In neurological conditions, physiotherapist mainly deals with people with movement and function disorders that have manifested from disorders to body’s nervous and neuromuscular system.
The main complaints of such patients are muscular weakness, balance and coordination loss, uncontrolled movements pertaining to increased muscle tone and tremors, functional loss and sensory issues.
Common neurological conditions that present to physiotherapist include:
- Functional Neurological Disorders
- Stroke, CVA or TIA
- Spinal cord and traumatic brain injuries
- Multiple sclerosis
- Parkinson’s disease
- ALS (amyotrophic lateral sclerosis), TM (transverse myelitis), MG (Myasthenia gravis)
- Muscular dystrophies
In cases of acute neurological conditions like stroke, spinal injury or traumatic brain injury, a patient needs immediate medical attention. Such patients are initially treated at hospital. Once the patient is stabilized through initial medical treatment, the neurologist will recommend physiotherapy treatment while the patients stay in the hospital. The Physiotherapist will undertake a comprehensive assessment of patient’s cognition, perception, strength, coordination and balance and then will design a treatment programme according to the needs of the patient. Depending on the findings of the patient, the physiotherapist treatment plan may include:
- Passive or Active assisted ROM Exercises: if the patient is unable or slightly able to perform the arm and leg movements.
- Positioning / splinting: the limbs are positioned in correct positions to prevent tightening of muscles in inappropriate position. It also helps in preventing bed sores.
- Breathing and Circulation Exercises: deep breathing exercises/segmental breathing exercises helps maintain the airway and prevent respiratory complications and chest infections. Ankle toe pumps, elevation and gentle passive movements reduce the risk of DVTs and improve circulation.
- Teaching transfer techniques: the physiotherapist train the patient in bed mobility, and easy transfer techniques to move safely in bed, sit up, stand and walk.
- Mobility Aids: Physiotherapist advice and instruct the patient how to safely use a walking frame, or other walking aids as required.
- Planning necessary changes at home: physiotherapist take a brief of home restrains and environment and advice necessary changes and equipments that may be require at home after discharge.
- Exercise: exercises to build strength, endurance, coordination and balance.
Following the discharge from hospital, the rehabilitation may be continues at a clinic, community based rehabilitation centre or at home as the patient’s condition demands. The Therapist and family members work in close coordination to achieve desired result. The exercises are mainly to reduce the tone of hypertonic muscles, which may include inhibitatory techniques and stretching exercises, facilitate the under working muscles through facilitatory technique, PNF and reinforcement techniques. Muscle stimulator can be used in early stages for weak muscles. A holistic treatment approach considering the patient as a whole, incorporating exercises into day to day living activities. Few patients may require additional support, high levels of care and specialized equipment. Patients with cerebellar involvement presents with balance and coordination problem. The fear of getting off the bed and difficulty in coordinated movement in any activity lets down the patient affecting the moral of the patient. Therapist has to help uplift the moral so to achieve maximum cooperation from patient while exercising. Frankel exercises for balance and coordination are specially designed exercises to address the problem and over the years have proved to be most reliable exercises for the problem.
PAIN FREE PHYSIOTHERAPY CLINIC helps you achieve the best possible level of fitness in neurological problems. Contact us to get in touch with an expert.