What it is
A short, honest summary.
- —TBI is brain damage from an external force — a road traffic accident, a fall, a sports impact, an assault.
- —Injuries are classified mild, moderate, severe — but every TBI is its own picture.
- —Effects span movement, cognition, behaviour, fatigue, sleep, and mood. Rehabilitation is multi-disciplinary.
What families notice
The signals worth taking seriously.
- 01Persistent headache, dizziness, or fatigue weeks after the event
- 02Memory or concentration changes
- 03Mood swings, irritability, or low motivation
- 04Sleep disturbance or sensitivity to light and sound
- 05Difficulty with the level of activity that was easy before
My approach
How the work is structured.
- —Cognitive-physical rehabilitation paced for fatigue management.
- —Goal-directed motor training — balance, gait, fine motor work.
- —Vestibular work where dizziness is part of the picture.
- —Coordination with the neurologist, psychologist, and occupational therapist.
What recovery looks like
A plain-language picture.
“TBI recovery is non-linear. Plateaus are real, but so are breakthroughs years out. The brain continues to repair on a slow, persistent timeline.”
FAQ
Common questions, answered briefly.
- I had a 'mild' concussion three months ago and still feel off. Is this normal?
- Yes, persistent post-concussion symptoms are common and treatable. Vestibular, visual, and cognitive work usually resolves the picture.
- Can severe TBI patients live independently again?
- Many do, with sufficient time and the right rehabilitation. We set near-term goals and re-evaluate honestly.
For clinicians
Clinical detail, assessment and evidence.
Clinical summary
The picture in clinician register.
TBI produces a heterogeneous picture of focal and diffuse injury — contusion, diffuse axonal injury, and secondary insult from oedema and hypoxia. Rehabilitation-relevant sequelae span motor, cognitive, behavioural and autonomic domains, with fatigue and poor exertion tolerance as cross-cutting limiters. Recovery is non-linear over months to years; intensity is titrated against cognitive and autonomic load, not motor capacity alone.
Terminology
Terms worth being precise about.
- Post-traumatic amnesia (PTA)
- Period of impaired memory after injury; its duration is a key severity and prognostic marker.
- Diffuse axonal injury
- Widespread shearing of axons; a common substrate of cognitive and arousal deficits.
- Paroxysmal sympathetic hyperactivity
- Episodic autonomic storming after severe TBI; activity must be paced around it.
- Executive dysfunction
- Impaired planning, initiation and self-monitoring; shapes how programmes are structured.
Assessment & measures
What the first sessions measure.
- —GCS and PTA duration as severity anchors; Rancho Los Amigos level for cognitive stage.
- —Functional status with the FIM; high-level mobility with the High-Level Mobility Assessment Tool where appropriate.
- —Balance with the Berg Balance Scale; vestibular and oculomotor screen where dizziness features.
- —Graded exertion tolerance — symptom response, not motor capacity, sets the ceiling.
Red flags
Signs that need urgent escalation.
- Progressive headache with vomiting or a falling level of consciousness — raised intracranial pressure.
- New seizure activity.
- Pupillary asymmetry or a rapidly worsening focal deficit.
- CSF leak from the nose or ear after a skull-base injury.
Referral & MDT
When and to whom to refer.
Neurosurgery for any deterioration. Neuropsychology for cognitive and behavioural rehabilitation; speech-and-language therapy and occupational therapy; physiatry for spasticity management; vocational rehabilitation to support return to work.
Evidence
References and guideline anchors.
- Multidisciplinary TBI rehabilitation outcomes — PLACEHOLDER — verify against current guidelines before launch.