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
APA Titled Neurological Physiotherapist