|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:
"Positive and coordinated neuro-rehab interventions for children and young people is proven to bring health improvements; improve independence; reduces the need for sheltered living; decreases vulnerability; decreases drop-out rates in schools; decreases youth offending"
"Rehabilitation interventions can lead to positive outcomes for children and their families if delivered in the familiar home environment and applied to everyday situations"
"NHS clinicians struggle with what intervention to prioritise in paediatric neuro-rehabilitation due to limited clinical time and the complexity of needs. Children, clinicians, parents and schools all have different neuro-rehabilitation priorities"
"With support parents cope better so the child has a better recovery"
"Families need to be properly supported as 'resilience' is key to delivering successful outcomes for children and young people."
"Participation in teen sports and normal activities leads to improved quality of life for children and young people post brain injury and helps to maximise outcomes"
"Case management for children and young people post acquired brain injury is 'pivotal' to successful outcomes and must be local"
"Pediatric neuro-rehabilitation cannot be delivered in isolation. The needs of the child have to be looked at both holistically and within the context of the family unit. Parents need to be empowered to be parents in post-acute pediatric neuro-rehabilitation following brain injury"
"Often families don't have the financial capability to access services. We need to rethink how we deliver neuro-rehab services to children and young people"
"Thousands of children and young people living in the UK today without the help and support that can make a huge difference to their lives"