This is a guest post by Chris Wynne from our partners at The Rehab Physio in the Wirral. Their excellent facilities provide intensive physical rehabilitation services and in this post, Chris explains something of their philosophy.

Neurological physiotherapy acknowledges a simple fact: the human body is an amazing thing with the ability to adapt to the changes we put upon it.

With the right physiotherapy skills, technology and techniques, we can help the body to find ways to help patients with a range of neurological conditions including spinal cord injury, stroke, brain injury and Cerebral Palsy to restore function, independence and quality of life.

This is a question that we are often asked. The short answer is yes, you can walk in a PRAFO (Pressure Relief Ankle Foot Orthosis). The PRAFO is an orthotic device family that is designed to provide complete relief from pressure or shear at the vulnerable heel area whether the user is in bed or walking around. Pressure ulcers represent a big problem for the NHS and protection from pressure and shear is key to prevention, or when things go wrong, to accelerate healing.

However, each PRAFO in the range offers much more than pressure relief though and this is essential to facilitate continuity of care. Continuity of care is an important part of the rehabilitation process and that is why our PRAFOs are designed so that the user can walk in them. If a product allows pressure protection but does not support the next step in the rehabilitation process then a different product would be required which necessitates further cost and inefficiency.

In this article we explain why functional electrical stimulation (FES) is an effective technique in enhancing functional recovery in patients with peripheral nerve injuries. The technique can improve muscle activation, prevent muscle atrophy, enhance muscular endurance and strength, and assist in nerve and axonal regeneration.

FES is a generally safe, non-pharmacologic intervention without significant side-effects, which adds an essential therapeutic option to neurological physiotherapy.

With muscle denervation the FES is designed to work directly with muscle fibre and not rely on the local nerve structure for success.

Further studies on FES are necessary to comprehend the scope, limitations, and best methodology. Programmes need to be customised for each user.

Carbonhand, a ground breaking assistive device, is set to transform the lives of individuals with weak grip and poor hand function in the United Kingdom.

Combining advanced technology and innovative design, this grip-strengthening, robotic glove offers newfound independence and enhanced quality of life to those who struggle with hand strength and dexterity. In this article, we will explore the product, who might benefit from Carbonhand, and describe the main features of this revolutionary medical device. The journey of Carbonhand began in the early 2000s with Hans von Holst, a neurologist at Karolinska Hospital, who often encountered patients with severely reduced strength and mobility in their hands. Teaming up with Jan Wikander, Professor of Mechatronics, they began developing a glove that could help strengthen hand grip. This collaboration led to the creation of the first Servoglove, the predecessor of Carbonhand.

We have known for a very long time that the delivery of certain forms of energy, including electrical, to the tissues of the body can bring about physiological and beneficial changes in those tissues. So called electrical stimulation devices are not all the same though, as we shall discuss below.

At Anatomical Concepts we have worked with various forms of electrical stimulation technology since the 1970’s and deal with leading products including the RISE Stimulator, and the RehaMove FES Cycling system and can offer advice and demostrations on request.

In earlier articles in this series, we have seen that motor training can induce constructive neuroplasticity providing that the tasks are practiced in a particular way and are challenging enough to stimulate positive adaptations. The human body is natural adaptive to the stimulus - or lack of it - that is provided.

Athletes learning new skills and training for peak performance in strength or endurance must draw on the same fundamental body resources as those individuals recovering from a neurological condition. There are many differences however in how to approach training due to the nature of the bodies energy systems and how these are influenced by disability.

When we are encouraged for rehabilitation purposes to train intensively, frequently etc we need to be aware of these energy systems and how they affect fatigue and the perception of effort.