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Changes After a Brain Injury

Physical Changes after a Brain Injury

​​​A brain injury may damage the pathways that have to do with movement. If this is the case, a physical therapist will assess the person’s physical status and abilities.

After the assessment, a treatment program is created that that fits the person’s needs.

The areas assessed are:

  • sensation
  • inner ear function
  • muscle tone and strength
  • range of motion
  • posture
  • endurance
  • motor control, balance, and coordination
  • functional mobility—bed mobility, transfers, walking, stair climbing


Sensation tells us about how we are moving, what we’re feeling, and what’s going on around us. Forms of sensation include light touch, pain, temperature, moving joints and muscles, and vision.

This may involve being able to sense movement or position, to feel changes in temperature, or to feel touch to the affected part of the body.

It also makes it harder to re-learn movement, since the sensation of movement is gone. Movement information must be sensed by thinking about the movement first.

Losing sensation can be a very serious safety issue because he may not be able to feel an injury.

It’s important to know what types of sensation have changed to help him stay safe. For example, if he can’t feel hot or cold, ask him to use his unaffected body part to check the water temperature before a shower. Your healthcare team can help you learn ways to manage sensation changes.

Muscle tone, strength, and co-ordination

Muscle tone is the amount of tension in a muscle when at rest. When muscle tone is normal, the limbs and body feel easy to move. A brain injury may damage the normal control of muscle tone. This may cause decreased muscle tone—the limbs feel floppy and heavy (hypotonicity) or more than normal muscle tone—the limbs feel stiff and tight (hypertonicity). Both affect the person’s ability to control movement.

After a brain injury, muscles may show different degrees of weakness. Some muscles may be stronger in one limb than another. Damage to certain parts of the brain may result in slow, jerky, or uncontrolled movements. You may hear the terms:

  • hemiparesis: muscle weakness on one side of the body only
  • hemiplegia: muscle paralysis (no movement) on one side of the body only


The head and neck give the eyes, mouth, and tongue a stable base. The trunk (the body between the shoulders and hips) gives us a stable base so we can use our arms and legs.

To move normally, the head, neck, and trunk need to be properly positioned when standing and sitting. A brain injury can affect the muscles that control head, neck, and trunk positions. It can also affect the sense of what is midline or upright.

This may be caused by wrong information coming from the senses about position, limited range of motion, abnormal muscle tone, pain, or weakness. It can also be caused because the person had a poor posture before the brain injury. If posture is abnormal or poor, you can help by asking the person to concentrate on what he feels, reminding him to visually check how he’s sitting, or standing, or by physically helping him into the correct posture.


Our brain and nervous system is always making adjustments so that we keep our balance. If the ability to balance is affected after a brain injury, the person may react too fast, too slow, or not at all. To improve balance, therapy may involve practicing in different situations (for example, walking on different surfaces like carpets, tile, rough concrete, and snow). For more information on balance problems, go to Balance Problems after Brain Injury.


Endurance is the strength one has over time. It can be measured how well the person tolerates a treatment or an increase in the treatment (for example, first make him walk further then make him walk faster).

Please talk to your healthcare provider, such as a physiotherapist or occupational therapist, for tips on how to help someone who has physical changes after a brain injury.​​

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