Acquired brain injury (ABI) encompasses any brain injury occurring after birth, including stroke, traumatic brain injury, hypoxic brain injury, and injury caused by tumour, infection, or surgery. The long-term consequences of moderate to severe ABI can be profound and wide-ranging.

The Stages of Recovery

In the acute phase, the priority is medical stabilisation and prevention of secondary injury. As the person emerges from altered consciousness, the focus shifts to early rehabilitation — preventing complications, promoting arousal, and beginning to restore basic function. The post-acute and community rehabilitation phases are where the greatest functional gains are typically made. Neuroplasticity underpins recovery and is maximised by intensive, meaningful, repetitive practice.

The Role of Physiotherapy

Physiotherapy after ABI addresses the physical consequences of injury including weakness, spasticity, balance impairment, coordination difficulties, fatigue, and reduced mobility. Goal-setting is central — goals should be meaningful to the individual, SMART, and developed collaboratively with the patient, family, and wider multidisciplinary team.

References

Cicerone, K.D. et al. (2011). Evidence-based cognitive rehabilitation: updated review of the literature. Archives of Physical Medicine and Rehabilitation, 92(4), 519–530. https://doi.org/10.1016/j.apmr.2010.11.015

Masel, B.E. & DeWitt, D.S. (2010). Traumatic brain injury: a disease process, not an event. Journal of Neurotrauma, 27(8), 1529–1540. https://doi.org/10.1089/neu.2010.1358

Turner-Stokes, L. (2009). Goal attainment scaling (GAS) in rehabilitation: a practical guide. Clinical Rehabilitation, 23(4), 362–370. https://doi.org/10.1177/0269215508101742

NICE (2014). Head Injury: Assessment and Early Management. Clinical Guideline CG176. https://www.nice.org.uk/guidance/cg176