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What Does Cognitive Brain Rehabilitation Entail?

A traumatic brain injury may result from internal factors or external factors. External factors are commonly due to car accidents and falls but may also be caused by any type of physical trauma to the head. Internal factors result from stroke or aneurysms causing bleeding on the brain. Illnesses and diseases are another cause.

These types of injury can result in mild to significant loss or impaired cognitive function. Impaired cognitive function may include the following:

- Short and long-term memory loss. - Inability to focus and concentrate and decreased attention span. - Difficulty with or loss of language resulting in impaired communication. - Loss of or impaired fine and gross motor coordination and skills. - Changes in personality and behaviour. - Impairment of visual or audio stimuli. - Impeded visual spacial conceptualization. - Poor judgement. - Difficulty executing tasks.

Rehabilitation to restore cognitive brain function often entails the retraining of the brain to relearn certain lost or impaired functions. In cases where brain tissue has been destroyed, other areas of the brain can assume these functions under rehabilitation. The focus of rehabilitation is to improve the quality of life and ability to perform basic daily tasks.

This results in two major approaches to cognitive rehabilitation therapy:

1. Restorative Approach

This therapeutic treatment aims to restore impairment that was a result of a traumatic brain injury. The process often involves repetition of certain actions, cognitive tests and behaviours in order for the brain to relearn how to interpret and then process information. The tests increase in difficulty in order to challenge the brain to restore specific areas of function such as speech and language or memory and concentration. The restorative approach may involve integrated therapy from occupational therapists, speech and language therapists, neuropsychologists as well as physical therapists.

2. Compensatory Approach

The compensatory approach teaches the brain alternative means to interpret and process information and different ways to function and cope with the traumatic brain injury. For example, where brain injury has resulted in significant impairment of memory, the use of alarms or calendars as reminders are taught as a coping mechanism to improve a patient's ability to function in daily life.

Pharmacotherapy, which is the use of drugs or medication, may also be integrated into a programme to treat traumatic brain injuries that have resulted in cognitive impairment. The integrated approach means that the pharmaceuticals are used in conjunction with the restorative and compensatory approaches and are less effective if used as a stand-alone therapy. Integration of various diverse approaches to cognitive rehabilitation are the most effective.

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