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The Ultimate Guide to Adult Neuro Physiotherapy

In the past several months, medical centres observed fewer individuals seeking emergency care after suffering strokes or other neurological conditions. And no, not because there were fewer cases, but because individuals and their families were too scared to visit their nearest hospital or healthcare practitioner due to COVID-19.


The fear is completely natural, but remember the sooner you seek medical attention and start with the rehabilitation-process, the better the outcomes!


In today’s article, we’ll discuss what adult neurology is, some of the conditions seen by physiotherapists, how your physiotherapist can help you and common techniques we use.


What is Adult Neurology?

Adult neurology is a branch of medical practice managing disorders or diseases of nerves and nervous systems among adults. Neurological disorders can affect the central - and peripheral nervous systems.


Unfortunately, damage to these neural structures may lead to complications affecting movement patterns, balance, coordination, sensation, strength, cognition, vision, and communication.


Which neurological conditions do physiotherapists manage?

Your physio can help you with just about any neurological condition, however, some of the conditions commonly seen by physiotherapists include;


1. Cerebrovascular accident (a stroke)

A stroke occurs when there is a disruption of blood supply to the brain resulting in brain damage. This may then lead to difficulties with walking, speaking, comprehending, eating, sensation and many other complications, depending on the area of the brain-damaged.


However, a stroke is definitely not the end of the world! Most individuals can continue with life by retraining certain activities and learning adaptive techniques through therapy.


To reduce the extent of brain damage it’s important that you know how to recognize a stroke and react fast. Remember the acronym F.A.S.T.




2. Spinal cord injuries

Damage to the spinal cord is known as a spinal cord injury. A spinal cord injury may result in a complete or partial loss of function, strength and sensation below the level of injury. This may occur due to certain diseases, tumours, or traumatic injuries such as falls, car accidents, gunshots or stabbings.


3. Multiple sclerosis

Multiple Sclerosis is an auto-immune disease in which the immune system attacks the central nervous system resulting in chronic inflammation, demyelination, and a breakdown of neural tissue. This, in turn, may lead to;

  • Pain.

  • Impaired sensation, coordination and balance.

  • Impaired movement patterns.

  • Cognitive decline.

  • Sexual dysfunctioning, as well as bladder and bowel complications.

  • Vision and hearing loss.

  • Difficulty speaking or swallowing.

4. Motor neuron disorders

Motor neuron disorder is a rare collection of neurodegenerative diseases affecting the motor neurons responsible for voluntary movement. This may result in weakness, spasticity, or abnormal reflexes.


5. Parkinson’s Disease

Parkinson’s disease is a progressive disease in which certain nerve cells, in the brain, breakdown and die. This then influences the dopamine levels secreted by the brain and therefore impacts movement or occasionally causes a tremor.


6. Brain injuries

Injury to the brain may result from medical complications like tumours and infectious diseases or traumatic injuries like falls, car accidents or pumping your head. The extent and type of damage will depend on the area of brain injury, as well as the severity.


7. Bell’s Palsy

Bell’s Palsy is the weakness of muscles in one half of the face resulting in the face to droop. This is typically caused by viral infections, generally only occurs once and with sufficient rehabilitation can resolve completely.


8. Peripheral neuropathies

When nerves running from the brain or spinal cord to the rest of the body are damaged, it results in peripheral neuropathy. This may cause impairments such as loss of sensation, muscle weakness, or a burning-tingling pain.


What is Adult Neuro physiotherapy?

Neuro physiotherapy is a therapeutic method aiming to assess and manage individuals with neurological disorders.


We aim to restore normal movement patterns, muscle activity, and movement control, while also improving strength, balance, sensation and coordination. The therapy improves these impairments through repetition of activities and sub-tasks, which in turn restore the connection between altered or damaged nerves.


Before rehabilitation starts, the physiotherapist will assess your highest functional ability, whether it’s walking, sit-stand activities, dressing, or rolling. Thereafter, the therapist will evaluate the missing components to determine the underlying reasons for your difficulty.


Once the therapist determined the underlying reasons, the rehabilitation starts.


The techniques below include some of the frequently-used techniques in treating adult neurology.


Techniques used by physiotherapists


1. Neural activation

Neural activation is facilitation techniques aiming to enhance muscle activity. This includes techniques such as;

  • Tapping: Your therapist will apply a light manual force over the specific tendon or muscle belly while you perform an action, to facilitate a voluntary contraction.

  • Ice Brushing: With ice brushing, your therapist will use ice in a similar way as explained above with ‘tapping’. The coolness will assist with pain management and facilitate muscle response.

2. Increased Tone management

You will often hear your physiotherapist talk of ‘hypertonia’. Well, this refers to the muscle tension or resistance felt when the muscle is stretched in a ‘resting’ state.


When left untreated, the increased tone may lead to contractures, immobility, falls and various other medical complications. Your physiotherapist can effectively reduce tone or spasticity by doing the following techniques;

  • Distraction

  • Deep pressure

  • Joint compressions

  • Vibrations

  • Passive sustained stretches

3. Pain management

Pain is a common complication among individuals with neurological conditions. This is due to the damage to the neural structures resulting in an abnormal sensation of tactile stimuli.


As you might already know, physiotherapists have numerous different techniques to reduce your pain. From myofascial release, heat therapy, dry needling, to TENS and general exercise therapy.


4. Rehabilitation exercises

This is where the hard work starts!


In order to regain, improve or adapt to the movement and function you’ve lost, your therapist will incorporate specific exercises to retrain these movement patterns.


Depending on the underlying reasons your therapist will include strength -, proprioceptive -, balance - and/ or coordination retraining by assisting or guiding you through specific exercise. They will guide you through tactile, verbal or visual facilitation.


5. Functional activity retraining

Following strength -, proprioceptive -, balance - and coordination retraining, your therapist will also include functional retraining. This typically includes a functional activity you have difficulty with, in your daily life, such as;

  • Rolling,

  • Dressing,

  • Moving from sitting to standing, or

  • Walking.

6. Chest therapy

If breathing and your ability to clear phlegm are affected, your therapist can assist with this as well. This is commonly seen in quadriplegia or paraplegia when individuals' abdominals are too weak to cough effectively or take deep breaths.


There are various different techniques your therapist use, but we will cover this in another blog post in the near future.




Benefits from Adult Neuro Physiotherapy

  • Improve joint range of movement

  • Increase muscle strength

  • Enhance motor control

  • Improve balance

  • Improve endurance

  • Increase independence and quality of life.

  • Improve mobility and functional activities.

  • Adjustment of a prosthesis or assistive devices such as wheelchairs, walking frames, walking sticks and/ or Ankle-Foot-Orthosis.

Bottom line

Your physio will help you become independent in your daily activities and guide your family or caregivers to help you if needed.


If you or one of your friends/ family members have any of these neurological conditions, book a consultation at Christiaan Moolman Physiotherapy Inc. now. We will assess your needs and help you start your rehabilitation journey today!





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