Problems with Coordination After Brain Injury

Brian D. Greenwald, MD, BrainLine

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  I'm a case manager and have gotten questions from patients and their families about TBI and spasticity — like how often is spasticity a problem and how is it best to treat spasticity that follows a TBI? I haven't been able to find any definitive research. Any ideas?
   
  Click here to go to About Ask the Expert. Increased Muscle Spasticity After Traumatic Brain Injury

I was in a coma for three months and my brain was injured on the right side, which affects the left side of my body. I am having difficulty walking because my left side wants to do its own thing. Anything I can be doing to get this under control? I just want to walk "normally" again.

Discoordination of the left side of your body is common after an injury to the right side of your brain. Even if you get good return of strength back on the left side side, coordination may still be a problem. Problems with coordination can be due to changes in strength, sensation, or reflexes. You may see this in more everyday occurrences like stubbing your toe when walking or during more stressful activities like sports that involve running and jumping. Overall, these problems with coordination are likely to be worse when you are tired.

Physical therapy should be working on this coordination to improve your walking and balance and the exercise program should to be tailored to your specific needs. Your PT should closely evaluate your strength, sensation, and reflexes. Symptoms tend to be worse when you are tired or under stress. Even being in very cold or warm temperatures can worsen your coordination.

The best way to improve coordination is by practicing regularly. Too often patients only do their coordination exercises in physical therapy. These exercises need to be done about five times per week, sometimes more than one time per day to get the full effect. As always — practice, practice, practice and you should hopefully see progress. Recovery takes time — but you should see gradual improvement over six months. Maintaining those exercises long term is often needed to maintain the gains made in therapy.

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