How Much Therapy Is Enough for Someone with TBI?

How Much Therapy Is Enough for Someone with TBI?

Two years ago, my son, now 29, was injured and sustained a severe TBI. He still has poor speech and poor motor skills. He’s incontinent and in a wheelchair, but his cognition is not too bad. Do you think one hour of physical therapy and speech therapy a week will make a difference? We are paying out of pocket and can’t afford any more therapy. And our insurance is exhausted.


We used to think that most recovery took place within 12-18 months after a brain injury. We know now that recovery can continue for longer periods; however, more likely at a slower pace. Unfortunately, the majority of people can’t afford to provide the optimal amount of rehabilitation or care. In fact, the Brain Injury Association of America estimates that only 5 percent of individuals with severe brain injuries have adequate funding for long-term treatment.

Any rehabilitation during this period should be focused on functional goals. Your description leads me to think that your son’s speech may be difficult to understand or that he may require a great deal of assistance to transfer from his wheelchair to the bed. Generally speaking, one hour a week of physical therapy or speech therapy at this stage may not be enough to see progress. Currently, researchers are trying to establish how much therapy is enough and which therapies are the most effective when.

Depending on your family’s circumstances and your ability to spend time at home practicing skills, a re-evaluation and a few sessions of physical therapy may be useful in setting up a home exercise program to prevent complications such as contractures or skin breakdown. Speech therapy for a limited time could help develop an alternative communication system such as a communication board if verbal expression is frustrating for your son.

If you haven’t already, be sure to contact your state’s governmental agency responsible for people with disability. There may be resources available for care or intervention, especially because your son will continue to have long-term care needs. And if you haven’t already invested supplemental security income under Social Security, that could be another source of support.


Posted on BrainLine February 11, 2011.

About the author: Elaine Sherard

Elaine Sherard practiced as a speech-language pathologist and had various roles in the neurorehabilitation field for 25 years, including management and serving as President of the Board of Directors of the Brain Injury Association of South Carolina. She continues as a consultant in the brain injury rehabilitation field as well as advocacy endeavors.

Elaine Phillips

Comments (5)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

He requires cognitive remediation classes. They are not only speech therapy...they will allow him to untangle the full extent of his injuries, and allow him, through time, and proper treatments to 'eventually' understand the full extent of his injuries, and thus, in the meantime be able to begin to compensate for his injuries. I received that treatment 12 years post my injuries, and the results I still have to show doctors who are taking care of me now. You don't fully rehabilitate unless you have become aware as to the full extent of your injuries...

Constant Therapy (for Apple and Android) its 19.99 a month...we love it! Have been doing it almost 2 years now. 29 yrs old...18 years post TBI...Check it out for free before you buy.

My brother suffered severe problems after brain tumor surgery and our family is in the same situation. Thanks for the question, this gives us some insight.

We look forward to seeing effective routines for home. Right now we work on e-stim 2x day everyday, and long list of exercises, it takes full-time would like to narrow it down to the most effective.

Elaine, Thanks for the reply to the question, it has inspired my question now. In your reply you indicated there currently much research taking place on how effective are some therapies recommended to TBI clients and there effectiveness. I and I am sure many TBI readers would love to read the results of such investigations so can you please provide a list. Steve