Adult Brain Injury


A brain injury can be caused by a traumatic event, such as being involved in a road traffic accident, fall or assault or acquired due to a stroke or infection.

The effects of a brain injury depend on the type of injury, how severe the injury is, and also the location of the injury within the brain.

Survivors of brain injury may have limited function of arms or legs, abnormal speech or language, loss of thinking ability or emotional problems. The range of injuries, and degree of recovery, and varies widely, depending on the individual.


Traumatic - this is typically caused by an external force, but can be compounded by complications of the trauma, such as damage to the brain tissue due to swelling, or increased intracranial pressure, or lack of oxygen.

Acquired - this is a brain injury that has occurred since birth. There are many possible causes, including stroke, haemorrhage, infection, hypoxic/anoxic brain injury and medical accidents.


Tests and Diagnosis

Imaging using CT and MRI can detect injury in the brain.

A neurological examination will be undertaken to determine physical deficits. There will be occupational and speech and language assessments to determine what each patient requires during their rehabilitation.

There will also be a cognitive evaluation with neuropsychological testing.

Orthotic Treatments

Following initial treatment in an acute setting, a patient will be in rehabilitative care for some time to help them restore their physical and psychological function to its optimum.

Physically, brain injury patients may suffer from strength, balance and posture problems.

The coordination and quality of movement can be affected. They may require help to become upright and more mobile.

In the acute phase of treatment following injury, PRAFOs (pressure relieving ankle foot orthoses) may be prescribed to maintain the range of motion at the foot and ankle while a patient is in hospital. These can also reduce the risk of pressure sores.

Many brain injury patients require furthermore long-term orthotic treatment during their rehabilitation and beyond:

  • helmet may be used to protect the head against falls following a seizure;
  • spinal brace is used to maintain the alignment of the spine;
  • Lycra suits are dynamic orthoses that increase proprioception and allow natural muscle movement but guide weaker or abnormal movement with specifically placed panels, which place pressure and direction on specific muscles. These garments can be gloves, socks or suits;
  • lower limb orthoses include AFOs (ankle foot orthoses) and KAFOs (knee ankle foot orthoses), which aim to control the foot, ankle, knee and hip during gait;
  • To return a patient’s gait pattern to one that is as near normal as possible, we are increasingly recommending and prescribing the Neuro Swing system. This has a number of advantages over traditional AFOs.
  • anti-contracture orthoses are used to stretch out tight muscles during rest such as KAFO's gaitors (for arms or legs) and night AFOs;
  • FES (functional electrical stimulation) can be used to stimulate weaker or affected muscles to function in a more normal pattern.


Above: Carbon Fibre Fixed AFO

Above: Carbon Fibre Fixed AFO

The treatment programme varies hugely between each patient, depending on the severity of the brain injury and the impact it has on the patient’s overall mobility. Each patient must, therefore, be carefully assessed by one of our experienced clinicians to determine what orthotic treatment is best suited to them. This may include a gait assessment in our video vector Gait Lab to accurately assess dynamic movement.

Above: Carbon Fibre Fior & Gentz KAFO

Above: Carbon Fibre Fior & Gentz KAFO


We have the following facilities and amenities at our Kingston Upon Thames location:

  • Free parking
  • Wheelchair ramp
  • Disabled toilet
  • Baby changing facilities

We also have the Gait Laboratory for orthotics patients and Onsite Manufacturing for speedy turnarounds and adjustments whilst you wait.

We have the following facilities and amenities at our Cambridge location:

  • Free parking directly outside the clinic
  • Large Waiting Room
  • No Toys (Due to Health & Safety Requirements of the clinic)
  • Baby changing space (In clinic room)

For more information about The Beechwood Complementary Medical Practice, please visit The Beechwood Practice.

We have the following facilities and amenities at our Bristol location:

  • Free parking directly outside the clinic
  • Large Waiting Room
  • Free tea, coffee and water
  • No Toys (Due to Health & Safety Requirements of the clinic)
  • Baby changing space (In clinic room)
  • Fully wheelchair accessible
  • Short walk to Clifton Village centre for shops, restaurants & cafes

For more information, visit Litfield House Medical Centre.

LOC’s clinic is based in the University of Salford’s Podiatry Department and provides treatments for orthotics, scoliosis, pectus deformities, positional plagiocephaly and club foot.

It is also the base for LOC’s northern OSKAR clinic which is run by Sam Walmsley, clinical director of LOC, in conjunction with Elaine Owen MBE MSc SRP MCSP.

Due to COVID-19, we have had to temporarily close the Salford clinic and are operating out of another clinic in Bolton. 

508 Blackburn Rd,

Astley Bridge,




For more information, please visit The Good Health Centre 

An insole is a contoured orthotic device which alters the characteristics and biomechanics of the foot and ankle area. Biomechanics are concerned with mechanical laws and how they affect the living body, especially the musculoskeletal system.

They are removable devices, often made from plastic, that are designed to fit inside a shoe to provide additional support for your feet. As well as offering shock absorption, an insole can help distribute the weight of your body more effectively across the foot and can be made bespoke to cover a range of biomechanical conditions.

If you have symptoms in your feet, ankles, hips or your lower back that are intermittent or were not there to start with in early life, and have started to cause you pain over a period of time, bespoke orthotic insoles could be an excellent option.

If you have already tried rest, icing, compression and elevation and your feet have not recovered, we recommend a biomechanical assessment to consider the possibility of insoles. They are a non-invasive approach to treatment and in many cases, are a great option for symptoms that are not severe enough to warrant surgical intervention. Alternatively, they can be considered as an option prior to surgery.

We will send patients away when an insole is not appropriate, if a patient is suffering with iliotibial band syndrome for example, the problem can be helped with physiotherapy and a stretching programme. That’s what our biomechanical assessment is all about; determining whether there would be any benefit from altering the alignment of your feet.