Change in neurological function can have a dramatic impact on family, job, social and community interaction and as such it is particularly important to access specialist rehabilitation which aims to help the person to learn alternative ways of working in order to minimise the long-term impact of their condition, and help the survivor and their family to cope successfully with any remaining disabilities.
- Traumatic Brain Injury (TBI) is an injury to the brain caused by a trauma to the head (head injury). There are many possible causes, including road traffic accidents, assaults, falls and accidents at home, work or during sporting activities.
- Life abruptly changes after traumatic brain injury and the range of injuries and degree of recovery is very variable and varies on an individual basis.
- Some considerations for treatment include working to improve upon: Stability / balance, functional strength and fitness, stamina and helping to dual process better rather than working harder all of which will help to reduce the effects of fatigue, which is often a feature after a brain injury.
Spinal Cord Injury
- Spinal cord injury occurs when there is any damage to the spinal cord that blocks communication between the brain and the body
- Spinal cord injury due to traumatic accidents may be caused by the stretching of or pinching of the cord where vertebrae have been displaced, or by direct damage to the cord by fragments of fractured bone. Non-traumatic spinal cord injury can be caused by pressure on the spinal cord from disease (cysts or tumours), or any interruption of local blood supply.
- Some considerations for treatment include working to optimise:Flexibility, postural control, functional strength and stamina to promote functional independence and efficiency of movement, which may include hands-on therapy, targeted exercises, the use of neuromuscular electrical stimulation , aqua therapy and the use of specific equipment and orthotics.
- If the supply of blood to the brain is restricted or stopped, brain cells begin to die which can lead to brain injury and disability
- There are two main causes of strokes:
- ischaemic – where the blood supply is stopped because of a blood clot, accounting for 85% of all cases
- haemorrhagic – where a weakened blood vessel supplying the brain bursts
Some considerations for treatment include working to:
Reduce pain and stiffness; improve flexibility and efficiency of movement to reduce the effects of fatigue; improve dual processing to help to reduce the risk of falls; empowering people to progress and keep active through creative, fun and sustainable exercise.
Rehabilitation for Covid-19 survivors
Ongoing rehabilitation is essential for many Covid-19 survivors who may still be coming to terms with the impact the virus has had on both their body and mind. These changes should get better over time, some may take longer than others and many Covid-19 patients will have one or more underlying conditions, therefore a multi-condition approach will be required to effectively meet their specific needs.
Our rehabilitation team can help people to build up their strength to reverse the decline from deconditioning, reduce breathlessness, reduce fatigue, manage pain and provide psychological support.
We are continuing to try and keep abreast of the emerging evidence and research relating to Covid-19 to enable us to effectively empower people to recover and build up resilience at their own pace.
We know that coronaviruses can affect the nervous system and it is currently believed that in concert with host immune mechanisms may turn these infections into persistent infections that may lead to neurological diseases.
High quality rehabilitation can empower people to return to their normal level of function, adapt to changes in their functional level and support people to make sense of their illness and recovery.
Neurological diseases such as Multiple Sclerosis, Parkinson’s Disease, Motor Neurone Disease, Primary CNS (brain)tumours, Guillain Barre Syndrome and Cerebellar degeneration.
Each condition creates different challenges and each person has their own unique goals so using our wealth of experience and knowledge of how the nervous system works we strive to help people to optimise their abilities, balancing activity with rest.
The dose, type and timing of exercise is key to making a difference as is sometimes using specific equipment, technology and orthotics .
- Physioworks for MS
- Physioworks for Parkinson’s
- People diagnosed with a primary brain tumour should have access to an appropriate level of rehabilitation if required, so they can optimise their function, mobility and quality of life, regardless of their life expectancy NICE (2004) Guidance on Cancer Services: Improving Supportive and Palliative Care for Adults with Cancer chapter 10, London, National Institute for Clinical Excellence. http://guidance.nice.org.uk/CSGSP
- NICE (2006) Guidance on Cancer Services: Improving outcomes for people with tumours of the brain and central nervous system, National institute for Clinical Excellence, London http://guidance.nice.org.uk/CSGBraincns
Balance and Vestibular Issues
Balance emerges through the interaction of multiple systems within the individual, organised according to task demands and constrained by environmental factors.
These multiple systems include:
- motor (strength, flexibility & alignment)
- sensory (vision, inner ear / vestibular & movement / position detectors)
- cognitive (attention & memory)
The task demands relate to the body’s ability to cope under different situations e.g the unexpected, such as slipping on a rug, or moving beyond one’s point of control such as reaching or stepping out too far.
Environmental factors may include community demands e.g the terrain, opening doors, covering a distance or moving at speed.
Balance senses therefore have to be specifically targeted when designing balance re-training programmes, which may necessitate accessing specialists other than neuro-physiotherapists to ensure all the senses are addressed effectively e.g Audiovestibular Physician, Behavioural Optometrist.
For further information please visit our dedicated balance and vestibular page.