What is neurological physiotherapy?

Specialist physiotherapy after neurological illness or injury can have life-changing impact. Here, PhysioFunction share their insight into the forms that can take and the many approaches taken by their expert team in rebuilding lives

Physiotherapy is described by the HCPC, its regulatory body in the UK, as the use of “physical approaches to promote, maintain and restore wellbeing”. Like many healthcare professions, the scope of Physiotherapy is extensive, covering sports and musculoskeletal, respiratory, geriatric, ICU, emergency care, paediatrics and neurological specialties to name a few. 

Following a diagnosis of a neurological disease, disorder or injury, individuals commonly present with varied and often complex symptoms caused by the dysfunction of their nervous system. In many cases these symptoms are permanent to some extent, and so long-term management is often required from a multidisciplinary team. Such a team would be directed by medical professionals, and would include specialists in Physiotherapy, Occupational Therapy, Nursing, Care, Speech and Language Therapy, Nutrition and Dietetics and Assistive Technology.

The role of a neurological Physiotherapist in such a team, is to work with the individual to address their physical needs, pertaining to their ability to move, feel, perceive and use their body. Many different techniques are employed to achieve this, from hands on therapy and facilitation of movement, to exercise and the use of rehabilitation technology. Indeed, due to the complex and debilitating nature of neurological illness and injury, technology has a profound role to play in optimising physical rehabilitation.

The use of rehabilitation technology in Neurological Physiotherapy increases the ability of patients to engage in mass practice of task-specific rehabilitation, improving their functional abilities in specific tasks, whether walking, feeding, opening jars or putting on clothes. Neurological Physiotherapists also understand the benefits of ‘take-home technology’ such as FES footdrop devices to improve the efficiency of walking and reduce the incidence of falls in individuals with neurological conditions.

Since the ancient Greeks it has been recognised that exercise is effective medicine for the recovery from and prevention of many health concerns, including obesity, diabetes, heart disease, Stroke and cancer. However, following in the case of a neurological condition, and individual’s ability to exercise can often be severely limited, placing them at a higher risk of developing such medical conditions which are ultimately life limiting.

Early engagement with Neurological Physiotherapy following diagnosis of a neurological condition provides the optimal opportunity to maximise functional rehabilitation. Intensive early rehabilitation has been widely supported for promoting recovery and optimising function after Stroke, and in degenerative neurological conditions such as Multiple-sclerosis and Parkinson’s disease, engaging with Neurological Physiotherapy early to maintain physical function can help to improve long-term independence and quality of life.

In cases of Spinal cord injury, significant changes are often required to the lifestyle of the individual to manage the parts of their body that they are no longer able to function. Neurological Physiotherapists trained in spinal cord injury rehabilitation, alongside their MDT colleagues, teach vital functional skills such as transfers, wheelchair propulsion and dressing, as well as identifying appropriate daily activities to maintain postural control, alignment, function and independence. These treatments also help in managing common comorbidities of Spinal cord injury such as spasticity, muscle weakness, pain and skin breakdown.

In the case of more chronic/long term neurological conditions, Neurological Physiotherapy remains an effective tool to be used to help in improving general health, improving functional abilities, learning new physical skills, and promoting independent function.

As well as ‘land based’ approaches, Neurological Physiotherapy also covers the use of Aquatic Physiotherapy. Aquatic Physiotherapy usually involves immersion in warm water (32-35°C) combined with physical activity. This treatment technique is immensely effective in the management of neurological conditions for multiple reasons including:

• Bodyweight supported environment: the effect of buoyancy in the water eliminates the effects of gravity and enables individuals to utilise muscle function that is not possible during land-based therapies.
• Hydrostatic pressure: The pressure exerted upon the body surrounded by water is greatest at the bottom of the pool, corresponding with the peripheries of the body which commonly accumulate fluid and swelling in the absence, or restriction of, movement of the legs, and aids in the drainage of these fluids, making limbs lighter and easier to move, as well as reduction pain and stiffness.
• Suppression to the sympathetic nervous system: In many neurological conditions the sympathetic nervous system dominates, leading to symptoms such as elevated blood pressure, poor sleep, and muscle tension. Warm water immersion and Aquatic Physiotherapy can help to suppress the sympathetic and promote the parasympathetic nervous system, allowing improved health and recovery.

In summary, Neurological Physiotherapy is a valuable, and potentially an essential tool for individuals with neurological illness or injury to access at any point along their individual journey (although the earlier the better) to enhance their ability to live independently, manage the symptoms of their condition, and optimise their health and wellbeing.

For further information please contact Physiofunction on 01327842321 or by email to rehab@physiofunction.co.uk