Overactive bladder and/or urinary incontinence, are common problems after a brain injury and spinal cord injury.  Approximately 63% of people with a brain injury and 70-84% of people with a spinal cord injury, struggle with one or both of these conditions. 1, 2, 3  Bladder dysfunction can also occur in 11-40% of the general population, due to hormonal changes, urinary tract infections and/or side effects of medication. 4 , 5 Normally, sensors in the bladder wall are designed to send information to the brain indicating how full the bladder is.  This helps the brain decide when it ..read more

  Monitoring a client’s weight regularly (e.g. monthly) after a catastrophic injury is essential.  Clients are often discharged from hospital and rehabilitation settings weighing significantly less than their “pre-injury” weight.  This is due to drastic changes to muscle mass (as a result of inflammation, immobility and insufficient protein intake) and/or frequent periods of being “nil by mouth” in hospital due to surgeries and procedures.  After discharge, however, weight tends to go one of two ways — clients either struggle to regain the weight they lost or they gain sig ..read more

Up to 66 – 73% of people with a spinal cord injury (SCI) are overweight and 30-45% are obese. 1, 2  These rates are almost double what is found in the general UK population, where 38% of people are overweight and 26% are obese.3  Why the difference?   Body composition changes after a spinal cord injury Any type of major trauma puts clients at very high risk of becoming overweight, whether that trauma is from a spinal cord injury, a brain injury or a complex orthopaedic trauma.  In the initial acute phase after the injury, clients lose significant amounts of weight and musc ..read more

    Imagine a life without being able to smell your favourite food or “taste” the delicious flavours in your favourite dish.  How would that affect the quality of your life? Sadly, smell loss (and to a lesser extent, taste loss) is quite common after any type of brain injury.  The more serious the brain injury, the more a person’s sense of smell tends to be affected.  “Olfactory dysfunction” (defined as a reduced or absent sense of smell) is reported in 20-44% of “mild” brain injuries, 37-68% of “moderate” brain injuries and 33-61% of “severe” brain injuries.1  T ..read more

    Imagine a life without being able to smell your favourite food or “taste” the delicious flavours in your favourite dish.  How would that affect the quality of your life? Sadly, smell loss (and to a lesser extent, taste loss) is quite common after any type of brain injury.  The more serious the brain injury, the more a person’s sense of smell tends to be affected.  “Olfactory dysfunction” (defined as a reduced or absent sense of smell) is reported in 20-44% of “mild” brain injuries, 37-68% of “moderate” brain injuries and 33-61% of “severe” brain injuries.1  T ..read more

Most traumatic injuries result in unwanted long-term weight gain.  However, an amputated limb presents its own unique challenges.  For those with a lower limb transtibial or transfermoral amputation, 40% of these people will go on to gain at least 10% of their body weight over the next ~2 years and will double their risk of becoming obese. 1, 2, 3 Weight changes can negatively affect the function of prosthetic limbs and socket fit.  In addition, weighing over 100kg generally exceeds the weight limit for both most prosthetic components and usually makes someone ineligible for os ..read more

  If your clients are scheduled for elective surgery, have you already screened them for malnutrition?   NICE guidelines for Perioperative Care in Adults, states that nutritional screening should be completed for everyone having intermediate or major/complex surgery. 1  Improving someone’s nutritional status before and after surgery, is a modifiable risk factor associated with improved surgical outcomes.2   Nutritional screening should be done a minimum of 6 weeks before elective surgery (but ideally as soon as the decision for surgery is made).  This is because blood ..read more

If your clients have type 1 or type 2 diabetes, are their blood glucose levels well managed?  How do you know? Just because someone is under the GP or diabetes team does not guarantee that the person’s blood glucose levels are well managed.  Sometimes advice isn’t adhered to and/or appointments get missed.  Other times, physiological changes happen in the body between annual review appointments and  insulin or medication needs to be changed sooner. Case managers can often be the first people to suspect that a client’s blood glucose levels have gone off track.   Symptom ..read more

  If you have a client with a Grade 3 or Grade 4 pressure sore and/or other wound which is slow to heal, have they ever been reviewed by a dietitian? This may sound like an unusual or surprising suggestion, but there is a massive link between someone’s nutritional status and their body’s ability to heal wounds.  This connection is frequently overlooked, in spite of the 2019 International Guidelines on the Prevention and Treatment of Pressure Ulcers/Injuries specifying that a comprehensive nutrition assessment be completed for ALL clients with a pressure injury.1 You can’t build skin ..read more

There are three ways to listen to our podcast “The role of a dietitian in injury and rehabilitation — an underused resource” (part of their Wider Issues in Catastrophic Injury series) Click on the links below: Timestamp/Outline 00:02 Introduction  05:09 Role of nutrition & dietitian in rehabilitation  12:27 Muscle mass & muscle loss; protein requirements  18:08 Nutritional challenges & deficiencies in brain injury  25:06 Bone density  30:18 Blood tests & investigations  36:24 Diabetes and cholesterol  40:24 Multi-disciplinary teams &nb ..read more