Heat Stress and Brain Injury Rehabilitation

When heat affects recovery: what we need to know

We all know how draining hot weather can feel, but for individuals recovering from a brain injury, the physical and cognitive consequences of a heatwave can be far more pronounced.

Fatigue increases. Concentration drops. Motivation dips. And for some, the body struggles to regulate temperature at all.

For clients receiving home-based rehabilitation, these challenges can have a direct impact on how well they engage with their therapy, how much energy they can access day-to-day, and how safe they feel in their own environment.

Why brain injury affects temperature regulation

One key area of the brain that can be affected after a traumatic or acquired injury is the hypothalamus. This part of the brain plays a crucial role in temperature regulation. When it’s disrupted, individuals may find themselves either overly sensitive to heat, unable to cool down efficiently, or unable to recognise when their body temperature is becoming unsafe.

Even without direct damage to the hypothalamus, heat stress can cause:

• Dehydration
• Reduced cognitive clarity
• Disrupted sleep
• Increased fatigue
• Sensory overload

These effects aren’t just inconvenient; they can directly interfere with rehabilitation outcomes. When a person is exhausted, foggy-headed, or overheated, they are less likely to engage fully with cognitive tasks, goal setting, or even basic daily activities.

The science: what the evidence says

• Research shows that heat stress impairs selective attention and reaction time, both of which are essential for daily functioning and rehabilitation progress.¹
• The body works harder in the heat by redirecting blood to the skin to produce sweat. This raises cardiac demand, making us feel more physically and mentally drained.²
• Dehydration, which comes quickly in warmer temperatures, leads to low energy and reduced cognitive performance.³

How we help clients manage heat at Reach

At Reach, our rehabilitation programmes are designed to be flexible, and that includes responding to environmental challenges like extreme weather. Our Neuro Occupational Therapists routinely work with clients to adjust routines, reframe goals, and introduce practical tools for managing fatigue and overload during heatwaves.

Here are five strategies our team often recommends:

• Stay hydrated
  Drink water regularly, and reduce alcohol where possible. Many clients benefit from setting hydration reminders using a phone or smart home device.
• Adjust your schedule
  Prioritise rehab activities during the cooler parts of the day, such as mornings or evenings, and build in rest breaks more frequently.
• Dress for the weather
  Lightweight clothing, sunglasses, and wide-brimmed hats can reduce both body temperature and sensory overload.
• Create a cooler environment
  Keep blinds closed during peak sun hours, use fans or cooling aids, and make sleep spaces as comfortable as possible.
• Speak to your Neuro OT
  When the heat becomes overwhelming, your OT can recommend personalised pacing strategies, cognitive tools, or energy-conservation techniques – all designed to help the client thrive, not just cope.

Why home-based treatment helps

One of the advantages of delivering rehabilitation in the home is the ability to observe and adapt to a client’s real-world environment. This includes how they manage in different weather conditions. From sleep quality to fluid intake, lighting, ventilation and even noise, our team considers all of these factors when designing and delivering rehabilitation support.

Reach out..

If you’re a case manager, solicitor, or rehabilitation provider supporting clients through warm-weather months, it’s worth remembering just how much the environment can influence outcomes.

Whether it’s a small tweak to a daily routine or a more detailed strategy developed with a Neuro OT, heat awareness should be part of every brain injury rehabilitation plan.

Need to discuss a client’s changing needs this summer? Contact the Reach team to find out how we can help.

Further reading

1. Evaluating Effects of Heat Stress on Cognitive Function – PMC
2. Hot Weather and Heat Extremes: Health Risks – The Lancet
3. Hypothalamic Dysfunction – StatPearls, NCBI Bookshelf