Care Guides for Caregivers

3 Tips a Physiotherapist Wants You to Know about Recovery

Post on 13/11/16

A physiotherapy regime can be challenging. But the goals are worth the effort! Physiotherapist Jane Gee shares how to get the most out of your physiotherapy experience.

HiResFrequently, I have heard the general public, not only stroke survivors, reporting little or no improvement in their function after a physiotherapist had prescribed an exercise programme. When asked, the person would smile and admit they did not have time to do the exercises as frequently as prescribed. Progress and improvement in function are reliant on therapy, mostly in the form of exercises or stretches, and these need to be done as prescribed by the physiotherapist.

Here are a few pointers as to why it is important to complete these exercises:

Changes in muscle strength will usually take one to two weeks to become apparent, but maintaining the new level of strength takes at least three months. This is dependent on how often you do the exercise, how long you do it for, how intensively you work the muscle and if you are working against a weight or resistance. These are all things your physiotherapist will guide you with.

Research shows that balance systems take at least three weeks to improve because the nervous system improves slowly with frequent targeted task practice.

It has been proven that if you practice a task or skill consistently and correctly, your abilities in that task or skill will improve. More recently, research has concentrated on whether practising a task such as “sit to stand” will improve your walking speed. Doing these tasks will result in improvements to leg strength and balance, but the research also recommends practicing the task of walking and increasing your speed to achieve a more significant effect. Lastly, there is no evidence that improvements in the task or skill are sustained if you stop training.

The Five-Minute Rule

Here is a challenge for you: Try following “the Five-Minute Rule”. Decide “I will do these exercises for just five minutes”. Once you start moving you will have the option to stop after five minutes. When you set small goals, fear is much less likely to kick in and suddenly those rehabilitation exercises seem much more doable. As long as you make the exercises optional for yourself, you’ll be more likely to do it. Think of it a bit like reverse psychology — on yourself!

Participate Regularly in an Exercise Meant to Prevent Falls

Approximately 80% to 90% of injuries in the community are caused by falls. The consequences of falls include injury (this can be severe, in particular, hip fractures), functional limitations, reduced mobility and activity and fear of further falls (which often result in reduced quality of life). Fracture rates are four times higher in stroke survivors than the general population, and so preventing falls is crucial. Evidence suggests that a range of exercise therapies completed two to three times weekly, including yoga, Pilates, qi gong, tai chi, the Feldenkrais Method and the Alexander Technique, along with aerobics and outdoor walking, can help.

Here are a few other strategies to prevent falls

  • Use nightlights in bedrooms, bathrooms and hallways
  • Make sure light switches are easily accessible
  • Use bathmats with suction cups and non-adhesive strips in the tub
  • Sit on a bench or stool in the shower and use a hand-held showerhead
  • Don’t walk around in stocking feet. Wear shoes or slippers that fit snugly
  • Remove throw rugs and secure area rugs with double-sided tape
  • Use a sturdy step stool with a handrail when reaching items up high and store frequently used items at waist level
  • Review medications with your doctor as some may cause dizziness and imbalance
  • If you feel lightheaded when first sitting or standing up, sit down and stay seated until your head clears, then stand up slowly
  • Ask for help. If needed, a caregiver or family member should be ready, willing and able to help out
  • Slow down and take all the time you need when walking. There is no need to hurry, and it may be safer to go more slowly

Move More Often

It is important to change position at least every 30 minutes to prevent your muscles from becoming tight and painful. You should concentrate on moving little and often; not necessarily participating in a full exercise programme. You are encouraged to do what you can: change your position; walk around the room; stretch both of your hands; shrug your shoulders. Movement supports a healthier circulatory system and brain; it prevents back pain, stiffness in joints and difficulties regulating your blood pressure after prolonged stationary positions. If it is challenging to move a part of your body, ask a carer or family member to gentle move it for you in the way a therapist has taught you previously. If you or your carer have not been taught how to do this, I would encourage you to book an appointment with a physiotherapist to learn safe and effective movements.

As a teenager, Jane watched a close family member recover following a stroke. She developed a keen interest in supporting others to regain their full potential after a life-changing event such as a neurological diagnosis. On obtaining her physiotherapy degree in Scotland, she decided to specialise in Neurological Physiotherapy in Surrey and Central London. Jane has worked with a wide variety of clients from the sub-acute, rehabilitation and maintenance phases post-stroke. She has further qualifications in the Bobath Method and APPI clinical pilates. Jane is a UK registered Physiotherapist.

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George Chiang says:

I think this is mainly for those who have stroke only. If accompanied by dementia it is extremely difficult to do it.


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