Traumatic Brain Injury A to Z - Spasticity

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Dizziness

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It’s not unusual for patients to feel dizzy during TBI recovery. Watch as Tracy and the group explore strategies for managing dizziness.
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Dizziness

Julie
You know Michelle, now that Tom’s awake he’ll probably be moving around more. You may find that he complains about dizziness.

Tracy
That’s right, Julie. Dizziness is a very common effect of TBI. Tom may complain that the room is spinning, moving, you know causing that sense of vertigo. So if that happens, he could lose his balance, he could fall. You just want to “fall-proof” the house.

Carl
Julie had me get rid of all her area rugs and electrical cords, things that Sam could slip or trip on. We also put on non-slip mats on the shower and bath floors.

Tracy
Good idea, Carl. Good idea. Also, you want to make sure that the room is well lit. That Tom is encouraged to use any of the assistive devices that his team might’ve provided for him.

Travis
What’s an assistive device?

Tracy
Oh things like canes, walkers…equipment that may help your Dad get around when he comes home.

Okay, just a few more things… You’ll want to remind your Dad to avoid sudden movements. It can also help to sit for a few minutes before walking. You know it just gives the brain time to adjust. So encourage him to sit or to lie down as soon as he feels dizzy.

Julie
Sam didn’t seem to get dizzy very often at first, but once he started walking again, he couldn’t seem to keep his balance. They had this kind of belt like contraption that Carl would hold onto while Sam walked up and down the halls in the hospital. It was a good part of Sam’s therapy.

Carl
Heck, it was good therapy for me, too. At least I felt like I was doing something.

Tracy
Something very helpful, Carl. Sam’s lack of balance is pretty common. Our brains control our physical movement, our balance, so obviously a TBI can cause problems with that. Now fortunately, those problems usually go away over time and with physical therapy.

In fact, many of the effects that you see may improve over time. Some of the others might be sensory changes, spasticity, vision problems, seizures, a variety of cognitive effects are some of the possibilities. So you’ll find a description of what to expect, along with those tips on how to manage those conditions, in the Managing Less Common Effects of TBI in your Guide for Caregivers.

Okay, I think this is a good point to take a break.

This week please take some time to write in your journal. It’s important. If you haven’t started one yet, you’ll find a template in your Guide for Caregivers. Keep track of the progress that your family member is making - - even those… those small steps. And write down your experiences, your feelings. But do take time for yourself.

Julie
Along that line, Tracy, we use a website called caringbridge.org. When Sam first got hurt, everyone in our family was calling every day, trying to get information. And it was just too much; it was overwhelming. Carl and I couldn’t keep up, and stay with Sam at the same time. Then the people at the Fisher House in Landstuhl, told us about caringbridge. It’s great. You can download pictures, and create a website for your injured soldier, and keep everyone posted. Every day I go on there and write in my journal. It’s good therapy for me, and our entire family can check up on Sam’s progress.

Tracy
That’s terrific, Julie. Yeah, I’ve met many people who’ve used both caringbridge and another website, called caringpages.com. It’s really helped in a couple of ways - - keeping family and friends updated, serves as a journal for the caregiver. You know if you have a chance, check the sites out. I think they’ll help.

So next week lets talk about taking care of yourself, which is key to being an effective caregiver. Okay. Thanks everybody for coming. And remember, I’m here for you if you need anything, you know where to find me. Okay.
 

Spasticity

An injury to the brain can cause an abnormal increase in muscle tone called spasticity. A spastic muscle does not easily relax the way a normal muscle does.

This effect is most common with a severe and/or penetrating brain injury.

Regular stretching, splints to keep limbs in proper position, and medications are common treatments.

Severe spasticity can be painful so pain management may be in order.

What you might see:

  • Involuntary muscle tightness and stiffness 
  • Muscle contractions 
  • Decreased range of movement and abnormal posture

How you can help:

  • The physical therapist will develop a stretching program for your family member. Ask the physical therapist to teach you this program.
  • Post diagrams of the stretches. Help your family member do the recommended stretches.
  • If splints are used, learn how to apply them. Find out how long they are to be worn each day.
  • Monitor your family member’s skin for pressure points from the splints. Alert nurses to areas of redness and breakdown.
  • Tell the health care team if the spasticity gets worse. This could be a sign of an underlying problem.
  • If spasticity is so severe that it interferes with comfort, positioning, and general functioning, ask the doctor about treatment options. These include implanting a muscle relaxant pump.
Related Information:
Dizziness
Other Physical Effects
Glossary
Frequently Asked Questions
"He really won’t tell me the whole story because I think he doesn’t want to scare me. But, he brought me a piece of metal back home that was embedded in the wall right behind him. He said it missed his head by a few inches. He said that he thanks God every day that he’s still alive, and that’s why he brought the piece of metal home, to show me that that’s how close he had come to dying." -  Lynn C-S.

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