supporting practice between sessions.
Our neurological physiotherapy service provides specialist rehabilitation for TBI patients at home, where treatment can be tailored to the individual's needs and environment. Our post-hospital rehabilitation service supports the transition from hospital to home, while our falls prevention programme addresses the balance problems common after TBI.