Neurological Physiotherapy Principles

How is neurological physiotherapy different from normal physiotherapy?

There are many different areas of physiotherapy ranging from sports to cardio-respiratory. Neurological physiotherapy provides rehabilitation to people who have damage to their brain or spinal cord, for example, stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Physiotherapy treatment will depend on your individual symptoms but will promote movement and functional ability. Physiotherapy for neurological conditions will identify and implement a treatment intervention in order to maximise physical potential and quality of life. 

My wife had a stroke last month. She is unable to walk. Can you get her walking again?

A specialist neurological physiotherapist will first assess your wife to see how the stroke has affected her. Short and long term goals will then be devised incorporating your wife's goals and her abilities. Following assessment the physiotherapist will be able to give a professional opinion as to the likelihood of your wife walking again. Physiotherapy treatment should be started as soon as possible in order to maximise your wife's fullest potential. Her treatment programme will involve exercises and activities to promote walking such as muscle strength training, stretching exercises and balance and coordination practise. These techniques will improve your wife's functional potential and promote her recovery. 

Can everyone benefit from neurological physiotherapy?

Neurological conditions affect people in different ways. Neurological physiotherapists are experienced in treating many different neurological conditions. Neurological physiotherapy will therefore depend on your individual condition. A person with a neurological disorder will benefit from physiotherapy as it will maximise their physical potential. An initial assessment will see how much benefit can be made. 

How many sessions do you recommend?

Following an initial assessment with your physiotherapist, they will decide how many sessions are necessary.

How long is a neurological assessment?

An initial assessment is between 1 ' - 2 hours and follow-up treatment usually lasts 1 hour. 

Can you recommend any neurological physiotherapists in the area?

Physiotherapists work closely with other health professionals and will recommend other neurological physiotherapists if necessary. 

What qualifications do neurological physiotherapists have? 

Qualified neurological physiotherapists will have a Bachelors or Masters Degree. Physiotherapists are also registered with the Health Professional Council (HPC) and Chartered Society of Physiotherapy (CSP). 

How long and how often will I need to attend neurological physiotherapy treatment? 

The length and frequency of physiotherapy treatment will depend on your individual symptoms and goals. Short and long term goals will be developed to help you monitor your progress and potential for change. When deciding on the number of sessions you will need, your physiotherapist will consider: your schedule outside of therapy, your treatment goals, and activity tolerance. Treatment goals are reassessed on a regular basis using different techniques. Self-management and education is the most important aspect of assessment for many people. You may have a short period of intensive therapy and then as your progress stabilises, physiotherapy treatment will reduce to a periodic basis. This will ensure that you maintain your functional ability. 

Are these treatments covered by medical insurance?

It is important to check the specific details of your policy, to see if private insurance policies will cover your physiotherapy treatment. Individuals who have been injured in an accident and are covered by an insurance plan will be funded based upon approval of the insurer. 

Do I need a doctor's referral to be seen by a neurological physiotherapist? 

No referral is necessary and we accept self-referral. However, some insurance policies will only fund physiotherapy treatment unless there is a doctor's signature. We often liase with doctors and other health professionals with your consent to provide the best possible care. 

What should I bring to my first visit? 

For initial assessment at Manchester Physio, we advise that you bring something loose fitting and comfortable such as a pair of shorts and a t-shirt to allow the physiotherapist to observe your movement. Any adaptive equipment such as braces, splints or walking aids should also be brought in so that the physiotherapist can assess their impact on movement. It is also helpful to bring any medical records, as well as a list of current medications that you are taking. 

Can therapy be provided in my home or do I have to come to the clinic?

Many neurological physiotherapists offer home visits as well as clinic visits depending on your individual requirements. 

What kind of equipment will do we use?

The kind of equipment used will depend on your current symptoms, your individual housing circumstances, your lifestyle, and your goals. Neurological physiotherapists often use equipment to teach you how to do things in a safer and effective way and to promote independence with everyday tasks. Neurological physiotherapists also work closely with occupational therapists who can provide additional equipment for you if necessary. Commonly recommended aids and adaptations include:

  • Walking sticks
  • Crutches
  • Zimmer frames
  • Gutter frames
  • Three wheeled walkers
  • Four wheeled walkers
  • Wheelchairs
  • Seating systems
  • Pressure relief cushions
  • Access ramps
  • Bath seats
  • Shower seats
  • Perching stools
  • Kitchen equipment /accessories
  • Cups / beakers for easy drinking / swallowing
  • Grab rails
  • Hoists / slings
  • Transfer boards / belts
  • Leg lifters
  • Bed levers
  • Toilet seat raises
  • Toilet frames
  • Adapted toilets

My doctor has told me that physiotherapy is not necessary, will I benefit from treatment? 

An initial assessment with a neurological physiotherapist will determine whether this is the case. Following injury many people recover good mobility but have subtle problems with balance, coordination, and strength. Your physiotherapist will develop a structured exercise programme to get you back to a level you were previously or teach you new ways of doing things e.g. getting in and out of bed, getting up from a low chair, climbing the stairs and carrying shopping. Exercises will be progressive to challenge and improve your fitness as well as muscle strength and balance. 

Will I be expected to do exercises at home? 

Neurological physiotherapists will recommend appropriate exercises or activities to do at home to promote your recovery and independence. The amount of exercises will depend on your individual ability, home environment and support. 

What happens in a physiotherapy session? 

During your first assessment, your physiotherapist will ask questions about your current problem, when it started and information on your medical and social history. They will then look at your posture, movement, muscle strength, balance and reflexes. Family and carers can be present during sessions and follow-up treatment if necessary. From the initial assessment a structured treatment programme will be individually tailored to your needs. Goals will be set to help you monitor your progress. Physiotherapy treatment will depend on your individual condition but may involve:

  • Exercise
  • Active and passive movement
  • Joint mobilisation
  • Advice on posture
  • Electrotherapy
  • Massage
  • Hydrotherapy