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Neuro rehab insights

Patient pathway – Pathways Physiotherapy

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Here, Louise Barker, specialist neurological physiotherapist, gives SR Times insight into the services Pathways Physiotherapy provides for stroke patients.

Pathways Physiotherapy is a private stroke and neuro physio clinic based in Staffordshire, near Burton-on-Trent. We provide specialist neuro physio, with patients able to self-refer to us.  We have stroke patients coming to us for therapy immediately following their in-patient discharge as well as those who had their stroke many years previously. 

As highly experienced stroke physios, we set up the clinic out of a desire to ensure that patients could receive a high level of specialist neuro physio if they wished to seek private therapy.  This may be to achieve personal functional goals not yet reached on discharge from NHS services, for increased intensity by supplementing their NHS therapy, or wishing to stay as active as possible following their neurological event. The idea of improving fitness and building strength is not always well addressed post stroke. We feel part of our role as health care providers is to encourage everyone to improve their fitness and wellbeing and to give patients confidence and knowledge to do this after a stroke. 

We appreciate that patients may need to be seen in their own homes so are able to provide home visits, which can be very beneficial for practicing functional tasks in their own environment. Additionally though, we like to deliver sessions in our spacious clinic. It can be great for patients to come to a bespoke, calm and safe space where they can focus on their therapy and utilise our equipment. 

We aspire to build a strong relationship with each of our patients to really understand their goals and the type of therapy approach that may work best for them. Through education, around their stroke and evidence-based treatment, patients can make an informed choice as to how they would like their therapy structured. We feel this trust and understanding is the key ingredient in delivering a great service and getting the best outcomes possible. We are a small team and enjoy getting to know all of our patients, and hope everyone having a session with us feels cared for as an individual. 

Most providers would probably say they deliver ‘patient-centered care’ and we believe that we absolutely do this – in fact our ethos is “working on what matters to you”. As therapists it is easy to believe that we know what is best and how we should be delivering treatment, but as experienced clinicians we understand that what motivates our patients can vary. One size does not fit all so listening, educating, discussing and collaborative goal setting is central to our therapy delivery.  As our clinic becomes more established, we are now including the use of more technology to support function and practice of movements and tasks. We aim to expand the range of technology we have, as the role it can play in aiding repetitions and recovery post stroke is becoming increasingly recognised.

We understand that private therapy can be expensive, so alongside our 1:1 treatments with a neuro physio, we also offer options such as sessions with our rehab assistant or group sessions as we wish to enable everyone to have access to our services. In these cases, each patient will still have a individual assessment to ensure that, even in a group setting, we can tailor input to their rehabilitation needs and functional abilities.

Involving and supporting carers is also something that we believe is invaluable, whether this be education, practical advice and assistance, or emotional support. We are currently hosting a new regional Different Strokes group and have been so pleased to see the benefits gained when patients and carers share their experiences. Sometimes those with the least deficits can be having the hardest time adjusting to having had a stroke. Others can share coping strategies and ways that they have adjusted to life post stroke.

We love the diversity of patients we see, and working through the different stages of post stroke recovery. For example our patient, discharged from hospital with a hoist, now mobilising independently with her frame. Or the gentleman who is 20 years post stroke and still making significant improvements leading to improved balance, confidence and positivity.  For us, every patient is unique in their presentation and their motivations which makes our job both challenging and rewarding every day.

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