Effective Interventions for Patients with Neurological Impairment
Exercise Promotion in Neurology- Test Your Knowledge!
Question
A 57 year old lady who is two years post traumatic brain injury is referred to your service. She resides in a nursing home and has recently become hoist dependent due to a recent decline in physical condition. Six months ago she was able to walk with a stick plus assistance of one person for up to 20 metres.
On assessment she has a right sided hemiparesis but there is some voluntary activity in her lower limb extensors and she can maintain independent, unsupported sitting. There is shortening in her right posterior crural muscles and she wears a raised splint. She appears to be sarcopenic and fatigues quickly.
Consider how you will improve her muscular performance and aerobic condition to enable her to recover the ability to walk short distances.
Answer
This lady is likely to be very deconditioned and will fatigue quickly. The duration and intensity outlined below are based on published guidelines but in the initial sessions you may need to be prepared to terminate the session earlier if she becomes too fatigued.
To improve aerobic condition an assisted exercise machine such as an assisted cycle or stepping machine could be used. She would require a 5-minute warm up before increasing intensity. The target heart rate during the conditioning phase would be between 50-60% of maximum intensity and you may opt for 10 minutes of continuous training or 13-15 minutes of interval training. Alternatively, a body weight supported harness treadmill could be used applying the same target intensity and duration as detailed above.
In the absence of assistive equipment repeated periods of standing using physical facilitation or a device such as standing frame or transfer aid will increase the demand on the cardiovascular system and improve her aerobic condition.
To improve her strength performance options could include:
- Facilitated knee extension from sitting with an ankle weight for progression
- Repeated sit to stand facilitated by therapist
- Hip abduction facilitated from side lying, use theraband for resistance/progression
The number of repetitions of each exercise per set should be between 8-12 and you should aim for 2-3 sets per session with a two minute rest between sets.
How did you get on?
This question and answer is from Rachel Young, tutor on the upcoming Online Mini Series Course 'Exercise Promotion in Neurology'. For help with these patients in your practice, read on....
Exercise Promotion in Neurology
Bridge the gap between exercise science and neurological rehabilitation in this easy to attend, fully guaranteed, Online Mini Series™ from CPD Solutions
- Incorporate this key area into your professional practice
- How to Measure and Assess Physical Performance
- Practical solutions for exercise interventions
- How to improve engagement with exercise programmes
- Get 8 Hours of CPD and your personalised CPD Certificate with this course
- AND…you have a whole year’s access to recorded sessions for reviewing key points
- No need to attend the live sessions - Watch the recordings on any device, any time, anywhere
- Superb value for money – you learn without travelling or paying for accommodation, childcare or petcare
Thank you for offering such a great way to achieve further knowledge
Being able to do the course in your own time at your own speed was really useful
What Will You Learn On This Course?
Session 1
Assessment and programme planning
Thursday 28th May 2020 2pm – 4pm (UK time)
- Assess cardiovascular condition and muscular performance in the clinical setting
- Identify outcome measurement tools relevant to exercise for the neurological population
- Apply published guidelines and training principles to exercise for the neurological population
- Plan an exercise programme underpinned by training principles
- Understand the physiological responses and adaptations to cardiovascular and muscular training
Session 2
Exercise interventions for people with neurological impairment
Thursday 11th June 2020 2pm – 4pm (UK time)
- Apply relevant research findings to real world scenarios
- Develop innovative exercise solutions for people with neurological impairment across a range of settings
- Integrate exercise within a wider programme of rehabilitation
- Monitor exercise intensity and be able to progress or regress an exercise intervention
- Understand the role of assistive technologies in exercise and rehabilitation
Session 3
Developing sustainable support and delivery pathways for the neurological population
Thursday 25th June 2020 2pm – 4pm (UK time)
- Understand the barriers and motivators for exercise uptake amongst people with neurological impairment
- Apply behaviour change principles to the uptake of exercise in neurology
- Consider the challenges and opportunities associated with exercise referral schemes for people with neurological changes
- Explore models of service delivery to optimise long term engagement
- Recognise the inter-relationship between exercise, physical activity and participation
About The Presenter
Rachel Young (MSc, BSc (Hons), MCSP)
Senior Lecturer in Physiotherapy
Rachel is a senior lecturer in the physiotherapy team at Sheffield Hallam University. Rachel has extensive experience of teaching and assessment in Higher Education. Her role as team leader involves ensuring consistent, high quality delivery of the under-graduate and post-graduate physiotherapy programmes. Her areas of specialist interest are neurological rehabilitation and exercise prescription. Rachel was central to the integration of vocational awards in fitness instruction within the under-graduate curriculum. She is passionate about developing cross sector working between physiotherapy and the fitness industry to enhance the support for people living with long term conditions.
No Need to attend the Live Sessions. You have unlimited access to all of the recordings for 12 months
12 months access to recordings and course materials is included. You can log on for the live sessions if you'd like to, or just watch the recordings after the live sessions have taken place.
What Do Previous Attendees Say About Online Mini Series™ Courses From CPD Solutions?
The video loops as well as the images really helped to visualise and reinforce learning
This course will definitely be useful in my future practice, not only for what concerns a more complete and efficient objective assessment, but also a better treatment plan.
The speaker gave really clear explanations and the notes really helped, I feel I now understand better and this will help me with examination skills in clinic.
Being able to do the course in your own time at your own speed was really useful
More confidence when assessing and rehabing patients with hand and wrist specific injuries.
Clear, logical explanation of progress through the stages of recovery with use of references to support work. It has given me more rehab ideas for progression and understanding of when a patient is ready to progress through stages and return to sport.
I can use some of the rehab ideas for my sporty patients. I feel more confident now on how to progress a patient from each stage. Having the biomechanical/physiology theory/latest literature is useful to back up our EBP.
I found the most useful thing about the course was being able to access it whenever suited me.
This course has helped me by being able to improve rehab of ACL clients.
Learnt loads! A good mixture of theory and practical elements. Very useful additional hand-outs for each section.
I found the clinical based information really useful, I feel I know more information about different forms of BPPV, which is very helpful in differential diagnosis.
I found the videos and descriptions of assessment and ideas for treatment techniques really helpful.
Take advantage of the easy Online Mini Series™ format and increase your confidence when dealing with these cases.
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