TBI Rehab Support Team
The rehabilitation process following TBI may involve a number of medical specialists and allied health professionals who may work independently or as part of a multi-disciplinary team to assess and treat individuals. Because every TBI is unique, each individual’s rehabilitation journey or requirement may vary. While many of the healthcare professionals are seen in cases for moderate to severe TBI, some may also be useful to consult following mild TBI (concussion).
A neurologist is a medical doctor who has undergone specialised training to diagnose and treat medical conditions that involve the brain, spinal cord, and peripheral nervous system. They do this by obtaining a thorough medical history and performing neurological examinations in which they may examine motor skills, balance, cognitive function, vision, speech and other sensory functions (e.g. smell, touch). Following mTBI, a neurologist may be seen for managing medical conditions such as post-traumatic seizures, and loss of motor or sensory function, as well as symptoms such as headaches, migraines and pain.
A neuropsychiatrist is a medical doctor that has undertaken special training in the assessment, diagnosis, treatment and management of mental and behavioural disorders that result from brain injuries. Following TBI, a neuropsychiatrist may be seen for a number of reasons, including cognitive problems (memory problems, inattentiveness, distractibility), behaviour or mood problems (depression, anxiety, bipolar disorder, inappropriate behaviour, anger management, apathy), as well and sleep disorders (sleep apnoea, insomnia, narcolepsy resulting from TBI). A neuropsychiatrist may monitor diseases arising from TBI, as well as the effectiveness and side effects of any medication that is prescribed.
A psychiatrist is a medical doctor that has completed specialised training in the assessment, diagnosis, treatment and management of mental health conditions. While not all psychiatrists have experience in treating mental and behavioural disorders that arise from brain injury, they may be a useful alternative when the services of a neuropsychiatrist are not locally available.
An endocrinologist is a medical doctor who has had specialised training to diagnose and treat hormone problems. The brain contains two important parts of the endocrine system- the hypothalamus and the pituitary gland. If these structures are damaged or affected by TBI, a person may experience immediate or delayed hormone problems that require medical management.
A Gastroenterologist is a medical doctor who has had specialised training to diagnose and treat gastrointestinal diseases and disorders. They are also able to investigate causes and factors that may contribute to significant bowel dysfunction following TBI.
Geriatrician or Paediatrician
Depending on the age of the individual who has suffered TBI, it may be necessary to involve additional medical doctors that specialise in elderly adult (geriatrician) and child (paediatrician) health. Their input may be needed to navigate other, complex health issues that the affected individuals may be experiencing (e.g. Alzheimer’s disease, mobility issues, growth and developmental disorders).
A Gynaecologist is a medical doctor who has had specialised training in the assessment and treatment of illnesses of the female reproductive organs. Following TBI, it may be necessary for female patients to consult a gynaecologist in conjunction with an endocrinologist if they are experiencing brain injury-related fertility issues or sexual dysfunction.
Pain Management Specialist
A pain management specialist is a medical doctor who has undertaken advanced training in the evaluation and treatment of a wide range of pain problems. Pain management specialists can come from a variety of different medical backgrounds (e.g. anaesthetics, psychiatrists, neurologists, surgeons, rehabilitation medicine, general practice), and treat sudden onset pain problems such as headaches, as well as different types of long-lasting, chronic pain, such as lower back pain. Pain management specialists often use a combination of biomedical (pharmaceutical, devices), psychological and behavioural strategies to help treat, manage and restore balance for individuals living with pain.
An urologist is a specialist doctor who has been trained in the assessment and treatment of kidney, bladder and urinary problems. They also care for men’s sexual and reproductive health. Following TBI, an individual may need to see an urologist for continence issues, adrenal dysfunction, or brain injury-related fertility issues or sexual dysfunction, if they are male.
General Practitioner (GP)
The role of GPs is often determined by the severity of TBI. While GPs are typically not involved in the acute care of moderate to severe TBI, they are often required to manage and coordinate follow-up care. GPs may be seen for cases of mild TBI (concussion), however, they may still refer patients to hospital for additional assessment if necessary.
A sports physician is a medical doctor that specialises in the treatment and prevention of injuries related to sports and exercise. Typically, sports physicians are seen for cases of mild TBI (concussion) that have occurred in sporting contexts, which may or may not be also associated with additional injuries (e.g. broken bones, ACL injury). Sports physicians can help create and advise on return-to-play protocols to ensure that individuals are fully recovered before going back to playing sports and/or engaging in pre-injury levels of physical activity. Sports teams typically have their own Sports Physicians, so if you experienced your mTBI (concussion) while playing a team sport, it is best to check with your team or overarching sporting body to see who they recommend.
Allied Health Professionals
Physiotherapists are health professionals that specialise in treating injuries and health conditions that impact movement. They can diagnose and manage a broad range of conditions involving bones, muscles, nerves and the cardiovascular system. Following TBI, a physiotherapist may suggest exercises or offer treatment to help with physical and/or cardiopulmonary rehabilitation, and pain management, so that the person can become as mobile and independent as possible.
A vestibular physiotherapist is a physiotherapist that specialises in treating and managing inner ear (vestibular) disorders. A vestibular physiotherapist may help alleviate or manage a range of problems that people may experience following a TBI, such as dizziness, balance problems/instability, and vertigo. A vestibular physiotherapist may also offer rehabilitation treatments for visual disturbances (e.g. gaze instability).
Exercise physiologists (sometimes also referred to as exercise therapists) are university qualified allied health professionals that specialise in exercise and movement for the prevention and management of chronic diseases and injuries. While there is some similarity to physiotherapy, exercise physiologist focus on increasing functional capacities and quality of life through exercise programs that are specifically tailored to the unique needs and capabilities of each individual. Exercise physiologists generally do not use ‘hands-on’ treatment methods, like massage, to assist their patients. Following TBI, an exercise physiologist may be consulted to devise exercise programmes and return-to-play strategies.
Respiratory therapists are health professionals that specialise in lung diseases and respiratory (breathing) disorders. They may be medical doctors (pulmonologists), physiotherapists, occupational therapists, or scientists that have completed specialised training in the diagnosis, treatment and management of respiratory conditions. Following TBI, a respiratory therapist may be seen to assess a TBI patient’s respiratory function, help treat dysfunctional breathing patterns through the use of breathing exercises and/or specialist devices, assist with devising rehabilitation programmes to maintain or improve exercise tolerance, as well as reducing thoracic pain associated with breathing.
OT practitioners liaise closely with individuals and their families to identify how a person’s injury affects their daily lives. They also assess their strengths and weaknesses to inform and guide the rehabilitation process. Through the setting of realistic and achievable goals, OTs assist individuals to achieve their highest level of ability and independence so that they can integrate back into their community. OT practitioners can assist individuals with TBI and their families in a number of different ways, including:
- Identifying and teaching memory strategies, such as checklists, planners, and technological devices, to compensate for changes in cognitive abilities (memory and thinking skills).
- Helping develop effective routines and schedules.
- Recommending ways to adapt home and work environments to assist with changes in physical, perceptual, and cognitive abilities.
- Providing training and assisting in adapting or developing compensatory techniques for activities of daily living, such as dressing, bathing and grooming, preparing meals, shopping, managing finances, and caring for children.
- Designing fatigue management plans to ensure that the individual with TBI paces themselves to achieve their goals.
- Assessing sleep hygiene.
- Educating individuals and family members on behavioural changes and identifying techniques to help cope in challenging social situations.
- Facilitate the identification and development of appropriate and fulfilling hobbies or other leisure activities.
Nurse Continence Specialist
A nurse continence specialist is a registered nurse with extensive training in continence (loss of bladder control) care. Nurse continence assess incontinence issues and assist in developing management plans catered to the needs of the individual.
Sleep specialists are health professionals that specialise in sleep disorders. They may be medical doctors, psychologists or scientists that have completed specialised training in the diagnosis, in the diagnosis, treatment and management of sleep-related issues and conditions. Following mTBI, a sleep specialist may be seen for problems such as trouble falling asleep (insomnia), trouble staying asleep, and chronic fatigue.
Speech and Language Therapist
A speech and language therapist is a health professional that specialises in speech and language disorders. Following TBI, a speech and language therapist may be seen to assess and manage speech, language and swallowing disorders. They may also assist in identifying alternative and augmentative ways to help an individual communicate following their TBI, like picture boards or computer-assisted communication devices.
Clinical psychologist are health professionals trained in the assessment, diagnosis and management of mental illnesses and psychological (behavioural) disorders. Clinical psychologists offer psychotherapy (e.g. cognitive behavioural therapy (CBT); Acceptance and Commitment Therapy (ACT)), and may help with cognitive rehabilitation, relationship management, anxiety and stress management. While therapy sessions are generally conducted one-on-one, some may involve relatives and caregivers.
A clinical neuropsychologist is a psychologist who specialises in the assessment and treatment of behavioural, emotional, and cognitive (thinking) problems. A neuropsychologist can assist in the preparation of rehabilitation programs that build upon the person’s existing skills and abilities, and advise on how to reduce some of their difficulties after TBI.
Audiologists are health professionals that specialise in identifying, assessing and managing disorders of hearing and balance. They can also prescribe and fit hearing aid devices.
Optometrists are health professionals that specialise in examining, treating, and managing diseases and disorders of the eye. Following a TBI, an optometrist may prescribe eyewear or recommend exercises for changes or problems with vision.
Following TBI, individuals may experience a range of medical conditions that require treatment with a number of different medications (pharmaceuticals, drugs). In such cases, it may be beneficial to speak to your local pharmacist to develop a pharmaceutical management plan. Pharmacists may also be able to provide further advice on medical products and devices, resources, and the details of local health service providers.
Social workers provide practical advice on issues such as benefits, housing, transport and assistance at home, which may be required following TBI.
Family Members and Friends
Family members and friends play a very important role in the recovery process for individuals who have experienced TBI. In addition to offering support, family members often need to be actively involved in the rehabilitation process to ensure that the rehabilitation programmes and newly learned skills are being followed correctly and maintained at home. Family members are usually invited to participate in formal meetings with staff members to keep them informed of their relative’s progress. Sometimes, family members and/or friends may need to advocate for the person with TBI when their loved one is unable to make decisions for themselves. A good working relationship between the family and the rehabilitation team is an important factor in helping the person with TBI make the best recovery.
Relatives and friends may sometimes need to learn new skills so that they can help provide the best support for the person with TBI. However, it is important that the family member does not become a ‘therapist’, and instead are encouraged to focus primarily of their role as someone who provides love and affection.
Disclaimer: This website does not offer medical advice for individuals. If you have suffered a TBI, please seek medical attention.