Physiotherapy services for neurological conditions

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Stroke is an emergency, even if you have had a stroke before. If you have any sudden, new or increased symptoms then follow the NHS advice - contact emergency services on 999

What is a Stroke?

A stroke is caused by interruption of the blood flow to the brain, either by a clot or a bleed. This causes damage to a small or large area of brain tissue and subsequent loss of function in speech, cognition, memory, vision, sensation or physical ability. The amount and type of damage depends on the blood vessel involved.

Early care in a hospital setting is important to minimise damage and help reduce the risk of having further strokes.

After this early care, recovery from stroke can continue. This is the rehabilitation phase, which is where Sharp Neurological Physiotherapy can help.

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Stroke and Physiotherapy

Approximately two thirds of stroke survivors are left with some physical disability.

Physiotherapy aims to help the stroke survivor learn new techniques or relearn old ones to maximise their functional abilities. This is achieved through many different techniques including exercise programs, education and adjunct technologies like CIMT and FES.

Some common problems and treatment examples are listed below:

Weakness

The most obvious and common symptom after a stroke is the lack of movement in the limbs on one side of the body. Although this is not the same as weakness caused by rest or lack of exercise, some of the same training principles can be applied. A physiotherapist will demonstrate and assist with an exercise program adapted to allow the stroke survivor to "strengthen" the working muscles and neural pathways available. This in turn improves movement and function.

Spasticity

Spasticity is a complex secondary complication after a stroke which results in the tightening of muscles on the affected side/part. Once the source and causes have been identified, spasticity can be managed with regular positioning, stretches and sometimes medication. Spasticity can sometimes disguise available movement and function, so these can improve when the spasticity is controlled.

Sensory Changes

Less visible but equally disabling are changes to the sense of touch, pressure, joint position etc. After a stroke the sensory system can be damaged either on it's own, or in combination with balance and movement problems.

This makes it more difficult to detect where a limb is or what it is pressing on. A lack of sensation can leave a person at risk of burns, pressure sores or other injury, as well as difficulty in function.

Physiotherapeutic techniques can directly improve rehabilitation of the sensory system and a physiotherapist can also give advice about prevention of secondary injuries.

Balance Disorders

Falls, difficulty walking or sitting and dizziness are all symptoms of balance problems. Balance in an upright posture requires an intact nervous system, so even small injuries to the areas of brain which control balance can cause difficulties. Balance is as responsive to rehabilitation as other problems. There is also a good range of walking and other aids to help with this problem which a physiotherapist can advise on or employ to help improve balance.

Difficulty functioning

Whether it is in returning to work or just getting to the toilet, the physical and perceptual problems caused by stroke can affect your ability to function as you did before.

Physiotherapists can work with you to adjust the environment, the approach to a task or tailor your treatment to improve the strength or movement needed to achieve your goals.

For example, if you could get to the toilet, but it's not on the same floor level, your therapist could help you learn how to manage the stairs. Alternatively you could work on how to transfer to a stair lift, or how to access a commode chair with the help of your carer.

Treatment techniques are selected depending on the specific problems a stroke survivor is left with, how severe these problems are, what suits them in terms of time, personality and preference. It also depends on the ability or difficulty a person would like to work on.

That is why a treatment plan from Sharp Neurological Physiotherapy is always tailored to each individual after a thorough initial assessment and discussion of needs.

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