Acquired Brain Injury Physiotherapy
Physiotherapy treatment for acquired brain injury
There are many different causes of brain injury including traffic accidents, sports accidents or lack of oxygen to the brain. It takes a long time to work out how serious a brain injury is.
One way is to measure how long after the injury your child is in 'post traumatic amnesia', which is the time after the injury they are confused, disorientated and have poor day to day memory. Each child's recovery will be different and take different lengths of time. Recovery usually continues for many years after the injury.
The most common causes of brain injury in Australia are:
Traumatic brain injury (from falls, motor vehicle accidents, sports).
Meningitis/encephalitis (infections around the brain).
Cerebrovascular accidents (or strokes) which can be caused by arteriovenous malformations or cardiac complications.
Hypoxic-ischaemic events caused by a lack of oxygen to the brain. These can be due to near drowning accidents, prolonged fits or cardiac complications.
After a brain injury your child may have changes to their physical function, cognition (thinking), personality, behaviour and way they communicate.
The short-term effects include coma (being unconscious) or concussion (being drowsy and confused). Longer term effects may include weakness, poor balance, poor coordination and fatigue. Cognitive effects can include problems with attention and concentration, difficulty in planning and organisation, changes in behaviour and changes in communication such as having problems with expression and understanding.
Gross Motor Effects:
What are gross motor skills?
Gross motor skills are large movements of the body that use large muscles to produce coordinated movements, for example walking, running, sitting, throwing and crawling. Children learn new gross motor skills by practising them until the skill is mastered.
The effects on gross motor skills may be seen in a number of ways, including:
• muscles may become stiff and difficult to move
• movements may be jerky or clumsy and difficult to coordinate
• muscles may become difficult to turn on (paralysis)
• planning and execution of movement becomes difficult
A child's ability to perform motor skills depends on several things including muscle strength, coordination and flexibility. Children who have had a brain injury can have long term difficulties with gross motor skills.
Physiotherapy can help your child to continue practicing or re-learning gross motor skills in the years after their brain injury. Changes to their control of muscles and movement after a brain injury can cause changes, such as shortening, in soft tissues including muscles. These changes may affect your child's ability to learn or perform gross motor skills in the following ways:
• Learning new skills: your child may need more practice than other children to learn new skills.
• Growth spurts: growth spurts can worsen your child's tendency to have tight muscles. Therefore, it is important to monitor muscle length during growth spurts. Children will be seen regularly in the brain injury clinic to monitor the effects of their growth.
• Joint pain: if your child changes posture or movement patterns (e.g. if the knee flicks back, or hyper-extends, during walking), they may experience pain. Practicing gross motor skills can help your child move in the best and most comfortable way possible for them.
• Splints/Orthoses: splints and orthoses will become too small as your child grows. It is important that your child has regular reviews of the size and suitability of any splints or orthoses.
Physiotherapy and occupational therapy
Trained physiotherapists and occupational therapists can assist your child in a number of ways:
• by teaching motor skills
• by helping to reduce muscle shortening through casts, splints and stretches
• by assessing and treating joint pain
• by reviewing current and recommending new splints or orthoses
Source: Kids Health Info series of factsheets under 'B' for brain injury: www.rch.org.au/kidsinfo