All neurological conditions or injuries vary considerably in presentation, response to medication or therapy, symptoms, long term implications and pathology. Abnormalities or injuries in the brain, spinal cord, or with the connecting nerves, can result in symptoms such as paralysis, atypical muscle tone, muscle weakness, poor coordination, loss of sensation, seizures, confusion, pain and behaviour changes.  However, what they all have in common is a significant impact on movement and function.

Depending on how the nervous system is affected, muscles can become hypertonic (spastic as in some stroke victims), hypotonic (floppy, lacking muscle tone as in some spinal cord lesions), very rigid (tight as in Parkinson’s disease), or have uncontrolled movements (chorea as in Huntington’s Chorea). Neurological conditions can be traumatic (spinal cord lesions), inherited (Huntington’s Chorea), delayed onset from a previous virus (Post Polio), result from other medical problems (stroke is caused by lack of blood supply to parts of the brain) or have poorly defined causes (MS/ALS).

Regardless of the cause, appropriate exercise is an important component in the overall management of any neurological condition and AAHPT physiotherapists are specifically trained to work with people challenged by neurological impairments. Abnormal movements and muscle tone need to be inhibited, tight muscles and soft tissue need to be stretched to prevent contractures, normal muscle needs to be strengthened, gait patterns need to be retrained and most importantly, our clients need to self manage these conditions in order to live a fulfilling life.

If appropriate rehabilitation is received, recent research demonstrates recovery from stroke, head injuries and spinal cord injuries may continue for years following the initial onset.

Long term physiotherapy may be beneficial to maximize and maintain a person’s functional level, advise caregivers on management of home exercise programs, assist in maintaining function and prevent caregiver burn out.  Some techniques are used to facilitate a specific movement responses and other techniques are used to inhibit unwanted movement that prevents functional activities or contributes to unsafe gait patterns and falls.

Also, physiotherapy can prevent the onset of secondary problems such as osteoperosis in stroke or spinal cord patients, respiratory infections, muscle contractures in post polio and MS clients and constantly reinforce cuing techniques for the Parkinson’s client. Statistical evidence shows that the majority of hip fractures resulting from falls in Canadians occur in people with pre-existing medical conditions. i.e. in the affected hip of the stroke patient or from the “freezing” of someone with Parkinson’s. Both these populations are predisposed to osteoperosis as the bones gradually become more fragile from disuse.

Neurologically trained physiotherapists with AAHPT have not only been very successful in providing clients with complex neurological problems valuable rehabilitation services in their own home but also in providing necessary training of family and caregivers so individuals can  self manage safely at home instead of been admitted to an institutional setting.

Many clients of AAHPT have surpassed physical expectations in functional status and strength gain. Neurological diseases/conditions cannot always be cured but they can certainly be managed so the individual can learn to control specific movements or weaknesses, lead a fulfilling life and remain living with their loved ones.

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