Physiotherapy
Mobility and physical abilities can be severely affected by a stroke or a neurological condition. Early assessment and treatment are imperative in facilitating positive brain plasticity and stimulating neural pathways, which result in better functional outcomes when discharged from the acute hospital. The Physiotherapists at RehabWorx use International Standardized Outcome Measures to assess and reassess each individual’s physical abilities, be it in hospital or when visiting our rooms as an outpatient. Using outcome measures serves as a tangible means to monitor and track progress for both the patient and the therapist.
uring therapy, we aim to improve both independence and confidence, be it rolling in bed or walking outdoors enjoying a hike. To optimize each individual’s physical abilities and independence, we address the difficulties (impairments) identified during our comprehensive assessments.
We have a number of Bobath-trained therapists who are passionate about treating patients with strokes and all other neurological conditions and who aim to achieve the highest functional outcomes for each patient.
PHYSIOTHERAPY PRACTICES
The physiotherapists at RehabWorx have different approaches to treating different conditions; one of the approaches to treating Parkinson’s Disease is by completing the LSVT BIG® therapy programme.
LSVT BIG® is an intensive, amplitude-focused therapy approach, developed from principles of the effective Parkinson’s specific speech treatment LSVT LOUD® . The LSVT Programs have been developed in the USA and scientifically researched since 1987.
How does it work?
It is a standardised treatment protocol, which is customized to the unique goals of each patient including both gross and fine motor skills.
The LSVT BIG® programme consists of:
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16 individual 1 hour therapy sessions
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4 consecutive days a week for 4 consecutive weeks
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Daily home exercises to be done
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Daily carryover exercises are discussed at the end of each session
RehabWorx hosts the Pretoria FES (Functional Electrical Stimulation) clinic. We have trained FES clinicians who perform FES assessments to establish whether a patient will benefit from the device. Should the patient feel the benefit, the clinician also assists in the set-up of the device according to each patient’s individual needs and trains the patient and or family in the use thereof. The device is also used as part of therapy to stimulate muscle activity and correct biomechanics when walking to ensure a functional walking pattern.
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What is a FES device?
FES produces contractions in muscles affected due to central nervous system lesions, by means of an electrical stimulation. The electrical device is designed to assist with gait difficulties such as the inability to clear the toes (dropped foot) when walking, allowing the heel to strike the ground first.
How does it work?
Two self-adhesive electrodes are positioned on the skin close to the nerve supplying the muscle allowing communication with the stimulator to contract the muscle. Two leads are connected to the stimulator, 1 lead connecting the electrodes and the other the foot switch which activates and deactivates the working of the device.
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Who can use it?
Complete nerve innervation is required for the device to work, thus patients with an upper motor neuron lesion will benefit from the use of the device. These include patients suffering from a stroke, brain trauma, multiple sclerosis or Parkinson’s disease. Benefits reported by patients are improved balance, walking speed, endurance and confidence when walking. All of the above directly influence quality of life. The effectiveness of the FES device is confirmed by both the users and the vast body of research which has been conducted.
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For contra-indications visit www.salisburyfes.com
Official Site of FES www.proffessa.co.za
When suddenly confronted with vertigo or dizziness, this seemingly simple complaint can affect one's quality of life significantly. Complementing the medical management, we have trained therapists who are able to objectively assess a variety of vestibular disorders and confidently treat a number of conditions causing the symptoms.
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Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of vertigo, which presents with a spinning sensation when a change in position occurs. Other common causes for dizziness are vestibular neuritis, labyrinthitis, vestibular migraines and acoustic neuromas, to name a few.
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Vestibular Rehabilitation Therapy (VRT) is an exercise-based treatment approach to treat a number of vestibular disorders addressing the dizziness symptoms, gaze instability and balance impairments which occur as a result of the underlying condition.
Physiotherapy is required following all spinal surgical interventions. Pre-operative assessments and advice form part of the surgery plan. Post-operative intervention includes advice, provision of exercise programs and therapeutic intervention to regain independence in walking.
When individuals require longer hospitalisation or care, the multidisciplinary team assists with further rehabilitative treatment, recommendations and discharge planning.
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Follow-up treatments are made should the individual require follow-up care to adjust the home exercise program or relieve muscle spasms or pain.
A Stimpod is a small hand-held device that uses neuromodulation and pulsed radiofrequency technology to treat neuropathy disorders with different aetiologies.
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A few of these conditions include (but are not limited to):
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Bell’s palsy
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Migraines
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Neuropathic pain
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Complex regional pain syndrome
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Neuropathies and post-surgical pain
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A small probe is used on the skin to locate the correct placement and deliver the current to target the affected nerve(s). This may elicit an impulse along the nerve’s pathway confirming accurate placement for the motor nerves and the patients’ feedback for sensory nerves.
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More information can be obtained from www.xavant.com
Specialised equipment is used to facilitate the patient’s mobility and functionality. We have a wide variety of equipment ranging from a tilt table, standing frame, different walking aids, Bobath plinths, the Wii (to address co-ordination, balance and upper limb function), different hand function activities, a treadmill, static bike, a MOTOmed and the Golvo.
MOTOMED ​
The MOTOmed is a motor-driven trainer imported from Germany, allowing a person to sit and train either his arms or legs to help regain muscle strength and improved mobility. Furthermore, it also allows a comparison to be drawn between the functioning of the left vs the right upper or lower limbs.
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The machine is software-controlled and allows passive (with motor power), assistive and active movement therapy and it addresses weakness, spasticity and endurance in the extremities.
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Who can use it?
Use of the MOTOmed in therapy is ideal for people with bilateral or unilateral arm or leg weakness, increased tone or reduced motor control. Since the MOTOmed has adjustable settings, an individual can exercise at his or her optimum level, be it to reduce tone, cycling passively with the motor, increase strength, cycling against light or heavy resistance or to increase endurance, cycling for as long as you can!
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For more information visit: www.motomed.com
GOLVO: BODY WEIGHT SUPPORT
SYSTEM TRAINING
​To be able to walk requires intricate co-ordination of various motor systems. Several muscles have to work together in collaboration to support the body in the upright position. Body weight support system training was designed to help maintain standing being supported in a harness and the therapists can then facilitate walking. The Golvo is a loose standing device with wheels that can be wheeled around and positioned over a treadmill to encourage walking at a constant speed. Articles have been published on using body weight supported treadmill training to support this therapy approach suitable for those patients who cannot maintain standing by themselves.
For more information visit: www.liko.se
