Rehabilitation
Rehabilitation & recovery for ANE patients will vary greatly from person to person. Some progress steps are usually made in the initial weeks after the Acute stage of ANE but many steps are not made for months or even years down the recovery road. In our experience, the earlier and more intensive rehabilitation the better the outcomes. Rehabilitation may include the expertise of the therapies listed below. We encourage the main caregivers to take time out for themselves to better help the patient. Keeping a journal or some video’s to look back on and see progress can be a great encouragement. Never be afraid to question clinicians about any treatment or therapy. You, the carer, know your ANE patient the best.
“Don’t compare progress with another child. Each brain and child recovers at their own pace”.
Sandra – ANE Member
“Be prepared for a long journey & celebrate any milestone no matter how small”.
Nikki – ANE Member
Types Of Rehabilitation
Conventional Therapies
Physiotherapy
Physiotherapy helps restore movement and function of limbs and muscles through movement and exercise, manual therapy, education and advice.
Occupational Therapy
Occupational therapy interventions helps people recovering from injury to regain skills, and providing support when experiencing physical and cognitive changes. It typically provides an individualized evaluation & customized intervention to improve the person’s ability to perform daily activities and reach their goals.
Vision Therapy
Vision therapy is a non-surgical and customized program of visual activities designed to correct certain vision problems and/or improve visual skills. Issues may include vision loss, (cortical vision impairment (CVI) ) and perception.
Serial Casting
Serial casting is a procedure that helps children and adults improve their range of movement. The procedure is the application of a fiberglass cast with padding to hold a part of the body in a position that will stretch a tight muscle. The cast is applied weekly and will stay on for 5-10 days maintaining the muscle in a stretched position. Sequential casts are done for up to three to six weeks to progressively stretch the joint and increase range of motion.
Botox
Serial casting is often used in conjunction with Botox intervention to gain muscle length and reduce tone. Botox therapy is used to treat patients with spasticity that restricts function or causes pain. Botox is a nerve impulse ”blocker.” It attaches to nerve endings and prevents the release of chemical transmitters, which activate muscles.
Orthotics
The term orthosis refers to an externally applied device intended to modify the structural and functional characteristics of the neuromuscular and skeletal systems. An orthosis may be recommended as one of a range of measures to manage the effects of altered muscle tone and associated abnormal postures. The prevention of persistently abnormal postures reduces the risk of musculoskeletal adaptations that lead to fixed structural deformities. Orthoses are often used in conjunction with other interventions such as physical therapy (physiotherapy and/or occupational therapy) or botulinum toxin (BoNT) treatment.
Communication and Cognitive Therapies
Speech Therapy
Speech-language pathologists can assess speech and language development and to treat speech and language disorders. They can also help people with swallowing disorders that can result from the brain injury caused by ANE.
Augmentative and Alternative Communication Service
Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. Special augmentative aids, such as picture and symbol communication boards and electronic devices, are available to help people express themselves. This may increase social interaction, school performance, and feelings of self-worth.
Psychotherapy
In psychotherapy, psychologists apply scientifically validated procedures to help people develop healthier, more effective strategies and habits. There are several approaches to psychotherapy — including cognitive-behavioral, interpersonal and other kinds of talk therapy — that help individuals work through their problems. The kind of treatment you receive will depend on a variety of factors: current psychological research, your psychologist’s theoretical orientation and what works best for your situation.
Complementary Therapies
Individuals with acquired brain injury (ABI) or other special need populations may be unable to exercise on land, but often can do so comfortably in the water. The buoyancy of water causes the individual to feel an upward thrust when submerged. This force acts in the opposite direction of gravity. Buoyancy allows for a variety of exercises to be performed in the pool with minimal equipment. In addition, people with balance deficits may experience less fear of falling while walking and exercising in the pool. Hydrostatic pressure decreases pain and edema, which in turn increases range of motions.
Snozelen Therapy
The Snoezelen Room is a multi-sensory environment filled with lighting effects, shapes, textures, soft music and colours. This multi-sensory room creates a stress free environment designed specifically for individuals with disabilities.
Pet Therapy
Pet therapy is a broad term that includes animal-assisted therapy and other animal-assisted activities. Animal-assisted therapy is a growing field that uses dogs or other animals to help people recover from or better cope with health problems.
Music Therapy
Music purposefully used within therapeutic relationships to support development, health, and well-being. Music therapists use music safely and ethically to address human needs within cognitive, communicative, emotional, musical, physical, social, and spiritual domains.
Art Therapy
A form of psychotherapy involving the encouragement of free self-expression through painting, drawing, or modeling, used as a remedial activity or an aid to diagnosis
Rehab Tips
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Positive Attitude.
- Allow plenty of time for sleep and rest with no distractions – fatigue and it’s management; not just physical, but cognitive is a huge factor in recovery.
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Routine & Structure-Extremely important, allows the brain to rest & time for rehab. A timetable is of great use here.
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Healthy Living (diet, exercise & particularly sleep).
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Family & Pets- Research shows improved outcomes for families that are engaged in the rehab process.
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Support Groups- Creating a social media based group can alleviate some of the pressure for staying in touch with everyone. These play a vital role for patients and their carers to identify with others and feel understood and discuss ways of managing.
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Maintain Friendships – Even a simple phone call, text or email to stay in touch.
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Challenging Behaviour -Identify issues early & develop a positive behaviour support plan.
Neuropsychological Assessments
A neuropsychological assessment aims to gather information about an individual’s cognitive functioning after an ABI. The assessment evaluates functioning in a number of areas including: attention/concentration, speed of thinking, intelligence, learning and memory, language, perception, problem solving, planning, organisation, and mood. Neuropsychological tests are standardised which means that the tests are given in the same manner to all people and scored in a similar manner time after time. An individual’s scores on tests are interpreted by comparing their score to that of non-injured people with similar demographics (e.g. age and education) and to their expected levels of functioning. In this way the clinical neuropsychologist can determine an individual’s profile of strengths and weaknesses to help make a diagnosis and/or develop rehabilitation strategies.
Research shows that motivation is critical to learning a task.
What ANE Families Are Saying
“We used Makaton sign language when our daughter had no speech”.
“Another therapy we have seen great results with is Lokomat. My daughter used it for 5 days in the past (we also used her PoNS device) and will be using it for a 3 week intensive in the future”.
“Our 4 year old woke up out of a coma after 3 weeks and she struggled. She became blind. After another 2 weeks she regained her sight (after they told us it was most likely not possible) and her speech”.
“She can breath on her own during the day, and goes to PT/OT twice a week where they help her stand, kneel, lay on her stomach. She started regressing at home, and we believe it is because she is not able to sleep well. We are hoping she gets accepted for inpatient therapy this summer”.
“Speech therapists, physical therapists, occupational therapists were our lifeline over the 14 years of my daughter’s life. She came back 3 times, thanks to great therapists”.
“She doesn’t need glasses any more but she’s challenged in the sense that she has a hard time locating things in the real world. If you say looks there a bunny and point there’s very little chance she will find it”.
“The effect (and the recovery) all depends which part(s) of the brain are attacked. Our two children both had to learn to do everything again. Their mother is a physio, when they were in a coma, we always figured the one thing we could do was massage them – especially keeping the legs flexible/stretching muscles and keeping joints moving. That made it much easier for them when they were ready to learn to walk again – legs weren’t tightened up. Our daughter has had to learn to walk 4 times now. We do have a wheelchair for her, that helped greatly with cognitive fatigue – something really interesting we took a few years to understand”.
“I was 16 when I had ANE and my parents were told I wasn’t going to make it and that if there was a slim chance I would, I wouldn’t be able to do anything on my own. I ended up walking while still in the hospital”.
“We were lucky that the physical issues resolved quite quickly over a number of weeks. However cognitively there has been quite marked changes. Memory, especially has been affected and how she needs to learn, it can’t be too much at once, it needs to be in small chunks. If too much is happening at once; too many people talking, she can become overwhelmed and her brain can’t cope with all the activity. Getting a neuropsych report was the best thing we did to come up with strategies that will work for her, especially in the class room”.
“We did 20 dives with Hyperbaric Oxygen Therapy for our daughter, it helped with her vision and cognitive awareness”.