Neurotherapy

What it is

Gloucestershire Neurotherapy Services based at Courtyard Clinic Ltd. offers specialist neurological therapy in a friendly, well equipped environment. We are a group of neurotherapists including Physiotherapists and Occupational Therapists who are keen to work with you to achieve your goals. “Life is not about waiting for the storm to pass but learning to dance in the rain” As Neurotherapists we specialise in treating individuals who have suffered damage to their central nervous system, i.e., the brain or spinal cord. We offer specialist assessment and treatment. Working together to improve or maintain functional independence and quality of life.

Common Conditions

We specialise in treating the following conditions.

  • Stroke
  • Multiple Sclerosis
  • Head Injury
  • Parkinsons Disease
  • Sensory Disorders
  • Guillain Barre Syndrome
  • Spinal Injuries

What to expect

We offer a range of different approaches including:

  • Bobath/Normal Movement
  • Motor re-learning
  • Function-based treatment

We offer specialist assessment and treatment tailored to your individual needs to enable you to get the most out of your therapy sessions. Time is taken to complete a thorough assessment and goals will be discussed with you to ensure your therapy is aimed at your needs. Ultimately we discuss your rehab pathway with you and choose the most suitable treatment. We promise to have an open and honest discussion with you regarding your potential. We aim to work with you to:

  • Achieve your goals
  • Maximise function in activities of daily living including:  Work, Leisure, Physical, Personal
  • Maintain as high a level of activity as you are able
  • Offer support and guidance in choosing suitable equipment
  • Provide advice on lifestyle adjustment

Please click on the link below for further information regarding different treatment options.

Lower Limb Assessment and Rehabilitation

Frequently people with neurological conditions find that their lower limbs have been affected. This can vary from patient to patient but may be due to a specific or generalised weakness, sensory changes, coordination difficulties or tone.

We undertake a full assessment to include the specific details of the lower limb as well as how it influences your functional abilities in relation to your everyday living. From this assessment, we build a rehabilitation programme designed to work towards your goals.

This may include specific therapist treatments, self-managed exercise programmes or group participation, gait re-education and other adjuncts like splints or Functional Electrical Stimulation.

Upper Limb Assessment and Rehabilitation

Following a stroke or diagnosis of a neurological condition, you may often experience difficulties with upper limb functioning. We aim to complete a thorough assessment of your upper limb/limbs and provide rehabilitation or a management plan to suit.

For some people, this will involve rehabilitation to restore function, for others it may involve management plans which involve stretches and splinting, which then may lead into rehabilitation to restore normal function. Some may require help to adapt to a non-functioning upper limb and we can advise on appropriate lifestyle adaptations and aids.

Some people may benefit from individual sessions, some may prefer group sessions. We aim to discuss your upper limb recovery openly with you and help you make a decision on the best treatment option for you.

Walking Assessment and Rehabilitation

Neurological conditions often affect peoples walking abilities. You may find that you are catching your toes and stumbling or that it is more difficult to bear weight through one of your legs. We are able to complete a full gait analysis working out what the difficulties are with your walking and then set up a rehabilitation programme aimed to work on these areas. This may include stretching and/or strengthening exercises, gait re-education and the possible use of adjuncts like splints or functional electrical stimulation.

Cognitive assessment and rehabilitation

If you have problems with your memory, concentration or general planning or you are having problems completing tasks that used to come automatically to you, we are able to assess your problems and devise rehabilitation plans to aid improvement in function in these areas or discuss with you compensations that will aid your ability to manage day today.

Fatigue is one of the commonest symptoms of neurological impairment, in particular, MS and can often have a major impact on people’s lives. As an ‘invisible’ symptom, fatigue is sometimes misinterpreted by family, friends or colleagues, who mistakenly assume that the person is depressed or just not trying hard enough.

Fatigue does not relate to relapses, or to any permanent increase in disability, although previously experienced symptoms may recur during fatigue but subside after rest. However, people can experience fatigue that interrupts their daily life or that prevents them from working whilst having no other symptoms.

Fatigue is very different from the tiredness or exhaustion that people without neurological conditions experience following strenuous exercise or a busy day at work. It is characterised by the sudden loss of energy and the inability to continue an activity that is out of all proportion to any activity undertaken.

Neurological fatigue cannot be worked through and recovery time also tends to be much longer. Although for some people drug therapy can help with fatigue, treatment is primarily based on learning how to pace your daily activities to enable you to manage better and lessen the impact of fatigue. We can discuss your daily activities and help you to plan and pace yourself to manage the symptoms of fatigue.

Work Assessments

Due to your condition, you may find your working life a challenge. We are able to assess and advise you regarding continuing or returning to work. This may be one or all of the following:

  • Issues relating to posture when carrying out your job
  • Fatigue management
  • How to grade your return to work if you have been out of work for a few weeks or more
  • Skills assessment to highlight your strengths and weaknesses at work
  • Assess you carrying out relevant aspects of your job in preparation for a return to work

We can also carry out a visit to your place of work to look at the job you are currently doing and make recommendations to help improve your performance at work, this might be regarding seating heights, the position of the computer, organisational skills, workload, concentration…. We would be happy to meet with your employers, Human Resources, Occupational Health, to advise on any recommendations we make.

The SaeboFlex allows individuals suffering from neurological impairments such as stroke the ability to incorporate their hand functionally in therapy and at home by supporting the weakened wrist, hand, and fingers. The SaeboFlex is a custom fabricated orthosis that is non-electrically based and is purely mechanical.

The SaeboFlex positions the wrist and fingers into extension in preparation for functional activities. The user is able to grasp an object by voluntarily flexing his or her fingers. The extension spring system assists in re-opening the hand to release the object. Saebo’s pioneering treatment principles are based on the latest advances in neurorehabilitation research documenting the brain’s ability to “re-program” itself through mass practice, task-oriented arm training.

The SaeboFlex takes advantage of the most recent research by allowing patients to immediately begin using their hand for functional grasp and release activities. Individuals up to 20 years post neurological injury can benefit from the SaeboFlex. In addition, the ability to use the hand in therapy and at home has been reported as extremely motivating during the recovery process. We are able to offer a free assessment of the saeboflex so you can try it and see if it will aid your recovery.

Fatigue Management

Fatigue is one of the most common symptoms of neurological impairment, in particular, MS and can often have a major impact on people’s lives. As an ‘invisible’ symptom, fatigue is sometimes misinterpreted by family, friends or colleagues, who mistakenly assume that the person is depressed or just not trying hard enough.

Fatigue does not relate to relapses, nor to any permanent increase in disability, although previously experienced symptoms may recur during fatigue but subside after rest. However, people can experience fatigue that interrupts their daily life or that prevents them from working whilst having no other symptoms. Fatigue is very different from the tiredness or exhaustion that people without neurological conditions experience following strenuous exercise or a busy day at work. It is characterised by the sudden loss of energy and the inability to continue an activity that is out of all proportion to any activity undertaken.

Neurological fatigue cannot be worked through and recovery time also tends to be much longer. Although for some people drug therapy can help with fatigue, treatment is primarily based on learning how to pace your daily activities to enable you to manage better and lessen the impact of fatigue.

Postural Management

Postural management may be defined as, “the use of any technique to minimize postural abnormality and enhance function” (Farley et al 2003). You may find sitting, standing and lying uncomfortable and may benefit from an assessment of your posture in these different positions and recommendations for management. Proper positioning is important in order to:

  • Normalise or decrease abnormal neurological influence on the body eg muscle tone
  • Maintain proper skeletal alignment
  • Manage pressure
  • Enable limb movement and functional use
  • Reduce fatigue
  • Facilitate normal movement patterns
  • Enhance autonomic nervous system functions such as breathing, swallowing, digestion and cardiac function
  • Maximise function

Postural management may be focused around advise on appropriate furniture, exercises to help you maintain an improved posture, recommendations for specialist seating and wheelchairs. Functional Electrical Stimulation, FES, is a technique used to produce contractions in paralysed muscles by the application of small pulses of electrical stimulation to nerves that supply the paralysed muscle. This electrical stimulation and the effect it has on the muscles can be controlled to allow improvements in function. It has been used particularly in the improvement of drop foot. The electrical stimulation can assist with the picking up of the foot and therefore the walking pattern is improved. It can be used successfully for conditions that are caused by a problem with the central nervous system (brain and spinal cord) including stroke and multiple sclerosis. At the clinic, we are able to assess your suitability for FES and assist you with the setup and ongoing management of using FES.

Rehabilitation to enable you to complete day to day activities such as cooking and self-care

Lower Limb Assessment and Rehabilitation

Neurological conditions often affect peoples walking abilities. You may find that you are catching your toes and stumbling, finding it more difficult to bear weight through one of your legs or just frustrated by how slow your walking is. We are able to complete a full gait analysis working out what the difficulties are with your walking and then set up a rehabilitation programme aimed to work on these areas. This may include stretching and/or strengthening exercises, gait re-education and the possible use of adjuncts like splints or functional electrical stimulation.

Fatigue and Condition Management

Fatigue is a common symptom of neurological impairment and can often have a major impact on people’s lives. As an ‘invisible’ symptom, fatigue is sometimes misinterpreted by family, friends or colleagues, who mistakenly assume that the person is depressed or just not trying hard enough. Fatigue does not relate to relapses, or to any permanent increase in disability, although previously experienced symptoms may recur during fatigue but subside after rest. However, people can experience fatigue that interrupts their daily life or that prevents them from working whilst having no other symptoms. Fatigue is very different from the tiredness or exhaustion that people without neurological conditions experience following strenuous exercise or a busy day at work. It is characterised by the sudden loss of energy and the inability to continue an activity that is out of all proportion to any activity undertaken. Neurological fatigue cannot be worked through and recovery time also tends to be much longer. Although for some people drug therapy can help with fatigue, treatment is primarily based on learning how to pace your daily activities to enable you to manage better and lessen the impact of fatigue. We can discuss your daily activities and help you to plan and pace yourself to manage the symptoms of fatigue.

Other services that can support your treatment

Splinting Including Saeboflex and Stretch Functional Electrical Stimulation Functional Electrical Stimulation, FES, is a technique used to produce contractions in paralysed muscles by the application of small pulses of electrical stimulation to nerves that supply the paralysed muscle. This electrical stimulation and the effect it has on the muscles can be controlled to allow improvements in function.  It has been used particularly in the improvement of drop foot during walking. The electrical stimulation can assist with the picking up of the foot, allowing the foot to clear the floor whilst the leg is being swung through and therefore the walking pattern is improved which in turn reduces the risk of falling.  This can also help to reduce the effort needed to walk.  It can be used successfully for conditions that are caused by a problem with the central nervous system (brain and spinal cord) including stroke and multiple sclerosis.  At the clinic we are able to assess your suitability for FES and assist you with the set up and ongoing management of using FES.

DM Orthotics

DM Orthotics (DMO) is a lycra based orthosis that aims to facilitate movement whilst helping to reduce unwanted movements. It is a dynamic, individually custom-made orthosis that can be measured to you once you have been assessed by one of our therapists.  The assessment will look at where the DM orthosis can have a positive effect on the areas of your body that you are having difficulty with.  Once the assessment has been undertaken the therapist can take measurements, order the orthosis and then check its fit once it has been made.  Each orthosis is designed to work in a specific way to aid your body.  It could involve increasing your sensory input and assisting with increasing your core stability, improving your postural position or improving your muscle function.  The orthosis is aimed to be directly in contact with your skin so it possible to look at ways to make it easier to get on/off and also to aid personal care. For further information please see the following website www.dmorthotics.com

Rock Tape

Our therapists are trained in the use of rock tape which is applied to the skin to assist with sensory input, reduce pain and also have an effect on reducing the stress through a muscle or facilitate with the contraction of a muscle. The tape can be used like therapists hands but can be kept on for longer having an ongoing effect and is used as a treatment adjunct to facilitate the treatments you are having with the therapist.  Our therapist aims to trial the tape and if it works will teach you or a family member how to apply it so that it can be a treatment that you can use independently when you require it.

What will it cost?

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Meet our Therapists

Kate Bird

Kate Bird

Occupational Therapist

I have spent most of my life being busy: playing sport, playing musical instruments, knitting, working, running the church music group, and bringing up a family. What activities we do, defines who we are.

Juliette Sherrington

Juliette Sherrington

Occupational Therapist

My career has taken me on a varied path, working with a range of ages from young adults to 100+ in both mental and physical health. The key thing I have gained from this is just how important health and wellbeing is.

Vicky Baker

Vicky Baker

Neurological Physiotherapist

I have been overwhelmed by the body’s ability to adapt to the most traumatic neurological event. This type of physio never says never.  I enjoy the individuality of my patients and I plan therapy accordingly.

Here’s What Our Clients Think of Us

For Karla (Hypnotherapist)

“I was here on 3-day work experience. The first day I was nervous but there was a ‘family atmosphere’ where everyone was really welcoming and made me feel comfortable. I enjoyed every minute and would love to come again.”

Charlie Edwards

For Vicky (Vim and Vigour)

“I am now nearing the end of my second course of Vim and Vigour sessions. I must say, along with thoroughly enjoying myself I have noticed an improvement in my balance, core strength and flexibility over this period. My thanks go to Vicky who has focused the activities towards my particular needs and has also raised my awareness of how to combat the ageing issues my body is facing. Thank you.”

Karen McDonald

For Jo (Physiotherapy)

“I have to say that in all my years, working and coaching, and being treated myself, that was one of the finest pieces of work I’ve ever witnessed. My daughter is a very complex, head strong young lady. I am truly in awe of the way Jo took on the mental and physical challenges in a way she could accept. Very grateful for all you’ve done”         

Tony Hillman

 For Jo Roberts (Equipment Based Pilates) “Over the last 2 years of rehab, I’ve done lots of different exercises, some extreme that have worked me hard. This is the only one that I’ve had to ask to stop mid-session to get a drink of water, that’s how hard it pushes you, do not underestimate this fantastic form of exercise.”

Jerry Fowler

Ready to Make a Change?

Making that first appointment is the most important part. If you’re not quite sure what you need don’t worry, give us a call or send an email. Our job is to help you find the best way forward with the most appropriate treatment plan or class for you.