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Occupational Therapy and Traumatic Brain Injuries

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Jasmine Georgia

Did you know that in 2019, the United States had about 223,135 traumatic brain injury (TBI) hospitalizations? That comes out to about 611 cases every day - and that's excluding those treated in an emergency department or who did not receive help! So, in honor of May being Stroke Awareness Month, keep reading to learn more about the symptoms of traumatic brain injuries and explore how occupational therapy can significantly help patients recover as well as regain a better quality of life. 

Potential Long-Term Symptoms Of TBI

Head injuries can happen to anyone, especially when people experience a head bump, blow, jolt or gunshot. Such accidents can cause damage to the brain tissue, which may be classified as a:

  • Mild TBI or concussion
  • Moderate TBI
  • Severe TBI

Patients may recover quickly from a concussion, but moderate or severe traumatic brain injuries are often far-reaching and varied, with severe TBIs being more stubborn to treat than stroke-related impairment. When it comes to a stroke, the disruption to blood pressure and circulation usually results in only localized damage, whereas head trauma as a result of an accident may lead to large blood clots in the brain. Additional time-sensitive injuries to internal organs are also common and should be addressed as soon as possible. 

While this mix of symptoms can make treatment exponentially more challenging, any TBI, from a mild concussion to a severe injury, can display symptoms that linger after the causative event. However, for more severe TBIs, symptoms can persist for months or years, with some patients experiencing the after-effects of a brain injury for the rest of their lives. Fortunately, treatment by an occupational therapist can help patients manage persisting TBI symptoms and achieve more independence. 

Mild TBI

According to the Mayo Clinic, physical symptoms of a mild TBI include fatigue, nausea or vomiting, dizziness and loss of balance. Additionally, a traumatic brain injury can interfere with speech and cause sensory issues such as blurred vision, perception of bad taste in the mouth, ringing in the ear or changes in sense of smell.

Cognitive and behavioral changes are also common TBI symptoms and may include:

  • Being in a dazed, confused or disoriented state
  • Memory/concentration challenges
  • Unstable emotions and mood swings
  • Insomnia or oversleeping

Moderate To Severe Traumatic Brain Injuries

Patients with moderate to severe brain injuries may experience symptoms of a mild TBI in addition to other physical and cognitive signs. For example, loss of consciousness may last from several minutes to hours rather than just seconds. Additionally, patients report experiencing persistent headaches, repeated nausea and loss of coordination. Other adverse physical symptoms to look out for include:

  • Loss of dilation of either or both pupils
  • Discharge from the nose or ears
  • Seizures and/or convulsions
  • Inability to wake up after sleeping

What's more, moderate to severe TBI may manifest cognitively in irritability, intense confusion, slurred speech or a coma. Other disorders of consciousness may be evident as well— a medical professional should be consulted for any unusual behaviors after head trauma, even if they may not be listed here.

TBI Symptoms In Children

Young children might not be able to fully communicate how they feel, so it is imperative that adults watch out for symptoms following a head injury. For instance, there may be a change in their eating and sleeping habits. A child with a TBI may also appear sad or depressed and cry persistently. Additional signs to watch out for include:

  • Seizures
  • Inattentiveness
  • Unusual irritability
  • Loss of interest in their favorite activities or toys
  • Unusual drowsiness

The Role Of Occupational Therapy In TBI Recovery

Working either independently or in a multi-disciplinary team, an occupational therapist assesses and recommends a treatment plan to help patients recover everyday functionality. The therapist may deliver care directly or delegate some activities to an occupational therapy assistant (OTA), but it's not uncommon for an occupational therapist to also involve family members in identifying problem areas that may impact daily routines as well.

To support an individual living with a traumatic brain injury, occupational therapy may focus on varied dimensions of a patient's life, including:

  • Routine planning and motivation
  • Fatigue management
  • Memory strategies
  • Sleep hygiene
  • Return to work support
  • Anger/behavioral health management
  • Home environment optimization 
  • Facilitated discharges
  • Accessing community facilities (i.e. supermarkets, gyms and cinemas)

Partnering with a caring and experienced occupational therapist can be life-changing for individuals living with a TBI. For example, one clinical study charted the progress of a 33-year old who suffered a TBI after falling from a 28' high roof, with performance and life satisfaction at the top of his five occupational therapy goals. Specifically, he wanted to return to work, drive, cook, pay bills and rejoin his basketball team.

To achieve these goals, the occupational therapist needed to formulate a treatment plan that could address the personal challenges the patient was dealing with as a result of his brain injury: self-awareness, behavioral and communication skills, understanding emotions as well as managing poor memory.  

Among the interventions used by the occupational therapist was goal attainment scaling, which fostered participation and accountability by the patient. Additionally, the occupational therapist employed restorative and compensatory strategies, such as automated reminders, to help the patient cope with short-term memory challenges. After undergoing six months of occupational therapy, the patient was able to meet his five goals and attain a better quality of life.

Much like the example above, occupational therapy is tailored to the specific goals and challenges a patient is facing. For example, someone who needs to improve motor function could be helped through exercise and computer-based interventions such as virtual reality. On the other hand, interventions for someone with cognitive impairments may include training in techniques such as encoding, a practice that focuses on shifting information from short-term memory to more permanent long-term memory. 

Delivering Optimal Care To Each Patient Living With A TBI

While occupational therapy delivers critical benefits to people living with TBIs, it often requires long work hours and extensive record-keeping. However, occupational therapists can use technology to reduce their administrative burdens and enhance patient engagement. Today's leading automation software can streamline routine tasks while allowing providers more time to serve patients and achieve a better work-life balance for themselves.

Here at Raintree, we are dedicated to providing scalable, powerful software solutions and services for the therapy and rehab market. Whether it be high-level automation, comprehensive clinical documentation, business intelligence or interactive revenue cycle management, our all-in-one platform is built to boost patient engagement and ease provider workloads. That's why therapists prefer us - because leveraging Raintree empowers them to more efficiently manage day-to-day operations, so that they can focus on delivering the highest-quality of patient care.


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