Neurological Physiotherapy: Everything You Need to Know

Physiotherapy is used to treat an illness, injury or deformity and aims at helping the patient to re-establish motor functions like balance, movements and coordination. Wastage and function deterioration can be prevented by ensuring the joints are kept flexible and the muscles active.

Neurological conditions are problems with the spinal cord, brain, or peripheral nerves. People with these conditions are likely to find it difficult to move around, have limited movement range, muscle weakness, vision changes and poor balance. These patients struggle with routine activities and self-care.

What is Neurological Physiotherapy?

Neurological physiotherapy is a specialized branch of physiotherapy that aims to improve movement in patients whose impairment is caused by neurological illness or injury. Neurological disorders affect the functioning of the brain, spinal cord and nerves.

Multiple sclerosis, stroke, Parkinson’s disease, Bell’s palsy, etc. are the common conditions which cause tremors, paralysis, motor deficits, spasms, and loss of sensation. When the central nervous system suffers trauma or damage, it can cause the different pathways that carry nerve signals to and from organs and muscles to break down, leading to the symptoms mentioned.

Neurological physiotherapy helps to rehabilitate patients with physical problems caused by neurological conditions. It aims to reduce the pace of deterioration and maximize the individual’s physical potential in terms of flexibility and movement range, and also to help children with disabilities to reach developmental milestones.

The different conditions differ in the way they impact the nervous system, even though the diagnosis is similar.

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Conditions That Require Neurological Physiotherapy

Let’s take a detailed look at the disabilities or conditions that require neurological physiotherapy:

Microcephaly

This condition causes a baby’s head to be smaller in size than those of other children of their age and sex. It can happen either before or after birth, but the main reason is that there is an abnormal growth of the brain. Microcephaly causes developmental delays.

Post-polio Syndrome

This is a viral infection that affects the nervous system, and the symptoms occur from 15 to 30 years after an acute attack of paralysis. Sudden fatigue, pain and impaired muscular function are typical symptoms.

Guillain–Barre Syndrome

When the peripheral nervous system gets damaged by the immune system, the muscles can get weakened suddenly. Weakness and tingling in the extremities are usually the typical symptoms.

Stroke

Stroke restricts blood flow to the brain, causing cell death in the brain. Symptoms arise from the portion of the brain suffering the damage. Trouble speaking, paralysis or numbness in the face or extremities and trouble walking are some of the typical symptoms of a stroke.

Traumatic Brain Injury (TBI)

This condition manifests as abnormal brain function due to sudden trauma to the head like a direct blow or jolt to the head or body. Symptoms can be divided as mild, moderate and severe depending on the site of injury to the head.

Parkinson’s Disease

This is a degenerative brain disorder resulting from the loss of Dopamine containing nerve cells, causing movement abnormalities such as tremors, slow movement, slurred speech and muscle stiffness.

Alzheimer’s Disease

This is a condition which causes brain cells to degenerate, leading to dementia. Alzheimer’s manifests as loss of memory, thinking, cognitive abilities, and behavioural skills.

Spinal Cord Injuries

The spinal cord connects the brain to the rest of the body through an intricate nervous system. When the spinal cord gets injured, trauma to the spinal discs, ligaments, or vertebrae, hamper the communication of the nerves with the body. Patients with spinal cord injuries experience loss of function below the injury site. Impaired breathing, weakness, poor bladder and bowel control, lack of sensation etc are the major manifestations of this condition.

Multiple Sclerosis (MS)

The body’s own immune system attacks the nervous system by degrading the protective nerve covering called myelin. Based on which nerves were damaged, the symptoms can differ from individual to individual.

Cerebral Palsy

This is a group of disorders where an individual has a severe motor disability, they are unable to move properly and maintain posture and balance. It is seen from childhood. They are unable to exercise muscle control due to abnormal brain development or damage to the developing brain.

Charcot-Marie-Tooth Disease (CMT)

This disorder is characterized by progressive muscle tissue loss caused by peripheral nerve damage. It is also known as heredity motor and sensory neuropathy.

Amyotrophic Lateral Sclerosis (ALS)

This is a neurodegenerative disease that affects motor neurons. Individuals affected by this experience slurred speech or loss of voluntary movement because motor neurons start dying.

Chronic Pain

Long-term pain conditions can be caused by other neurological ailments like nerve compression or nerve damage due to trauma or surgery and this can seriously affect the quality of life of individuals, necessitating neurological physiotherapy.

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Benefits of Neurological Physiotherapy

For the best possible outcomes, neurological physiotherapy must be started as soon as it is possible after the injury or diagnosis.

Most often, muscles become weak, and movement flexibility and range are affected. Muscle weakness can also lead to loss of sensation, spasms, breathing problems, lack of balance, and difficulty in swallowing or speaking.

Physical therapy for neurological rehabilitation aims to use exercise and therapeutic activity to stimulate the nervous system, helping patients to learn new ways to use their muscles and move. The treatment is usually tailored to meet the individual needs of each patient.

Benefits of neurological physiotherapy may include the following:

Increased strength

To achieve muscle strength, strengthening exercises are used to target the muscles that were impacted by the injury or ailment and weakened. Patients may be able to improve muscle control and increase the range of movements. They may also be better able to manage the continuous contraction of muscles.

Enhanced endurance

Patients can begin walking independently on various surfaces for different activities with the right training and strategies. Mobility aids are often included to help individuals with posture, balance and easy movement. Physiotherapy treatment often includes training the patient in the right techniques to use the mobility aids.

Improved balance

Balance training is provided to improve a patient’s confidence and steadiness and help them to walk and participate in routine activities. An individual with a good or improved balance is unlikely to fall and injure themselves.

In a nutshell, neurological physiotherapy can help in:

  • Improving muscular strength
  • Increasing movement range
  • Improving posture and balance
  • Helping make an individual independent for daily activities
  • Making goal-oriented, precise movements, simpler to achieve
  • Stretching tightened muscles to reduce contractions and spasticity
  • Retraining normal movement patterns
  • Enhancing fine and gross motor skills
  • Improving breathing
  • Improving stamina and fitness levels
  • Decreasing the possibility of chest infections
  • Pain relief
  • Lowering anxiety and stress
  • Achieving an individual’s maximum potential

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What Does a Neurological Physiotherapist Do?

Neurological physiotherapists are trained in the treatment of neurological conditions. They provide interventions which help patients to maintain or regain the maximum possible movement and functional independence. New pathways to movement are developed through exercise and repetition to achieve these goals.

Neurological physiotherapists combine numerous neurological physiotherapy principles to deliver optimal benefits to patients. Conductive education and functional rehabilitation, Bobath concept or normal movement, and Brunnstrom approach of synergistic movement are some of the approaches followed.

The approach of treatment depends on the patient, their problems and goals so that the physiotherapist can maximise their potential. Treatment plans are unique and focus on enhancing overall coordination, movement, balance, strength, and cardiovascular function. A neurological physiotherapist helps patients optimize functionality in their present condition, along with guidance on modifying spaces at home and work to allow a safe, efficient, and independent life.

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Treatment Interventions

Typical treatments performed by a neurological physiotherapist are as follows:

  • Re-educating patients about balance and gait
  • Mobilizing joints
  • Stretching and strengthening of muscles
  • Exercises to improve posture
  • Activities to manage spasticity or frequent muscular contractions
  • Guiding patients on lifestyle changes, managing fatigue and exercise at home.