Persons with disabilities are often at high risk for falls. For example, general stroke survivors fall about twice as often as people who have not had a stroke. Falls account for many of the severe injuries we see in the community and can contribute to worsening disability.

Our physiotherapy intervention depends on the severity of the brain injury, the problems the person is presenting with, and the individual’s goals.

Many factors may increase your risk of falling such as:

• Your age
• The type and number of medications you take each day
• Balance issues
• Any difficulties you may have with walking or moving around your home
• Your ability to get in and out of your bathtub or shower
• Loss of strength or sensation in your legs or feet
• A previous fall or near fall in the past 12 months may increase the likelihood of another fall
• If you are sometimes confused or disoriented
• Being in a depressive state can make you more likely to fall

The physiotherapists at Action Potential Rehabilitation can help you identify and modify potential risk factors that make it more likely to have a fall.

After a thorough assessment, they will review your environment and make suggestions for modifications.  For example, they may recommend that you put your favorite chair on risers to help you get up out of the chair more easily or, they may prescribe a cane or walker that is adjustable for your height and needs.  If the assessment identifies areas of muscle weakness or other balance problems, your physiotherapist will work with you to help you get stronger and to improve your balance.

They will also teach you what to do in the event of a fall and how to get back up off the floor if you are uninjured.

Physiotherapy interventions may be needed after a mild or moderate brain injury for assistance with:

• Balance deficits
• Co-ordination deficits
• Difficulties in crowded environments, e.g. mall, outside walking
• Anxiety regarding falls
• Fitness requirements and re-integration into community programs, if feasible
• Preparing for return to work
• Specific skills for activities of daily living such as bathing, dressing, cooking
• Assessment and prescription of walking aids

Physiotherapy interventions maybe needed after a severe brain injury for assistance with:

• Respiratory care
• Skin care and DVT (blood clot) prevention
• Contracture prevention or treatment
• Regaining head control (assistance with swallowing in conjunction with the Speech-Language Pathologist)
• Sitting balance retraining
• Transfers training
• Early standing initiation
• Assessment for equipment, e.g. splints
• Spasticity management

Following a severe acquired brain injury, a team approach is essential. Our team is experienced in working in a multi-disciplinary team including other health care professionals, case managers, and insurance adjustors, to create the optimal recovery environment in the community.

Additional Resources:

1. Ottawa Public Health http://www.ottawa.ca/health/
2. Bruyere Continuing Care http://www.bruyere.org