Traumatic Brain Injury
Traumatic Brain Injury
Defined
• Traumatic Brain Injury (TBI): According to the
Brain Injury Association, traumatic brain injury is
an insult to the brain, not of a degenerative or
congenital nature but caused by an external
physical force, that may produce a diminished or
altered state of consciousness, which results in an
impairment of cognitive abilities or physical
functioning. It can also result in the disturbance
of behavioral or emotional functioning. These
impairments may be either temporary or
permanent and cause partial or total functional
disability or psychosocial maladjustment.
Acquired Brain Injury
• Acquired Brain Injury (ABI): Most symptoms of acquired brain
injuries are very similar to that of traumatic brain injuries; however,
there are some difficulties that are experienced more frequently or to
a greater degree by persons with acquired brain injuries. This
information is not intended to be a substitute for medical advice or
examination.
Symptoms can include:
• Cognitive impairment- Thinking skills, especially memory.
• Longer lengths of time spent in a vegetative state.
• Severe behavior problems- Psychosis, depression, restlessness,
combativeness, hostility.
• Muscle movement disorders.
Types of TBI
• Diffuse Axonal Injury (TBI)
• Penetrating Injury (TBI)
• Concussion (TBI)
• Shaken Baby Syndrome (TBI)
• Contusion (TBI)
• Locked in Syndrome (TBI)
• Coup-contre coup injury (TBI)
• Anoxic brain injury (ABI)
• Second Impact Syndrome (TBI)
• Hypoxic brain injury (ABI)
Causes of TBI
• Airway obstruction
• Near-drowning, throat swelling, choking, strangulation, crush injuries to the
chest
• Electrical shock or lightening strike
• Trauma to the head and/or neck
• Traumatic brain injury with or without skull fracture, blood loss from open
wounds, artery impingement from forceful impact, shock
• Vascular disruption
• Heart attack, stroke, arteriovenous malformation (AVM), aneurysm,
intracranial surgery
• Infectious disease, intracranial tumors, metabolic disorders
• Meningitis, certain venereal diseases, AIDS, insect-carried diseases, brain
tumors, hypo/hyperglycemia, hepatic encephalopathy, uremic
encephalopathy, seizure disorders
• Toxic exposure- poisonous chemicals and gases, such as carbon monoxide
poisoning
• Asthma attack, loss of oxygen
Levels of TBI
• Mild traumatic brain injury:
– Loss of consciousness is very brief, usually a few seconds or minutes.
– Loss of consciousness does not have to occur—the person may be dazed or
confused.
– Testing or scans of the brain may appear normal.
• Moderate traumatic brain injury:
– A loss of consciousness lasts from a few minutes to a few hours
– Confusion lasts from days to weeks
– Physical, cognitive, and/or behavioral impairments last for months or are
permanent.
• Severe traumatic brain injury (include and are not limited to):
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Coma
Vegetative State
Persistent Vegetative State
Minimally Responsive State
Akinetic Mutism
Locked-in Syndrome
Cognitive Characteristics
• Short and/or long term memory loss.
• Poor concentration .
• Communication disorders related to
speech, writing, and reading.
• Logical reasoning, organization skills,
orientation.
Daily Life of TBI
• Take 2 minutes to write down on a blank
sheet of paper everything you have done
from the time you woke up this morning to
the time you walked into class. Use as
much detail as you can.
Daily Life of TBI
• This is what the list
for a person with TBI
may write down.
• Woke up
• Brushed Teeth
• Walked to class
• Sat in seat
“My short term goals are just remembering to
brush my teeth, take my pills, eat my breakfast.
Just the simple things.” –Anonymous person
with TBI
Psychomotor Characteristics
• Slowness or confusion in the planning and
sequencing of movements (ataxia, apraxia)
• Muscle spasticity
• Contractures, fatigue, & balance
impairment.
• A variety of sensory impairments, including
vision and hearing loss.
Affective Characteristics
• Lowered self-esteem.
• Lack of motivation.
• Difficulty relating to others.
• Impulsivity, impatience, social dependency,
irritability, apathy, inability to profit from
experience, changes in personality, short
temper, lack of awareness of physical
and/or mental limitations.
Teaching Strategies
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PATIENCE!!
Upon knowing the students TBI severity
(mild, moderate, or severe), you should
decided on whether or not to use inclusion
or work 1 on 1 with the student.
Keep in contact with the Physical Therapist
if the student is currently with one.
Expect the unexpected
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Allow for flexibility in the classroom if
student is included with the regular physical
education class
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Some students who have suffered TBI have
gone through seizures.
Differentiated instruction may be geared
towards this student if not the entire class
Students may need adaptive equipment for
the classroom, sometimes the equipment is
not easy to deal with as they can be large and
difficult to maneuver for both you and the
student.
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Stand up wheelchair as seen at right
TBI Rehabilitation
Interesting Facts about TBI
• IT CAN HAPPEN TO ANYONE!
• Every 16 seconds, one person in the US sustains a Traumatic Brain
Injury.
• An estimated 3.17 Million Americans currently live with disabilities
resulting from Traumatic Brain Injury.
• 1.4 Million Americans sustain a Traumatic Brain Injury each year.
• More than 50,000 people die every year as a result of Traumatic
Brain Injury.
• Males are two times more likely than females to sustain a brain injury.
• The highest rates of brain injury typically occur in males ages 15-24.
• Individuals who have already sustained a brain injury are also at an
increased risk of sustaining another brain injury.
Resources
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http://www.biausa.org/education.htm
http://www.twu.edu/inspire/Aquatic/TBI.htm
http://www.youtube.com/watch?v=BwIOF98rbMo
http://www.neurologychannel.com/tbi/symptoms.shtml
Marion, Donald W. Traumatic Brain Injury Thieme
Publishing
• Winnick, Joseph P. (2005) Adapted Physical Education
and Sport Champaign, IL Human Kenetics
• Stoler, Diane Roberts & Hill, Barbara Alberts Coping
with Mild Traumatic Brain Injury Alberts Publishing