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Concussion Management: Restoring the Brain-Body Connection With Physiotherapy

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Understanding Concussions and Brain Injuries

Although our brains are protected by the hard barrier of our skull, a blow or jolt to the head—or a similar jolt to the body that causes the head to move back and forth quickly—is enough to cause a mild traumatic brain injury.

Any kind of brain injury that leads to dysfunction can be referred to as a traumatic brain injury (TBI). One of the most common types of TBI is a concussion, which specifically describes an injury that occurs when the brain moves and hits the inside of the skull, which bruises it.

Since the sudden movement of the brain can result in the twisting and stretching of the brain’s cells and nerves, or temporarily change how chemicals in the brain function, this can alter the way the brain sends messages to the rest of the body. This is why people who suffer brain injuries may think, act, move, or feel different than is usual for some time.

When someone suffers a concussion, this injury may affect their judgment, reflexes, speech, balance, or muscle coordination. They may also experience a brief period of amnesia that prevents them from remembering what happened immediately before or after the injury occurred.

In addition, a concussion could lead to symptoms such as headaches, dizziness, nausea, vomiting, sensitivity to light, and visual disturbances. Even minor concussions should be taken seriously, especially if it is not the first time a person has experienced one.

How Physiotherapy Aids Concussion Rehabilitation

The amount of time that it takes for someone to recover from a concussion varies greatly. In some cases, a person can fully recover from a mild concussion in 7-10 days, while in others, symptoms could last for months.

Fortunately, there are proven methods to help speed up this recovery process, including physiotherapy. After conducting an in-depth assessment of the concussion and its symptoms, a physiotherapist can help someone gradually return to normal brain function while helping to relieve concussion symptoms during this process.

Depending on the problems that a concussed patient may be experiencing, a physiotherapist may help correct cervical spine issues, vestibular issues, visual disturbances, or exertion problems through various exercises.

By continuously assessing these issues, a physiotherapist can cater their approach to meet the specific needs of their patient until a satisfactory level of rehabilitation has been achieved.

Different Types of Physiotherapy Rehabilitation

There are several common approaches for physiotherapists who aim to help patients by administering physiotherapy treatment and rehabilitation. Depending on the kind of health condition or injury that a patient suffers from, sometimes a combination of different rehabilitative methods may be necessary throughout the healing process.

In most cases, the following four rehabilitation approaches are crucial elements of the treatment plan for patients, as these methods have proven to be most effective:

Preventative Rehabilitation

Shortly after a patient begins experiencing a new impairment, it is crucial for a physiotherapist to provide information, advice, and interventions on how to slow or prevent the onset of further impairments. By teaching them how to best manage their condition, a physiotherapist can help the patient maintain their level of ability.

Restorative Rehabilitation

Through interventions specifically focused on improving a patient’s impairments, such as their muscle strength or cognitive dysfunction, a physiotherapist can help them recover as much function as possible.

Supportive Rehabilitation

With a supportive rehabilitation approach, a physiotherapist can help boost their patient’s self-care abilities by guiding them to use self-help devices or showing them alternative ways to do things while they are in recovery.

This can occasionally include the provision of environmental modifications as well, depending on the type and severity of a patient’s condition.

Palliative Rehabilitation

When patients have life-limiting conditions, palliative rehabilitation can aid them in restoring their quality of life in a number of ways, including physically, psychologically, and socially.

It does this by relieving symptoms like pain, dyspnoea, or oedema to help foster comfort and maximize functional independence.

Cognitive and Psychosocial Considerations

When someone experiences serious harm, such as a traumatic brain injury, the immediate symptoms of the injury may naturally become the primary focus as they recover. However, it is often not the only concern that needs to be addressed.

It is also natural for people in such circumstances to have psychological and emotional responses to this injury, which may manifest in feelings of depression, stress, or anxiety, especially in cases where the injury is debilitating in some way.

Unfortunately, the negative effects of a serious injury on one’s mental health are unpredictable and could extend from the time immediately following the injury through to post-rehabilitation when it is possible to return to normal activity.

To help intervene in circumstances when a patient’s mental health has been more severely impacted by their injury, it is important to avoid rushing their recovery. As well, it helps to discuss short- and long-term goals for their recovery to maintain their motivation while also encouraging their friends and family to form a support network.

The Ethical Considerations in Concussion Management

Since concussions are often sports-related injuries, there are ethical considerations that occasionally come into play in the treatment of patients. For example, doctors may be expected to provide such patients with clearance to continue playing their sport even when this is not in the best interests of their health.

It is always important for doctors who are tasked with caring for concussed athletes to remember that they have an ethical responsibility to ensure that it is their priority to protect the current and future physical and mental health of their patients.

Therefore, it is their duty to provide these athletes and their families with adequate information about concussion symptoms and risk factors, including the risk of neurological impairments.

When a doctor feels that a patient is unfit to immediately return to active participation in their sport due to a concussion, it is crucial that they explain why this is the case and provide guidance to the patient and/or their caregivers about a timeline for returning to the sport.

If they neglect to do so because they feel it is not what the patient or their caregivers will want to hear, they could be putting the health and safety of their patient at risk.

Why Concussions Are Serious Injuries and Should Always Be Treated as Such

A concussion is quite unlike most injuries. This is because the brain is such a central component of our body, and is responsible for numerous vital functions like our memory, speech, mobility, and more.

While some people may recover from a concussion at a faster rate than others, when the symptoms are more serious or longer-lasting, it is best to seek treatment, such as physiotherapy rehabilitation.

Through such treatment, a person can gradually overcome the symptoms of their concussion, and their brain will gradually return to its normal function again.

How Physiotherapy Helps Support Patients With Neurological Disorders or Conditions

Understanding Neurological Disorders

Neurological disorders include any diseases that affect the nervous system, which includes the central nervous system (CNS) and the peripheral nervous system (PNS).

Such disorders can affect both adults and children and often impact various parts of the body, such as the spinal cord, the brain, peripheral nerves, cranial nerves, nerve roots, neuromuscular junctions, and muscles. The disorders that typically tend to affect the CNS and PNS differ from each other, but there are some common disorders that affect these systems.

When it comes to disorders that commonly affect the CNS, some of the most common conditions include Alzheimer’s disease, multiple system atrophy, fetal alcohol spectrum disorder, Rett syndrome, traumatic brain injury, stroke, Parkinson’s disease, cerebral palsy, multiple sclerosis, and dementia.

In terms of disorders that commonly affect the PNS, this list includes Erb’s palsy, Bell’s palsy, diabetic neuropathy, Guillain-Barre syndrome, alcoholic neuropathy, HIV neuropathy, myasthenia gravis, cauda equina syndrome, and radiculopathy.

These conditions each have unique impacts on those who suffer from them. Their symptoms include everything from loss of mobility, sensation, balance, or coordination to impaired speech, cognition, memory, or speech, as well as significant behavioural changes.

The Specialized Approach of Physiotherapy Clinics

One of the ways that people who are faced with neurological disorders can seek treatment is by going to a physiotherapy clinic for neurological physiotherapy. This therapy is aimed at helping an individual to either maintain or regain maximum movement capabilities and/or functional independence.

A neurological physiotherapist is able to help along this kind of recovery in patients suffering from neurological disorders by using repetition and exercise to aid in the development of new pathways.

Although a physiotherapist may not always be able to directly or independently treat a specific medical condition other than musculoskeletal conditions, through various therapeutic approaches, they can help optimize recovery outcomes while also educating a person on how to help themself in various ways.

In most cases, physiotherapy treatment includes examinations of a person’s flexibility, movement, and muscle and joint motion, leading to a clinical diagnosis, prognosis, and the development of a care plan that includes both long- and short-term goals.

This is followed by various treatments and interventions targeted at the relief of certain symptoms, or the enhancement of particular functions, which is paired with detailed instructions on exercises the patient can do on their own at home.

What are the specialized techniques in neurological physiotherapy?

Neurological physiotherapy involves specific concentration on the comprehensive functionality of the nervous system, including the spinal cord, brain, and nerves. Neurological physiotherapists utilize specialized techniques to help enhance their patients’ motor function, balance, and coordination.

Treatment approaches vary depending on the individual’s condition, symptoms, and goals. In many cases, however, a combination of methods focused on the improvement of normal movement, motor relearning, and synergistic movement are employed. As such treatments progress, a patient will likely be able to regain their ability to complete everyday tasks like walking, climbing stairs, and getting out of bed on their own.

One example of an approach often used in neurological physiotherapy is the application of facilitation techniques. These involve proprioceptive maneuvers like joint compression, joint distraction, and the use of reflexes such as stretching and resisting to achieve optimal muscular function.

Tapping is another technique used to facilitate voluntary muscle contractions by applying a light amount of force to muscles or tendons. One more method is cryotherapy, which uses ice to facilitate muscle responses through the combined sensations of coolness and pain.

In recent years, traditional neurological physiotherapy approaches have become increasingly combined with the use of modern technologies that enhance the effectiveness of rehabilitation.

Thus, some of the specialized approaches to therapy may include robotic-assisted training, virtual reality, non-invasive brain stimulation (NIBS), and functional electrostimulation, which are various ways to manipulate brain excitability and plasticity.

How Physiotherapy Helps Enhance Neuroplasticity and Functional Improvement

Various parts of our brains are constantly transmitting information to each other and to other parts of our body. This information circulates within our brains from neuron to neuron via special connections called synapses.

Neurons have the ability to increase or decrease the strength of existing synapses, and they can also form new synaptic connections or eliminate old ones. Our nervous system thus has the ability to alter its activity by reorganizing its structure, functions, or connections, which it does as a result of intrinsic or extrinsic stimuli. This is known as neuroplasticity.

Neurological physiotherapy takes advantage of the brain’s capacity to adapt and recover in this manner by providing targeted activities and exercises that stimulate the nervous system in various ways.

Certain movements and exercises target neural pathways and assist in the growth of new neural connections. Therefore, by encouraging a patient to engage in such repetitive and functional movements, a physiotherapist can help improve functional recovery and promote neuroplastic changes.

After assessing a person’s specific needs, a physiotherapist can design rehabilitation exercises and an overarching rehabilitation plan that will be most suitable for promoting neuroplasticity in that person’s brain.

As this rehabilitation plan is executed and the patient’s physiotherapy treatment progresses, they should experience notable improvements in their motor function, as well as other types of functional restoration and reduced pain.

By encouraging neuroplasticity, physiotherapists can also help halt disease progression and development, resulting in significant ongoing improvements to patients’ quality of life.

The Role of Physiotherapy in Managing Neurological Disorders and Conditions

Working with a physiotherapist who specializes in neurological physiotherapy is one of the best chances that someone has to overcome the symptoms that negatively impact their life when they are afflicted by a disorder or condition.

Whether you have a condition like Alzheimer’s disease, Parkinson’s disease, or cerebral palsy (which affects your central nervous system), or one like Erb’s palsy, Bell’s palsy, diabetic neuropathy, or radiculopathy (which affects your peripheral nervous system), the various methods and technologies employed in neurological physiotherapy can help improve your quality of life.

By engaging in specialized treatments and exercises that are aimed at triggering neuroplasticity in your brain so that it can form new synapses and, in turn, regain motor control and mobility, you can recover the ability to participate in all kinds of activities that you may otherwise struggle with.