Brain Injury Prevention and Post-Injury Care

  •   July 15, 2014
  •  Leanne Loranger, PT


It is estimated that every hour, six Canadians sustain a brain injury.5 Brain injury can range from a mild injury to a major trauma requiring hospitalization and extensive rehabilitation.1,2 The most common causes of head injury are falls, motor vehicle accidents and sport/recreational activity related injuries.3 Regardless of the severity, the challenges faced by individuals who have sustained brain injuries, such as concussions,  can include issues with: memory and thinking, movement, and speech as well as personality changes.1,2 Brain injuries are often described as ‘invisible injuries’ with many of the symptoms being ascribed to a personality choice, rather than an injury or impairment.2,4

Brain injuries can also impact the person’s ability to work, socially interact with others, or be able to participate in activities they once enjoyed. They may experience the loss of close personal relationships and struggle with the financial impacts of their injury.2,3,4

In Canada it is estimated that about 200 of every 100,000 people who sustain a head injury require hospitalization, however, the true incidence of brain injury is not known, as data is not collected for those who do not enter the hospital system.2 There are an estimated 2,200 major head injury cases requiring hospitalization in Alberta each year,6 with more than 1,000 individuals requiring rehabilitation services.2

Evidence is mounting that concussions can result in significant, lasting brain injury.1 The culture around sport-related concussion has seen a significant shift in the last several years from an attitude of having had “your bell rung” to recognizing the importance of properly managing concussion injuries.6 Prevention of sport-related concussion through changes to rules of sport such as ‘no-checking’ leagues and changes to the rules of hockey, participant and coach education and awareness are having an impact.8

It is important to know that concussions can occur outside sports from something as simple as a bump or blow to the body, head or face or a fall.6 A loss of consciousness is not necessarily a marker of a concussion. Click here to see a list of concussion signs.
 

Prevention tips

The primary causes of brain injury are falls, motor vehicle accidents and sports-related injuries; in many cases these injuries are preventable.3 The statistics on traumatic brain injury and concussions are improving, thanks to efforts directed at changing the behaviours leading to brain injury helmet use, seat belt use, fall prevention programming and no-hit hockey.3,8 However, there is still room for improvement.

The Alberta Centre for Injury Control & Research6 and Parachute9 provide these tips for how can you ‘injury proof’ yourself:

In the car:

  1. Wear a seat belt and secure children in an appropriate infant or child safety seat
  2. Don’t drink or use drugs and drive
  3. Drive the speed limit
  4. Give driving your full attention


At home, prevent falls in adults by:

  1. Staying active
  2. Watching your step
  3. Talking to your doctor about dizziness
  4. Reviewing your medications


Prevent childhood injuries by using:

  1. Window guards and safety gates to prevent falls in babies and young children
  2. Safety straps in child swings, high chairs, shopping carts and strollers


At play:

  1. Wear a bike helmet and do it up!
  2. Check to make sure your sports helmets fit properly and replace them when worn out or damaged. One impact is often enough to damage sports helmets and require replacement.
  3. Check the playground for hazards. Ensure that equipment is safe and that there is a deep, soft surface to land on in the event of a fall.


How physiotherapy can help

Physiotherapists often work with individuals who have sustained a brain injury and have ongoing movement problems. Physiotherapy after brain injury targets the unique and specific physical problems arising from the injury as well as treating some of the root causes of injury, such as balance and fall prevention programs, and vestibular rehabilitation (to treat dizziness) with good success.10,11 Physiotherapy in the area of concussion management focuses on the treatment of neck symptoms that may be contributing to concussion related symptoms as well as balance retraining, advice on general conditioning, and assessments of attention and cognitive function.12

To find a physiotherapist that treats brain injuries, click here.


References:

  1. Neurological Health Charities Canada. Brain Injury [Internet]. [Toronto]: [publisher unknown]; 2010 [cited 2014 July 8]. Available from: http://www.mybrainmatters.ca/condition/brain-injury
  2. Northern Alberta Brain Injury Society. Insight into brain injury [Internet]. [Edmonton] : [publisher unknown]; 2001 [cited 2014 July 8]. Available from http://66.181.209.104/files/brochures/insight.pdf
  3. Canadian Institute of Health Information. (2006). Analysis in brief: Head injuries in Canada: A decade of change (1994-1995 to 2003-2004) [Internet]. [Ottawa]: [publisher unknown]; 2006 [cited 2014 July 8]. Available from: https://secure.cihi.ca/free_products/ntr_head_injuries_2006_e.pdf
  4. Theobald C. While untold numbers go untreated, Edmonton’s Brain Care Centre’s concussion program struggles to keep up with demand [Internet]. Edmonton: Edmonton Examiner; 2014, June 18 [cited 2014 July 8]. Available from: http://www.edmontonexaminer.com/2014/06/18/while-untold-numbers-go-untreated-edmontons-brain-care-centres-concussion-program-struggles-to-keep-up-with-demand
  5. Brain Injury Association of Waterloo-Wellington. Stats [Internet]. [Kitchener]: [publisher unknown]; 2012 [cited 2014 July 8]. Available from: http://www.biaww.com/stats.html
  6. Alberta Centre for Injury Control & Research. Take action to prevent brain injuries. [Internet]. [Edmonton]: [publisher unknown]; 2014 [cited 2014 July 8]. Available from: http://acicr.ca/Upload/TAKE-ACTION/HeadInjury2013.pdf
  7. Cummings, R.G. A blow against brain care. Edmonton Journal [Internet]. [Edmonton]: [Edmonton Journal]; 2012 [cited 2014 July 8]. Available from: http://www2.canada.com/edmontonjournal/news/opinion/story.html?id=905398b7-1dc6-4d58-8b71-4488ef7a90dc&k=7938
  8. Hockey Canada. Concussions. Hockey Canada [Internet]. [Calgary]: [publisher unknown]; 2014 [cited 2014, July 15]. Available from: http://www.hockeycanada.ca/en-ca/hockey-programs/safety/concussions/facts-and-prevention.aspx
  9. Parachute. Concussion Toolkit: Roles and responsibilities of parents and atheletes. [Internet]. [Toronto]: [publisher unknown]; 2014 [cited July 15, 2014]. Available from: http://www.parachutecanada.org/active-and-safe/item/roles-and-responsibilities-of-parents-and-athletes
  10. Chartered Society of Physiotherapy. Physiotherapy works: rehabilitation. [Internet]. [London]: [publisher unknown]; 2014 [cited 2014 July 8]. Available from: http://www.csp.org.uk/professional-union/practice/your-business/evidence-base/physiotherapy-works/rehabilitation
  11. Chartered Society of Physiotherapy. Physiotherapy works: Vestibular rehabilitation. [Internet]. [London]: [publisher unknown]; 2014 [cited 2014 July 8]. Available from: http://www.csp.org.uk/professional-union/practice/your-business/evidence-base/physiotherapy-works/vestibular-rehab
  12. Schneider KJ, Iverson GL, Emery CA, McCrory P, Herring SA, Meeuwisse WH. The effects of rest and treatment following sport-related concussion: A systematic review of the literature. Br J Sports Med. 2013; 47:304-307.