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7 Effective Physical Therapy Interventions for Traumatic Brain Injury

Therapist helping TBI patient with rehab equipment

If you want to regain movement and strength after a brain injury, the best thing you can do is work with a physical therapist.

Your PT will act as your coach throughout the recovery process, helping you find ways to get back your independence. In fact, there are several techniques and interventions that therapists have at their disposal to help you accomplish this goal.

In today’s article, we’re covering some of the best physical therapy interventions for traumatic brain injury you might encounter.

Physical Therapy Interventions for Traumatic Brain Injury

The primary goal of physical therapy is to recover independent movement. 

For traumatic brain injury patients, this will involve activating a mechanism known as neuroplasticity.

Neuroplasticity is the process through which the brain can repair itself after an injury. The best way to engage it is through massed practice exercises.

This explains why a physical therapist will have you do multiple repetitions of the same exercise. Because the more you practice, the more you activate neuroplasticity.

Therapists base nearly all physical therapy interventions on this principle. With that in mind, let’s look at some specific techniques they can use to improve your muscle function.  

1. Neuromuscular Re-education

neuromuscular re-education is one of the most effective physical therapy interventions for traumatic brain injury

Neuromuscular re-education seeks to retrain the nervous system to control normal movement.

After a brain injury, the connection between the brain and muscles can become damaged or destroyed. Fortunately, engaging the brain’s neuroplasticity allows a person to rebuild those neural connections.

That’s what neuromuscular re-education is concerned with: activating neuroplasticity through exercise.

Most of it will involve practicing specific movements, such as moving your arms or standing up. That’s because when we practice something, it creates new neural pathways in our brain.

The more you practice, the more you reinforce those pathways, which strengthens the connection between the brain and muscles. So be prepared to do lots of exercises.

Bonus: Download our free TBI Rehab Exercises ebook. (Link will open a pop-up that will not interrupt your reading.)

2. Passive Exercise

therapist using passive exercises on traumatic brain injury patient

Passive exercise is another intervention therapists will often use to help a person regain movement.

Sometimes the neural connections between the brain and muscles are severely severed after an injury, making it almost impossible to move the affected muscles. Doctors call this symptom brain injury paralysis.  

To treat this condition, a physical therapist might employ passive exercise, where they move your affected muscle for you

Even though you technically aren’t moving it yourself,  having someone else do the motion is enough to stimulate the brain and rekindle the neural networks that help you move. 

As the connections between your brain and muscles grow, you can take over and continue to improve your movement.

3. Home Exercise

physical therapist showing patient how to do her exercises at home

Consistent exercise is really the heart of brain injury rehabilitation. It’s what will allow you to regain function and make a good recovery.

That’s why most therapists urge their patients to continue exercising even when they are not at the clinic. 

Luckily, there are home therapy devices, such as FitMi, which help you do just that. FitMi walks you through the best PT exercises in a fun and engaging way.

4. Vestibular Training

Woman standing on balance board during vestibular training, another physical therapy intervention for TBI

Your physical therapist may teach you how to regain your balance through vestibular training.

During vestibular training, your physical therapist will perform a series of tests such as vision and balance tests to determine if your issues are stemming from the inner ear.

Based on the results, they create a customized exercise plan to address your specific vestibular issue.

Vestibular training can also involve different balance techniques that help you reduce falls and prevent further injury.

5. Gait Training

Woman using walker during gait training session with therapist

In order to regain the ability to walk, your therapist will most likely have you try task-specific gait training.  

Task specificity is an important aspect of engaging neuroplasticity. All it really means is you must practice an action directly if you want to improve it. (That’s why, to learn how to play the piano, you practice on a piano, not a flute).

Therefore, to improve your walking ability, therapists will have you practice proper walking motions, also known as gait training.

Gait training begins with assisted forms of walking first, such as walking on a treadmill with a body harness. As your strength improves, you will work your way up to using a walker or cane, until you can walk unsupported.

6. Constraint-Induced Movement Therapy (CIMT)

Therapist guiding patient through constraint-induced movement therapy

Constraint-induced movement therapy (CIMT) is an intervention designed to prevent learned non-use after a stroke or brain injury.

Learned non-use occurs when a person develops methods that help them avoid using their affected muscle.

For example, if a brain injury has made a patient’s right hand weaker, they might use their left hand for everything.

Unfortunately, if this goes on too long, the right hand will deteriorate until it is effectively useless. This is learned non-use.

CIMT attempts to thwart this process by forcing the patient to activate their affected muscle.

In order to force someone to use their weaker arm, a therapist will constrain the stronger arm, usually with a strap or mitt. That way the stronger side can’t help you with a task.

The hope is that by exercising the weak arm, neuroplasticity will kick in and the person will regain full function.

7. Aquatic Therapy

Man in pool with therapist try aquatic therapy for traumatic brain injury

Aquatic therapy is a form of physical therapy that takes place in a heated pool.

During a water therapy session, a therapist works one-on-one with the patient while the patient is floating or standing in water.

The water allows a person to participate in physical therapy without fighting against gravity. In addition, the water’s viscosity offers more resistance to movement, which increases muscle strength and endurance.

Aquatic therapy is ideal for patients with limited movement. It allows a person to experience both more freedom in their body movement and more challenge to their muscles. That’s a combination difficult to find traditional therapy.

Physical Therapy for Traumatic Brain Injury

Physical therapy, with its focus on helping you regain function, is one of the most crucial aspects of TBI rehabilitation.

We hope this article has helped you better understand the different PT interventions available so you can the treatment that best fits your needs.

Keep It Going: Download Our TBI Rehab Exercise Guides for Free

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Each exercise features pictures of a licensed therapist to help guide you.

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Get Inspired with This TBI Recovery Story

Independance, motivation and hope!

“My son Sharat suffered a severe traumatic brain injury 23 years ago leaving him with Aphasia and right sided weakness from his vision,hearing to his limbs. The lockdown in June was a great challenge for him as his caregivers stopped coming, no gym workouts and no outings for a coffee.

Being his mother and primary carer I feared that this was a hotbed for depression. I scoured the net and chanced upon FlintRehab. As there was a trial period it was safe for us to risk getting it across to Auckland.

His OT checked it out and felt that it was ideal. I can honestly second this.

He enjoys working on it and now after three months can do it on his own. His left hand helps his right hand. The FitMi video explains and shows him what to do, it gives him marks and applauds him too!!

He has to use both sides of his brain. The caregivers are OT students who returned enjoy working on it with him.

In three months there motivation built up in him with a drive to use his right hand. There is definitely a slight improvement in his right hand.

This encourages him as well as the caregivers to try harder.His overall mood is upbeat. He enjoys it, so much so, that it doesn’t matter if his caregiver is away.

FitMi is a blessing.”

Sharat’s review of FitMi home therapy, 10/10/2020

5 stars

More Ways to Recover with Flint Rehab:

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