Why is rehab so important?
Recent research indicates that the adult brain can show
experience-dependent recovery of neural circuits. This finding has
three important implications, as follows:
- A lack of use and stimulation of the brain, such as the absence
of rehabilitation opportunities or inactivity, may prevent
experience-dependent recovery.
- If people reduce their activity and participation in their
world because of the effects of brain injury, they may develop
secondary or additional social, cognitive and behavioural
disabilities.
- Depression and other emotional disorders, such as anxiety and
post-traumatic stress, can lead to poor motivation and may lower a
person's use of helpful coping strategies.
There are five common forms of recovery and adjustment following
a brain injury. To explain these forms of recovery and adjustment,
the following sections use speech impairment as the example.
Remediation
Remediation involves relearning how to perform tasks and skills in
a similar way to pre-injury performance, e.g. investing time and
effort to practice speech therapy exercises in order to relearn and
master language skills.
Substitution or
compensation
This form of recovery involves using previously acquired skills or
learning new skills to perform tasks in a different way, e.g.
learning alternative means of communication such as writing
messages, using a communication board, sign language or maximising
non-verbal communication skills.
Accommodation
Accommodation involves the adjustment of personal goals,
expectations and priorities to reflect the changed level of
abilities, e.g. accepting that the speech deficit is a long-term
effect of the injury and adjusting self-expectations about speech
abilities.
Assimilation
Assimilation involves modifying the environment or adjusting the
expectations of other people, e.g. selecting supportive
environments or tasks that match the person's level of
communication skills or educating other people to use alternative
means of communicating with the injured person.
Decompensation
Decompensation is often more problematic than it is beneficial. It
involves reducing the need to use a skill, e.g. avoiding or
withdrawing from social interaction to reduce the need to
communicate.