We are instructed by case managers and solicitors for assessment, recommendations, detailed report and to formulate client centred goal setting,treatment plan for individuals with brain injury. We are instructed as treating therapists or medicolegal expert witness.
Up on receiving instructions, based on the client’s condition and nature of difficulty, one of our specialist physiotherapists will complete a detailed assessment.
A detailed bespoke report and costings are produced, highlighting client’s areas of difficulty, goals and therapeutic approach.
Treatment reports are formulated after a comprehensive assessment of the client, evidence of impact of injuries and its long term implications for the client.
We provide detailed equipment assessment to include innovative technology and specialist splinting and costings.
Once the funding is approved, we will commence treatment targeting our client’s goals and bespoke approach to improve their abilities.
Treatment is carried out in the community, at clients home, school, college, day care centres, leisure centres, gym, pool etc.
We are involved in training and supervising support staff and carers on physiotherapeutic approaches, postural management and handling schedule for our client.
We will complete detailed risk assessment and guidelines for use of specialist equipment, hydrotherapy or rebound therapy.
We aim to integrate our clients well within the community using leisure and sports activities, promoting social skills and confidence.
We offer periodic updated goals and review reports as per our client’s progress and give our professional input in multidisciplinary team meetings.
We use vestibular rehabilitation techniques, Sensory Integration and Bobath approaches. Our personalised physiotherapy programmes are entirely client and family focused. They are designed to be incorporated in client’s daily routine at home, school, college, gym, work, play, social and at routine physical activities. Our treatment approaches are evidence based and are supported with references from independent clinical trials. We use objective goal setting specific to each client and use a wide range of assessment tools to evaluate client’s progress. Uses of measurement tools make treatment goals specific and achievable.
Neurological Gait Analysis and Advice on Orthotic Management
Most of the disabling conditions like cerebral palsy, acquired brain injury, stroke, peripheral neuropathies have associated gait pathology resulting in standing and walking difficulties. We offer biomechanical assessment to review forces, movements and power, undertake gait analysis and orthotic assessments to understand the biomechanical alignment and help assess for ankle foot orthosis (splints) and footwear combination. We work closely with established network of clinical orthotists to offer this comprehensive care to our clients.
Manual Handling Training to Carers, Staff and Families
Children or adults with complex neurological involvement more often suffer from restricted mobility. Appropriate manual handling techniques are imperative for any safe transfers. We offer comprehensive training and written guidelines for the family/carers’ team to be able to work safely and efficiently with our clients.
Risk assessments are carried out for any procedure, where there could be a potential hazard.
5 Steps of Risk Assessment:
Identify hazards Decide who might be harmed Evaluate the risk Record the findings Review assessments and update.
Following assessment, we would complete risk assessment reports and guidelines for staff and family to follow. Such assessment is carried out at schools, colleges, gym, hydrotherapy pools, in the community or at clients’ homes.
Hydrotherapy/ Aquatic therapy
Hydro therapy is derived from the Greek work “hydro”- water and “Therapia”- healing, also called aquatic therapy. Physiotherapy programmes utilising properties of water is widely used with clients having neurological and musculoskeletal conditions. It is much easier to initiate movements in water and exercise can be effortless and fun. We use hydrotherapy as an adjunct to help our client’s achieve their goals. We are trained to work with children and adults with complex physical needs and maximize their potential in a pool environment.
Rebound Therapy is used to facilitate movement, promote balance, influence muscle tone, promote sensory feedback, improve fitness and exercise tolerance and to facilitate relaxation. The principles of Rebound Therapy form the basis of gymnastic movements. It teaches progressions of movement patterns which are designed to encourage the child to experience healthy exercise while having fun. Rebound therapy is widely used in children and adults with various levels of functional difficulties. Please ask your therapist if your child or yourself are suitable for an assessment.
Specialist Equipment Assessment
Children and adults with physical difficulties need 24 hours postural care in sitting, lying, standing and walking. We offer specialist assessment and recommendations for a wide range of therapy equipment like standing frame, walking frame, sleep systems, TRIKES , mobility and transfer aids. We use wide variety of postural management equipment that work in adjunct with ongoing therapeutic programme.
Assessment and Treatment with Functional Electrical Stimulation (FES) and Neurostimulation.
FES is an orthotic and therapeutic intervention to improve walking and other motor functions for individuals who have upper motor neuron lesion. The technique produces contractions in paralysed muscles by application of small pulses of electrical stimulation to nerves that supply the paralysed muscle. Stimulation may be applied using skin surface electrodes or using an implanted device. For FES to be effective, both the nerve and the muscle supplied by the nerve must be undamaged, hence it can be used in cases of cerebral palsy, head injury or any upper motor neuron lesion. FES is widely used in children or adults with foot drop.
FES has several benefits over ankle foot orthosis (ankle splints). This is an active intervention that enables the client to use of their own muscles. Active contractions are produced, which help in muscle retraining, possibly leading to strengthening and could also develop voluntary control through motor learning. Clients using FES also show reduction is quadriceps spasticity and (Quality Adjusted Life Years Analysis) have indicated significant positive cost benefit from the treatment.
Audits of clinical service and surveys indicate reduced effort of walking, reduced tripping and improved confidence while walking. People using FES for treatment report greater mobility and improvement in activities of daily living than the control group receiving only physiotherapy treatment.
Saebo Splinting - Arm and Hand Training
Saebo offers wide range of products ranging from Saebo Glove, Saebo Flex, Saebo Reach. There Dynamic splints allow individuals suffering from neurological injuries to develop functional independence while using their hand and arm during therapy and at home. These unique orthoses position the wrist and fingers in appropriate extension to help grasp and release. The client is assessed for the right type and size of the orthosis and fitted. The client is then trained with repetitive task specific grasp and release activities, which is done by voluntarily flexing his or her fingers.
Once the individual relaxes his fingers, the extension spring system assists in re- opening the hand and releases the object. Repetitive activities are proven to aid neuroplasticity developing into learned motor patterns. For more information about this assessment, please get in touch with the team, we will be happy to discuss criteria and objective of this treatment.
Elastic Therapeutic Taping
Elastic therapeutic taping or kinesiotaping is a technique used to facilitate activity in skin (dermis and epidermis) that could facilitated or inhibit muscle activity and particular movement pattern. This treatment approach is used in neurological, orthopaedic, musculoskeletal or in lymph flow disorders. Taping is used either on muscle belly, myofascial chains, cutaneous and trigger points, fascial sheets or on dermatomes. We use this treatment as an adjunct to influence muscle function and train on typical movement patterns. The treatment is highly evidence based and help clients with neurological or underlying orthopaedic problems to achieve their targeted goals and objectives.