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Changes after a brain injury

Physical changes

A brain injury may damage the pathways that allow you to move. If this happens, a physical therapist will assess changes in movement, sensation, strength, and other physical abilities (like walking and balance). They can then make a treatment program that fits your needs.

Changes in sensation

Sensation tells you how you’re moving, what you’re feeling, and what’s going on around you. It also tells you where you’ve moved your body, if there is a change in temperature, or if something is touching you.

When you have changes in sensation, it makes it harder to relearn a movement. This is because the sensation of movement is gone.

Loss of sensation can be a very serious safety issue since you may not be able to feel if you get hurt.

It’s important to know what types of sensation have changed after a brain injury to help keep you safe. For example, if you can’t feel hot or cold on one side of the body, you’ll need to use the other side or a different body part to check water temperature before you shower.

Your healthcare team can help you learn ways to deal with sensation changes.

Changes in muscle tone, strength, and coordination

Muscle tone is the amount of tightness (tension) in a muscle when it’s at rest. When your muscle tone is normal, your arms, legs, and rest of your body feel easy to move. A brain injury may damage the normal control of muscle tone so your legs and arms may feel:

  • floppy and heavy (if you have less muscle tone)
  • stiff and tight (if you have more muscle tone)

Having less or more muscle tone than normal can prevent you from controlling body movement.

A brain injury may also cause:

  • muscles to be weaker or stronger than others
  • slow, jerky, or uncontrolled movements
  • muscle weakness on one side of the body (called hemiparesis)
  • muscle paralysis (no movement) on one side of the body (also called hemiplegia)

Changes in posture

A brain injury can affect the muscles that control our posture. This is the position that you hold your head, neck, and trunk (the part of the body between the shoulder and hips) in. A brain injury can affect where you feel the midline of your body or if you’re upright.

Changes in posture may be caused by a limited range of motion, abnormal muscle tone, pain, weakness, or your senses giving wrong information about your position. But it can also happen if you had poor posture before the brain injury.

Changes in balance

Your brain and nervous system is always making adjustments to keep your balance. If a brain injury affects your balance, you may react too fast, too slow, or not at all.

Therapy can make your balance better. It may involve having you walk on carpets, tile, rough concrete, snow, and other surfaces.

Changes in endurance

Endurance is the strength you have over time. It can be measured by how well you handle more activity or treatment over time (such as walking further or faster).

Tips for family and caregivers

To help someone with poor posture:

  • ask them if they feel like they’re stronger on one side, leaning one way, or are upright
  • remind them to check how they’re sitting or standing
  • show them how or help them to get into a better posture

Talk to a healthcare provider, such as a physical therapist or occupational therapist, about how to help someone with these physical changes after a brain injury.

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