Have you been told you may have had a concussion or a mild traumatic brain injury (mTBI) that doesn't feel mild? You are not alone. By definition, traumatic brain injury (TBI) arises from external forces or actions that cause the brain to move against the skull or be penetrated. This can occur in sports, automobile accidents, unintentional falls, gunshot wounds, assaults but the majority of TBI that result in hospitalization are from falls and motor vehicle accidents.
A TBI is classified as mild (mTBI), moderate or severe. A concussion falls under the mildTBI category but does not mean the symptoms are mild. A mTBI can result in physical, visual, auditory, cognitive and emotional problems that interfere with someone's ability to participate in their usual daily activities.
The people at the highest risk of sustaining a TBI requiring hospitalization are people over the age of 75 and males. These injuries were mostly causes by unintentional falls and car accidents. TBI is most common amongst people ages 15 to 24 years old. For additional statistics on brain injury visit Brain Injury Canada (www.braininjurycanada.ca) or Center for Disease Control (CDC) (www.cdc.gov /traumaticbraininjury).
The Centre for Disease Control (CDC), also provides useful information on Brain Injury including monitoring, prevention and links to apps for training and concussion identification.
PROGNOSIS
Once a diagnosis of concussion or TBI is made it is important to follow the recommendations of your treating family doctor or specialist and maintain regular follow-up to monitor symptoms. The majority of individuals diagnosed with a concussion or mTBI will have a full recovery within six weeks; however, a small percentage may continue to experience disruptive symptoms and require additional medical care and specialized rehabilitation services. Spontaneous recovery or natural healing of the brain tends to occur within the 18 to 24 months after a moderate to severe TBI, but adaptations will continue to occur that may improve daily functioning.
Many personal factors can speed up or prolong recovery. Recovery tends to be slower in adults over the age of 40. Other factors that impact recovery including: low blood pressure, loss of oxygen to the brain, severity of the injury, prior head injuries, mental illness and other health factors. At Turning Point, we identify risk factors early in the recovery process and belief in early intervention to help the recovery process.
ASSESSMENT
Occupational therapists (OTs) are trained to identify the physical, cognitive and emotional impairments that are restricting participation in daily activities. The assessment process typically begins with a referral from a family physician, insurance company, lawyer, other therapists or a self-referral. Turning Point provides in-home assessments consisting of interview, testing, observations and consultation with other team members to provide a coordinated recovery progress.
TREATMENT
Occupational therapists develop physical activation and cognitive rehabilitation programs while recognizing the psychological impact of the injury. Education is key and other functional activities are designed within a community-based rehabilitation program to optimize recovery. OTs are responsible for the assessment and planning of rehabilitation programs, and OT Assistants (COTAs) help reinforce the strategies taught by the OT. For example, if memory is an issues, the OT will determine a targeted intervention and set up repeated sessions with the client and COTA. The COTA may review use of memory strategies such as establishing a routine; use of assistive technology such as a smart phone or smart watch to set reminders; remediation activities such as challenging the memory through memory exercises; and functional activities such as creates to-do or other lists to participate in weekly grocery shopping or work tasks.
For those with moderate to severe TBI, treatment is likely to be prolonged and may also include wheelchair and seating assessments, recommendations for home modifications, assistive technology and home support services.
RESOURCES
There are many online and local resources to help support those who have experienced a TBI. Our OTs often provide clients with support group information, apps available for smart phone, virtual exercises options, etc. Some clients require OT assistance to apply for disability services such as government benefit programs or school accommodations. Our OT practitioners love what we do and are available to take your questions and try to help you get the services you need to improve recovery and daily functioning. We take self-referrals and will attempt to secure funding for services if needed.