Neurophysiotherapy: Getting Moving Again After a Stroke, Injury or Nerve Condition

People call it neuro physio, neurological physiotherapy, neurophysiotherapy. All the same thing. It's physio for when the problem sits in the brain, the spinal cord or the nerves, not in the muscle itself. A lot of families find this confusing at first, and fair enough. After a stroke the leg muscle is usually fine. What's gone wrong is the signal from the brain telling it to move. So we don't just hand out weights. We get the person standing up from a chair, turning in bed, taking a step, over and over, because that's how the brain slowly works out a new route. Doctors have a word for it, neuroplasticity. In the therapy room we mostly just say "relearning".

Worth getting checked if any of this sounds like home:

• Weakness or heaviness in an arm or leg
• Falls, near-falls or a new fear of falling
• Needing help to get up from a chair or bed
• Shuffling, or a foot catching on the floor
• Stiff, tight muscles that make dressing hard
• Feet that "freeze" or feel stuck to the floor
• Coming home from hospital with no clear plan
• Getting tired after just a few steps

"He seems a bit better" isn't much to go on, so we time and score things. In the Timed Up and Go test, the person gets up from a chair, walks three metres, turns, comes back and sits down, and we note the seconds. The Berg Balance Scale is a set of balance tasks. The 10-metre walk test gives walking speed. The 6-minute walk test shows how far someone can go before they tire. After a stroke we may add the Fugl-Meyer assessment, which looks closely at the arm and leg. Do the same tests a few weeks later and you can actually see the difference, or see that there isn't one yet.

Yes. In fact most of the practice ends up happening at home anyway. Just get a proper assessment first, so you know the exercises are safe for that person. Some people need to stay at a rehab centre for a while, with therapy several times a day and a doctor nearby. Others come in two or three times a week. Plenty do a bit of both. Where it happens matters less than doing it regularly and having a plan behind it.

Physio is safe for most people. Still, a few signs mean you stop and get medical help. A drooping face, an arm or leg that suddenly goes weak, slurred speech, a sudden terrible headache: these can mean a new stroke, so call 112 or get to a hospital straight away. Chest pain, fainting, getting unusually breathless or a calf that's swollen and sore also need a doctor before you carry on.