Neurological Physical Therapy
What is Neurological Physical Therapy?
Neurological Physical Therapy involves improving mobility, balance and co-ordination, as well as prescribing individualized exercises aimed at increasing strength and body awareness.
Our approach can be quite "hands on" as the body needs guidance to do the activities it has lost the ability to do and in doing this it helps re-educate the brain (and Central Nervous System) on how to achieve these movements.
This involves the physical therapist working with the patient, through movement, to re-align joints and muscles to allow optimal activity. It can be quite tiring both physically and mentally, due to the degree concentration required of the patient. To maintain this, strengthening work is often required and these new movements need to be functional for every day tasks.
The Brain is a very adaptable organ
Brain growth and nerve cell change is not limited only to childhood. Nerve cell connections and functions of different areas of the brain change throughout our lifetimes, depending on the situations and needs of the brain. A good example is learning new information. Older individuals can learn new skills, such as learning a language, learning how to play the piano, or finding the way around in a new town. Although these examples may seem common, each requires new activity in groups of neurons. Physical and mental activities that have already been acquired can also be improved. A good example might be better performance while singing a song, or perfecting a tennis serve.
Response to injury
In addition to the changes that the nervous system makes while learning a new task or reacting to the environment, we have learned that the nervous system can adapt in response to injury to a remarkable degree. The changes and adaptations in response to injury is sometimes called “plasticity”. The term conveys the dynamic nature of neural change, somewhat akin to the “flexibility” of a piece of soft plastic. The brain actually changes activity levels of neurons to compensate for the injury. Scientists have discovered when a nerve is injured, or a person has an amputation, the areas of the brain responsible for movement and sensation of the injured part start to change.
Neuronal Plasticity
Plasticity, or neuroplasticity, is the lifelong ability of the brain to reorganise neural pathways based on new experiences. As we learn, we acquire new knowledge and skills through instruction and experience. In order to learn or memorise a fact or skill, there must be persistent functional changes in the brain that represent the new knowledge. The ability of the brain to change with learning is what is known as neuroplasticity.
Recently, there has been exciting evidence that intensive training results in changes in brain activity correlated with recovery. Several studies using tiny electrodes to map parts of the brain that control movement have been performed in monkeys who have had a stroke. These studies have shown that if the stroke occurs in the part of the monkey’s brain that controls finger and hand activity, a training program forcing the monkey to use its weak hand causes brain reorganization. The portions of the brain previously responsible for moving the elbow and shoulder become active when the monkey is moving its hand, and this seems to correlate with improvement in use of the hand. Studies performed in Germany on people who have had a stroke show a similar pattern. In these studies, transcranial magnetic stimulation in persons who have undergone constraint-induced movement therapy show an expansion of the hand area, suggesting that brain cells previously involved in the other functions can now be retrained to move the hand.
Studies performed at Emory University Hospital in Atlanta by physical therapist Dr. Stephen Wolf also shared these finding. These studies show that intensive therapy called Constraint Induced Movement Therapy can enhance functional ability of the affected side post stroke and thus facilitates brain plasticity. This exciting information gives us hope that carefully designed therapy programs might be even more effective in the future.
The Central Nervous System has a remarkable ability to reorganise and recover after injury. Neurological Physical Therapy aims to enhance this recovery by relearning the skills needed to improve function in patients with neurological injury or disease. This includes patients with balance difficulties, and those suffering with chronic pain.
For example a stroke does not affect the body’s muscles and nerves, instead it affects the brain and the messages sent out by the nerve bundles from the brain. The job of these bundles is to relay messages to your muscles and a stroke often will stop or slow down these messages. It is very important to get limbs moving again following stroke. After a stroke has occurred, it may not be possible for an individual to move and stretch their muscles without assistance from a caregiver or physical therapist. If you don’t move daily, your muscles and ligaments will become stiff and may become permanently shortened. This results in limited mobility as well as discomfort or pain. Following a stroke, a physical therapist can advise patients, teach them how to move their bodies correctly, and show them how to exercise safely.
Typical conditions that can respond to treatment include
- Stroke
- Acquired Brain Injury – head trauma
- Parkinson’s Disease
- Multiple Sclerosis
- Motor Neurone Disease
- Post Polio Syndrome
- Vertigo