|Physical||Communication||Cognitive||Behavioural / Emotional|
All brain injuries are unique depending on the location(s) of the injury within the brain. Impairments can result which may be permanent or temporary and may also cause partial or total disability.
Brain injury can affect gross and fine muscle movements. Gross motor movements are large muscle movements as seen in muscle use during exercise or sporting activities. Fine motor movements are movements requiring dexterity and small very well controlled movements e.g. threading a needle.
The brain is ‘wired’ so that damage to the left side of the brain can cause motor deficits on the right side of the body, and damage to the right side of the brain can cause motor deficits on the left side of the body.
Muscle wasting otherwise known as atrophy can occur following an acquired brain injury and consequent loss of muscle function. Although a muscle itself may be undamaged, if it is not being stimulated by the nerves arising from the brain it will waste away. Physiotherapy and continued use of the muscle where possible is therefore important to prevent muscle wasting.
Paralysis can occur if a part of the brain that controls specific muscles is damaged as a result of acquired or traumatic brain injury involving the motor system. Paralysis is defined as a loss of muscle function for one or more muscles. Paralysis can be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory damage as well as motor damage.
Muscle tone (residual muscle tension or tonus) is a continuous and passive partial contraction of the muscles. Both extensor and flexor muscles (which act against each other), are involved in the maintenance of a constant tone while at rest. In skeletal muscles, this helps maintain a normal posture.
An acquired brain injury involving damage of motor neurons can result in abnormal muscle tone which can involve a state of low muscle tone (Hypotonia,) or a high muscle tone (Hypertonia).
Hypotonia, is also commonly known as floppy baby syndrome. It is a state of low muscle tone, often involving reduced muscle strength. Recognizing hypotonia, even in early infancy, is usually relatively straightforward. The long-term effects of hypotonia on a child’s development depend on the severity of the muscle weakness. The principal treatment for hypotonia is physical therapy, occupational therapy for remediation, and/or music therapy.
Hypertonia is sometimes also referred to as spasticity. Damage within the brain may result in muscle spasms, stiffening or straightening out of muscles, or shock like contractions of all or part of a muscle group. Rigidity is a severe state of hypertonia. Physiotherapy has been shown to be effective in controlling hypertonia through the use of stretching aimed to reduce motor neuron excitability. Medicines can also be used to reduce spasticity.
Ataxia is a term for a group of disorders, including acquired brain injury that affect co-ordination, balance and speech. Any part of the body can be affected, but people with ataxia often have difficulties with:
The exact symptoms and their severity vary depending on the type of ataxia a person has.
Treatment may include:
"Rehabilitation interventions can lead to positive outcomes for children and their families if delivered in the familiar home environment and applied to everyday situations"
"We are medical practitioners. The real experts are the parents. Over the last 35 years they have taught me everything I know"
"NHS clinicians struggle with what intervention to priorities in pediatric neuro-rehabilitation due to limited clinical time and the complexity of needs. Children, clinicians, parents and schools all have different neuro-rehabilitation priorities"
"When someone has a brain injury, early access to local, specialist rehabilitation is crucial to ensure the maximum recovery and make significant savings to the state in health costs"
"Our 10 year study proves that family-led home-based neuro-rehab interventions deliver the best outcomes for children and young people"
"We need to harness the power of brain plasticity for treating children and young people with brain injury. Stressful experiences alter brain development of a child, especially at the key ages of 0-3 and at ages 10-16"
"New parenting support intervention showed how parenting style is related to executive dysfunction in children and young people post brain injury. With support parents cope better so the child has a better recovery"
"Different 'experts' involved in pediatric neuro-rehabilitation come from different organisational cultures which causes conflict and has a negative effect on the outcomes for the child."
"Brain development is complex and prolonged. Brain plasticity is influenced by a range of factors. Plasticity provides a base for neuro-rehab therapies and treatment"
"We would like to see earlier identification and support for children with brain injuries to help them succeed in school."