By Prodyut Das

Neuro Rehab

Neuro Rehab provides care for patients with neurological (nerve/nervous system) injuries or illnesses. Individuals who may benefit include those who have suffered a stroke, experienced a head injury or need speech therapy. A team of specially-trained therapists work hand-in-hand with physical medicine and rehabilitation physicians to provide exceptional, individualized care.

The Neurological Rehab team works with primary care and other specialty physicians to manage neurological conditions. As a result, patients receive outstanding coordinated care for any kind of neurological disorder.

What is Neurological physical therapy?

Neurological physiotherapy (Neuro Rehab)is a discipline focused on working with individuals who have a neurological disorder or disease. These include Alzheimer's disease, ALS, brain injury, cerebral palsy, multiple sclerosis, Parkinson's disease, spinal cord injury, and stroke. Common problems of patients with neurological disorders include paralysis, vision impairment, poor balance, inability to ambulate, and loss of functional independence. Therapists work with patients to improve these areas of dysfunction.

A neurologic physical therapist specializes in the evaluation and treatment of individuals with movement or functional problems due to disease or injury of the nervous system. Physical therapists who specialize in neurology work with a broad range of conditions in both adults and children that include:

  • Spinal cord injury
  • Brain injury that results from trauma or conditions such as stroke or tumors
  • Multiple sclerosis
  • Parkinson's disease
  • Amyotrophic lateral sclerosis
  • Polyneuropathies such a Guillian-Barre syndrome or chronic inflammatory polyneuropathy
  • Vestibular disorders such as BPPV, acoustic neuroma, or other conditions that cause dizziness and loss of balance
  • Pediatric conditions such as spina bifida or cerebral palsy
  • Balance Deficits
  • Coordination

When should you see a physical therapist who specializes in neurology?


A neurologic physical therapist can help you with Neuro Rehab if you have any of the following complaints:

  • Dizziness
  • Imbalance that results in falls
  • Difficulty walking or moving around in your daily life
  • Changes in your ability to do the things that you enjoy in your life like recreational activities or outings with your family
  • If you are not able to walk 6 minutes without having to stop to rest
  • If you need more help than you did before to go through your daily activities
  • If you have a brace or wheelchair that is in disrepair and needs to be re-evaluated

The brain and spinal cord control movement and sensation. Injuries to the brain or spinal cord can cause death of the cells that control certain movements and sensations, and therefore you lose function. Without physical therapy following a neurological injury, patients may lose many functions and not be able to perform certain activities. Decreased activity leads to many other health problems such as heart problems, lung problems, diabetes, decreased independence, and an overall poor quality of life.

Following the 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 knowledgeable about human movement and can teach patients how to move correctly again. Neuro Rehab help patients regain some to most of the functions they lost because of the injury. Many patients can learn to live independently again with Neuro Rehab, which makes them happier with their lives.

Brain

Your brain is the most important organ in your body. It controls all of your other organs subconsciously while controlling your movement consciously. This means that your brain makes sure that your heart beats and your lungs breathe without you having to think about it (subconsciously). It also means that when you want to move (consciously), your brain makes sure that the correct muscles work to allow you to move.

Here is an example of how your brain works. If you decide you are going to walk, a part of your brain is activated by your thought. This part of your brain co-ordinates the activity and sends information to all of the correct areas of your brain that are involved in controlling walking. The correct muscles have to be told to move. Other muscles have to be told to relax. Parts of your body have to be notified so that you can have appropriate balance while you are walking. Other parts of your body have to be notified so that your heart rate changes and your breathing rate changes in order to efficiently supply your body with the proper blood and oxygen. There are also many more things that have to be notified so that the activity of walking can occur. Your brain then sends the information down your spinal cord and out your nerves to the places in your body that need to work.

Spinal Cord

Your spinal cord starts at the base of your brain and runs down your back. It had many nerves that run to and from it. The spinal cord carries information from your brain and sends it out these nerves to all areas of your body. If you want to walk, the brain sends information down the spinal cord and out the nerves to give information to the muscles used to walk. These muscles are activated and in response, you can walk.

The spinal cord also receives information from all areas of your body. Nerves take this information into your spinal cord and then the spinal cord sends it up and into your brain. If someone steps on your toe, the information is sent through nerves and into your spinal cord and then to your brain which makes it possible for you to feel the pain.

Basically, your spinal cord acts to relay information between the brain and the rest of your body.

Nerves

Your nerves pick up information from your environment and send it to your brain through your spinal cord. This allows you to feel something on your skin such as heat and touch. Your brain also sends information down your spinal cord and out your nerves to your muscles and skin. This allows your muscles to move.

They are all connected to the thick spinal cord that runs straight up your back and into the base of your brain. Your nerves, therefore, are used to transfer information between the brain and the rest of your body. Some nerves have the function of picking up sensations, while other nerves have the function of making muscles work. Other nerves in your body are deep and work to tell organs what to do.

If a nerve is injured it can heal, unlike the spinal cord. However, it takes a very long time for nerves to heal. This means that while your nerves are healing, you may not be able to feel or move parts of your body. In the mean time, physical therapy and other Neuro Rehab team members can help to keep your muscles and skin healthy and ready to get back to work when your nerves have healed.

If the nerve has a very large injury, it may not be able to heal correctly. Therefore, you may need surgery or you may need to wait and see what recovers and what does not. With nerve injuries, the outcomes may not be predictable.

Neuro Rehab

Gait Re-training

Gait is all of the different components that make up the activity of walking. Re-training gait as a part of Neuro Rehab focuses on helping a person develop the easiest and most effective strategies for walking. Treatment to re-train gait involves:

  • improving or preventing injuries
  • developing gait strategies to increase stability and speed of walking
  • developing strategies that can help people to adapt to different walking surfaces and different activities

If a person can walk easier and safer, they will usually be able to do more activities, independently. This will make the person happier and healthier, and therefore increase their quality of life.

Balance Re-training

Many people lose a significant amount of balance as they get older. This loss of balance can cause people to fall and break arms, legs, hips, or their back. Some elderly people are afraid of falling because they do not feel as steady on their feet. Because of this fear they may not want to leave their house and therefore may become immobile. This immobility can lead to many other health problems as well as a poor quality of life. Some injuries or illnesses that may cause balance problems are:

  • Multiple Sclerosis (MS)
  • Parkinson's Disease
  • Traumatic Brain Injury
  • Concussion
  • Joint Injuries

There is a lot of research being done which focuses on physical therapy treatment to re-train balance. A Neuro Rehab with stretching, strengthening, walking, and balance exercises can help to increase balance in people with balance problems. Physical therapists can assess people's balance problems and make an exercise program that can increase the individual's steadiness.

Mobility Aids

Mobility aids are used to help people get to where they want to go. Mobility aids can improve your posture and your balance and can help you move in the most efficient way possible. These effects can help to increase your independence and improve your overall quality of life. Some mobility aids are walkers, crutches, canes, and wheelchairs.

It is important in a Neuro Rehab department to have a physical therapist who assess your mobility problems and decide whether or not a mobility aid could benefit you. If needed, a physical therapist can choose the best mobility aid to help your problem and teach you the proper way to use it. If the mobility aid is not used properly, it will not be as helpful as it should be. In some cases, a mobility aid used wrong can actually be harmful to your joints and could increase your risk of falling.

Hydrotherapy

Hydrotherapy is a physical therapy treatment that takes place in a heated pool. Patients are individually assessed in a Neuro Rehab depatment by a physical therapist, and if hydrotherapy can benefit their medical condition, they are entered into an exercise program designed for the pool and supervised by a physical therapist. Some hydrotherapy programs are in a group setting and some are individually conducted.

Moving in water can be easier than moving on land. The buoyancy of the water, as well as the warmth of the hydrotherapy pool, helps to decrease muscle stiffness, spasms and pain. Hydrotherapy programs are used for people with many medical conditions such as osteoarthritis, osteoporosis, Parkinson's Disease, and Stroke. It is also used as a cardiovascular exercise to improve overall fitness and health, to increase the range and strength of joints and muscles, and as a relaxation exercise.

Fall Prevention Program

The Fall Prevention Program as a part of Neuro Rehab offers balance evaluation and training designed especially for older adults with balance problems. Injuries from falls are particularly devastating for older adults, who can face a loss of independence or the ability to remain in their own homes.

Vestibular Rehabilitation

Vestibular rehabilitation is a part of Neuro Rehab that involves specific exercises designed to decrease the symptoms of dizziness, nausea and spinning. The symptoms may be caused by injury or disease. This treatment is also helpful in improving balance and increasing a person’s functional activity level and quality of life.

Read more on Neuro Rehab here- Neurorehabilitation

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