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Neurological Physiotherapy ((EXCLUSIVE))



Depending on the medical condition, the effects may range from motor deficits, paralysis, tremor and spasm to ataxia or lack of sensation. This is because damage to the central nervous system can lead to the breakdown of afferent and efferent pathways carrying nerve signals to and from muscles and organs, causing the symptoms of neurological conditions.




Neurological Physiotherapy



The aim of neurophysiotherapy is to help rehabilitate physical impairments caused by neurological conditions as already mentioned. It is tailored to the specific needs of each individual with a personalized goal-oriented target. For example, does the patient need big improvements such as learning to walk again, or is it small fine movements that need correction? This will be determined by trained neurological physiotherapists on an initial visit


The brain is able to both lose and form new connections, a phenomenon called neuroplasticity. Neurophysiotherapy is different from traditional physiotherapy in that it takes advantage of this phenomenon, helping the brain to form new synaptic connections. In effect, it rewires the brain to learn or re-learn tasks and abilities.


Neurophysiotherapy can either be conducted on a one-on-one manner, as when the posture is to be improved or a patient needs to re-learn how to walk, stand or sit if the damage is severe. Other tasks such as walking and moderate exercises may also be performed in groups to create a friendlier environment and make rehabilitation more enjoyable.


Neurophysiotherapy does not stop at simple passive exercises or tailored exercises to build strength and coordination. Depending on the extent of motor dysfunction, limb positioning or splints may be prescribed to aid joint recovery. In certain cases, mobility aids may be needed such as a walking frame or specialised wheelchair, including training to use them.


Neurological physiotherapists are experienced and trained to treat neurological conditions with the aim to provide interventions which assist an individual to regain or maintain their maximum movement and functional independence. This is achieved by aiding in the development of new pathways through repetition and exercise.


The Neurological Alliance [3] reported the total number of neurological cases in England to be 12.5 million or 59,000 cases per CCG in 2013-14, with a further 1 million cases in Scotland reported in the NHS QIS Clinical Standards on Neurological Health Services [4].


The survey stated that 58.1% (n=3402) of NHS England respondents (n=6916) have experienced difficulty accessing the service/treatment they require, 39.8% (n= 2357) of respondents had a 12-month waiting period from the time of observation of the first symptom to seeing a neurologist specialist, 31.5% of respondents (n=2140) had 5 or more GP visits related to the health problems experienced due to their condition prior to being referred to a neurological specialist, and 71.5% (n=4603) of respondents were not provided with a care plan to help manage their condition [5]


It has been recognised that many patients in stroke units feel they do not receive enough therapy during their hospital stay. The SSNAP [16] reported that physiotherapy is required by 85% of stroke patients. Despite this, patients who need physiotherapy only receive 32 minutes on average on just over 50% of their days in hospital. This is one of the NHS's downfalls as patients should be obtaining the equivalent of 45 minutes of physiotherapy per day for 5 days a week. These are the opinions of stroke survivors regarding the care they received in the UK by the NHS in 2013-2014, highlighting some key areas of concern.[16].


Due to the long waiting period between diagnosis and referral to physiotherapy, as highlighted in table 12 above, private physiotherapy can aid in reducing shortfalls in early therapeutic and preventative interventions.


Following an interview with a physiotherapist treating neurological conditions in Edinburgh, it is clear that private physiotherapy for neurological conditions plays a pivotal role in helping clients achieve a threshold level of mobility and gain confidence and competence with exercise in order to support the transition to a local leisure club or community-based activity groups. The physiotherapist describes the role of a private physiotherapist, in addition to providing an incredible opportunity for improvement, is to help a client reflect on important outcomes from a functional perspective to quality of life using careful documentation and involving family members. He believes this offers the client time to make a decision independently as to whether a change in functional status is possible and help shape their ideas about the future management of their long term condition.


Neurological physiotherapy is the treatment of patients who have a neurological disorder. Neurological disorders are those affecting the brain, spinal cord and nerves; such as stroke, MS and Parkinson's disease. Treatment in neurological conditions is typically based upon exercises to restore motor function through attempting to overcome motor deficits and improve motor patterns. To achieve this aim various theoretical frameworks have been promoted, each based upon inferences drawn from basic and clinical science research. Whilst some of these have remained static, others are designed to take into account new developments, perhaps the most notable example being the "movement science" framework. The various philosophies often generate considerable debate.


Neurological physical therapy is extremely important for those patients who have had or who currently have neurological diseases or injuries. The brain and spinal cord and the central nervous system control movement and sensation. Injuries to these areas, the brain or spinal cord can cause death of the cells that control certain movements and sensations, and therefore people lose function. Without neurological physical therapy following a neurological injury, patients may lose many functions and not be able to perform certain activities. Decreased intensity of activity leads to many other health problems such as diabetes, heart problems, lung problems, decreased independence, and an overall poor quality of life.


Following the neurological disorder or injury, there is a certain amount of time when the cells that are not injured in the brain and spinal cord can learn to control the missing functions. Physical therapists are very well-informed about human movement and can teach patients how to move correctly again. This skilled assistance can help patients regain some to most of the functions they lost because of the injury. Most of the patients can learn to live their lives independently again, which makes them happier with their lives and contributes to their overall quality of life.


The JNPT readership community is an important partner in our efforts to provide content that is of value to physical therapists, researchers, and other rehabilitation professionals who work with people with neurological health conditions. We are performing a reader survey to collect information on how our readers use and value JNPT that we hope will guide the journal in the future. Please take the time to share your opinions about JNPT by clicking on the link below. It should take you approximately 15 minutes to complete. Please complete the survey in one sitting.


Acute neurological conditions, such as a stroke, spinal injury or traumatic brain injury, often present to hospital for immediate treatment. Depending on your symptoms and condition, your doctor may request physiotherapy treatment while you are in hospital. Your Physiotherapist will undertake a comprehensive assessment of your strength, coordination and balance and will then tailor a treatment program to your unique needs. Depending on the impairment, your physiotherapy treatment may include:


This systematic review was carried out to compile and assess original studies that included economic evaluations of neurological physiotherapy interventions. A thorough search of PubMED, Cochrane and Embase was developed using keywords such as health economics, neurological physiotherapy and cost analysis, and studies published during the last six-year term were selected. A total of 3124 studies were analyzed, and 43 were eligible for inclusion. Among the studies analyzed, 48.8% were interventions for stroke patients, and 13.9% were focused on Parkinson's disease. In terms of the countries involved, 46.5% of the studies included were developed in the UK, and 13.9% were from the USA. The economic analysis most frequently used was cost-utility, implemented in 22 of the studies. A cost-effectiveness analysis was also developed in nine of those studies. The distribution of studies including an economic evaluation in this discipline showed a clear geographic dominance in terms of the pathology. A clear upward trend was noted in the economic evaluation of interventions developed in neurological physiotherapy. However, these studies should be promoted for their use in evidence-based clinical practice and decision-making.


From a single physiotherapist in 1993, Neurological Physiotherapy has developed into a leading practice providing the treatment for all neurological presentations, both adult and paediatric, throughout Cheshire, South Manchester and Derbyshire.


The INPA aims to support national organisations and individual physiotherapists with an interest in advancing the scope and practice of neurological physiotherapy. It does this by supporting and facilitating research, evidence based practice, clinical specialisation, knowledge exchange, inter-professional and international collaboration and by promoting partnerships with clients and carers.


Neurological physiotherapy is a specialist area of physiotherapy. Focusing on assessing and treating people with movement disorders that have resulted from injury or disease to the brain, spinal cord or extremities of the body. With an aim to improve quality of life by maximizing your potential. 041b061a72


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