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Services
Although it has been acknowledged that the specialist rehabilitation services required to manage the aforementioned conditions can be equally and effectively provided in Hospital, realistically access to these services remains limited once a patient is medically fit to go home.
Many patients, having been introduced to the benefit of neurorehabilitation on the NHS would like to continue their rehabilitation but either have to wait weeks for an outpatient appointment and / or accept that they will only receive a specific number of sessions due to the demands on the NHS.
Milestones is able to offer patients ready access to specialist, multidisciplinary neurorehabilitation within a purpose built clinic, in their home and / or the community.
- Specialist multidisciplinary team comprising ;
- Consultant in Rehabilitation Medicine
- Occupational Therapists
- Physiotherapists
- Speech & Language therapists
- Orthotist
- Masseur
- A Disability Clinic lead by our Consultant, Dr Philip McCluskie, offering a comprehensive assessment of a person’s needs to establish a management and treatment plan, which may include ;
- a review of their medication
- possibility of Botulinum Toxin injections alongside bespoke splinting for spasticity
- recommendation for therapy from one or more of the therapy team
- a review of the person’s seating needs
- a referral for Orthotics
- The Saeboflex – this custom, dynamic hand splint enables certain people who have regained some shoulder and elbow movement after a Stroke, Head Injury, Spinal Injury or Cerebral Palsy, but are still unable to grip and release
with their hands, to perform grasp and release exercises that have previously been impossible for them
- Neuromuscular Electrical Stimulation (NMES) - this works by passing a weak current via an electrode that sits on the surface of the skin. The current stimulates the nerve to contract and relax muscles. The main recorded benefits are that it may promote recoery of movement, reduce stiffness, increase muscle strength and function.
- Orthotics – an Orthosis is an external device used to modify the structural or functional characteristics of the neuromuscular system and is named after the body section over which it acts e.g an Ankle Foot Orthosis (AFO) may be used to help someone with a ‘foot drop’. Therapeutically an Orthosis may be used to improve stability and alignment, limit or prevent movement, relieve pain and change sensory input.
- Training – we can also provide bespoke one-to-one training for people in their home and community to optimise upon their abilities with their families, carers and / or support workers. The training is centred on the person’s goals and aims to offer practical solutions to people’s problems to enable them to function more effectively.
What is neurological Physiotherapy ?
Physiotherapy is a health care profession concerned with human function and movement and optimising potential.
It uses physical approaches to promote, maintain and restore physical, psychological and social well-being, taking into account the variations in health status.
A neurological Physiotherapist has a special interest in treating patients who have sustained damage to their nervous system from either injury or disease.
The nervous system is highly complex and includes the brain, spinal cord and nerves to the face, body, arms and legs.
These patients may need help to overcome some of the following functional difficulties ;
- Swallowing (dysphagia)
- Eating
- Washing and / or dressing
- Toileting
- Communicating
- Getting in and out of a bed / chair / car
- Walking
- Negotiating stairs
- Driving
Movement may have become awkward, painful and / or difficult to control, making these everyday activities more of an effort and could lead to a loss of independence.
The Physiotherapist needs to use their knowledge of movement, how the nervous system works and ways of promoting learning to work with each patient to solve their unique problems in the most appropriate way.
- A thorough assessment to determine the effects of neurological damage on your ability to move and function
- An analysis of these findings to establish a treatment plan, which will be discussed and explained to you
- Individualised treatment with experienced and specialist neuro-physiotherapists
- Joint goal planning and evaluation of treatment using outcome measures
- Advice on specific home exercises and management programmes, tailored to your needs
- Advice and training for families, carers and other professionals
- With your permission, detailed reports to your GP and / or other health care professionals involved in your rehabilitation
What is neurological Speech & Language therapy ?
Speech and language therapists assess and treat speech, language and communication problems in people of all ages who have acquired neurological difficulties in order to enable them to communicate to the best of their ability
Speech & Language therapists also work with people who have swallowing and eating problems.
Problems with communication, swallowing and eating can arise following a stroke, traumatic brain injury or as a result of a progressive neurological disorder such as Multiple Sclerosis, Parkinson’s Disease or Motor Neuron Disease for example.
The management of a person presenting with a communication and / or swallowing difficulty will include a thorough assessment of the presenting problems using a range of standardized assessments. It may also include a less formal approach where this is more appropriate.
Assessments will take into account all factors including emotional and environmental factors which may impact on a person’s ability to communicate. The assessment will usually take place in the environment most suited to the individual.
Following assessment a therapeutic programme will be devised tailored around realistic goals set by the client in conjunction with the clinician, and where appropriate carers and other members of the multidisciplinary team. These goals will reflect the individuals circumstances and may include vocational goals.
What is neurological Occupational Therapy ?
Occupational therapists treat people of all ages with psychological, emotional, physical or social problems to improve their everyday function and prevent disability. Occupational Therapists are specialists in understanding the link between occupation and health.
Assessments may include:
- Physical abilities
- Cognitive abilities
- Personal activities of daily living e.g. washing, bathing, dressing
- Domestic activities of daily living e.g. meal planning, cooking
- Home management skills e.g. budgeting, bill paying
- Community skills e.g. shopping, route finding
- Day time occupation e.g. leisure, work skills
- Assessment of risk
Following assessment the Occupational Therapist works with the individual to identify realistic goals and then may involve them in a range of structured activities and interventions which could occur in a variety of settings, e.g. home, work, college or clinic, depending on the issues identified at assessment. Treatment may include:
- Advice and training in the use of adaptive equipment and techniques to enable a person to manage such things as eating, bathing, dressing cooking or using a computer.
- If there are cognitive difficulties the Occupational Therapist may develop and teach strategies to manage everyday tasks. For example if a person cannot remember or has difficulty in carrying out and managing everyday routines, the occupational therapist may introduce planning, organisational and memory strategies to enable them to become more independent in tasks like cooking a meal or traveling on public transport.
- Education and advice on how to cope with the physical and psychological effects of a condition. For example if a person presents with fatigue, anxiety or depression they may benefit from advice on relaxation or energy conservation.
- Education and liaison with family and carers to enable clients to maximise their independence in many areas of their lives.
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