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stroke & neurological physiotherapy

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5 areas neurological physiotherapists work with Parkinson’s patients

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Every patient is an individual, we take the time to assess each patient not only at the first session but also throughout the duration of treatment, and to ensure the programme we develop is right for each patient and their circumstances.
At initial enquiries and consultations we are often asked, what are 5 areas a neurological physiotherapist may work on with people with Parkinson’s:

1. Physical mobility – for example getting in and out of bed or standing up from a chair.

2. Improving walking and turning – strategies to get going more easily and get into a rhythm of walking and doing walking exercises, for example marching.

3. Posture – keeping posture as good as possible by regular specific stretching exercises and working together to keep a good range of spinal mobility.

4. Strength and fitness – working on the anti-gravity muscles which keep us upright and making sure that physical activity is appropriate to keep up strength and maintain an optimal level of fitness.

5.  Balance and co-ordination – understanding which particular activities are providing most
challenge and working on strategies and building strength and confidence to improve balance.

headsup! Is a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

5 reasons early neurological physiotherapy is important for Parkinson’s

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We must remember that a positive difference can be made to people who have lived with Parkinson’s for a number of years. But the question we are regularly asked is, why early neurology physiotherapy is so important?

1. When presented with a diagnosis of Parkinson’s most people will have questions which they would like to put to a knowledgeable professional experienced in the field.

2.  Most people want to know what they can do to minimise the effects of Parkinson’s Neurological physiotherapists will give helpful tips and advice.

3.  Regular exercise is a powerful tool to keep the body and mind in the best shape possible. Specific advice for each person helps to tailor the exercise and activity to best address their individual needs and preferences.

4.  Assessing and minimising postural asymmetry and any areas of specific spinal stiffness           together with postural advice help to optimise posture.

5.  Taking baseline measures and providing a monitoring and advisory role is reassuring. The person with Parkinson’s will feel that there is somebody who knows about their physical state and can help them to remain as active as possible.

headsup! Is a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

ACPIN 2016 Conference Round-up

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Three members of the heads up! specialist neurological physiotherapy team attended the recent ACPIN (Association of Chartered Physiotherapists in Neurology) two-day conference in London, in association with INPA (International Neurological Physical Therapy Association).

The event brought together experts from across the globe, in neurological physiotherapy, rehabilitation and research. We have pulled together the key points, from a selection of the programme speakers:

Dr. Emma Stokes, Dublin, introduced day one by talking about the World Congress of Physical Therapists and the three priority areas they had identified:

  1. Research
  2. Evidence
  3. Practice

 Prof Derek Wade, Oxford presented “How to use evidence, follow guidelines, and be patient centred”. He discussed what we could do is not necessarily what we should do and how rehabilitation is all about behavioural change:

  • Guidelines – the evidence is always incomplete. They are not binding and not enforced. They are focused on treatment and not the problem
  • Evidence – has enormous limitations, often not well described on what they did and RCTs patients are allocated and not randomised
  • Theories – should be developed which are based on evidence, but developed over time.

Prof Louise Ada, Sydney presented: “One size does not fit all” concept in mobility intervention for stroke:

  • The speed of walking post stroke is a key determinant in whether a person walks outside the home. There is a need to look at groups of people with different walking speeds differently
  • Current trials are not good at describing participants or interventions
  • Cueing of cadence using a metronome is cheap and effective in improving walking speed and distance in people who have had strokes.

Prof Gert Kwakkel, Amsterdam (visiting Prof Chicago) presented: “Understanding upper limb recovery early post stroke: some lessons of the EXPLICIT – stroke programme”

  • The quality of trials is improving, up one Piedro point over the last 10 years and how.
  • In the future, there will be 4D analysis of movement – 3D+EEG
  • Stroke rehab app http://www.viatherapy.org

 Prof Sarah Tyson, Manchester presented “Patient-led therapy during in-patient stroke rehabilitation”

  • In hospitals all policies focus on patients NOT doing something in order to prevent damage
  • Good rehabilitation is about good organisation
  • Out of 28 days, when patients were supposed to exercise daily, only 7% exercised every day. The average was 11 days and 1/3 people exercised less than 7 days.

Prof Steve Wolf, Emory University USA presented: “Collaborative decision making and the development of best evidence apps”

  • PASS Physical Therapy and Society Summit – recommendations advocate for leadership role in prevention, health & wellness
  • He discussed genetics, robotics, telehealth and regenerative medicine
  • Frontiers in Rehabilitation Sciences and Technology (FIRST Initiative) www.viatherapy.org; www.neurorehabdirectory.com

 Prof Fiona Jones, London presented: “It’s all about the small steps” sharing and creating solutions for successful self-management after traumatic brain injury:

  • Lots of stories of people who had had traumatic brain injury not being heard
  • Often people denied that they had had a brain injury
  • Need change agents, people who really get it and want to make it work
  • People needed to support their partner/family member to take some risks. Risks are an essential part of neurological rehabilitation
  • Pilot carried out at King’s College Hospital, now looking at training people in all four major trauma centres in London and making a training film.

Prof Valerie Pomeroy, University of East Anglia presented: “Generating the evidence base for personalised stroke rehabilitation”

  • One third of people with stroke will decline to participate in research trails
  • Evidence Based Practice = “Using the best evidence available considering the person you actually have in front of you”.

Prof Lisa Harvey, Sydney presented: “Spinal cord injuries: recent trails and their relevance to other areas of neurology”.

 Prof Robert van Deursen, Cardiff presented: “Exploration of clinical-academic collaboration to achieve evidence based practice”:

  • Developing research evidence is about developing theory
  • In neurological physiotherapy we are dealing with behavioural change
  • Emphasised the importance of researchers and academics with a clinical background.

Prof Karen Middleton, Chair Chartered Society of Physiotherapy gave a punchy address talking about “knowing the customers and what their local needs are”

  • Prevention is the only way we are going to deliver sustainable health care
  • We are exemplary problem-solvers. We really do work in partnership with patients, their hopes and what they want to achieve
  • To focus on supported self-management and self-referral. Self management is about education for people to understand their disability and know when they need to seek help
  • We are in danger of being obsessed with evidence
  • We need to pull together as a profession and make the most of our professional body.

Prof Helen Dawes, Oxford Brookes University presented: “Walking and simulated walking control”

  • Used imaging and treadmill training
  • After stroke, people used a lot more metabolic and brain activity to move and walk
  • Pre-frontal cortex more active soon after stroke, but the activity decreases over time
  • Internal planning seems to affect walking more than external distractions i.e. thinking about what you are going to buy at the shops, is more distracting than confronting something in the environment.

To find out more about the conference – Evidence into Practice – visit www.acpin.net

 

Can you put a time on stroke recovery?

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Stroke recovery is a highly individual process, which depends on many different things. The severity of the stroke and location of the area of damage in the brain will all have an effect on the recovery time.

Initially, the biochemistry of the brain is disrupted by the stroke. Over a period of days and weeks things settle down and the initial shock wears off.

Stroke rehabilitation consists of treatment from stroke doctors and nurses, neurological physiotherapists, occupational therapists and speech and language therapists. This multi-disciplinary stroke rehabilitation is most effective in maximising stroke recovery.

Stroke recovery, in our experience of working with people over many years, takes place over many months and even years. At heads up! we have a hands-on approach, using our neurological physiotherapy treatment skills to re-align, re-activate and strengthen muscles.  We teach people how to move most efficiently and with the least effort possible in each person’s particular case.

Stroke recovery is a journey and specialist neurological physiotherapy input gives people treatment, advice and appropriate exercises specific to that person at that time. Doing the exercises given regularly and diligently as an adjunct to neurological physiotherapy treatment, will help to consolidate progress.

You can find out more from the Royal College of Physicians Stroke Guidelines https://www.rcplondon.ac.uk/guidelines-policy/stroke-guidelines

Longer term stroke recovery – one person’s story
A few years ago I saw a man who sadly had had a stroke only a few weeks after retiring, following a long and distinguished career. After five months spent in hospital and local rehabilitation unit, he came to heads up! and was unable to stand on his own without support.

His loving wife was his greatest supporter and inspiration. His previous employers were extremely generous and funded regular treatment for many months. At our suggestion he also worked regularly with a local personal trainer (under our supervision) and improved slowly, but surely.

Three years after his stroke he completed a sponsored walk of one mile. He used a stick and a bespoke leg splint. With many friends, family and some of the heads up! team cheering him, he walked a mile in just over three hours. This was his marathon. We were extremely pleased and proud to support him and delighted to report of his determination and amazingly successful fundraising effort.

 

headsup! have practices in the London and Kent areas. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

Hands-on neurological physiotherapy at heads up!

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We offer individual and specialised neurological physiotherapy treatment. Helping each patient work towards improving their movement and confidence, following a stroke or neurological condition such as Parkinson’s, multiple sclerosis, vestibular dysfunction and adults who were born with cerebral palsy.

We have worked with many people who have had a stroke, both recently or a long time ago. In the weeks and months following a stroke, recovery can be accelerated and optimised by specific hands-on treatment.

Our physiotherapists have many years’ experience, activating and re-aligning muscles and joints by physically moving the patient’s body. We work together to improve movement quality and although everybody is different, if we work hard it is invariably possible to make a positive impact.

headsup! have practices in the London and Kent areas. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

Why hands-on physiotherapy matters

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3 reasons hands-on neurological physiotherapy treatment helps recovery of control of movement after stroke.

Working together
People who have had strokes or have other neurological conditions such as Parkinson’s or balance disorders often find moving around difficult. Movement may be weak and limited, slow or lack co-ordination. Simply telling people to move, talks to the part of their brain which is responsible for producing movement. This part may not be communicating clearly with the other parts of the nervous system, which are responsible for actually doing movements. This may mean that movements are simply not able to be initiated without a little help.
During hands-on physiotherapy treatment the neurological physiotherapist and person receiving treatment work together, so that the patient can again feel how to move with more control and less effort.

Information
Stroke and other neurological conditions often affect the feeling, or sensory part of the nervous system. This means that the body may feel numb or not normal. Hands-on therapy gives information, through pressure, touch and manual guidance to help the nervous system learn to feel again.

Training
Physiotherapists are trained in using their hands. An experienced neurological physiotherapist will use their hands to re-align muscles and stabilise the body so that it can be more efficiently active when movement is difficult.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

3 tips: improving the quality of your standing practice (advanced)

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Create a checklist

Have a checklist in your head about the quality of your standing. The aim is a good posture, which allows a relaxed standing position, with weight evenly distributed on both feet and the back in a neutral position.

Everybody is different and people find individual reminders useful. Some common ones are “feet level, hip width apart, knees soft, bottom tucked in, tummy strong, ribs gently down but breast bone up, shoulders relaxed with soft arms and head up with chin gently tucked in and back of the neck long with crown of head up”.

2. Create and develop sense of your posture

Developing your own personalised checklist (with the help of a neurological physiotherapist ideally) and using a mirror if this helps you. A mirror may help to create and develop your sense of your own posture. Keeping still in your “best” posture and closing your eyes to enhance your appreciation of where your body parts are in relation to each other will help this improved posture to become more familiar and natural to you.

3. Joining posture with movement

Thinking about posture and movement is the next stage and developing strength in the trunk muscles. An easy way to do this is to take something with both hands from a shelf in front of you, or simply touch the wall in front of you or stand in a door frame and touch the frame either side at about shoulder height and then squat down and touch the floor with both hands or put an object on the floor, then pick it up again.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities

3 tips: improving the quality of your standing practice (intermediate)

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Standing and using your arms

Think about HOW you stand up. Ideally weight should be evenly distributed on both feet and although using hands on the arms of a chair is something we would often do, if we take a lot of weight through the hands to push up then we are not asking the legs to work as hard as they might, so we may miss out on opportunities to strengthen the legs.

2. Stand up tall

When you are standing up make sure that you stand up as tall as you possibly can before you start doing anything in standing. Think about having strong legs and your hips forwards, chest lifted and head up with shoulders and arms relaxed. Say to yourself “stand up tall”, or “heads up! bottom in!”

3. Weight on each leg

Having checked that you are standing up tall, gently take more weight over to one leg so that you are putting 75% of your weight on one leg and 25% on the other. Hold this position for three seconds and then change so that there is more weight on the other leg.

Do this five times on each leg. Try to keep your body up tall and hips facing straight forwards.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities.

3 tips: Increasing the time you spend in standing

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

  1. Identify a daily activity

Identify an activity you can do in standing as you become more confident on your feet. Examples of this may be brushing your teeth, washing your hands or brushing your hair.

2. Listening to music and watching TV

If you listen to the radio or watch television, stand up either during a news bulletin or during the advertisement breaks. If you listen to music, identify a particular song you like and try to stand up for the duration of the song. You can then build up the time by adding other songs.

3. Build on your confidence

As your confidence improves in standing, increase the number of times you stand up in the day. If you cannot stand for long then try and stand more often. This will build your confidence and strength.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities

3 tips: improving the quality of your standing practice (introduction)

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Foot control

If you are able to move your feet forwards and backwards with reasonable control, then do this a few times with each foot if possible, whilst you are sitting down, before you get ready to stand. This warms up the leg muscles and gets them ready for action.

2. Distributing body weight

When standing up try and get the weight transferred evenly over both legs. Think “is my weight even? How much weight have I got on my right foot – press a little into the floor with your right foot if you can as you think this, then do the same on your left foot.”

3. Turning your head

Stand up as tall as you can, bring your hips forwards, raise your chest – imagine a light on your breast bone shining straight in front of you. Lift up your head and if you feel stable enough, slowly turn your head to look over to one side and then the other side. Do this three times each way.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities

3 tips: preparing for standing practice (intermediate)

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Slow breathing

Take three slow deep breaths, sitting up as tall as you can, as you breathe in through your nose and out through your mouth. Do this five times.

2. Sitting tall

Sit up as tall as you can, imagining a very strong elastic band through the top of your skull pulling you gently but strongly towards the ceiling. Stay sitting up tall for ten seconds. Do this five times with a short rest in between.

3. Working your tummy muscles

Place your hands in your lap and think about where your shoulders are in relation to your pelvis. If your shoulders are behind your bottom, try to sit forwards (without using your arms if possible, so that your tummy muscles do the work, not your arm muscles) so that you are sitting in your best sitting posture. Imagine a torch light shining from your breast bone and slowly turn your body to shine the torch to one side and then to the other. Do this three times to each side keeping your best posture all the time. Try to lead the movement with your tummy muscles rather than shoulders or head. Do this five times each way.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities

Is your Mum, Dad or a relative in hospital after a recent stroke?

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The early days after having a stroke are often very tiring and people who have had stroke and are in hospital may find it difficult to sleep well. Taking in your Mum or Dad’s pillow from home may help them to get comfortable.

After having a stroke, people may have difficulty swallowing. A speech and language therapist will assess the ability to swallow and advise on management. Physiotherapists in hospital will assess movement and sensation and balance and advise on the best ways to move around. Getting back on your feet is very important as early as possible after stroke.

As a visitor, you will often sit by your Mum, Dad or relatives bed. In the very early stages, if the person who has had a stroke is finding it difficult to move one side of the body and cannot see one side, they may need reassurance from the side, which is stronger. As soon as the person is more relaxed about being in hospital, try to approach them from the weaker side so that their attention is drawn to that side.

Even if movement is very difficult, taking a few really deep breaths in and out slowly and looking slowly to the left side and then to the right side a few times will help to relax the neck and shoulders, which is often an area of muscle tension. Reminding your Mum, Dad or relative to do this regularly, for example every time they have a cup of tea or coffee will help establish a routine of activity and make them more comfortable.

Is there more recovery early after stroke?

The first few months following stroke is when fastest recovery takes place. During this time, the body and brain are re-organising themselves to cope with the damage caused by the stroke, which is an interruption in the blood supply to the brain.

Specialist neurological physiotherapy in the period soon after stroke is extremely helpful in guiding the body to re-organise itself (neuroplasticity) in the best possible way. People who have had strokes are often not very confident on their feet and working with an experienced physiotherapist helps to build confidence and improve balance.

The more practice and treatment a person with stroke has early after stroke, the more quickly they will re-gain their confidence. Specialist neurological physiotherapists will work with each person after stroke, at their pace, to improve their movement control and get them back to doing things they enjoy.

At heads up! we work with our patients to create tailored treatment programmes and are here for continual support, advice, information and encouragement.

Get in touch to talk to a physiotherapist and find out how we can help your Mum, Dad, family member or friend in their stroke recovery.

3 tips: preparing for standing practice an introduction

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This is part of our series of tips to reduce time sitting after stroke and practice standing. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Breathing

Take three slow deep breaths, breathing in through your nose and out through your mouth. Pause for a minute or so and then repeat.

2. Sit up tall

Sit up as tall as you can, imagining a very strong elastic band through the top of your skull pulling you gently but strongly towards the ceiling. Stay sitting up tall for three seconds.

Do this five times.

3. Posture

Take three more slow deep breaths, this time concentrating on your tummy button and imagining the area behind your tummy button filling up with air and your lower ribs going out to the side as you breathe in. As you breathe out concentrate on your posture, trying not to slump downwards as you breathe out. Do this five times.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities.

Has your Mum or Dad just had a stroke?

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If your Mum or Dad has had a stroke, especially around the busy family Christmas period, and is in hospital, you may feel unsure as to what you can do to help. Stroke happens suddenly and changes peoples lives.

Approximately 152,000 people have strokes in the UK each year and more than one million people in the UK are living with stroke (Stroke Association 2013).

When you visit your Mum or Dad in hospital it is important that you talk to them calmly and normally, assuming that they understand everything you say, even if they are unable to converse and even if they aren’t making a lot of sense. In the early days after stroke, the whole body is in shock and initially your Mum or Dad may experience significant difficulties, which may resolve, at least partially, over time.

Maintain a positive attitude and re-inforce every sign of recovery, no matter how small to encourage your Mum or Dad.

Is there more recovery early after stroke?

The first few months following stroke is when fastest recovery takes place. During this time, the body and brain are re-organising themselves to cope with the damage caused by the stroke, which is an interruption in the blood supply to the brain.

Specialist neurological physiotherapy in the period soon after stroke is extremely helpful in guiding the body to re-organise itself (neuroplasticity) in the best possible way. People who have had strokes are often not very confident on their feet and working with an experienced physiotherapist helps to build confidence and improve balance.

The more practice and treatment a person with stroke has early after stroke, the more quickly they will re-gain their confidence. Specialist neurological physiotherapists will work with each person after stroke, at their pace, to improve their movement control and get them back to doing things they enjoy.

At heads up! we treat everyone as an individual, working with our patients to create tailored treatment programmes. We are also here for continual, support, advice, information and encouragement.

Get in touch to talk to a physiotherapist and find out how we can help you, a family member or friend and keep in touch with our latest news by following us on Twitter.

Festive meals & family gatherings: 3 tips on how to reduce time sitting after stroke

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This blog is part of our series of tips on how to reduce time sitting after stroke. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Get involved

Whilst the Christmas meal is being prepared, try to get close to the action so that you can, for example, stand up whilst the potatoes are being peeled, or whilst the table is being laid.

2. Check out your surroundings at the start

Find somewhere where you feel safe and confident to stand up, either with or without some help or support. This may take some investigation and trials, but it will be worth doing at the start of a busy day. Having sufficient time and opportunities to practice and gain confidence in standing are essential in building strength and improving ability to stand for longer.

3. Make a point of standing

Making a point of standing up at different stages of the day will minimise stiffness. For example, stand up when people arrive, stand up when you sit round the table to eat, stand up when you have finished your turkey, stand up when you have finished pudding and stand up if there are any chocolates or other treats on offer.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities.

Shopping and other outings: 3 tips on how to reduce time sitting after stroke

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This blog is part of our series of tips on how to reduce time sitting after stroke. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read the important note below*

1. Set an alarm

If you need a wheelchair when you are out shopping or for longer distances, then set a phone alarm to remind you every hour to stand up and have a good stretch.

2. Pushing a wheelchair

If you are being pushed around in your wheelchair and you can manage to walk a short distance yourself, then change places each hour – so you push them!

Pushing a wheelchair with someone sitting in it is easier on the flat than pushing an empty chair. If you need to, walk with a wall close by on one side so that you can stop and lean if necessary when you need to.

3. Posture check

When you go to the W/C or get back to the car and have to stand up, spend longer in standing than you need to. Check your posture and gently place more weight on one foot than the other and, if possible, step one foot back and forwards a few times with each leg.

Check your posture again and turn your head slowly to look over one shoulder and then the other three times.

The next blog will cover 3 tips for reducing time sitting after a stroke at festive meals and family gatherings over the holiday season.

headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists.

If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities

Why is spending time standing up important?

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Humans are bipedal creatures. We have evolved so that we can stand up and balance on our feet and use our hands for an enormous variety of tasks.

Initially hunting, gathering, tending, nurturing and feeding would all have been vital skills. Today we use our hands with a slightly different emphasis – for example the skills of grooming and intricate tool use receive more attention, as well as pushing the correct buttons on a remote control.

In more affluent societies the time spent in sitting rather than standing has historically increased. The average time spent watching television per day is nearly 4 hours and this is done sitting down. With the advent of the management of our lives using keyboards and smartphones we spend more time relating to electronic devices in our lap area and less time on our feet.

The support of the body in a sitting position is the subject of enormous research and there are now a huge variety of ergonomic and posturally supportive chairs and seating systems.

Over the next few months we will sharing a series of tips, to help anyone who has had a stroke build their strength, confidence through increasing time in standing by incorporating this into their daily routine wherever they are. *

We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of our specialist neuro-physios, just get in touch on 01306 888171.

* heads up! neuro-physios assess and treat people with strokes and many other neurological conditions. Each person has different individual physical characteristics and capabilities and whilst our blogs contain some general advice and information, any activity should first be practised with a specialist neurological physiotherapist while the most effective and safe exercise programmes are those designed in conjunction with, and regularly reviewed and progressed by, a neuro-physio.

Building up average standing time: 3 tips on how to reduce time sitting after stroke

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This blog is part of our series of tips on how to reduce time sitting after stroke. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read important note*

1. Timing an everyday task

If you stand to brush your teeth, wash your face or do any personal grooming activity, time yourself in standing and record it over one week.

2. Setting a target

Calculate an average each morning and set yourself a target. An example might be that you would like to double the time you spend in standing over a four-week period.

3. Keep a record

Keep a daily diary. You might want to include something about quality of sleep and rest, how you feel on waking, physically and in relation to mood, what your plan for the day is etc.

The next blog will cover 3 tips standing while out shopping over the holidays. headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists. If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities.

Making a start: 3 tips on how to reduce time sitting after stroke

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This blog is part of our series of tips on how to reduce time sitting after stroke. Visit our website for more tips. Before carrying out any of the exercises in our blogs please read important note*

1. Somewhere safe, where you can be confident

Find somewhere to stand up where you feel confident and safe to do so. Always having a chair or stool behind you so that you can sit down when you have had enough is ideal. Safe places might be in front of the basin in your bathroom, with a stool or chair behind you, or standing at the kitchen sink or in the kitchen facing a corner worktop with a chair behind. Standing at the bottom of the stairs where you can hold on to the bannisters may also be a good place.

2. Start with short burst

Start standing for a short time, even if you can only manage moments standing up. By doing this regularly, you will build up your confidence and strength so that your ability to stand improves.

3. Making it part of your normal daily routine

Establish a routine for regular standing practice. Linking standing to your daily routine helps to fit it into the day without it becoming a chore or “exercise”. An example might be standing in the kitchen whilst the kettle is boiling for morning coffee and again for an afternoon tea.

The next blog will cover 3 tips for building up average standing time. headsup! are a team of specialist neuro physiotherapists covering London and the South East. We are always happy to discuss individual requirements and explore suitability for treatment over the telephone. If you would like to talk to one of the team, just get in touch on 01306 888171.

* Please read before undertaking any exercises listed in this blog:

Neither headsup! neuro-rehab Ltd nor Anna Hamer accept any responsibility for any individual undertaking the activities or exercise suggested in our blogs, except to the extent those individuals are acting upon specific instructions from headsup! neuro-rehab Ltd specialist neurological physiotherapists. If you are in any doubt please consult a specialist neurological physiotherapist. Please make sure you have suitable help to hand before embarking on any activities

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