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Brain Injury

Brain Injury

Many types of brain injuries exist, however, brain injuries are commonly categorised as traumatic or acquired.

Traumatic brain injuries (TBI) - a traumatic brain injury is the result of a blow to the head which might be caused by anything from a simple trip, a collision on the sports field to a major road accident or assault. TBIs are usually classed as mild, moderate or severe.

There are many different types of brain injury that can occur as a result of a TBI:

  • Concussion - the most common brain injury, and often described as a ‘mild injury’
  • Closed head injury - occurs where there is impact without breaking the skull
  • Penetrating head injury - occurs when an object fractures the skull and enters brain tissue
  • Diffuse brain injury - occurs when the brain moves within the skull when the head is shaken
  • Brain contusion - describes a bruised or swollen brain tissue that occurs when the skull cracks or breaks.

Acquired brain injuries (ABI) - An ABI is an injury that occurred at or since birth. Whilst that does include TBIs, it is more commonly used to refer to injuries due to, for example, an infection, stroke, drugs, physical injury or a lack of oxygen during birth (hypoxia).

Symptoms commonly associated with mild traumatic brain injury

Physical symptoms

  • Headache
  • Nausea or vomiting
  • Fatigue or drowsiness
  • Problems with speech
  • Dizziness or loss of balance

Sensory symptoms

  • Blurred vision, ringing in the ears, bad taste in the mouth or changes in the ability to smell
  • Sensitivity to light and sound

Cognitive, behavioural or mental symptoms

  • Loss of consciousness for a few seconds to a few minutes
  • No loss of consciousness but a state of confusion or disorientation
  • Memory or concentration problems
  • Mood changes or mood swings
  • Feeling depressed or anxious
  • Difficulty sleeping
  • Sleeping more than usual

Symptoms commonly associated with moderate to severe traumatic brain injury

Physical symptoms

  • Loss of consciousness
  • Persistent headache that worsens
  • Repeated vomiting or nausea
  • Convulsions of seizures
  • Clear fluid draining from the nose or ears
  • Weakness or numbness in fingers and toes
  • Loss of coordination

Cognitive or mental symptoms

  • Profound confusion
  • Agitation, combativeness or other unusual behaviour
  • Coma or other disorders of consciousness

Symptoms commonly associated with acquired brain injury

What Types of Orthotics Might Be Effective

Ankle Foot Orthoses (AFO) - are devices that cover the ankle, foot and the leg below the knee. AFOs are highly durable and are custom made to the individuals' requirements. AFOs are normally made from thermoplastics, silicon, lycra or carbon fibre to control unwanted movements, assist weak muscles and improve mobility. Children’s Orthotics prescribe these orthoses to target areas of the leg that require specific support while maintaining as much natural function as possible.

Knee Ankle Foot Orthoses (KAFO) - are similar to AFOs but also cover the knee joint. KAFOs help in preventing excessive joint motion so to lessen joint pain. They also help with joint alignment and stability. KAFOs are customised for each individual and are usually made of metal or thermoplastics. Newer KAFO varieties are made of carbon fibre and are lightweight while still offering the support needed to complete a gait cycle.

Wrist Hand Orthoses (WHO) - wrist hand orthoses can be used for a variety of conditions. The WHO can be used for positioning/stabilisation, range of motion assistance or to stop the joint from flexing or extending excessively. It can be further used for fracture management. Children’s Orthotics has access to a wide range of WHO devices that come in different materials, such as canvas, metal or low-temperature thermoplastics. Our experienced team of paediatric orthotists will ensure we select you best device for you and your child to ensure the best treatment plan.

Palmer resting splint - palmer and dorsal splints are available as bespoke or off the shelf devices. In some cases, you may be prescribed an off the shelf device whilst a bespoke one is being manufactured for your child. Palmer splints can be worn to inhibit or encourage certain positions in the hand (to prevent contractors or add stability) depending on the needs of your child. Palmer splints come in many different materials, including off the shelf items that can be heated in water and shaped to give your hand, wrist and arm a perfect fit with the device.

Spinal orthoses - spinal orthoses protect the spine in cases of instability to regenerative changes that can result from spinal conditions. Applications of spinal orthoses occur in four general areas:

  1. Congenital disorders
  2. Trauma
  3. Various disease states
  4. Pain management

The use of spinal orthoses attempts to hinder the natural progression of the conditions. They accomplish this objective through one or more of the following biomechanical principles:

  1. Three-pressure point control
  2. Indirect transfer of load by increasing intra-abdominal pressure
  3. Correction of spinal alignment
  4. Sensory feedback

For pain conditions, mitigation of the painful condition is the goal. In some congenital disorders, spinal orthoses can provide postural support and subsequently improve function such as in activities of daily life.

Spinal orthoses can range from softer materials to rigid materials. The type of orthoses prescribed will be dependent on your child’s needs, lifestyle and goals.

What Might the Assessment Procedure Involve

In the first instance, an appointment would be made with an orthotist in which a full initial assessment would be conducted. Areas assessed would look at:

  • Skin condition
  • Sensation in the affected area
  • Temperature
  • Ranges of motion (passive and active)
  • Normal locomotion
  • Footwear
  • Spatial and temporal measures during gait

Your orthotist will ask you questions about your child’s daily activities and medical history. The paediatric orthotist will undertake a gait examination and watch them walk, paying attention to movements at their affected joints and making observations of how their body moves. Following this, your child’s treatment options and goals will be discussed and a prescription made. Any devices that are required will be fabricated using materials chosen specifically to meet their requirements and then a fitting session arranged. All of our prescriptions and fittings are followed by a review to ensure that the treatment is effective and any adjustments can be made.

To get in touch or arrange an appointment, you can call us at 0330 088 3949 or email office@orthotics.co.uk.

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