Neurological Physiotherapy
Neurolife Physiotherapists assess a client's current movement and potential to move
The brain will naturally problem-solve and compensate for a neurological injury. For example, to sit, instead of recruiting the small, efficient postural muscles at the base of the spine, which may be weak, the brain will quickly compensate by using the large muscles at the front of the hips. Large muscles are designed to work hard for short bursts.
When they are used to hold your body up against gravity for long periods, they "hold or fixate" and get tired. This inappropriate muscle activity becomes learnt or "a bad habit" and limits the smaller muscles' normal stabilisation and balance reactions. Fear of falling becomes a problem that feeds into these compensatory movement patterns. Although they help achieve a task in the short term, these learned compensatory patterns can limit natural balance and movement potential.
When they are used to hold your body up against gravity for long periods, they "hold or fixate" and get tired. This inappropriate muscle activity becomes learnt or "a bad habit" and limits the smaller muscles' normal stabilisation and balance reactions. Fear of falling becomes a problem that feeds into these compensatory movement patterns. Although they help achieve a task in the short term, these learned compensatory patterns can limit natural balance and movement potential.
Many clients are not aware of this and believe they move the way they move because of their stroke or "the MS is getting worse". The Neurolife neurological physiotherapy approach is to view the person's movement as a result of the brain's compensation to a neurological injury, and we work to optimise the central nervous system's function. Our approach to Bobath neurological physiotherapy aims to reduce ongoing compensation and show the brain a more efficient way to stabilise the body.
These may be familiar to the brain or new to it. The smaller postural muscles, which are designed to work efficiently for long periods, can then have the opportunity to regain function, allowing balance reactions and more efficient movement. When these smaller muscles begin to function again, the larger muscles, which have often become fixated or "spastic", are then able to relax as it is no longer necessary for them to work so hard.
Analysis and treatment are based on the Bobath Concept.
The Bobath Concept involves intensive postgraduate training that offers a deeper analysis of movement and handling skills to apply appropriate sensory input, which stimulates muscle activation. The Bobath Concept is supported by emerging neurophysiological evidence and is distinguished from other therapies by its emphasis on postural control, sensory-motor processing
and handling skills.
The Bobath concept aims to provide opportunities for strengthening and practice that does not just strengthen the use of compensatory muscles without changing the movement pattern. Recent research now shows that stretches for neurological problems are ineffective at maintaining increased range. We need to understand why muscles are becoming tight in the first place.
Often muscles are not short but are "on" (the brain is actively contracting the muscle) because this is the person's learned way of attempting to hold themselves up against gravity. Lying down and stretching is not beneficial if the muscle contracts again the next time the person sits up against gravity. More information on the Bobath Concept can be found at www.ibita.org
The Bobath concept aims to provide opportunities for strengthening and practice that does not just strengthen the use of compensatory muscles without changing the movement pattern. Recent research now shows that stretches for neurological problems are ineffective at maintaining increased range. We need to understand why muscles are becoming tight in the first place.
Often muscles are not short but are "on" (the brain is actively contracting the muscle) because this is the person's learned way of attempting to hold themselves up against gravity. Lying down and stretching is not beneficial if the muscle contracts again the next time the person sits up against gravity. More information on the Bobath Concept can be found at www.ibita.org
The systems of the brain and spinal cord have a large capacity for "plasticity".
There are many "parallel wiring" of the nerve pathways from the brain to the spinal cord. The postural stabilisation pathways and goal-directed movement pathways converge in the spinal cord to produce smooth, goal-directed movement. In any given treatment, the Neurolife Physiotherapist constantly works to manipulate their handling, the task, client alignment, and client position to trigger a familiar automatic movement pattern or balance response.
The person's individual characteristics guide treatment.
Movement varies greatly among individuals depending on a person's lifetime of experiences, sport, leisure activities, vocation, posture, mood, personality, etc. The best way to stimulate appropriate muscle activity will depend on these individual factors and the person's learning style.
Dedication to therapist training is essential.
Neurolife Physiotherapists are trained and experienced in movement analysis and facilitation (handling skills). All our staff are supported to attend Neurological Physiotherapy courses in relevant areas.
A person's arm can improve movement and use after a stroke.
Some possible reasons why the arm does not recover as well as the leg during hospital neuro rehabilitation can be summarised as follows:
1. Arms do not get as much therapy as legs and walking do. 2. Hand function is the result of a very complex relationship between head alignment, eye stabilisation and motor control of the hand. 3. We can manage with the other arm in many functions, so the need to use it is not as strong a driver of brain plasticity.
1. Arms do not get as much therapy as legs and walking do. 2. Hand function is the result of a very complex relationship between head alignment, eye stabilisation and motor control of the hand. 3. We can manage with the other arm in many functions, so the need to use it is not as strong a driver of brain plasticity.
