Physiotherapists to challenge NICE stroke guidelines


January 12th 2018

The Chartered Society of Physiotherapy (CSP) have reported on their website that Neuro physiotherapists will now have direct influence on the guidelines for stroke patients. This comes because of a successful challenge by the Association of Chartered Physiotherapists Interested in Neurology (ACPIN).


They go on to explain that the professional network highlighted that the National Institute for Health and Clinical Excellence (NICE) guidelines did not acknowledge latest evidence. They also pointed out that no physiotherapists were due to be included in the guideline development group.


Due to this NICE have now looked to include advice surrounding early mobilisation and optimal positioning. A further development has been the recruitment of a neurological physiotherapist to the development group, giving physiotherapists direct influence on the guidelines.


NICE provide medical professionals, and others who rely on the NHS for their care, with advice on the most effective, and best value, treatments. They look at the evidence surrounding the topics in question and compile it all to provide guidance for those working with these groups of people. Therefore it is important that the evidence from all aspects of care are investigated, including physiotherapy.


The NICE guidelines for stroke and transient ischaemic attack in patients over 16 are due to be published in March 2019.


For more information on this visit:

http://www.csp.org.uk/news/2017/12/07/csp-neuro-network-makes-successful-challenge-nice-stroke-guidelines

Exploring the research for post stroke interventions


November 30th 2017

Andrew Marr: My Brain and me” was shown several months ago on BBC2. In 2013 Andrew Marr, had a stroke, this was a documentary about his experience and the medical and therapeutic interventions he had tried since his stroke. I watched intently to see if physiotherapy would be mentioned, to see how Andrew Marr had been affected and to see how he was getting on now.

Andrew was initially affected quite severely on his left side. He had a facial droop and had only limited use of his left arm and leg. More significantly for him, his voice was affected, he was concerned he may not be a able to work again. The physiotherapist working with him improvised an autocue and he would practice for several hours a day, reading and talking. He made good early progress and he was very complimentary about his physiotherapy team.

Initially intensive physiotherapy also helped restore some movement to his left side, but having made limited progress in the last year Andrew decided to explore a range of new and cutting-edge (slightly experimental) stroke treatments.

Andrew went to Florida to see if a newly-developed treatment would help improve movement on his left side. He paid £7,000 to have an anti-inflammatory drug injected into his head. This unconventional experiment yielded some marginal improvement in Marr's gait and a small increase in the use of the fingers on his left hand; he could get round the hospital car park about 30 seconds faster than before.

He also went to the John Radcliffe Hospital in Oxford to have a tiny electric current transmitted into his brain, this had shown some success in other Stroke survivors but did not demonstrate any improvements for Andrew. They also discussed stem cell treatment to help restore mobility to affected limbs.

Following the programme I felt quite frustrated. I was frustrated that several new innovations were mentioned but there was not much information as to how many people this had helped, there was no evidence or research mentioned as to the benefits in controlled situations. I felt that this could be encouraging Stroke survivors to seek alternative treatments and possibly giving false hope. This made me realise what a difficult position people are in who have suffered a debilitating injury, keen to try any new treatment that reports it may restore previous function, and open to any innovation that may not yet have been fully tested and evidenced.

This, for me, reinforced the importance of evidenced based practice and the need for clients to be able to make informed choices. I have tried to put together some information regarding the treatments mentioned in the program in the hope that this will clarify options available but I would encourage people with neurological conditions to engage with their GP's, Health Professionals and Physiotherapists before embarking on new or alternative treatments.

The first treatment which Andrew Marr underwent has yet to be fully tested. It has been pioneered by the US doctor Edward Tobinick, who founded the Institute of Neurological Recovery. It involves being injected with Etanercept, an anti-inflammatory drug used for arthritis.

Dr. Edward Tobinick is pioneering Etanercept (Enbrel) for a long and apparently growing list of conditions. Enbrel is an FDA-approved drug for the treatment of severe rheumatoid arthritis. It works by inhibiting tumor necrosis factor (TNF), which is a group of cytokines that are part of the immune system and cause cell death. Enbrel, therefore, can be a powerful anti-inflammatory drug. However, Tobinick is using Enbrel for many off-label indications including Alzheimer's, stroke, traumatic brain injury, Parkinson's disease, carpal tunnel syndrome, brain tumour, spinal cord injury, and back pain.

Dr. Edward Tobinick”s clinic claims to treat or cure diseases that are currently believed to be incurable, there is only one clinic in the world that can perform their special procedure and the clinic claims to cure a variety of diseases, all with different causes and pathophysiology, with a single treatment. Mmmm maybe too good to be true?

The use a medication for something that is was not licensed for, is not good practice. If a medication is to have an alternate use then there needs to be robust evidence to show its benefit and justify the altered use. It is possible if a medication is very effective, and there are no adverse side effects, that the popularity gets ahead of the evidence and it becomes widely used. In these situations, careful documentation of use and effects of the medication should be recorded and shared across specialist centres. This then leads to the body of evidence which will either support or refute the claims and informs further usage guidelines.

Tobinick, however, has only conducted one study. He cites many studies, but most of them are simply identifying that TNF is increased in the condition he is claims to treat. Tobinick’s study was an observational study of 629 patients, conducted over the course of nearly two years. It documents a diverse range of positive effects, including statistically significant rapid clinical improvement in motor impairment, spasticity, cognition, etc. in the stroke group, with a similar pattern of improvement seen in the traumatic brain injury group. The study involved 617 patients treated an average of 42 months after stroke and 12 patients treated an average of 115 months after TBI, this is stated as 'long after further spontaneous meaningful recovery would be expected'. He states that significant improvement was noted irrespective of the length of time before treatment was initiated; there was evidence of a strong treatment effect even in the subgroup of patients treated more than 10 years after stroke and TBI.

It is questionable that stroke or TBI deficits will be equally responsive to an anti-inflammatory treatment (or any treatment) regardless of time since the stroke or trauma. Stroke researchers are also very familiar with what is known as the "cheerleader effect." That if you take any patient with chronic deficits, give them any intervention and then encourage them to function better, and they will function better. This can result simply from trying harder, or even just the incidental physiotherapy benefit of engaging in a treatment and being evaluated. With robust evidence researches would normally use a 'control' group that would receive either placebo treatment or a different treatment that may involve more therapist contact or focus more on recovery. If the new treatment showed benefit over and above that of the control group then they may make conclusions about its effectiveness. Unless all these factors are controlled and proper blinding (researchers unable to influence results), no conclusions about the treatment effect are possible. Tobinick is providing the kind of evidence that is guaranteed to be positive, but not the kind of evidence that would determine if his treatments are effective or not, therefore his claims have not undergone any scrutiny and should be viewed with extreme caution. I have referenced the study below for your interest if you would like to draw your own conclusions.

Transcranial Direct Current Stimulation (tDCS) is he second technique tried by Andrew Marr. It is an emerging technique of non-invasive brain stimulation.

There have been numerous animal studies since 1870 into electric stimulation of the exposed brain. This then led to exploring the clinical applications of electric stimulation, including the use in depressed patients. Brain stimulation has gone in and out of favour since then but there has been renewed the interest in the past 8-10 years for the treatment of various neurological disorders.

A Constant Current Stimulator is used to provide a steady flow of direct current. A positive current is applied on the side of the brain where damage has occurred via saline soaked electrodes on the scalp. Brain stimulation has previously been shown to increase the learning of motor skills in healthy people therefore the hope was that this effect could also be demonstrated in stroke patients, using tDCS to reinforce training that helps patients relearn how to use their body.

Amongst numerous other studies, in a recent (2016) study at Oxford University, they included twenty-four volunteers who had had a stroke affecting their hand and arm function. They were split into two groups, both groups were given nine days of therapy. One group had tDCS during the training sessions, while the other group acted as a control: they were fitted with electrodes but did not receive tDCS.

Three months after training, the group that had received tDCS had improved more on clinical measures than those in the control group. This showed that the patients who had received tDCS were better able to use their hands and arms for movements such as lifting, reaching and grasping objects. fMRI scanning also showed that those who had had tDCS had more activity in the relevant brain areas for motor skills than the control group.

The research team concluded that there is positive evidence for the use of tDCS to aid stroke recovery but caution that the technique must be proved to have long term benefits and functional improvements to quality of life.

The huge number of studies in tDCS ranging back for many years demonstrate numerous effects that have been well evidenced as effective, therefore this may continue to emerge as a advantageous therapy to try. However this treatment is not yet available in mainstream healthcare as there is a need for long term studies to see if the effects last long enough and make relevant gains in function for the people that undergo treatment.

The next therapy that Andrew Marr discussed, but didn't try, was stem cell therapy. Evidence is growing regarding the potential for stem cells to modulate pathways involved in the growth and development of nervous tissue, the growth of new capillary blood vessels, immune modulation and neural plasticity. It is hoped that these processes could help the structural and functional regeneration after stroke. Although the research is wide and varied its interpretation in to meaningful effects is very complex. It is very difficult to control all of the variables to produce the favoured Randomised controlled trial and there are numerous different arms to the investigations. Different types of stem cell are being used, there are differing modes of delivery for the treatment. The area of the brain which has been affected by the stroke and the type of stroke, ischaemic or hemarragic, varies hugely. Some studies have looked at acute stroke and some at Chronic and many studies have been on animals.

These variables mean it is difficult to combine the evidence to formulate a robust conclusion. Due to these complexities groups of experts have been providing frameworks to work within 'STEPS I/II/III' (Stem Cell Therapies as an Emerging Paradigm in Ischemic Stroke) These provide a framework to standardise regenerative research in stroke but provide more confusion as many of the published studies had started prior to formulation of these guidelines which therefore leads to questions as the relevance of anything before STEPS. Conclusions from the recent 2017 meta analysis suggest that 'there is reasonable evidence to suggest feasibility, safety and potential effectiveness of these therapies'. But that further trials following the STEPS 111 framework are needed.

Andrew Marr succeeded in bringing the difficulties post Stroke to mainstream viewing but I felt the lack of information regarding the evidence around the innovations could have mislead people and given false hope. Physiotherapy and hard work by the Stroke survivor still remains the gold standard to improve function.

Within the Physiotherapy framework there are new interventions being used like the Saeboflex and SaeboReach, giving the client the ability to incorporate their arm and hand functionally in therapy at home, or the Mollii suit to relieve muscle tension, imbalances, spasticity and improve range of motion, function and activity. At Physio@home we are using these devices with our clients with good success. I therefore plan to do my next blog on these products, bring you the evidence and hopefully some pictures and client accounts of how they are using them and whether they have helped or not.

Reference

Tobinick E, Kim N, Reyzin G, et al. Selective TNF Inhibition for Chronic Stroke and Traumatic Brain Injury - An Observational Study Involving 629 Consecutive Patients Treated with Perispinal Etanercept. CNS Drugs. 2012;16(12). DOI 10.1007/s40263-012-0013-2. ://drmelrichardson.com/Publications/PSEstrokeCNSDrugs2012PN.pdf

Anodal tDCS enhances the functional benefits of rehabilitation in patients after stroke, is published in journal Science Translational Medicine (10.1126/scitranslmed.aad5651).www.ncbi.nlm.nih.gov/pmc/articles/PMC2779259/

Safety and effectiveness of stem cell therapies in early-phase clinical trials in stroke: a systematic review and meta-analysis. Anjali Nagp, Fong Chan Choy, Stuart Howell, Susan Hillier, Fiona Chan, Monica A. Hamilton-Bruce and Simon A. Koblar

Stem Cell Research & Therapy20178:191
https://doi.org/10.1186/s13287-017-0643-x
Published: 30 August 2017

Stem Cell Therapy as an Emerging Paradigm for Stroke (STEPS) II
Sean I. Savitz, Michael Chopp, Robert Deans, S. T. Carmichael, Donald Phinney, Larry Wechsler
https://doi.org/10.1161/STROKEAHA.110.601914"
Stroke. 2011;STROKEAHA.110.601914

Parkinson's And Physiotherapy


September 7th, 2017

Parkinson's is a progressive neurological condition. In the UK there are 127000 people diagnosed with the condition, making it the 2nd most common neurological disorder.

The main changes arise from the loss of nerve cells in the brain which reduces the production of the chemical messenger dopamine. Diagnosis is usually based on clinical examination when patients present with some form of motor symptom. People with Parkinson's might present with falling, loss of confidence and independence and reduced quality of life. Many people experience symptoms of movement disorders such as bradykinesia (slowness), rigidity (stiffness) and tremor.

Drug therapy and deep brain stimulation can provide partial relief of symptoms but many people require additional support from allied health professionals including physiotherapists.

Physiotherapy assessment and management focuses on improving physical capabilities and quality of movement in daily life. Physiotherapists may help with walking and easier ways of transferring, balance and falls education.

The two main areas of Parkinson's specific physiotherapy relate to exercise and movement strategy training. During the earlier stages, physiotherapists emphasise education and self-management promoting general fitness and flexibility. Physiotherapy-specific exercises can limit the effects of Parkinson's to reduce the deterioration in strength, endurance, flexibility and balance.

As Parkinson's progresses, physiotherapists teach movement strategies to overcome difficulty in generating automatic movement, including developing strategies using external (auditory, tactile, visual and sensory) or internal (mental rehearsal and visualisation) cues. Physiotherapy can therefore improve walking, balance, transfers, manual tasks and reduce the risk of falls.

Research showing the effectiveness of physiotherapy for people with later stage Parkinson's Disease is well established. Recently NICE (National Institute for Health and Care Excellence) guidelines highlighted the importance of physiotherapy in the early stages of the disease too. Recommendations are to refer people who are in the early stages to a specialist physiotherapist for assessment, education and advice, especially regarding physical activity. This may offset the development of symptoms as the disease progresses ensuring people with Parkinson's maintain a level of mobility for as long as possible.

Parkinson'sUK website and factsheet. URL: www.parkinsons.org.uk

CSP Physiotherapy works: Parkinson's

Frontline Magazine: Aug 2017, NICE recommends specialist physio for early-stage Parkinson's

Cochrane Primary Care. Physiotherapy Effective in PD, May 2014

University of Essex MSc Physiotherapy Student


August 14th, 2017

For my 6th and last placement I was based with the Physio@Home team, providing Neuro and Elderly rehab in a community setting all around Essex. Their policy is generally to take on students that are in their final placement and I think that this is a good approach in light of the particular challenges of private community work. The nature of long term neurological conditions means that patients will often present with issues which are more closely linked to musculoskeletal and cardiorespiratory physiotherapy. In that respect, it really helped that I had already completed placements in those core areas as I felt more confident in recognising and treating issues that arose. The placement provided an excellent opportunity to consolidate & refine everything I'd learned over the previous two years which will be particularly useful ahead of starting a new band 5 rotational role.

Something else which I quickly learned about community work is that, as well as having to have a broad scope of physiotherapy competency, you also have to have an awareness of the roles of other health professionals to identify where they may be able to help the client. Unlike the hospital setting, where patients are under constant review by various professionals, in the community you may often be the only healthcare worker who is seeing the person at that time. You therefore need to have an awareness of how the person is coping with things outside of the immediate physiotherapy scope. For example, noting deterioration in swallowing or identifying if the person is in need of household adaptions and making the client/family aware of the specialist services that are available to provide help.

One of the things I enjoyed most about this placement was the fact that I was able to put into practice many of the adjunctive treatment modalities which I had seen in the in class setting but not had the chance to use while on the wards due to lack of time or resources. Physio@Home are very up to date with the latest neuro rehab tools and using things like the Saebo flex and Saebo glove, MyoTrac functional electrical stimulation machine, mobile arm support and various specially fitted orthotics to complement treatments was something I found clients responded really well to. During my placement, a training day was also organised for a new electrical stimulation device called the Mollii suit. Aspects of the placement like this provide an excellent overview of some of the treatment options for neuro rehab above and beyond what you will see in the public domain. Similarly, this was the first placement where I had the time to consistently implement outcome measures to track the effectiveness of my treatments which I found very useful.

On the placement I saw a huge range of neurological conditions. Having only had a previous neuro placement on a stroke ward my knowledge of treatments for conditions such as cerebral palsy, Parkinson's, traumatic brain injury and spinal cord injury was limited. Having the chance to work with Kat, Tanya and Rachel was very helpful in terms of improving my knowledge of the conditions themselves and how to approach their management. They have a plethora of experience working in the neuro setting and I was able to draw on this throughout the placement as they were always happy for me to bounce questions off them. I was then able to build my own ethos/approach to treatment based on an amalgamation of some of the techniques they introduced to me. They always encouraged an evidence based approach and pushed me to improve my knowledge by consulting the latest research and guidelines for each condition.

Overall, I learned a huge amount on the 5 week placement and this was not confined solely to neurological knowledge, I had to draw on every aspect of my physiotherapy experience which has provided the ideal preparation for me heading into my working life as a band 5.

A Mary Berry in our midst!


July 3rd, 2017

So it turns out that we have a budding baker in our team! Some of our staff attended the European Neuro Convention at the beginning of the month, at the excel arena in London. Before leaving Saebo UK set the challenge to bake a cake which resembled either the SaeboStep or the SaeboGlove and the best cake would win both of these products as demos for their company.

An image of cake baked to look like a SaeboGlove Always being up for a challenge Kathryn decided to have a go and baked a convincing SaeboGlove (see picture). She boxed it up and carried the cake into London with her and presented it to the Saebo UK team. She had a nervous wait ahead of her as they didn't announce the winner until the end of the day and you guessed it....she won first prize! So not only did the team have a great day listening to lectures from some of the top professionals in the field and have a chance to trial some of the new technology/equipment entering the market, they also came away with a demonstration SaeboStep and SaeboGlove- well done Kathryn!

To view any of the great products Saebo have to offer please visit their website www.saebo.com or give us a call on 01206 396789 for an informal chat.

Smashing goals!


May 22nd, 2017

Click on the link below to read a great article on the BBC Suffolk website about one of our clients. Ben is an inspiration to us all and just shows that hard work pays off. Well done Ben!

www.bbc.co.uk/news/uk-england-suffolk-39992017

Pilates by Tanya Jewell


January 26th, 2017

Having been with the Physio@home team now since November I thought it would be good to do a blog about Pilates, one of my favourite exercise techniques. I have been a Physiotherapist for 9 years and have worked with lots of different clients with various underlying problems. During this time I have used a multitude of Physiotherapy treatment techniques but the one that I have enjoyed using the most and found hugely beneficial to people with long standing conditions or persistent pain, is Pilates.

So what is Pilates? Pilates is great for strengthening and puts particular emphasis on core strength to improve general fitness and wellbeing. Pilates exercises can be done on a mat, standing, in a wheelchair or using special equipment. There is a large focus on breathing techniques and on correct alignment and posture throughout the exercises with a gradual progression of difficulty depending on the individuals ability.

Pilates was developed by German-born Joseph Pilates, who believed mental and physical health were closely connected. His method was influenced by western forms of exercise, including gymnastics, boxing and wrestling. He immigrated to the US in the 1920s and opened a studio in New York, where he taught his method – which he called contrology – for several decades.

Pilates then passed on his methods to others and in order to get as many people using the technique as possible he did not protect the name. This means that anyone can call themselves a pilates teacher as there is currently no legal requirement to be registered or have a pilates qualification. There is a recognised qualification for mat-based pilates teaching, therefore when choosing a pilates teacher, you should consider their experience and the quality of their training.

I have been teaching Pilates for 4 years. I have completed the APPI (Australian Physiotherapy Pilates Institute) Mat work 1 and 2. I have also done the antenatal and post natal course. I am due to continue my Pilates studies in March when I will be learning about Pilates specifically for people with Neurological problems. Being a diligent student I thought I would have a look in to the evidence behind Pilates for people with MS. The MS trust website has some great information on this and they talk about a couple of studies published in 2013.

One study looked at the benefits of Pilates for people who are in a wheelchair. Fifteen people took part in the 12-week Pilates programme. They looked at sitting stability, posture, pain, function, fatigue and impact of MS. The majority of participants described various physical, functional, psychological and social benefits from participation that reflected increased confidence in activities of daily living. Everyone really enjoyed the classes, and most wished to continue after the study stopped.

Another study looked at the effects of Pilates on balance, mobility and strength in people with MS. 26 people took part. They were split into 2 groups, one group did Pilates and the other did active exercises at home. The Pilates group showed improvements in balance, mobility, and arm and leg strength whereas no significant differences were shown in the non pilates group observed in the control group.

So these studies suggest Pilates is really good in improving balance, posture and decreasing pain in people with MS, and most important of all it was well tolerated and enjoyed by the participants.

Since starting work with Physio@home I have enjoyed integrating pilates techniques in to my treatment programs and I look forward to continuing this in the future.

Studies mentioned:

van der Linden ML, Bulley C, Geneen LJ, et al.

Pilates for people with multiple sclerosis who use a wheelchair: feasibility, efficacy and participant experiences.

Disabil Rehabil. 2013 Aug 19. [Epub ahead of print]

abstract


Gunduz A, Citaker S, Irkec C, et al.

The effects of pilates on balance, mobility and strength in patients with multiple sclerosis.

NeuroRehabilitation. 2013 Jul 12. [Epub ahead of print]

abstract



Acupuncture for Stroke Rehabilitation


December 14th, 2016

An interesting piece of research on acupuncture for stroke rehabilitation was published earlier this year (August 2016). The purpose of the publication was to look at the research that had already been undertaken in the subject. For this the authors searched recognised databases for truly randomised clinical trials among people with ischaemic or haemorrhagic stroke, in the subacute or chronic stage.

Briefly their results found that acupuncture may have beneficial effects on improving dependency, global neurological deficiency, and some specific neurological impairments for people with stroke in the convalescent stage, with no obvious serious adverse events.

However, they did identify the need for further research into the area because most included trials were of inadequate quality and size.

To read more about the work conducted visit: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004131.pub3/full

New Recruits


November 18th, 2016

Over the next few weeks we are going to be introducing you to some new members of our team. Today we would like to welcome Lois Bloomfield, who works evenings and weekends. To find out more about her see our "staff" page here www.yourphysioathome.co.uk/staff.html

National Clinical Guidelines for Stroke- Royal College of Physicians (RCP)


October 14th, 2016

This month the fifth edition of the National Clinical Guidelines for Stroke were published. The guidelines have been prepared by the RCP and accredited by the National Institute for Health and Care Excellence (NICE). These guidelines are to update the previous 2012 version.

We are pleased to report that the guidelines support our current way of practice and that we already offer the modalities suggested. Some of the main points from the guidelines are around goal setting, rehabilitation intensity, upper limb function, mobility, balance and NMES (Neuromuscular Electrical Stimulation).

To read the full guidelines visit: https://www.strokeaudit.org/Guideline/Full-Guideline.aspx

Thank you! - Parallel London 2016


September 13th, 2016

Imagine achieving something you never thought was even possible 2 and a half years ago and now imagine achieving it in an environment and atmosphere you would never have imagined could, but always hoped would exist. Well, this is exactly what I did, with the help of Kat from Physio@Home at Parallel London 2016.

I think it is hard to fully comprehend what this event represented in my life. Since starting physio with Kat, 2 and a half years ago, my whole outlook on the way I can teach and use my body has changed. I have always been determined to achieve my goals but until starting physio, it was in spite of my disability, because of progressive weakening due to surgery. However, Kat has gradually changed my viewpoint so that I can achieve my goals whilst working with my body by learning how to get the best out of myself at all times.

With lots of teamwork and dedication, we have gone from working on sitting posture to walking stamina and technique and whilst every small achievement was massive, it was always celebrated on a personal level but did not always translate to honed skills I could use in everyday life, so whilst I had a quite sense of achievement and a steely determination, the progress was not always obvious.

Parallel London came at a perfect time in my progression and allowed me to achieve with a sense of community and on a par with everybody else. After the day, I have thought and talked a lot about how this event felt so different to anything I had experienced before and I think it’s because I didn’t feel different. The 1km was achieved by everyone in whatever way they could and was celebrated equally.

I feel without Parallel London, I would have reached my goal of walking 1km but it would have been another quiet achievement, that was massive to me and the people around me but could not be celebrated in a community of fellow sports people. The buddy system and the ability to use any equipment needed, allowed me to achieve with like-minded people and I think the impact of that on my own sense of achievement was massive.

So thank you to Parallel London and Kat, for making what seemed impossible, possible and see you for Parallel London 2017.

Parallel London 2016


September 7th, 2016

As you may have seen from our twitter and Facebook updates last weekend, we supported two of our amazing clients to take part in the parallel run event in London.

Physiotherapy This was the first event of its kind and was held at the Queen Elizabeth Olympic Park for all ages and abilities. Participants had the option of taking part in four different distances, (10k, 5k, 1k or 100m) and you could complete the course anyway possible; running, walking, being pushed or cycling.

We all had a fantastic day and both our clients completed the 1k route, smashing their individual goals along the way! We are already looking forward to next year's event and hope that we can encourage more of you to participate with us. Watch this space!




Physiotherapy Student Feedback


August 12th, 2016

Recently we had a physiotherapy student from the University of Essex spend five weeks with us for his final placement. We asked him to write a small piece about his time with us and what he learnt, below is what he had to say:

Reflecting on my time with Physio@Home, there are a few aspects of the company that really stand out, including the huge variation of pathologies/conditions they come across and the variation within each pathology and the wide ranging and up to date treatment methods.

During my short 5 week placement, I have come across clients ranging from 15 to 78 years of age, conditions including cerebral palsy, stroke, traumatic brain injuries and spinal cord injuries. Within each condition there has also been a huge variation in presentation from one client to another, also an individual client's symptoms may vary from week to week and are affected by a huge number of factors. This meant that the physiotherapists and assistants at Physio@Home must have a vast and wide ranging knowledge base and skill set to be able to draw upon. Another key skill practitioners must have in order to work in this environment is the ability to think on their feet, various scenarios could put the best made plans out of action and therefore the ability to improvise and create the best possible treatment plan in the circumstances is invaluable.

Another aspect of Physio@Homes practice that impressed me is the huge amount of treatment options available and the manner in which the physiotherapists use these. Clinicians are not limited on treatment options, unlocking the use of many modalities not often used in more traditional environments; these include Saebo equipment, functional electrical stimulation, hydrotherapy and access to places like the MS-UK centre in Colchester. This enables the staff at physio@Home to keep up with technological developments and advancements in the evidence base, every treatment option used at Physio@Home was clinically reasoned and supported by relevant literature including research papers and national guidelines. There was a large emphasis on active rather than passive treatments, this empowers patients and helps them to self-manage their condition, hopefully avoiding reliance on clinicians in the long run.

To conclude, even though I found myself having to do more external reading outside of the placement hours than in any of my previous placements, it was definitely one of my most enjoyable, educational and rewarding experiences."



Exciting stem cell research for stroke patients


July 7th, 2016

I found an interesting article outlining the recent research undertaken at Stanford University in America.They were looking into stem cell transplants in post stroke patients.

The research was completed on a small group of patients; 18 in total, who had suffered a stroke between six months and three years before the research started. All of the patients had the stem cells injected into the stroke damaged area of their brains.

The researchers noted signs of recovery within a month of the transplant, with these improvements continuing over several months. Due to the success of this small study the researchers are now planning to try the method on more patients. They are recruiting for a group of 156 post stroke patients to further assess the benefits.

Not only could this be great news for stroke patients but it has the potential to benefit other brain injury-related conditions.

To read more on this exciting subject visit: www.medicalnewstoday.com/articles/310769.php


Welcome to the team!


June 23rd, 2016

As you may have noticed from our website we have a new member to our team. Her name is Sonja and she joins us as a Physiotherapy Assistant. She started her career at Colchester hospital in 2012 and since then has had a wide variety of experience which makes her a great asset to our team. To find out more about Sonja, and to see what she looks like, visit our "staff" page on the website.


Recent research


June 10th, 2016

We have been in demand recently, as you can tell from the lack of blogs! However, now that our team has grown, it has given us time to turn our attention back to keeping you all updated on what's going on.

I listened to an exciting segment on Radio 4 today about a small trial conducted on stroke survivors. The participants were all at least six months post stroke and had stem cells injected into the damaged part of their brain. The results sound really positive and have been successful enough to warrant more trails on a larger scale. To learn more visit www.bbc.co.uk/programmes/b07dly5j and listen at 8.40am. Exciting times!!


FREE Saebo Assessments from June 2014


June 1, 2014

From June 2014 we are very excited to announce that we will be a centre where you can be assessed for Saebo products for free! Saebo have revolutionised upper limb rehabilitation and integration of function for those with upper limb weakness and tonal changes following strokes/head injury and other similar conditions. We will be able to assess for a variety of orthoses and dynamic splinting options and customise them according to individual need. Using devices such as the Saebo Flex alongside physiotherapy techniques to strengthen the affected upper limb has shown a massive improvement in function and ability. Our sister company Kidsphysio2u are also offering this fantastic opportunity for those under 18.

Did we mention that we will assess your suitability for FREE from our clinic in Colchester? If you would like more information or to book an appointment you can call Beth or Kathryn on 01206 396789 or email info@yourphysioathome.co.uk to see if we can help.


MS Awareness Week


On April 23, 2014

We have been a bit quiet on the blog side for a while..but here we are back again!

28 April - 4 May is MS Awareness week and in preparation we thought we could provide an overview of how physiotherapy can support people and their families living with MS.

The main thing people think about when considering physiotherapy is that we can help with mobility. This can vary greatly from considering different walking aids to use, advising on different manual handling techniques and equipment for transfers or focusing on gait re-education, balance and strength training. Physio@Home also have the Walkaide FES device which aids people with foot drop without having to wear an orthoses in your shoe.

We can also provide support and treatment for respiratory problems, teaching and performing chest clearance techniques if you are having trouble clearing secretions.

Physiotherapy can also be effective in reducing pain and discomfort, for example if you have areas of tightness through muscle spasm - advice on positioning, stretches, massage and exercises are some of the options we consider to alleviate pain for our clients.

Another vital aspect is appropriate liaison with other professionals to ensure a holistic approach to your care, for example, occupational therapists, dieticians, MS nurse specialists, speech and language therapists and so on.

If you would like to discuss with us in detail how physiotherapy can be of benefit please contact us on 01206 396789 or info@yourphysioathome.co.uk to see if we can help.


The Walkaide has arrived!


On March 14, 2014

Our clinicians kits have arrived and this week we completed our training in the assessment and use of the WalkAide.

The WalkAide uses FES (functional electrical stimulation) to provide gentle electrical impulses to the muscles that help control lifting your foot and toes up. Drop foot is commonly a problem for people with conditions such as stroke, MS, traumatic brain injury or cerebral palsy and the WalkAide addresses this by helping increase the strength of the muscles that lift your foot,which in turn can help improve your walking pattern and balance.

For more information see http://www.walkaide.com/en-US/Pages/default.aspx

We are more than happy to answer any questions you might have so please give us a call or email us or book in for an assessment to try it out!


Home exercises reduce falls for people with MS


On March 5, 2014

A study published recently has found that completing a home based exercise programme reduces falls risk in older adults with MS.

In the study participants completed the exercise programme consisting of leg strengthening and balance exercises 3 times a week for 12 weeks. The researchers completed balance and walking assessments at the start and finish of the study, finding that those who completed the exercise significantly reduced their risk of falling compared to the control group (who continued with usual activity), where falls risk actually increased.

Here at Physio@home we have a great deal of experience in treating clients with MS and those at risk of falls and would be happy to tailor an exercise programme specifically for you.

We are always happy to discuss your individual situation, so please don't hesitate to call us for an informal chat on 01206 396789, or email us on info@yourphysioathome.co.uk to see if we can help. to see if we can help.


Andrew Marr advocating physiotherapy post stroke


On February 20, 2014

Many of us will have heard about Andrew Marr suffering a stroke last year and he has spoken out previously about the challenges he has faced through his rehabilitation journey. At the weekend he was on the Jonathan Ross show talking about the massive benefits of physiotherapy, in particular daily strength training post stroke. This is something we, at Physio@Home, consider a hugely important part of rehabilitation and can tailor programmes to target individual goals. If you would like to talk to us further about our rehab approach please call or email us!

We are always happy to discuss your individual situation, so please don't hesitate to call us for an informal chat on 01206 396789, or email us on info@yourphysioathome.co.uk to see if we can help. to see if we can help.


FES service from Physio@Home


On February 13, 2014

An exciting development for our clients and their families for 2014! Physio@Home are pleased to announce that we will be offering FES assessments and treatment in 2014. The device that we have sourced is called the Walkaide, provided by Trulife and has shown to have fantastic results in improving the walking pattern of people who suffer with foot drop. FES (functional electrical stimulation) has shown to be particularly effective in those who have neurological impairments following conditions such as Multiple Sclerosis or stroke.

The Physio@Home staff will be undertaking full training within the next month to allow us to assess you for the device and use within treatment sessions. Clients can then purchase their own FES device if required.

For more details and to watch videos of the Walkaide In action see http://trulife.com/all-products/orthotics/neuro-rehabilitation/walkeaide/walkaide


We are always happy to discuss your individual situation, so please don't hesitate to call us for an informal chat on 01206 396789, or email us on info@yourphysioathome.co.uk to see if we can help.


Testimonials
In August 2013 I had a Brain Hemorrhage aged 29 before this I was a solicitor at a top 10 law firm and a busy mum of two.

My father-in-law found Kathryn on the internet and having read her profile I knew she was for me. I met Kathryn shortly after in February 2014 after a second stint in hospital. The original Brain hemorrhage has left me with Ataxia, which in turn, has left me with balance, strength and core problems.

When I first met Kathryn I was pleased to use my zimmer frame now I have a walker and crutches (July 2014) and I am far less reliant on my wheelchair.

I find the physio tough in a good way. Kathryn recently went away and the organization was seamless - Beth turned up and was just as tough. Both Kathryn and Beth are really personable and an hour goes by very quickly.

I find Kathryn (and Beth) approachable and friendly. Kathryn often emails me between appointments and her local market knowledge is very good.

I am really/finally starting to see a difference and I hope if we keep on I'll get a semblance of my old life back.

- CW
In March 2010 my wife and I had the 4 o'clock in the morning call that all parents dread. Our son, 29 years old, had had a serious motorcycle accident in Bali. He was in a critical state, with serious head injuries and brain damage, in a coma in a hospital in Bali. What followed was massive anguish and uncertainty, air ambulance jet repatriation a thousand miles away to Singapore, five weeks of fantastic hospital treatment, and then repatriation to UK.

At that point we were more or less on our own; the first available appointment offered for physiotherapy was more than a month away. We came to Beth via a personal contact and she was the best thing that could have happened to us. Beth is definitely not a 'one size fits all' therapist. She listened carefully to the detail of his situation. She carried out her own assessment. Then she devised targeted exercises specific to his needs.

Each visit progressively moved him along the road to improving balance, strength, physical co-ordination, hand to eye co-ordination, fine motor skills and, of equal importance, confidence in his ability to get his old life back.

Beth stressed that her visits were to demonstrate and advise, so that our son's own daily routines in between visits, would be best suited to his continuing improvement.

In those early months she gave him the encouragement, confidence and motivation that he so badly needed.

No one who now meets our son has any idea that he suffered brain injury. Even his old friends cannot tell the difference between the before and after. He was undoubtedly lucky, but a significant chunk of his luck came from knowing Beth.

- Garry, Essex
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