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Dec 19 23

Post-Concussion Rehabilitation

by sciasulli

Customized Post-Concussion Rehabilitation

If you are a football or soccer fan, you regularly hear about athletes undergoing concussion protocol. Sports collisions alone are responsible for up to 3.8 million concussions each year.1 A concussion, the result of a hit to the head or a whiplash-like action that shakes the brain, can result from car crashes, bicycle accidents, fall, etc. 

So, what happens to the brain when you get a concussion?

When your head is hit hard, the brain moves against the skull and damages brain tissue, causing a mild traumatic brain injury (mTBI) that can result in temporary loss of some brain functions. Concussion symptoms may appear immediately after the injury or days or weeks later, with the most common being headache, dizziness (a sense of disequilibrium and imbalance more often than vertigo) and nausea.2   It’s important to remember you don’t need to have a loss of consciousness to sustain a concussion. 

Every concussion is a serious injury, so the sooner you are evaluated by a healthcare provider and begin rehabilitation, the sooner your symptoms may resolve with no lasting damage. Most patients will make significant progress with a concussion rehabilitation program, and concussions usually resolve within 1 to 3 months with a personalized rehabilitation program. However, some patients experience long-term physical, cognitive and emotional effects and need a longer-term, specialized plan to treat those symptoms.

Post-concussion syndrome (PCS)

If concussion symptoms persist longer than three months, you may have PCS. Your risk of PCS increases with every subsequent concussion, number of concussion symptoms or a history of behavioral or certain brain-related conditions. If left untreated, PCS symptoms may last years or decades. 

Symptoms of PCS include many typical concussion symptoms but these may also be present:

  • Body temperature irregularities
  • Heart rate issues
  • Gastrointestinal difficulties
  • Blood pressure changes
  • Chest pain
  • Sexual dysfunction
  • Reduced alcohol tolerance

Concussion Rehabilitation

Every concussion’s symptoms are unique, so your post-concussion rehabilitation is customized to treat your specific symptoms. Your health-care team will evaluate your vision, balance and eye movements. They will ask questions about your symptoms and about the event that caused your concussion. If your doctor suspects you have a serious concussion, a CT scan or MRI of your brain may be ordered.

Post-concussion, your brain needs at least a few days to rest, with no intense thinking or physical activity during this time. In fact, resting your brain and giving it a chance to heal is important for any level of concussion. 

After the initial resting period, your concussion rehabilitation will begin and continue until you are symptom-free.

Your post-concussion rehabilitation may include:

  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Vision therapy
  • Balance & Vestibular therapy
  • Headache management
  • Neuropsychology
  • Nutrition counseling

Your health-care team will work with you through the dynamic changes that happen during concussion rehabilitation, to get you back to school, work, exercise, sports and other activities as quickly as possible.

For more information about concussion therapy at Penn Therapy & Fitness, call 877-969-7342 or visit our concussion therapy page.

1. Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil.

2. Physiopedia, Post-Concussion Syndrome.

Aug 8 23

Brain Injury Rehabilitation: What is the best therapy for brain injury?

by Jon Brannan
What is the best therapy for brain injury

A football tackle. A stroke. A combat injury. A car accident. Any of these events can cause a brain injury.  And just as each cause of brain injury is different, so will be its symptoms and the specific therapies needed to resolve them.

What is a brain injury?

Traumatic brain injuries may be caused by a blow or bump to the head, an object piercing the skull, a violent shaking of the head (such as whiplash) or a fall. Non-traumatic brain injuries may be caused by an infection, cancer or an abnormality in one of the blood vessels of within your brain. The symptoms of your brain injury are directly related to the part of your brain that is impacted by the traumatic or non-traumatic event.

What types of therapy are available for brain injuries?

No two brain injuries are alike, each person’s therapy plan is designed to treat their unique symptoms and restore as much physical and cognitive function as possible.

Brain injury treatment at Good Shepherd Penn Partners is managed by a team of professionals trained in brain injury rehabilitation. Your team may include:

  • A physiatrist to oversee your treatment, prescribe medication and manage medical problems.
  • A neuropsychologist to assess your impairment and help you learn coping strategies.
  • Physical therapy to restore sensory deficits and regain strength, coordination, flexibility, range of movement, posture, balance and gait.
  • Occupational therapy to help you relearn daily tasks, such as eating, getting dressed, bathing and grooming.
  • Speech and language therapy to help you regain communication skills that may be diminished and strategies to compensate for those that are lost.
  • Recreational therapy to improve physical, emotional and cognitive function.
  • Psychological counseling to improve your well-being.
  • Cognitive therapy to help improve your memory and attention.
  • Vocational counseling to help you return to work.
  • A social worker to facilitate access to outside service agencies, assist with care decisions and help with communication between care providers.

What is the best therapy for brain injuries?

There is no singular “best” therapy for a brain injury. The best therapy is the therapy that’s right for you, that addresses your unique set of symptoms.

Recovery can be a matter of days or years. However, if it is recommended, it’s crucial to begin inpatient therapy at an inpatient rehabilitation facility such as Penn Medicine Rehabilitation as soon as medically possible. Starting as soon as possible after the injury takes advantage of your brain’s plasticity and its capacity to reorganize its neural networks in response to your injury. After you’re medically stable, outpatient care will help you continue to improve over the subsequent months and if necessary, years.

The ultimate goal of brain injury rehabilitation is to enable you to do what you love and need to do daily (activities of daily living) so that you can return home and live independently and safely.

If you or a loved one have experienced a brain injury, please visit our Brain Injury Rehabilitation Program page or call 1-877-969-7342.

Jun 23 23

What is the Role of Speech Therapy in Brain Injury Recovery?

by Jon Brannan
Senior Couple Relaxing In Autumn Landscape

A brain injury can be a life-changing event. There are two types of brain injury: traumatic and non-traumatic.  Traumatic is caused by an external event such as a car accident or a fall, while non-traumatic brain injuries occur as a result of an event inside your body, like a stroke.

Regardless of the type, when a brain injury occurs, your ability to speak, think, chew or swallow may be affected. Speech therapy is critical in restoring these skills and learning strategies to compensate for any deficits.

What speech disorders occur after a brain injury?

The most common disorders accompanying a brain injury are Dysarthia, Dysphagia, Cognitive-Linguistic Disorder, Aphasia and Apraxia.

Dysarthria

Dysarthria occurs when you have difficulty controlling the muscles used for speech. The inability to control these muscles may cause reduced movement of your lips, tongue and soft palate and problems managing the airflow from your lungs when speaking. Symptoms of dysarthria include slurred or slowed speech that is difficult to understand or difficulty producing varied patterns in tone when speaking.

Dysphagia

Dysphagia occurs when there is weakness in the muscle used in swallowing and/or when the natural timing and coordination of swallowing is impaired.

Cognitive-Linguistic Disorder

Cognition refers to thinking processes that include attention, memory, and executive functioning. A cognitive linguistic disorder may affect your ability to remember important information, reason, or problem solve.

Aphasia

Aphasia is impaired ability to express or understand language. It may also affect your ability to read or write. Aphasia occurs when the left-side portions of your brain responsible for language are damaged.

Apraxia of Speech

Apraxia of Speech is a motor speech disorder caused by the brain’s inability to control the muscles used to speak or the muscles of the lips or tongue. Symptoms of apraxia of speech include an impaired ability to say sounds correctly.

How does speech therapy treat brain injury?

The good news is that speech therapy can treat brain injury and help your recovery in two ways:

1) Restorative therapy: the goal of restoration is to improve the strength of the muscles and coordination needed for speech and swallowing or improve the neuronal connections needed for cognitive linguistic tasks.

2) Compensatory therapy: the goal of compensation is to support speaking, swallowing, and language through implementation of strategies that improve daily life.

A speech-language pathologist (SLP) at Penn Therapy & Fitness will design a therapy program to help improve your abilities impacted by brain injury.  We work to help you regain speaking, swallowing, communication, and cognitive skills that will support your goals in your home environment.

Depending on your diagnosis, your SLP may use exercises to:

  • Help you speak louder
  • Strengthen or coordinate your mouth, tongue, jaw and throat muscles
  • Improve your memory
  • Improve organization and problem-solving
  • Retrain your swallowing function
  • Help you say words clearly
  • Enhance your word choice and tone
  • Integrate augmentative communication like text-to-speech apps
  • Incorporate low-tech communication tools like a whiteboard, images or pen and paper

If you or a loved one has speech, language, swallowing, or cognitive changes due to a brain injury, visit our speech therapy page or call 877-969-7342.

Jun 13 23

Meet the Expert: Jeremy Yves Charles, MD

by Jon Brannan

Brain Injury Rehabilitation Program Director
Penn Medicine Rehabilitation
An inpatient rehabilitation unit of the Hospital of the University of Pennsylvania

“Working with someone to achieve their full potential is a priceless experience.”

Jeremy Yves Charles, MD

After experiencing a brain injury, it can be difficult to find the right resources to help you or a loved one recover. As Director of the Brain Injury Program at Penn Medicine Rehabilitation, Jeremy Yves Charles, MD, oversees the Brain Injury Recovery Center, a program dedicated to the holistic recovery of brain injury patients.  From their Rittenhouse location in Philadelphia, he and a team of therapists, rehabilitation nurses and neuropsychologists help hundreds of patients learn the skills they need to lead productive, fulfilling lives.

Here we learn more about Dr. Charles’ background and why his work is so important to him.

Q. Can you tell us a little about your role?

A. My primary role is to connect patients with the care and resources they need. I spend a lot of time with new patients and their families so I can understand their needs and how to best support them. Those observations allow me and the treatment team to coordinate the best plan of care for each patient and family.

Q. What is a brain injury?

A. There are two primary types of brain injury – traumatic and non-traumatic.  Traumatic injuries occur as the result of an external force like car accidents, falls and sports injuries, while non-traumatic injuries occur as a result of internal conditions such as strokes, vascular malformations (such as aneurysms) and brain tumors

Q. How does brain injury impact patients?

A.  Both traumatic and non-traumatic brain injury can cause debilitation. Sometimes patients have milder symptoms and improve their function quickly. Sometimes patients have severe symptoms and have longer-term issues with cognition, motor and/or sensory deficits and personality changes.

Q. What motivates you?

A. It is really a privilege to do the job I do.  Inpatient rehabilitation can truly make miracles happen. Every day, I get to witness patients get better. Seeing a patient achieve their potential – something as simple as speaking their first words – makes me grateful for the opportunity to play a role in their recovery.

Q. What role can families and caregivers play in recovery?

A. The patient’s caregiver is truly one of the most important parts of the team. We work very hard to educate them about what to expect and how they can support the patient.  The more they understand, the better the outcome.  Caring for someone with a brain injury is definitely an adjustment, so we want to make sure we do everything possible to support that person.

Q. What advice would you offer someone who’s experienced a brain injury?

A. Be patient with yourself and the recovery process. The brain is a complex and amazing organ that can and does recover. Don’t be afraid to ask for help – it’s why we’re here.

Q. What is on the horizon in treating brain injuries?

A. Technology (via new imaging techniques) is helping us better identify the specific pathways involved in brain injuries. As we learn more, we can further target our approaches to optimize outcomes. Technology (i.e. non-invasive brain stimulation) is also key to new therapeutic opportunities. We work closely with the University of Pennsylvania research teams to evaluate the potential of new treatments to help our brain-injured patients.

Jeremy Yves Charles, MD

  • Undergraduate: Cornell University
  • Medical School: SUNY Downstate College of Medicine
  • PM&R Residency: Penn Medicine
  • Neurorehabilitation Fellowship: Brain Injury Medicine: Hackensack Meridian Health JFK Johnson Rehabilitation Institute
  • Professional Memberships: Association of Academic Physiatrists, the American Academy of Physical Medicine and Rehabilitation and the American Board of Physical Medicine and Rehabilitation

To learn more about the Brain Injury Program at Penn Medicine Rehabilitation, visit our web page.

May 8 23

How to Choose an Inpatient Rehabilitation Facility

by Jon Brannan
How to choose an inpatient rehabilitation facility

A severe injury, disease or condition can be life-changing. The quality of care you receive in the hospital and your choice of an inpatient rehabilitation program are crucial for your recovery.

But how do you choose an inpatient rehabilitation facility at a moment like this? You and your family have just been through a life-changing crisis and you may find yourself in unfamiliar territory, unsure of where to turn for help.

Every inpatient rehabilitation facility offers different services, specialization and expertise, so it’s essential to find one that best meets the needs of your recovery. Your choice should have a proven track-record in successfully treating patients with similar conditions to yours. It should also have professionals on staff who will help you address the emotional component of your condition: Does it provide emotional support like neuropsychologists, support groups and similar services to help you navigate the changes in your life?

What is an inpatient rehabilitation facility?

An inpatient rehabilitation facility (IRF) is a type of hospital that provides care and therapy after your health is stabilized in the hospital. An IRF administers therapy to each patient at least three hours a day, five days a week, by licensed therapists who specialize in treating your condition. A highly trained, multi-disciplinary team of therapists, nurses, physicians and physiatrists oversees your care.

What should I look for when choosing an inpatient rehabilitation facility?

During a health crisis, the thought of choosing an IRF can be daunting. Here are six questions to ask to help you make an informed decision:

  1. Does the facility specialize in treating your illness, injury or condition? This is especially critical in the cases of stroke, spinal cord injury, major multiple traumas (multiple injuries at once), brain injury or amputation. The nursing and therapy staff should be specifically trained in the type of care you need.
  2. Does the facility have a successful history of providing physical rehabilitation as its core focus?
  3. Is the program led by doctors who specialize in physical medicine and rehabilitation?
  4. Do they have the highest level of accreditation from an organization like CARF (Commission on the Accreditation of Rehabilitation Facilities)? This official rating is based on high care standards and positive health outcomes.
  5. Does the facility practice individualized care? Do they take your goals, preferences and anxieties into consideration?
  6. Does the facility offer inpatient and outpatient care? If your rehabilitation team can follow you through your outpatient rehabilitation, it will set you up for long-term success.

Why choose Penn Medicine Rehabilitation?

Penn Medicine Rehabilitation offers innovative, individualized rehabilitation programs that meet a high standard for patient safety and care. Our highly skilled nurses, therapists, physiatrists, physicians, neuropsychologists, and case managers are recognized for their excellence in treating spinal cord injuries, traumatic brain injuries, neurological conditions and cancer.

The staff who will treat you at our inpatient rehabilitation facility includes experts who conduct research, author text books and peer-reviewed publications, hold advanced certifications in their fields and are board certified in physical medicine and rehabilitation, physical rehabilitation, and neurology.  You’ll have access to comprehensive, specialized, leading-edge care and will participate in at least 3 hours of therapy 5 days a week, utilizing innovative technology.

Penn Medicine Rehabilitation offers a calm, quiet atmosphere with modern, private rooms and bathrooms to support your healing. To learn more about the benefits of inpatient rehabilitation at Penn Medicine Rehabilitation, visit our web page or call 1-877-969-7342.

Learn more about why you should choose Penn Medicine Rehabilitation for your inpatient care needs.

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