What does NeuroRehabilitation look like after a traumatic brain injury?
A traumatic brain injury (TBI) can affect movement, balance, speech, swallowing, thinking, behaviour, mood and sleep. Because the effects differ greatly between people, NeuroRehabilitation is planned individually.
Severity makes a difference
A Cochrane review of multidisciplinary NeuroRehabilitation for acquired brain injury found that, in predominantly mild injury, most people recovered well when given appropriate information, without additional specific interventions. For moderate to severe injury, the review found strong evidence of benefit from formal NeuroRehabilitation, limited evidence that starting early leads to better outcomes, and strong evidence that more intensive programmes are associated with earlier functional gains [1]. A later systematic review and meta-analysis of people with moderate to severe traumatic brain injury found consistent evidence that early-onset NeuroRehabilitation in the trauma centre and more intensive NeuroRehabilitation afterwards were associated with better functional outcome than usual care [2]. The authors concluded that problems after brain injury vary, so different combinations of interventions are needed for different patients [1].
Typical stages
- Early phase (intensive care and acute ward): positioning, breathing and swallowing safety, preventing complications, and starting mobilisation when medically safe.
- Inpatient or intensive NeuroRehabilitation: physiotherapy for movement and balance, occupational therapy for daily activities, speech and language therapy, cognitive NeuroRehabilitation for attention, memory and planning, and psychological support.
- Later phase: outpatient or home-based therapy, return to daily roles, and regular review. The Cochrane review reported moderate evidence that continued outpatient therapy could help to sustain gains [1].
The team
NeuroRehabilitation is usually led by a physician in physical medicine and rehabilitation working with physiotherapists, occupational therapists, speech and language therapists, neuropsychologists, nurses and other specialists as needed. Technology-supported methods such as robotic physiotherapy may be part of the plan for movement goals.
Frequently asked questions
Does every brain injury need a long NeuroRehabilitation programme? No. Needs depend on the severity and type of problems. Mild injuries often need information and monitoring, while moderate to severe injuries usually need structured NeuroRehabilitation [1].
What about behaviour and mood changes? These are common and are part of the assessment. Psychological and family support are included where needed.
See also: Brain injury guide · Who plans and supervises the programme?
Please note: NeuroRehabilitation results vary from person to person. What is possible for an individual depends on their condition, and any plan requires an individual medical assessment.
Assessment and contact
This page is general health information and does not replace an in-person examination. In an emergency, call your local emergency number.
Sources
- Turner-Stokes L, et al. Multi-disciplinary rehabilitation for acquired brain injury in adults of working age. Cochrane Database Syst Rev. 2015. PMID: 26694853
- Königs M, et al. Effects of timing and intensity of neurorehabilitation on functional outcome after traumatic brain injury: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2018. PMID: 29428344