heads up!

stroke & neurological physiotherapy

Contact us  01306 888171

Where does the belief in stroke recovery deadline come from?

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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 Partly it’s rooted in out-of-date theories about how the brain works and also because many doctors and other health professionals who deal with strokes don’t often see the patients who’ve made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.

When our balance is gone, we never think about anything else

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For us to feel balanced we rely on information from three sources: vision, muscles and joints together with the vestibular organs in the inner ears. Receiving accurate information from these about how we relate to the surrounding environment makes it possible for us to switch on the muscles that control our eyes, head, neck, trunk and legs so that we stay upright and have clear vision when we are moving.  A person can become very disorientated if the sensory input from one of these sources conflict.

Balance problems are particularly distressing for the individual suffering them.  It is not just the effect of the symptoms but worrying about when the symptoms may appear can drastically affect someone’s confidence in their ability to carry out daily activities.

There are three systems in the body that are especially important for balance:

1. Information the body gets from the muscles, joints and skin tell us where our body parts are both in relation to each other and in relation to the supporting surface

2. The vestibular system is a 3-dimensional spirit level which orientates us in the environment and gives the brain information about whether the head is moving up or down or from side to side

3. We rely on our vision. We use our eyes to tell us about our surroundings and objects in our way. Our eyes stay steady whilst our head is moving.

Normally we don’t think about our balance. However, when balance is impaired we often have to think very carefully about doing things we would normally just do without any thought.

At heads up! we see with people who have balance problems everyday and it is incredible to see how the introduction of simple techniques can improve our patients lives.

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.

 

What are the benefits of early stroke rehabilitation

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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.

Why neurological-physiotherapy stroke treatment works

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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!

Recently had a stroke? Make sure your out-patient rehabilitation doesn’t stop

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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

New website and blog from heads up!

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What an exciting time this is for heads up! A new website, blog launch and Emma back from maternity leave in September. I started heads up! in 1997 and am still as passionate about my work today. We have grown to a team of five specialist neuro physios, always providing individual, hands on treatment.

Making a difference to the quality of life for anyone who has had a stroke or difficulties with movement and balance as a result of neurological deficit. Our new website is clear, simple and most importantly easy for people to find the information they need. It shows visitors the journey of recovery we embark on, gaining strength and confidence with our patients and their families to get the very best potential recovery possible. A big thank you to all our patients who kindly agreed to have their session photographed and used on the website.

Please take the time to have a look around headsup.co.uk and let us know if there is anything we have missed. We offer our patients, their families, careers and friends more than just treatment. We give continual support and advice. Following feedback we decided to create a blog, a place where we can share useful information on neurological conditions, tips on exercise at home, new research, more about the team and guest blogs from professional experts.

If there are any topics you would like to see us talking about please get in touch.

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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