The difference between an Acquired Brain Injury (ABI) and Traumatic Brain Injury (TBI)
An ABI is when an internal force, such as a stroke, or tumour, has damaged an area of the brain, or, when the brain is deprived from oxygen for an extended period of time. A TBI is when someone’s brain tissue becomes damaged due to an external force. There are different types of TBI’s, but most can be categorised into either a penetrating, which is when an object enters the brain tissue and damages only part of the brain, or a non-penetrating TBI which can be caused by a fall, motor vehicle crash, or sports injury. Both ABIs and TBIs happen after birth.
In some cases, someone may have both types. Both of these types can present differently and vary from mild, moderate, to severe, however, there are similarities that cross over depending where in the brain the injury has occurred.
Common Symptoms of ABI and TBI’s
Symptoms can appear differently to each individual, and someone may experience all or only one. The most common can be broken down into three groups:
Physical symptoms
- Motor changes: complete or partial loss of function/ movement in a particular part of the body. This can also include muscle weakness.
- Vestibular changes including balance, coordination and feeling of dizziness or unsteadiness when moving around.
- Difficulty or an inability to get out of bed, stand or walk independently and therefore needing support or assistive technology to move around.
- Pain can be a very debilitating symptom that many will experience which can be neuropathic or mechanical in nature.
- Experiencing low energy levels or becoming very quick to fatigue. For example, walking up and down the hallway can feel like running a marathon.
- You might find that your hand and arm are not working the way they used to and this can impact your daily life.
Sensory and Perception:
- Difficulty identifying correct sensory experiences: unable to identify temperature correctly on one, or both sides of their body, numbness in a particular area, heightened or decreased sensitivity
- Visual disturbances: such as blurred vision, photophobia (light sensitivity), decrease range and clarity in vision, difficulties with depth perception and spatial awareness, neglecting one side of the visual field
- Sensory Processing Difficulties: unable to filter environmental information which can lead to increased fatigue and confusion
- Impaired interoception: the process of how our body tells us of internal cues like being hungry, having to go to the toilet
- Impaired proprioception: difficulty knowing where our body is in space, which is usually associated with balancing difficulties that can lead to dizziness,
vertigo, and unsteadiness - Olfactory and Gustatory changes: changes in how a person used to taste and smell
Behavioural and Cognition
- Unable to complete simple tasks containing more than 1-2 instructions. For example, unable to put toothpaste on toothbrush and then brush teeth
- Difficulty solving problems. This can look like trying to put on your shoe, and not being able to first untie it so that it fits comfortably on your foot.
- Difficulty attending to a task for a long period of time (or in some cases, short period of time).
- Memory problems, which can look like difficulty recalling new information or recalling old information. In some cases, both can be affected.
- Becoming easily frustrated and the inability to control emotions. For example, crying at spilling a cup of water.
- Changes in sleep patterns and levels of consciousness. For example, difficulties waking up or falling asleep.
The Role and Benefits of Physiotherapy, Occupational Therapy, and Exercise Physiology after a TBI
Recovery is a team sport, and healing does not move in a straight line. There are physical, cognitive, emotional, and social challenges that are deeply connected and
best handled by a coordinated rehabilitation team, each with distinct but complementary roles.
Early intervention of physiotherapy (PT), occupational therapy (OT), and exercise physiology (EP), all play an integral role in rehabilitation following a brain injury. Most
hospitals consist of a specialised allied health team dedicated to improve recovery outcomes for patients, however, staying in the hospital forever is not an outcome anybody wants. Community PTs, OTs, and EPs, help clients re-integrate back into the world with their new normal. In addition, there is strong evidence that suggest exercise can improve cognitive impairments, mood disorders, and post-concussion symptoms that usually follow a brain injury.
Here is a quick snapshot of the PTs role:
- Complete detailed neurological assessments which cover a wide range of topics from visual-motor impairments to gait analysis as well as functional task
assessments. - Can help to regain the ability to move safely, especially with walking, balancing, or if coordination if it feels different than before.
- Supports recovery from impaired balance or unsteadiness, including difficulty with head turning, looking around, or moving through busy spaces like
shopping centres - Provide one on one sessions to target the impairments and provide impactful solutions with a wide variety of treatment techniques and modalities.
- Provide education on pacing strategies and how to build activity gradually without overdoing it
- Help relearn everyday movements like getting up and down off the bed/floor or chair, getting in/out of a car of gaining confidence in the community again.
The OTs role:
- Complete detailed assessments of personal care, domestic tasks, cognition, fatigue management, sensory processing, and executive functioning. This may include analysing how physical, cognitive, emotional, or environmental factors are impacting performance at home and in the community.
- Reteach essential self-care skills. This can look like supporting independent showering, dressing, grooming, toileting, eating, and managing personal routines.
- Educate practical strategies to support attention, memory, planning, sequencing, problem-solving, and task initiation. This may include routine building, using visual supports, and compensatory techniques to reduce the cognitive load.
- Assessing the home, workplace, or community environments to identify barriers and recommend modifications. This may include layout changes, task simplification, falls risk strategies, and easier accessibility
- Assessing and prescribing adaptive equipment ranging from simple aids (shower chairs, dressing aids) to complex assistive technology. OTs ensure equipment is individual to the client, making sure it is appropriate and fitted correctly
- Supporting return to valued life roles — parent, worker, volunteer, friend — by rebuilding confidence, problem-solving participation barriers, and facilitating graded re-engagement with community activities.
The EPs role:
- Assess cardiovascular fitness, muscular strength, endurance, balance, joint mobility, posture, and movement efficiency to identify areas of weakness, deconditioning, or asymmetry.
- Periods of reduced movement can lead to rapid muscle loss and decreased metabolic health. EPs implement progressive resistance training programs tailored to the individual’s condition and tolerance.
- Structured, graded programs are developed to improve heart and lung fitness, increase stamina, and reduce fatigue.
- Create exercise programs that are tailored to account for comorbidities as well as neurological conditions.
- Education on safe exercise dosage and progression to progress safely without flare-ups or overexertion.
- EPs consider the interaction between physical health, mental wellbeing, sleep, stress, and overall lifestyle factors to support sustainable long-term change.
How the team at CNRS can help
We know that life after a brain injury can feel overwhelming, and that recovery isn’t just about physical rehabilitation. That’s why we take a whole-person approach.
Alongside therapy, we can help connect clients and their families with local resources, community supports, and support groups. Because we know an ABI or TBI doesn’t affect just one person, it can impact whole families.
One of the benefits of CNRS is that we offer multiple allied health services under one roof. With PTs, OTs, and EPs working closely together, communication between disciplines is seamless. This allows us to provide a more coordinated and efficient therapy that is centred around your goals.
Our clinic is brand new, and innovation is at the heart of what we do. Our mixed approach offering both clinic and community sessions allows our clinicians to meet an individual exactly where they are at, to help create individualised and specific interventions. We’re committed to providing evidence-based therapy approaches, while also being flexible and creative in how we deliver care. Our therapists tailor sessions to be functional, meaningful, and yes, even enjoyable, because we believe that therapy doesn’t have to feel clinical or intimidating.
Most importantly, our team is genuinely passionate about supporting people to rebuild confidence, independence, and quality of life after an ABI and/ or TBI. Wherever you are on your journey, you don’t have to do it alone.
What is an acquired brain injury?
When an internal force causes permanent damage to an area of the brain after birth, for example a stroke, tumour, or lack of oxygen.
What is traumatic brain injury?
When an external force causes permanent damage to an area of the brain after the birth. Can be penetrating (object entering the skull) or non-penetrating (motor vehicle accident)
How do clinicians at CNRS support a client with an acquired brain injury?
We work collaboratively with the individuals entire care team. We focus on gathering information from the client and their support system to get an idea of what their situation is and where they are at in their rehab journey. From there, we can identify practical goals that best suit the individual and their family.
How is a brain injury diagnosed?
This involves a series of medical imaging scans to confirm an area of the brain has been damaged, along with a series of cognitive,
visual, and physical tests to determine how the injury will impact a person. A medical doctor is required to make the formal diagnosis.