Traumatic brain injury, or TBI, results from a sudden trauma that causes damage to the brain. It can occur when your head is hit suddenly and violently or when an object pierces your head and enters your brain. TBI has taken a huge toll on soldiers; auto accidents are responsible for many other TBIs, which are classified as mild, moderate and severe. These classifications are a bit misleading, as the symptoms for mild TBIs---ranging from confusion to behavioral changes to dizziness to difficulties with memory, attention span and thinking---are serious and may be permanent. Moderate to severe TBI symptoms include slurred speech, loss of coordination, confusion and agitation.
Cognitive Rehabilitation Therapy
Cognitive rehabilitation therapy, or CRT, is a comprehensive approach to rehabilitation for TBI patients. It includes physical therapy, speech therapy and psychiatric care for conditions ranging from depression to post-traumatic stress disorder. Dr. Darryl Kaelin, medical director at Shepard's Center in Atlanta, a facility for treating TBI patients, says, "CRT is not a single thing, it's not a procedure. There's a science here, but it's wrapped around an art." CRT is expensive, and insurance coverage or coverage by the Veterans Administration for individualized care is often lacking.
Mental Rehabilitation
You can perform many exercises if you are trying to regain your cognitive function after a TBI. An example from the University of Alabama at Birmingham's Traumatic Brain Injury Model System center focuses on spatial ability and writing skills. At level 1, the clinician will ask you to copy different shapes on paper, including straight lines, circles, squares, triangles and letters of the alphabet. At level 7, the highest, you will write thank-you letters to friends and relatives.
Physical Exercise
You may recover from a TBI more quickly if you exercise. As "The New York Times" reported in 1997, TBI patients who exercise are "significantly less depressed, better at cognitive thinking and physically healthier" than those who do not. Neuropsychologist Wayne Gordon indicates that patients who maintained their exercise routine had to display discipline, focus and motivation---attributes that carried over to the rest of their rehabilitation.
Identity and Cognitive Skills
Physicians at the Northeast Center for Special Care in New York, a highly advanced rehab facility for TBI, believe that restoring self-awareness, identity and the ability for reflection is crucial to the success of your TBI rehabilitation. You or your therapist may write out a first-person narrative of what happened to you, what you are working on in CRT, and what your long-term goals are. You then present the narrative to your family members and friends. Once you begin to internalize your story, it creates a basic sense of identity, and you may become more spontaneous, sociable and hopeful. A variety of activities can advance cognitive skills, including video and board games, sports activities, painting, singing, crafts, art, dance and writing.
References
- National Institute of Neurological Disorders and Stoke: Traumatic Brain Injury Information
- University of Alabama at Birmingham Traumatic Brain Injury Model System: Tasks for Home-Based Cognitive Stimulation Program
- "The New York Times": Sports Medicine; Study Suggests That Exercise After Brain Injury is Beneficial; Grace Lichtenstein; Nov. 1997
- Northeast Center for Special Care: Cognitive Impairment and Cognitive Rehabilitation after Traumatic Brain Injury
