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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.

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.

The Bobath Concept explained

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For many people the Bobath concept is a new idea, however it has been practised for over 80 years. It is based upon two key principles:

  • People with neurological problems can improve their movement skills.
  • The importance of treating the body holistically.

First developed by Berta Bobath MBE PhD (Hon), she had come to the UK from Germany in the 1930s with her Czech husband, a neurologist and psychiatrist. She specialised in neurological disorders and set up a centre for children with cerebral palsy.

At the time, the prevailing wisdom was that people with strokes couldn’t improve any of their movement skills that had been damaged. At best, people were encouraged to strengthen their undamaged sides; at worst, rehabilitation wasn’t even encouraged.

Bobath’s revolutionary ideas showed that people could improve movement on their damaged side after a stroke. Her holistic approach also showed that the body functioned as a whole, and that walking and balance could be improved through treatment of the arm.

Bobath explained the concept in an interview as “a whole new way of thinking, observing, interpreting what the patient is doing, and then adjusting what we do in the way of techniques – to see and feel what is necessary, possible for them to achieve. We do not teach movements, we make them possible.”

The basis of the Bobath concept lies in handling patients so that the physiotherapist helps to facilitate movement by lengthening short muscles, mobilising or moving tight joints, strengthening weak muscles and helping to keep their bodies in better alignment. This can be summarised as ‘stabilising wobbly bits and mobilising stiff bits’.

It is difficult for people to learn new movements or to become confident in their existing movements on their own. Physiotherapists can give them the opportunity to practice movements in an atmosphere of safety.

The Bobath approach helps people to move in the most efficient manner possible, so that they conserve their energy, lessen the wear and tear on their bodies, and reduce the strain they are feeling. The aim is to teach the body and mind how to move most easily – involving as many parts of the body as possible, using all the movement already available, and trying to increase movement skills.

If one part of their body is out of balance because it is stiff or painful, feels like concrete or is working too hard, the physiotherapist will try to help by providing balance and giving all parts of the body a chance to work together.

All the heads up! physiotherapists follow the Bobath approach in their work. To find out more about this approach, contact Sally Watt, Practice Manger on 01306 888171.

Bobath Training programmes

Bobath training is mostly given at post-graduate level. Those physiotherapists specialising in neuro-physiotherapy who want to train in the Bobath concept have three levels of training:

  • Introductory modules on movement analysis
  • A 3-week residential course, including a project on strokes
  • A week-long advanced Bobath course, which can only be taken a year after the second course.

On completion of all these levels, a physiotherapist can use the designation ‘Bobath trained’.

All physiotherapists working at heads up! have completed the three week course, at least one advanced course, and further training courses through the British Bobath Tutors Association (BBTA).

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