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Why is rehab so important?

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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.

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