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.

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

Moving around can be difficult enough for those of us who haven’t experienced strokes. But I think it’s impossible for us to understand, how difficult it must be, for someone who has trouble standing, let alone walking.

People with stroke often have difficulty balancing when standing and find the effort required to remain standing tiring. Furthermore, safe opportunities to practice standing are generally limited in the early stages of stroke recovery. A key part of neurological physiotherapy is to work with people with hemiplegia and encourage more balanced and confident standing.

Neurophysios work to improve standing balance in clinical and hospital settings, but also in many other places in the community. Encouraging outings and finding places with even floors, good lighting and suitable access is all part of working towards improved confidence in walking in a variety of places. Recently at heads up! we have helped people to walk more confidently in their gardens, gyms, supermarkets, swimming pools, golf clubs, hairdressers and on allotments, places where they can improve their quality of life and return to doing things they enjoy.

English et al (2015) recently completed a study on thirty-three people with stroke, investigating the feasibility of giving counselling sessions with a message of ‘sit less, move more’ to encourage spending less time in sitting. The study lasted seven weeks and the baseline average of 640 minutes per day (10.66 hours) sitting down was decreased in both experimental and control groups. In particular, the time spent sitting for more than 30 minutes at a time decreased. The people with stroke increased the time they spent in stepping and standing.

Prolonged, uninterrupted bouts of sitting are particularly detrimental to health and there is increasing evidence regarding the relationship of time spent in sedentary inactive behaviours and an increase in the risk of developing cardiovascular disease.

As hard as it is to prove the efficacy of neurological physiotherapy in an experimental setting, it is clear for all to see that the confidence and the motivation that is provided by neuro-physios the world over is fundamental in getting people who have had strokes back on their feet.

Find out more:

English C et al. Reducing sitting time after stroke. A Phase II safety and feasibility randomised controlled trial 2015 Arch Phys Med Rehabil. E pub ahead of print

English C, Healy GN, Coates A, et al. Sitting and Activity Time in People with Stroke. Phys Ther 2015; 95:

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.

Often the diagnosis of a neurological condition follows some time of wondering what is wrong. Sometimes even being told that nothing is wrong but later discovering there is. Whatever the circumstances of a diagnosis, such as Parkinson’s or multiple sclerosis, there is uncertainty and often anxiety over what the future holds.

Physiotherapy early after diagnosis is extremely helpful, not only as an opportunity for the person with the new diagnosis to be listened to and share any concerns, but also to become better informed about the things they can do to minimise the effects of the condition.

In our experience at heads up!, we find that people are greatly reassured by an early visit to see us following a diagnosis. They have time and space to think about questions they have, to share anxieties with an experienced and well-qualified physiotherapist. One of the reasons neurology is so fascinating is that no two people are the same, and the same condition presents itself differently from person to person.

If you, a friend or family member have recently been diagnosed with a neurological condition and would like to find out more about how neuro physio can help please get in touch.

Find out more and keep in touch at headsup.co.uk and follow us on twitter @headsupphysio

There are 2 main reasons for the belief about the 6 month deadline. Partly it’s rooted in out-of-date theories about how the brain works and also because many doctors and other health professionals who deal with strokes don’t often see the patients who’ve made longer-term progress.

The NHS does not have the resources to provide long-term treatment for stroke patients, so treatment tends to be very much focused on the initial period after a stroke. However, this very unhelpful belief, puts a lot of pressure on patients in hospital who are struggling to come to terms with having had a stroke but who can already hear the clock ticking away. It also discourages people from reaching their recovery potential because they think that further treatment will bring no benefit.

Progress after a stroke doesn’t come easily and always requires hard work and commitment, so it’s important not to give false hope. This can be just as destructive. A patient’s progress is dependent on many factors, apart from the amount and quality of rehabilitation treatment, such as:

• The severity of the stroke
• The amount of time that has passed since the stroke happened
• The patient’s determination to improve, with their willingness and ability to do home exercises
• The support of a spouse and/or family members.

It’s also important to realise that a stroke is a potentially deteriorating condition. If the stroke has been severe and a person doesn’t have continuing treatment, then they may well get stiffer and their movement repertoire is likely to decrease. Elderly people who have had a stroke may also become less mobile as a function of their increasing age.

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.

Until relatively recently the consensus was that the brain was a fixed structure that couldn’t change much over time. Thus stroke damage was seen as irreparable. However, leaps and bounds in neuroscience over the past few years have shown that the brain is a much more fluid and flexible structure than we previously believed. The neuroplasticity of the brain is truly remarkable and largely thanks to Paul Bach-y-Rita, it is now common knowledge. The ability of the brain to “re-wire” itself by creating new connections and reassigning neural circuits for different tasks explains how the brain can re-organise itself to recover at least some of the movement abilities that are lost after a stroke.

However, this re-organisation doesn’t happen by magic. Neurological physiotherapy works by specifically targeting stimulation of the brain through moving and activating limbs and muscles. This directed movement stimulates the brain to re-organise itself in the most efficient and functional way.

Of course, a patient’s progress is dependent on many factors, apart from the amount and quality of early stroke rehabilitation treatment, such as:

• The severity of the stroke

• The amount of time that has passed since the stroke happened

• The patient’s determination to improve and their willingness and abilityto do individually designed exercises outside treatment sessions

• The support of a spouse and/or family members.

It’s also important to realise that a stroke is a potentially deteriorating condition. If a stroke has been severe and a person doesn’t have continuing neurological physiotherapy treatment, then they may well get stiffer and their movement repertoire, balance and confidence are likely to decrease. 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.

The heads up! team support people in early stroke rehabilitation, read our patients stories to find out more.

For a long time, scientists believed that the adult brain was a fixed structure and that it couldn’t change much over time. This was why there was a belief that recovery could only happen during the period immediately after a stroke. However, the amazing developments in neuroscience over the past few years have shown that the brain is a much more flexible and responsive structure than we previously believed.

The brain’s neuroplasticity means both that previously unused circuits (synapses in neuroscientific terminology) can be brought into use and that new connections can be formed within the brain. This explains how the brain can re-organise itself to recover at least some of the movement abilities that are lost after a stroke. However, this re-organisation doesn’t happen by magic.

Neurological physiotherapy works by specifically targeting stimulation of the brain through moving and activating limbs and muscles. This directed movement stimulates the brain to re-organise itself in the most efficient and functional way. The role of a neurological physiotherapist is not just to treat you but also to provide support and encouragement when you are feeling disheartened – and to help keep you focused on your long-term goals.

After having a stroke, every person changes their movement in different and sometimes subtle ways because of ongoing challenges, which are completely individual. Often a period of illness, or a spell of bad weather can mean that a person is less active and mobile than they have been. Confidence in moving around and getting about can be knocked in many ways. Neurological physiotherapists work with you to get you as mobile, strong and confident as possible. Moving can be effortful and people very often comment that, with treatment they feel looser and they can move more freely and confidently.

At heads up! we treat everyone as an individual, working with our patients to create tailored physiotherapy stroke 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.

Find out more about stroke neurological physiotherapy with heads up!

Having a stroke is a sudden and shocking experience. Whilst in hospital, people who have had strokes usually get treatment from neurological physiotherapists, occupational therapists and speech and language therapists. Treatment is most effective when delivered in stroke units.

However, with the pressure on hospital beds, people will often get an early supported discharge with treatment continuing at home. Rehabilitation at home in this way should be a continuation of the stroke rehabilitation done in hospital. Unfortunately, there are often gaps in the provision of service. Delays are common, reducing the intensity of treatment and therefore optimum recovery.

At heads up! we often step in where there is a delay in out-patient treatment provision. Our highly trained and skilled specialist neurological physiotherapists provide hands on treatment along with giving information, advice, support and encouragement. We work alongside community NHS stroke teams, a combined approach which is supported by the Chartered Society of Physiotherapists to ensure the best possible recovery.

To find out how heads up! can support your home rehabilitation please get in touch with the team.

Find out more and keep in touch at headsup.co.uk and follow us on twitter

Looking for someone to come along to your group and talk about neurological rehabilitation? We give talks to a number of local groups supporting people who have had strokes, Parkinson’s disease and multiple sclerosis.  Please get in touch if you would like us to come along to your support group.