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It is Action for Brain Injury Week and today we are looking at the importance of rehabilitation.

There are two types of brain injury: traumatic brain injury and acquired brain injury. Both inevitably disrupt the brain’s normal functioning and can be life changing.

  • Traumatic Brain Injury (TBI) is caused by an external force such as a blow to the head.
  • Acquired Brain Injury (ABI) occurs at the cellular level. It is most often associated with pressure on the brain.

The severity of brain damage will inevitably vary depending upon the type of brain injury. With a severe brain injury, there will often be life-changing and debilitating problems which may include cognitive, behavioural, and physical disabilities.

Causes of traumatic brain injury include road traffic accidents, blows to the head, sports injuries, falls or accidents and physical violence

Causes of acquired brain injury include poisoning or exposure to toxic substances, infection, strangulation, choking, or drowning, strokes, heart attacks, tumours, aneurysms, neurological illnesses and abuse of illegal drugs.

What is clear with any brain injury is the need for neurorehabilitation. Neurorehabilitation can avoid or minimise disability and optimise recovery. Early access to specialist and/or community neurorehabilitation are critical. Sadly, we know that gaining access to essential specialist services and rehabilitation can often be difficult.

An interesting read is the All-Party Parliamentary Group on Acquired Brain Injury and the UK Acquired Brain Injury Forum report published in September 2018. That informative report entitled “Acquired Brain Injury and Neurorehabilitation, Time for Change” made a number of recommendations relating to neurorehabilitation and other issues. In an application made to the Backbench Business Committee for a debate on this important issue, Mr Bryant (Chair of the APPG on Acquired Brain injury) highlighted the report and stated: “There are 1.4 million people living with brain injury in this country. One of the great successes of the past few years has been that we save more lives from road traffic accidents than previously—about 800 more lives a year—but unfortunately we are not able in all instances to give people the quality of life that would benefit them, because there is simply not enough neuro-rehabilitation available around the country”

This is a massive problem. Figures taken from the report suggest that total ABI hospital admissions have increased year on year. The recorded level in 2017/18 was 304,800 admissions. Notwithstanding clear pathways for assessment, treatment and rehabilitation laid down by NICE (the National Institute for Clinical Excellence) and proven benefits of neurorehabilitation investment in in-patient neurorehabilitation beds and service provision are said to remain inadequate and variable across the United Kingdom.

So what is neurorehabilitation? Neurological rehabilitation is provided by a team of clinicians and specifically trained staff across a wide range of disciplines. These include:

  • Rehabilitation Medicine
  • Occupational Therapy
  • Physiotherapy
  • Speech & Language Therapy
  • Neuropsychology
  • Neuropsychiatry
  • Nursing
  • Rehabilitation/Therapy Assistants

Other disciplines also support elements of the neurological rehabilitation programme where needed for example; dieticians, chefs, art and music therapists, general practitioners, other health and social care professionals.

In circumstances where a personal injury compensation claim arises following an acquired brain injury use of the Rehabilitation code enables the collaborative use of rehabilitation and early intervention in the compensation process. The purpose being to help the injured claimant make the best and quickest possible recovery. This means ensuring that his or her need for rehabilitation is assessed and addressed as a priority. Even where there is no agreement on liability, the parties may still agree to use the code. With rehabilitation a post code lottery it is essential that the claimants solicitor considers, as soon as possible in every claim whether additional medical or rehabilitative intervention would benefit the claimant and to seek to arrange it.

The journey to recovery following an acquired brain injury can be long and hard. Stories of those affected by brain injury are many. For some the impact can be lifelong with ongoing complaints of fatigue, heightened sensitivity and daily struggles to get through each day, even making choices as to what to eat can be overwhelming. Helping those affected to get back to some normality is a privilege and demands commitment and genuine expertise.