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Multiple Sclerosis: Early Intervention, Treatment and Causes

Multiple_Multiple_Sclerosis__Early_Intervention,_Treatment_and_Causes.jpg     How Does Neurospace Help in MS?  Our therapists at Neurospace are trained to help people with neurological conditions like multiple sclerosis (MS).  Multiple Sclerosis is the most common acquired ...

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How Does Neurospace Help in MS? 

Our therapists at Neurospace are trained to help people with neurological conditions like multiple sclerosis (MS). 

Multiple Sclerosis is the most common acquired neurological disease in young adults, with most people being diagnosed between the ages of 20 and 40. MS is a condition of the central nervous system that interferes with nerve impulses in the brain, the optic nerve and the spinal cord. 

At Neurospace, we focus on helping people with complex problems – and your brain is the most complex of all, controlling the rest of your body. We assess you carefully then make recommendations for tailored exercises, walking aids if you need them, and pain and fatigue management strategies.

We have also started a new program for people in the early stages of MS, called MS Get a Head Start. It is an innovative, 6-week high intensity exercise and education program to empower self-management. The program is designed to maximise your understanding of how MS can be positively influenced by exercise and education.

You can make an appointment to see us at Neurospace to help you maintain your wellbeing and assist you with any difficulties you may be facing.

 

Living with MS

If you have MS, you may experience varied and unpredictable symptoms including problems with motor control, fatigue, neurological disturbances, incontinence, depression, cognitive difficulties, issues with temperature regulation and memory loss. 

 

Types of MS

There are a few types of MS. Most people have relapsing-remitting MS. In a relapsing period, MS affects life significantly. Then comes a remitting period where the disease is in remission for a while. Eventually, for most people, the disease progresses steadily with fewer periods of remission. This is known as secondary-progressive MS. 

The second main type is primary progressive MS. In these cases, there’s a steady progression of symptoms from the start without any periods of remission. Another type is progressive-relapsing MS.

 

Early Intervention for MS

Early intervention refers to providing specialist help and support in the early stages of a disease or disability.

Even in the early stages of MS, damage occurring in the brain and spinal cord can affect your cognition, emotional wellbeing, quality of life, day-to-day activities and ability to work.  Early intervention is vital (both with a disease-modifying therapies and lifestyle changes) to preserve brain tissue and maximise lifelong brain health. The goal is to reduce the impact of debilitating symptoms and maximise the opportunities for independence. 

Early intervention for MS can include: 

  • Support from neurological physiotherapists to address strength, balance and any reduced sensation. 
  • Helping you understand the neuro-protective effects of exercise on the central nervous systems, with specific exercises that have the potential to slow the progressive disease down
  • Help to manage appointments and social engagements and remaining connected to family and friends
  • Domestic help with household tasks
  • Psychological and emotional support to help you adjust to living with a long-term medical condition
  • Occupational therapy to overcome difficulties with everyday activities
  • Help from Specialist Employment Support Services to help you continue working, including aides and other support to help you continue doing your job

 

Other Treatments for MS

There’s no known cure for MS but there are medical treatments to relieve symptoms, reduce the risk of relapses or slow the disease progression. 

If you have relapsing-remitting MS, disease-modifying therapies (DMT) slow the frequency and severity of attacks to your central nervous system by modifying your immune system. Steroids can reduce the inflammation at the site of an MS attack while immunosuppressants may help if you have progressive MS. 

 

Causes of MS

Frustratingly, we don’t yet understand what causes MS, though we suspect it’s a mix of genetic, environmental, immunologic and infectious factors. We know it’s an autoimmune disease where your body’s immune system attacks itself. This destroys myelin, the fatty substance that protects the nerves in your brain and spinal cord. When the myelin is damaged and the nerves are exposed, the messages your brain sends along the nerves get slowed or blocked. 

 

MS is more common in people who are:

  • Aged 20-50
  • Female (women are three times more likely to develop MS than men)
  • Closely related to someone with MS
  • Caucasian of northern European ancestry (MS still occurs in most other ethnic groups including African Americans, Asians and Hispanics/Latinos but is more common in white people)
  • Living in a temperate climate like southeastern Australia, Canada, northern USA, Europe or NZ
  • Someone who has had certain viruses such as glandular fever
  • Living with other autoimmune diseases like type 1 diabetes, thyroid issues or inflammatory bowel disease.  

If you’re experiencing difficulties due to MS, please make an appointment to see us at Neurospace. And if you have MS and are feeling good, please make an appointment so we can help you maintain your wellbeing. 

 

 

How Physiotherapy Can Promote Healthy Ageing

How-Phys_Untitled_design_(10).png   Physiotherapists specialise in understanding the human body and its movements. We often focus on a particular area, such as musculoskeletal (aches and pains), neurological (recovery after a stroke or Parkinson&rs...

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Physiotherapists specialise in understanding the human body and its movements. We often focus on a particular area, such as musculoskeletal (aches and pains), neurological (recovery after a stroke or Parkinson’s disease) or cardiovascular (after heart surgery or a heart attack). But as you get older, you often need help with all of the above, and some specific help with making sure you keep moving well as you get older.

 

Physical Changes Due to Ageing

Each season of life has its joys and frustrations. As you get older, you might enjoy spending more time with loved ones or on favourite hobbies. You might be able to contribute more to your community or offer wise advice to someone struggling with an issue you’ve faced yourself. 

There are undeniable physical changes associated with ageing though, including reduced bone density and muscle strength, stiff joints, poorer coordination and an increase in body fat. Those underlying changes have effects on your general fitness, balance and mobility, increasing the risk of falls. A raft of illnesses are also more common in older people, which may make daily life more difficult and increase the temptation to be sedentary rather than active.  

But don’t be disheartened – we can help keep you moving well and make the process of ageing easier. Research shows that physiotherapy helps older people maintain health, well-being, mobility and independence by improving strength, balance, coordination and flexibility. It really is a case of move it or lose it!

 

Improve Your Joints

Arthritis is quite a common condition among older people, and the main types are osteoarthritis and rheumatoid arthritis. The most common is osteoarthritis, and this was thought to be ‘wear and tear’, it is now thought to be the body trying extra hard to repair the affected joint. Your GP may prescribe medication to help with arthritis and may also recommend physiotherapy. Don’t think of this as an optional extra – it’s actually a core part of the treatment.

Regular exercise is one of the most effective treatments for arthritis, improving strength and flexibility, improving posture and balance and reducing pain and fatigue. Neurospace’s physios are skilled in assessing joint problems and prescribing exercises that suit you best. This could be a gym program, cycling or walking, strength training or even low-impact exercises in the water.

 

Improve Your Balance and Mobility

Balance, (or postural control as we like to call it) is a complex interplay of sensory system providing inputs to your brain, and then your brain responding with a specific action requiring strength, coordination and movement. This all happens in a split second to keep you upright whilst you are either moving or standing still.

As you get older, one or more of these systems can be working less effectively and this can lead to difficulties walking and getting around, a fear of falling and often unexpected trips or falls.

If you are concerned that your balance is getting worse, it is worth checking in with your GP and your physiotherapist. They can work together to rule out more serious causes, and your physio can design a program to help you improve your balance and mobility. Physiotherapists look at how well the different parts of your body work together. Then we train them to do better. We’ll tailor exercises to your particular areas of weakness, aiming to challenge your body enough to see improvements whilst still exercising safely. And we’re not just training your body; we’re training your brain too. It’s the command and control centre of your body, in charge of coordinating your movements. Your brain adapts to new situations. It’s always learning and changing through a process known as neuroplasticity.  

 

Prevent Falls

You’re at an increased risk of falling as you get older. At least 1 in 3 people over the age of 65 falls once each year and sometimes more often. Falls can have big consequences including injuries and dented confidence that causes some people to withdraw from activities and become increasingly dependent on others. There’s strong, high-quality evidence from many studies to show that exercise can prevent falls, but the exercise needs to be challenging to your balance, of a sufficient dose, and also needs to be ongoing. This is where we can help get you started and keep you motivated.

 

Promote a healthy heart

As you get older, the walls of your blood vessels and arteries get stiffer, which makes it harder for your heart to pump blood around your body. This puts you at risk of high blood pressure and other cardiovascular issues. As you exercise, your heart rate won’t increase as much as it used to. A healthy heart needs regular physical activity, a healthy diet, plenty of sleep and not too much stress. We can help with the exercise!

 

Rehabilitation After Injury or Surgery

Some injuries such as fractures become more common with age, especially in women. The injured bone or joint is usually immobilised to protect it while it heals. Physiotherapy improves your recovery by helping you address the joint stiffness and muscle weakness caused by immobilisation. We can also help with specific exercises to reduce the incidence of fractures with people with osteoporosis.

 

Prevent and Manage Medical Conditions

Physiotherapy may help prevent and manage many common conditions that become more common as you age. That includes incontinence, heart disease, osteoarthritis, lung diseases and stroke. Physical activity also helps your mental health

 

Healthy Ageing at Neurospace

Our Neurospace therapy team includes physiotherapists, exercise physiologists and massage therapists. We focus on treating people with complex issues and we understand both the process of ageing and its effect on other medical conditions you may be living with. We understand how important your physical capability is to your ongoing independence and quality of life as you age. 

We assess all new patients carefully and then we’ll recommend a tailored program of treatment. Please make an appointment today to begin strengthening your body under our guidance. 

 

 

Considering Surgery? Try Physiotherapy First

Consider_Copy_of_BACK_PAIN__IS_SURGERY_MY_ONLY_OPTION_.png   If you’re living with ongoing pain in your ankle, neck, knee or back, you may have begun to wonder whether you’ll eventually need surgery to fix the problem. A common question we’re asked as ph...

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If you’re living with ongoing pain in your ankle, neck, knee or back, you may have begun to wonder whether you’ll eventually need surgery to fix the problem.

A common question we’re asked as physiotherapists is, ‘Do I need surgery for my back/hip/knee/ankle/shoulder?’ It is a very good question to ask, as in many cases, conservative management (medications, exercise and hands on therapy) can provide as good as, if not better results than surgery.

 

Considering Surgery?

Surgery can be seen as a quick fix that will deal with the problem.  Surgery carries risks, including bleeding or clotting problems, infection, or a bad reaction to the anaesthetic. It can be costly, with bills from the hospital, surgeon, and anaesthetist if you’re going private, and ongoing post-surgery rehabilitation, where you’ll usually be referred to a physiotherapist to regain strength and flexibility in the affected area.

Surgery is a good option if you really need it. That’s the crucial bit. The physical risks, financial costs and recovery times associated with surgery are only worth it if the operation is likely to have significant benefits. 

 

What Is Physiotherapy?

Physiotherapy can help you reduce pain and stiffness, move more easily, recover from injury and reduce the likelihood of getting injured again. Physiotherapy uses a range of non-invasive treatments including:

  • Exercises and stretches to improve your movement (mobility) and muscle strength
  • Massage
  • Joint manipulation or mobilisation
  • Dry needling
  • Laser therapy
  • Hydrotherapy.

Physiotherapists are trained to at least degree level though many have post-graduate qualifications too. You can book your own appointment to see a physio; you don’t need a doctor’s referral (though getting one may help with costs).

The decision to have surgery is not an easy one.  In addition to the surgical risks consideration can also be given to time off work, recovery time, and out-of-pocket costs. With the right exercises, advice and attention, physiotherapy can change the way your body is moving, allow the body to heal and strengthen and in many cases, avoid the need for surgery.

If you’re interested in working on your body first, and considering surgery second, it is time to come and see us at Neurospace.

 

How Can Physiotherapy Help Prevent Surgery?

There are many common surgeries that could be delayed or even avoided with physiotherapy – hip replacement, knee arthroscopy, total knee replacement, spinal fusion, laminectomy for example.

A skilled physiotherapist may be able to help you avoid or delay the need for surgery on your ankle, neck, knee or back. And, if surgery does prove necessary, your efforts have not been wasted; having physiotherapy before surgery may help you bounce back more quickly afterwards.

Here’s a quick comparison of physiotherapy and surgery for some common conditions affecting the back, knees, fingers, neck and ankles.

Lumbar spinal stenosis: A study published in the Annals of Internal Medicine found physiotherapy to be just as effective as surgery (and with fewer associated risks) in treating this type of lower back pain.

Degenerative disc disease: When followed-up five years later, there was no difference between patients who had had physiotherapy for their degenerative disc disease and those who’d had surgery in terms of pain levels, overall health, satisfaction levels and disability, according to a study at Thomas Jefferson University Hospital in Philadelphia.

Meniscal tears and knee osteoarthritis: The evidence supports trying physiotherapy for meniscal tears and knee osteoarthritis before deciding on surgery. A study published in the New England Journal of Medicine found that patients who had physiotherapy and those who had surgery gained equal improvements in the use of the knee and equal reductions in pain over a 6-12 month period. About 70% of physiotherapy-only patients were able to avoid surgery because the physical therapy was effective. 

Carpal Tunnel Syndrome: After a month, patients having physiotherapy focused on the neck and median nerve were making faster improvements than patients who’d had surgery. After a year, the two groups had both made similar improvements in their grip strength, according to a study published in the Journal of Orthopaedic and Sports Physical Therapy.

Neck pain: A 2013 review of the available evidence concluded that it’s hard to decide whether surgery or conservative treatment is best for neck pain. In itself, that’s an argument for avoiding the risks of surgery since there’s no clear evidence that it’s better than the alternatives. The researchers found that no particular intervention seemed to be consistently better than the other options and most patients found their neck pain improved over time. 

Chronic ankle instability: Some people develop long-term ankle instability after a sprain. At the moment, it’s not clear whether physiotherapy to improve strength and coordination is better or worse than surgery to shorten and tighten your ankle ligaments.

 

How Neurospace May be Able to Help You

Your body may be capable of healing itself when given enough time and the right techniques.

We can help give you those at Neurospace. Our trained physiotherapists can carefully assess your condition and develop a tailored treatment plan for you. It may help you avoid the risks and costs of surgery on your neck, back, knees or ankles. If you do still need surgery, we can work with you on pre-op fitness and post-op rehabilitation, helping to minimise the risks and maximise your recovery.

Please book an appointment online or call us on 02 6162 0450.

 

Why Am I Dizzy? Eight Possible Causes

Why-Am-I_Copy_of_Copy_of_WHY_AM_I_DIZZY__(1).png It can be hard to describe dizziness in a way that does justice to the sickening feeling of being woozy, unsteady, light-headed or faint. Sometimes it feels like the whole world is spinning out of control. Dizziness is...

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It can be hard to describe dizziness in a way that does justice to the sickening feeling of being woozy, unsteady, light-headed or faint. Sometimes it feels like the whole world is spinning out of control.

Dizziness is surprisingly common. It is not a condition in its own right but usually a symptom of something else. Dizziness is your brain’s way of telling you something is wrong. Those unpleasant sensations certainly get your attention!

Here are 8 possible causes of dizziness.

 

1.   Inner Ear Problems (Vertigo)

Your inner ear plays a vital role in helping you balance as well as hear. Your vestibular system, housed in your inner ear, tells your brain about your head’s position and helps you balance.

Problems with your inner ear can cause vertigo, the false sense that your surroundings are spinning.

Vertigo happens when your brain is trying to sort out contradictory messages. Your inner ear is telling your brain that your surroundings are spinning but your eyes and other nerves say things are still.

There are several causes of vertigo including:

  • Benign paroxysmal positional vertigo (BPPV): This causes an intense but brief sense of spinning triggered by moving your head suddenly. It’s the most common type of vertigo.
  • Meniere’s Disease: A build-up of fluid in your inner ear causes sudden bouts of vertigo that may last several hours. It can be accompanied by tinnitus and hearing loss.
  • Infection: Vestibular neuritis, an infection of a certain nerve can cause extreme and ongoing vertigo. A nerve inflammation called labyrinthitis may also cause dizziness and sudden hearing loss. 

 

2.   Migraine

A vestibular migraine can cause dizziness. You may or may not have a headache but you may experience problems with your hearing, vision or balance. It may last just a few minutes or it might go on for hours. Physiotherapy, medication and lifestyle changes may help reduce the frequency or severity of migraines.

 

3.   Stress

There’s a two-way relationship between dizziness and stress. Feeling dizzy can certainly make you feel stressed. And feeling stressed can also make you feel dizzy.

When you’re feeling stressed, anxious, afraid, frustrated, angry or embarrassed, there’s often a physical response. You might notice that your heart is beating faster, you’re sweating, you feel nauseous, or you’re trembling and shaking. Dizziness is another physical symptom that can be related to your mental and emotional state.

 

4.   Circulation Problems

Your heart’s job is to pump blood around your body, including your brain. If your brain isn’t getting enough blood, you’ll feel faint or dizzy.

Have you ever stood up quickly and suddenly felt woozy? That happens when your blood pressure drops quickly.

Conditions that stop your blood circulating properly can cause dizziness. That includes an irregular heartbeat (cardiac arrhythmia), a heart attack, cardiomyopathy or a minor stroke (transient ischemic attack), which temporarily blocks blood flow to the brain. Circulation problems are serious and should be investigated by a doctor.

 

5.   Medication

Dizziness is a common side-effect of many medications including:

  • Drugs that lower your blood pressure (you get dizzy if the drug lowers your blood pressure too much)
  • Antidepressants
  • Sedatives
  • Tranquilisers
  • Drugs to control seizures.

If you’re struggling with dizziness and think it relates to your medication, then talk to the doctor who prescribed it. They may be able to put you on a different medication that can treat your condition without causing dizziness.

 

6.   Underlying Medical Condition

Dizziness can be a knock-on effect of another medical condition.

That can include:

  • Diabetes: Dizziness is a common symptom of low blood sugar if you’ve had too much exercise, or haven’t balanced your food and your insulin properly. The dizziness usually passes once you’ve eaten a few jelly beans to get your blood glucose level back to normal.
  • Anaemia: Dizziness is one symptom of low iron levels.
  • Neurological disorders: Parkinson’s Disease and Multiple Sclerosis can lead to a progressive loss of balance.
  • Anxiety: You might feel lightheaded or dizzy during a panic attack.
  • Heart conditions: As noted above, a drop in blood pressure or a circulation problem can cause dizziness.

 

7.     Overheating

Aussie summers are baking hot and heat stress is common. If you’re active in hot weather or if you don’t drink enough water, you may feel dizzy as a result of overheating or dehydration.

When you’re hot, your body sends more blood to your skin in an attempt to cool you down. That means there’s less blood flowing to your brain, which can lead to a sudden drop in blood pressure. That can make you faint or feel dizzy.

 

8.     Age

As you get older, you’re more likely to experience dizziness, which affects 30% of people over 60 years old and 50% of people over 85.

Age-related changes in your inner ear make you more prone to vertigo. You’re also more likely to have one or more underlying medical conditions that can cause dizziness. And you’re more likely to be taking medications that can cause dizziness as a side effect.

Dizziness is a strong predictor of falls in older people. Those falls can cause injury, fear of falling again, loss of independence and even death in some cases. That’s why it’s so important to investigate dizziness in older people.

 

How Neurospace Might Help You

Dizziness can have a significant impact on your quality of life. Thankfully, there are treatments available for dizziness.

Our staff at Neurospace have many years of experience in identifying and treating the causes of dizziness. We’ll discuss your lifestyle, your stress levels, your medical history and your symptoms before deciding on a diagnosis and course of treatment to improve your symptoms.

You can make an appointment online or call us on 02 6162 0450.

Bell's Palsy

Bells-P_bells_palsy_image.jpg Bell’s Palsy   Bells Palsy is a weakness of the muscles on one side of the face, often affecting young adults. The palsy is caused by damage to the facial nerve. The nerve can be affected by a number of things...

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Bell’s Palsy

 

Bells Palsy is a weakness of the muscles on one side of the face, often affecting young adults. The palsy is caused by damage to the facial nerve. The nerve can be affected by a number of things. In particular, there can be viral infection causing inflammation and swelling along the nerve which disrupts the relay of muscle activation messages to the facial muscles. The weakness be partial or total. There is often a fatigue or stress component with the viral onset, and the virus itself causes further fatigue.

The symptoms of Bell's palsy are paralysis or weakness on one side of the face, pain around the ear, poor eye closure, and poor capacity to eat and drink. The face feels heavy and can have a numb feeling from the weakness.   There can also be a difference in the way food tastes.

 


Management

The aim of any management is to reduce complications such as damage to the eye and maximise the speed and extent of recovery.

Bell's palsy usually resolves by itself within a few months and 70% of people will make full recovery without any intervention.

Eye management: Blinking naturally cleans and lubricates the cornea of the eye. If there is incomplete blinking the eye is protected with patching, eye drops and gels.

Medications may be given and have an effect. Prednisolone is a corticosteroid given to reduce the inflammation on the facial nerve. For maximum benefit this needs to start within 72 hours of onset and may continue for up to 10 days.  A summary of literature found that prednisolone led to a more complete recovery at 6 months post onset (17% incomplete if had drug and 28% if no drug) and reduction in abnormal muscle activity

Antiviral drug may be given but has so far not shown to be of benefit or add more than what the prednisolone does. (Somasundara and Sullivan, 2017).

Physiotherapy has not been demonstrated to be useful with a lack of controlled studies (Teixeira and Valbuz, 2011). There is low quality evidence that tailored facial exercises can help to improve facial function, mainly for people with moderate paralysis and chronic cases. There is low quality evidence that facial exercise reduces sequelae in acute cases.

At Neurospace we use a range of techniques to help manage the recovery depending on the severity of the weakness and time since onset. The best results are with those we see earliest post onset, but we have seen people 5 years post nerve damage and been able to reduce the severity of the weakness.

Techniques include:

  • laser therapy to help manage the inflammation of the nerve,
  • muscle stimulator to help the maintain the weak muscles and trigger their activation,
  • massage and specific facilitation techniques to maximise muscle activation
  • teaching you how to exercise correctly at home and progress the exercises.

Occasionally there are other nerves affected, such as those going to the inner ear and balance system. We help to recognise and diagnosed the symptoms associated vestibular nerve damage and help you to manage this.

Reference

Somasundara D., Sullivan F. Management of Bell’s palsy Aust Prescr 2017;40:94-7 DOI: 10.18773/austprescr.2017.030

Teixeira  LJ, Valbuza  JS, Prado  GF. Physical therapy for Bell's palsy (idiopathic facial paralysis). Cochrane Database of Systematic Reviews 2011, Issue 12. Art. No.: CD006283. DOI: 10.1002/14651858.CD006283.pub3.

 

Strength Training if you have a neurological problem

Strength_20180612_steph_and_leg_press.jpg Strengthening is an important part of any fitness routine and is particularly important as we get older and the muscle bulk and bone density start to naturally reduce without actively maintaining this. Weakness can occur...

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Strengthening is an important part of any fitness routine and is particularly important as we get older and the muscle bulk and bone density start to naturally reduce without actively maintaining this.

Weakness can occur for a range of reasons in the perosn with damage to their neurological system including:

  • the loss of neural commands to activate the muscles
  • secondary loss due to doing less activity or poorly controlled activity

If you are going to do strength training that is really going to impact on how you move there are a few things that need to be considered.

Testing the muscle for how much strength there is can be complex and deficits compounded by other issues such as contracture, sensory loss, inco-ordiantion and spasms.  The muscle can have problems at different parts of the range or with different types of contractions. There may also be an influence of how the tester sets up the test position that influences the result of the strength test.   This requires a skilled practitioner to help break down the issues.

In planning what muscles are going to be strengthened and how, the effect that muscle weakness has on movement also needs to be considered in terms of the range and type of muscle activation required. There are other factors such as muscle fatigue to consider that will vary with different conditions as to how the repititions and weight loading are managed.

If you are undertaking a strengthening program and you are trying to change something specifically, eg getting up from a chair, then getting some movement retraining to ensure the muscles are learning to integrate and activate in the right way is vital. The body will not necessarily use the new strength without retraining as the motor pathways are already stored, and we have to rewire the brain.

We encourage to you to get an accurate assessment to integrate good strengthening activities into your routine.

Aquatic Physiotherapy

Aquatic-_hydrotherapy.jpg Aquatic physiotherapy (also known as hydrotherapy) is an alternative way of doing physiotherapy that offers a range of benefits that are more difficult to achieve on land when undertaking rehabilitation.  There are ...

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Aquatic physiotherapy (also known as hydrotherapy) is an alternative way of doing physiotherapy that offers a range of benefits that are more difficult to achieve on land when undertaking rehabilitation.  There are a small number of research studies completed, but they do support the improvements that can be made in the neurological population and in other populations such as people recovering from joint replacements.

 

The properties of the water offers the therapist ways to either promote relaxation and flexibility of a limb, or promote more activity and build up strength and stability within a body part depending on how the exercise is set up and progressed.    The therapist will use a range of techniques and equipment to facilitate the best outcome for the stage of the condition that is being managed.

 

Specific issues can be addressed such as muscle weakness, joint contracture, spasticity and inco-ordination.  Tasks can be modified to practice everyday activities in a safe, supported way such as sit- to stand, balance, use of arm and hand, and walking.   The level of complexity of these tasks is gradually progressed in the water.

 

The warmth of the water and the graded pressure can be important to help manage painful conditions and extra fluid in limbs.  Generally, the water enhances the overall feeling of well being and gives confidence feel movements that are difficult on land.

 

There are many conditions that benefit from treatment in the water including: 

 

  • Strokes, head injuries, spinal cord injuries
  • Multiple Sclerosis, Parkinson ’s disease
  • Peripheral neuropathy, muscular dystrophies
  • Cerebral palsy 
  • Post fall recovery and balance retraining to prevent further falls
  • Chronic pain
  • Joint replacements and reconstructions
  • Spinal surgery
  • Arthritis/Fibromyalgia

 

Water may not be the best place for everyone to use for therapy. We do need to do a screening assessment to check, understand your underlying health condition and the goals you are working toward.  To get the best from your water therapy integration into land based exercises and movements is essential.

 

Neurospace is fortunate to have access to Hartley Hydrotherapy pool, which is usually around 34 degrees.  We offer continuing therapy services at the pool, or intermittent treatment to set your own individualised program with reviews.

 

Feel free to make further inquiries with our reception team.

 

 

Five easy ways to sneak exercise into your festive season:

Five-eas_activity-exercise-fitness-1556710[1].jpg The festive season is where fitness routines go to die. Sneaky drinks after work, Christmas parties, relatives visiting and stacks of incredible food. We get it! It’s easy to give in to the “festive blowout&r...

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The festive season is where fitness routines go to die. Sneaky drinks after work, Christmas parties, relatives visiting and stacks of incredible food. We get it! It’s easy to give in to the “festive blowout” and just stop exercising all together. But you shouldn’t! If you’re already thinking of retiring your sneakers until January 1st, read on.

With the inevitable increase in calorie consumption over the festive season, finding time to work out is more important than ever. It will keep away those dreaded “Christmas kilos” and help to manage your holiday stress levels (relatives, am I right?!).

If you’re struggling to stay motivated, we’ve got you covered.

Five easy ways to sneak exercise into your festive season:

 

1. Work out in the morning.

It might seem like a no-brainer, but simply switching your workouts to the morning can save your routine this Christmas. Things pop-up in the evening, especially at this time of year. 5pm work drinks, festive dinners… They all get in the way of your exercise regime. Plan ahead! Do your exercise first thing in the morning when you’re less likely to be led astray!

2. Hit the shops.

Walking is great for your health! Swap out online shopping for the real deal… Sure, braving the shops at this time of year can be scary, but all those extra steps can add up quickly!

 

3. Move at Work.

Make the most of your time at work by adding exercise into your routine. Park further away from your office, take the stairs, take a walk at lunchtime or even squeeze in a mini-desk-workout. It’s surprising what a few squats every hour can do for your health!

4. Up the Intensity.

You might not have time to spend an hour at the gym, but short, high intensity workouts can be even more effective. High Intensity Interval Training (HIIT) triggers the after-burn effect, known as Excess Post-Exercise Oxygen Consumption or “EPOC”, and for this reason it’s much more effective at burning calories than your steady state or regular aerobic exercise. Try HIIT-style workouts to get the most bang for your buck.

5. Grab a mate.

Part of what makes the festive season so wonderful is catching up with friends and family. So why not recruit a workout buddy? Not only are you more likely to stick to your routine if you exercise with someone else, but it’ll also make it more fun.

If you need some help getting motivated this Christmas, chat to an expert. An Accredited Exercise Physiologist can help you to exercise right, regardless of your health status or level of experience.

Christmas Trading Hours

logo Neurospace Clinic we will be closing for the Christmas holidays from 22nd December 2018 and will reopen 8:30am on 2nd January 2019....

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Neurospace Clinic we will be closing for the Christmas holidays from 22nd December 2018 and will reopen 8:30am on 2nd January 2019.

International Day of People with Disabilities 3rd December 2018

Internat_IPDW2.jpg To celeberate the year that was and our wonderful clients, their family members and care teams, we will be holding a twilight street party in the park opposite our clinic on 3rd December 2018! We would love to see you&nb...

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To celeberate the year that was and our wonderful clients, their family members and care teams, we will be holding a twilight street party in the park opposite our clinic on 3rd December 2018! We would love to see you here for games, sausage sizzle and musicperformed by our verey own Simon Smith and Amy Rose!

Race Runner

Race-Run_10008-1.jpg We have come across a great new "walking cycle" that helps people with limited mobility to get them out into the community and moving more....   The Petra race runner ™ allows supported walking and running des...

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We have come across a great new "walking cycle" that helps people with limited mobility to get them out into the community and moving more....

 

The Petra race runner ™ allows supported walking and running designed to allow those with limited mobility in legs to be able to use what they have and improve on this.   The beauty is the sizing from children to adults, and the range of environments the race runner goes in.   The action is upright and walking, quite different from cycling. Being upright with weight bearing through the legs will improve balance, leg strength and co-ordination, and endurance for standing and transfer tasks. This allows more potential to transfer the movements into every day activities. 

 

Read more…

https://by-conniehansen.com/product/racerunner-petra-racerunner/

Designed in Denmark and in use since at least 2010, the use race runner is now going to be used in Para athletics

https://www.dejay.com.au/wheelchair/race-running-will-be-a-world-para-athletics-event/

Dejay medical offer the opportunity to trial this in Australia. 

 

Working with your physio and the sales representative allows you to get the best device for your needs and the right training to optimise your performance with the new equipment.

 

Free Occupational Therapy drop in clinic at Neurospace!

Free-Occ_Commode_(1).jpg We are partnering with Rosella OT to offer a free Occupational Therapy drop in clinic. The first one will be Monday 24 September 11am - 12pm, and Rosella Occupational Therapy staff will be on hand to answer your question...

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We are partnering with Rosella OT to offer a free Occupational Therapy drop in clinic. The first one will be Monday 24 September 11am - 12pm, and Rosella Occupational Therapy staff will be on hand to answer your questions.

What can you expect?

A friendly OT will have a quick chat about what your needs might be, and how OT can help. There will be a variety of basic equipment for you to see and great advice on how to make things easier and safer for you.

It may include:

• Advice about selecting basic assistive equipment e.g. shower seating, toilet equipment, home seating, bed positioning equipment, kitchen / meal / dressing aids
• Advice on setting up / using existing assistive equipment
• Advice about installing basic home modifications e.g. lift off doors, rails, door wedges
• Falls prevention advice
• Equipment Loan Service (ELS) referrals for basic equipment needs

 

If you have more complex conditions or needs, you may need further individual assessment to meet your goals. This can be discussed too, as well as the options for getting the support you need.

 

This will run as a drop-in clinic, so all you need to do is pop in to the clinic on Monday the 25 September between 11am and 12pm. There may be a little wait, so best to bring a book to read or you can pop up the road for a coffee while you wait. Any questions, please call us on 6162 0450.

 

 

 

Camino for a Cure: Trek for Parkinson’s 2018

Camino-f_jeff.jpg One of our Neurospace regulars, Jeff, is trekking in Spain to raise funds and awareness for Parkinson's Disease. We are little envious that we all can't join him, but the best we can do is get behind him and help gather ...

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One of our Neurospace regulars, Jeff, is trekking in Spain to raise funds and awareness for Parkinson's Disease. We are little envious that we all can't join him, but the best we can do is get behind him and help gather as much support as we can. We hope you are inspired as much as we are!

We are all aware that further research is our best hope for finding a way to delay, stop and cure Parkinson’s Disease (PD). But in the meantime, there is no reason those of us with PD can’t have an adventure.

So, I recently signed up to Shake It Up Australia Foundation’s Camino for a Cure challenge.  This September I am travelling to Spain to raise funds for PD research by walking the last 111km of the Camino, from Sarria to Santiago de Compostela. 

I am seeking your support to raise donations for PD research and to offer you the opportunity to walk the Camino with me. 

My fund raising target is $6,000. Any amount you can give will make a difference. If you or your friends are able to make a tax deductible donation please go to:https://donate.grassrootz.com/shakeitupaust/camino-for-a-cure-trek-for-parkinsons-2018/jeff-smart ( or search for grassrootz & Jeff & Camino)

You are welcome to like my Facebook page to follow my preparations and where I hope to post daily trip photos. (https://www.facebook.com/Jeffs-Camino-for-Parkinsons-552173705176678/)

You can also support me by encouraging others to get involved.  If you have any family, friends or community groups who may be interested in supporting PD research I would appreciate if you shared this message widely.

Thank you for your friendship and support -- it means a lot to me.  Muchas gracias

Jeff

 

Simon set to ride from Sydney to Wollongong

Simon-se_bizzy2small.jpg Hi Neurospace family,   On the 4th of November, I shall be riding 82km from Sydney to Wollongong to raise money for research and support for people with MS.   I shall be riding with my wife, her father and brot...

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Hi Neurospace family,

 

On the 4th of November, I shall be riding 82km from Sydney to Wollongong to raise money for research and support for people with MS.

 

I shall be riding with my wife, her father and brother. It is a cause close to our hearts with both her father and aunty being affected with MS.

 

Her father was diagnosed at age 18. He's one of the relatively lucky sufferers with the milder and most common form of MS - remitting relapsing (RRMS). He'll be cycling with us in November. 

 

His sister, sadly is not well enough to cycle with us. She has a rarer and more aggressive version of the disease - primary progressive (PPMS). About 15% of people with MS have this type. 

We are taking part in the 2018 MS Sydney to the Gong Ride to fight MS.

Multiple sclerosis is the most common disease of the central nervous system in young adults and it strikes young people in the prime of their lives.

Currently, there is no cure.

 

Every working day, 4 Australians are diagnosed with MS and the average age of diagnosis is just 30 years old.  

 

So we're taking on this challenge to ride from Sydney to the Gong to help people living with MS get the support they need to achieve their goals and live life to the fullest.

Please donate now to support our challenge and change the lives of Australians living with multiple sclerosis.

 

Thank you for your support.

 

Simon Smith, Physiotherapist

Team Bizzy Bodies

 

 

Exercise in Cancer Care

logo The Clinical Oncology Society of Australia have released a position statement on exercise in cancer care. Clinical research has established exercise as a safe and effective intervention to counteract the adverse physical...

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The Clinical Oncology Society of Australia have released a position statement on exercise in cancer care.

Clinical research has established exercise as a safe and effective intervention to counteract the adverse physical and psychological effects of cancer and its treatment. This article summarises the position of the Clinical Oncology Society of Australia (COSA) on the role of exercise in cancer care, taking into account the strengths and limitations of the evidence base. It provides guidance for all health professionals involved in the care of people with cancer about integrating exercise into routine cancer care.

 

Main recommendations: COSA calls for:

  • exercise to be embedded as part of standard practice in cancer care and to be viewed as an adjunct therapy that helps counteract the adverse effects of cancer and its treatment;
  • all members of the multidisciplinary cancer team to promote physical activity and recommend that people with cancer adhere to exercise guidelines; and
  • best practice cancer care to include referral to an accredited exercise physiologist or physiotherapist with experience in cancer care.

Changes in management as a result of the guideline: COSA encourages all health professionals involved in the care of people with cancer to:

  • discuss the role of exercise in cancer recovery;
  • recommend their patients adhere to exercise guidelines (avoid inactivity and progress towards at least 150 minutes of moderate intensity aerobic exercise and two to three moderate intensity resistance exercise sessions each week); and
  • refer their patients to a health professional who specialises in the prescription and delivery of exercise (ie, accredited exercise physiologist or physiotherapist with experience in cancer care).

For more information and help on incorporating exercise into your recovery, book an assessment with our Exercise Physiologist, Amy Rose.

 

Authors: Prue Cormie, Morgan Atkinson, Lucy Bucci, Anne Cust, Elizabeth Eakin, Sandra Hayes, Sandie McCarthy, Andrew Murnane, Sharni Patchell and Diana Adams

Med J Aust || doi: 10.5694/mja18.00199
Published online: 7 May 2018

Optimise your mobility

Optimise_20180612_steph_and_leg_press.jpg No matter what your physical status is, it will always be changing. The body will be continually regenerating new cells and energy. The changes affect all our body systems but in particular, from a movement perspective, ...

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No matter what your physical status is, it will always be changing. The body will be continually regenerating new cells and energy. The changes affect all our body systems but in particular, from a movement perspective, change will be in a positive or negative way. Positively, there will be increased strength and flexibility and allow us to participate more easily in every day activities. Negatively, muscles and joints will get tighter, muscles weaker, and other less desired things such as weight gain, and loss of cardiovascular fitness. The noticeable reduction in mobility and increase in falling is one of the biggest triggers to knowing that the body is changing negatively and trying to understand why. My clinical observation is that these affects accelerate in a person with a disability, and that regular small interventions can stop the deterioration.

 

Turning the cycle back to positive is more challenging for the therapist where there is long standing movement changes, but is possible. The challenge in long standing disability is multifaceted including: a very accurate understanding of what is weak and strong, tight or too flexible; structural changes; neural changes; and being able to work slowly to implement change.

 

Identifying where flexibility should be increased, and which muscles could be strengthened first to improve overall quality of movement is a skill. Caution is given to not continuing to overwork the muscles that are already strong, and training given to involve the muscles that have got weaker over the years.

 

Structural changes need to be accounted for and splinting and bracing options can be considered to help this process.

 

The nervous system controls how well we move. Understanding how the nervous system might be changed in the person with movement disorders is important for how exercises are designed within every day activities. The therapist wants to achieve tasks where there can be the right amount of challenge to bring about positive change, but not too much to avoid the wrong muscle activation.  

 

In the world of disability we expect slow changes, because the underlying physical structure and neural structure are not the same as a ‘normal‘system. But experience shows that slow and focused expectations and practice will help bring improvements.

 

Overall if you note that your body is slowing down and not doing as well as it used to, consult with your local physiotherapist to determine why. If you have a disability consider looking for a therapist with special skills in helping with movement changes

 

 

Deborah Carrera

APA Titled Neurological Physiotherapist

 

Football in Canberra

Football_CP_Football_Flyer.jpg Canberra has a newly developed CP Football Program, and aiming to have an ACT team to go to the National Championships held each year in Sydney (around the end of October).  In the last two years we have had in incl...

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Canberra has a newly developed CP Football Program, and aiming to have an ACT team to go to the National Championships held each year in Sydney (around the end of October).  In the last two years we have had in include players from SA and NSW to make up an ACT team.  Capital Football are supporting the program. At the moment there are fully developed programs and squads from QLD, NSW, VIC and WA.  Programs are being developed in SA and ACT.

 

PLAYERS WANTED - ACT CP Football program. Opportunity to develop your football skills (soccer), meet new people and be part of the ACT representative team. CP Football is for people with cerebral palsy, acquired brain injury or symptoms resulting from a stroke. All ages and experience welcome. For more information visit https://capitalfootball.com.au/game-devel…/football-connect/

Contact Capital Football for more information or Kathleen Moorby . Kathleen.Moorby@heartfoundation.org.au

 

On a similar note, it has just been announced that the recently produced Pararoos documentary will be played here in Canberra on Monday 9th July at Palace Electric at 6:30pm ($20 per ticket).  This movie has been made by film maker Tom Ferguson to raise awareness of the Pararoos and tell their story.
The Pararoos is Australia’s national team for people with cerebral palsy and other disabilities.  More information about the Pararoos can found here https://www.pararoos.com.au/our-story.  All proceeds from ticket sales will go directly to the Pararoos to support them on their journey to qualify for the World Cup next year.

https://kangacup.com/exclusive-pararoos-film-screening-monday-9th-july/

Walking faster is better for your health

Walking-_walking.jpg Everyone is always telling Deb to “slow down!”, but maybe she is just trying to live a little longer. A new study has found those who report faster walking have lower risk of premature death. Compared to slow...

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Everyone is always telling Deb to “slow down!”, but maybe she is just trying to live a little longer.

A new study has found those who report faster walking have lower risk of premature death. Compared to slow walkers, average pace walkers had a 20% lower risk of early death from any cause, and a 24% lower risk of death from heart disease or stroke.

The results suggest walking at an average, brisk or fast pace may be beneficial for long term health and longevity compared to slow walking, particularly for older people.

Findings suggest it is a good idea to step up to a pace that will challenge your physiology and may even make walking more of a workout.

Long term-health benefits aside, a faster pace will get you to your destination faster and free up time for all those other things that can make our daily routines special, such as spending time with loved ones or reading a good book.

Another study has found that active people spend less time in hospital. The inactive people (taking 4,500 steps per day) averaged 0.97 days of hospital care per year. The more active people (taking 8,800 steps per day) needed only 0.68 days of care per year.

If we could get everyone to walk more, what effect would this have on health services? Considering only the people aged over 55, at a minimum it would reduce the need for hospitalisation by 975,000 bed days per year, for a saving of $1.7 billion dollars. Not a bad outcome for getting on your feet a bit more!

And getting an extra 4300 steps per day is not much. It’s just 40 minutes walking, which might include going to the shops, picking up kids, or taking the stairs at work.

Let us know how you go!

Knee pain? Surgery vs conservative management

Knee-pai_Knee_Photo_918.jpg Recent media attention has given a lot of credence to exercise to minimise the need for surgery with exercise. This is not new information in the physiotherapy world and we have known the benefits of the right exercises...

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Recent media attention has given a lot of credence to exercise to minimise the need for surgery with exercise.

This is not new information in the physiotherapy world and we have known the benefits of the right exercises for a long time and also the problems created with the wrong exercises. The important emphasis in this article is twice a week supervised exercise. Many people will put the effort in after the surgery, but if they started earlier with the same intensity the story could be very different.

When approaching knee pain at Neurospace, our team of physiotherapists, exercise physiologists and massage therapists have a 4-pronged approach:

1. Alignment: from the feet up through the knee, hips and spine we will help restore the biomechanical alignment. This will often be about flexibility of certain structures that are tight and contributing to poor wear pattern of the knee.

2. Strength: for the ankle, knees, hip, core as needed, focusing on the imbalances and then a more global approach. In particular, strength with eccentric and closed chain emphasis is important for knee control.

3. Motor control: to stabilise the alignment through stance phase of gait and then into more advanced activities including stairs.

4. Laser therapy: for pain relief, accelerated healing, reduction of scarring and to help restore the knee cartilage.

Your current weight may be a factor.  This may need attention with general reconditioning and fitness work, and diet advice. Losing a few kilograms can make a big difference on reducing the pressure going through your knees.

How much weight is going through your knees during different activities?

Walking across level ground: 1.5x your bodyweight

Up and down stairs: 2-3x bodyweight

Squatting to tie your shoelace or pick something up: 4-5x your bodyweight

Bracing may also be an option to help support and offload the knee while trying to rebuild the strength and control.  This needs to be carefully considered and fitted to get the best outcome.

Deborah Carrera

Physiotherapist

We need help!

logo I had with me today a youngish couple, and they needed help. Bruce started having balance issues two years ago, till he gradually stopped walking freely and started using a walking frame. In February he received a diagno...

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I had with me today a youngish couple, and they needed help. Bruce started having balance issues two years ago, till he gradually stopped walking freely and started using a walking frame. In February he received a diagnosis of Cerebellar ataxia. Bruce is only 49 years old and has stopped work due to increasing difficulties. In getting that diagnosis Bruce has been to endless doctors, neurologists, had extensive testing including 5 MRIs. In all that searching, no one has suggested having neurological physiotherapy input. No one has suggested that change would be possible to make their lives easier and stop the slow deterioration. Bruce and his wife had tears in their eyes as they discussed their frustration with the system. In today’s session we were able to identify clear things to change and give them strategies to start improving his safety in transfers and walking. We are confident over the next 2 months there will a significant difference in his abilities and capacity to move around.

The question remains, why is specialised assessment so undervalued, and the role of physiotherapy and exercise not recognised in all neurological disorders? Neurospace has been here for 8 years and we continue to grow and make in difference in the lives of people with complex movement issues.