What to expect

Exercise plays an important role in ABI recovery

 

Contributed by Helen Rousso, Medical Exercise Specialist/Nutritionist

Following a brain injury, individuals who exercise are typically less depressed and report better quality of life than those who don’t exercise.

A safe and effective exercise program can play a very important role in the rehabilitation process following a brain injury.  Regular physical activity can help improve your balance and coordination, reduce reliance on assistive devices, and enhance your ability to do daily activities and thus remain independent.

The key is to determine what type of exercise is best for you and to follow a program that accommodates and addresses your special medical concerns.

Range of motion exercises are a type of physical therapy that keeps the joints mobile and functioning. Range of motion exercises can be done by the individual, or with help from physical therapies in a method known as passive range of motion. Range of motion exercises help maintain strength and can be separated into short or long term goals.  Such exercises as simply extending and flexing the forearm or the lower leg help to maintain muscle tone and functioning ligaments and tendons that enable you to gradually regain strength or function of the limb over time.

One may recover from a traumatic brain  injury (TBI) more quickly if they 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.

In one of his studies, A sample of 240 individuals with traumatic brain injury (TBI) (64 exercisers and 176 nonexercisers) and 139 individuals without a disability (66 exercisers and 73 nonexercisers).

It was found that the TBI exercisers were less depressed than nonexercising individuals with TBI, TBI exercisers reported fewer symptoms, and their self-reported health status was better than the nonexercising individuals with TBI. There were no differences between the two groups of individuals with TBI on measures of disability and handicap.

In conclusion, the findings suggest that exercise improves mood and aspects of health status but does affect aspects of disability and handicap.

Getting Started

-Talk with your healthcare provider before starting an exercise program and ask for specific programming recommendations.
-Take all medications as recommended by your physician.
-The goals of your program should be to improve cardiovascular fitness, increase muscle strength and endurance, improve flexibility, and increase independence, mobility and ability to do daily activities.
-You may find that it is easier to focus on your exercise if you avoid busy, crowded locations.
-You may need to do some exercises such as cycling or walking with a work-out buddy if you have difficulty with balance or with finding your way throughout a community.
-Choose low-impact activities such as walking, cycling or water exercises, which involve large muscles groups and can be done continuously.
-Start slowly and gradually progress the intensity and duration of your workouts. -If your fitness level is low, start with shorter sessions (five to 10 minutes) and gradually build up to 20 to 60 minutes, three to five days per week.
-Perform resistance-training and stretching exercises two days per week.
-Take frequent breaks during activity if needed.

Exercise Cautions

-Avoid exercises that overload your joints or increase your risk of falling.
-Begin each exercise in a stable position and monitor your response before proceeding.
-Reduced motor control in your limbs may restrict your ability to do certain exercises.
-Exercise equipment may need to be modified to accommodate your specific needs.
-Always wear protective headgear when cycling or doing any other activity in which a fall is possible because the rate of a second head injury is three times greater after you have had one head injury.
-Don’t hesitate to ask for demonstrations or further explanations about how to perform exercises properly.
-Your exercise program should be designed to maximize the benefits with the fewest risks of aggravating your health or physical condition.

Who your team is and what they do

When someone suffers a brain injury, they and their loved ones are thrust into a confusing situation where they will be surrounded by many unfamiliar people. Each of these people will play an important role in the patient’s recovery and rehabilitation.

(M.D.) – The Physiatrist is a physician who is a specialist in physical medicine and rehabilitation. The physiatrist is the Team Leader who directs your care.

(RN) – Your Nurse is also a very important person. She/he will:

  • Assess you physically and obtain pertinent information necessary to design your personal care plan
  • Take care of you and instruct you and your family so that you will be as independent as possible. The concept of independence is very important for you and your family to understand, as nursing care is based on this goal. Your nurse will encourage you to do as much for yourself as possible – and then some!
  • Follow through with your other therapists’ recommendations for your care. After the first few days, you will be given a daily therapy schedule. You will be expected to keep your therapy appointments on your own whenever possible. If you are unable to get to your therapy appointments independently, a transporter will assist you.

The Case Manager is a vital member of your rehabilitation team. She/he will assist you with many aspects of your care, such as preparing and implementing your discharge plan, arranging meetings with you and your family, arranging a schedule for family observation and training days, working with other interdisciplinary team members, and working with your insurance carrier to communicate the rehab team’s short and long term goals. Your case manager will also arrange any equipment and/or home modifications that may be necessary.

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