Considerations for functional training in adults after head injury

Functional deficits in head-injured patients are a major concern to physical therapists involved in the rehabilitation process. Functional outcomes are affected by deficits in behavior, cognition, communication, and sensorimotor abilities. These deficits interact frequently and must be considered in planning and implementing treatment. The purpose of this paper is to describe the deficits affecting functional abilities, to discuss the rationale for functional assessment, and to provide treatment suggestions for functional retraining. The suggestions include retraining of protective and equilibrium responses and advanced locomotor skills and use of assistive devices or orthoses. Problems are identified in functional outcome reporting methods. Research endeavors are addressed for physical management during the recovery process and its relationship to functional outcomes.