Often there are many complex issues and difficulties that arise following a neurological illness or injury. It can be hard to identify what needs take priority and difficult to identify who is best to help. Access to Rehab pride themselves in being a cohesive and integrated team of Occupational therapists, Physiotherapists and Rehabilitation Assistants. We also partner closely with Clinical Psychologists and Speech and Language therapists.
Following discussion with you or someone on your behalf, Access to Rehab can recommend which professionals would be best placed to assess your needs. They will visit together and carry out an assessment of your needs jointly. Discussions can then happen to identify your goals and an individualised treatment plan can be made to include the professionals that will be able to assist you.
Case managers- Access to Rehab can provide your team, so that the treatment of your client is seamless and you can work more effectively with them.
Many people have difficulties with their posture and body alignment after a neurological illness or injury. A postural assessment looks in detail at the different ranges of movement that you have in each of your joints and if there are any limitations or constraints upon this. A detailed picture of your current posture can be gained in any position e.g – sitting or lying.
A postural assessment will involve the occupational therapist or physiotherapist moving your limbs and taking measurements of the ranges within your joints. This will usually be done both with you lying down and with you sitting. Photographs may also be taken with your consent to compare your posture before and after any intervention. Recommendations can then be made to ensure that your posture is at its optimum over a 24 hour period. We are able to liaise with wheelchair services or independent providers of static seating and wheelchairs. We are also able to advise whether any equipment or aids would be recommended to support your posture when you are in bed.
An upper limb assessment involves the detailed assessment of one or both of your arms. Many people’s arms are affected following a stroke or other neurological illness/injury.
The Occupational therapist or Physiotherapist will ask to see how much movement you have in your arm and if you are able to use it in any way functionally. They will also move your arm and measure the range of movement, strength and assess for increased tone/spasticity. They may also assess your sensation and proprioception within your arm (your ability to feel with and know where your arm is). Access to Rehab are able to offer bespoke upper limb treatment programmes to work on the movement and function of your arm. Evidence based treatment approaches are used. We are skilled in the approaches of movement science, constraint induced movement therapy, motor imagery, mirror box and also electrical stimulation.
If you have limited movement within your arm, or your arm has increased tone or spasticity, it may be recommended that wearing a splint would be beneficial to prevent further deterioration of difficulties arising from this. Your therapist will measure the range of movement you have in your joints and will advise whether a splint may be appropriate or not. We are able to advise on off the shelf splints and also make bespoke custom made splints.
The Occupational therapist or Physiotherapist will ask to see how much movement you have in your arm and if you are able to use it in any way functionally. They will also move your arm and measure the range of movement, strength and assess for increased tone/spasticity. They may also assess your sensation and proprioception within your arm (your ability to feel with and know where your arm is). We will then be able to advise on whether wearing a splint may be beneficial to you and assist you in the process of identifying which type would be most effective. We are highly skilled in fabricating splints if this is the right choice for you.
Sometimes following a neurological injury or illness, individuals can present with behaviours that challenge. This can be very upsetting for the individual and their loved ones and can have a huge impact upon the care needs and ability to live as independently as possible. Access to Rehab have extensive experience of working with individuals who have behaviours that challenge. We are able to meet you and your loved ones or carers and discuss the impact that this is having on your daily life and those that support you.
Access to Rehab are able to meet you and your loved ones and carers and discuss the impact that this is having on your daily life and those that support you. We are able to partner with Clinical Psychologists if this is required. We are able to support those working with and caring for the individual and can suggest a treatment approach/plan to be able to manage the behaviours that challenge.
Access to Rehab have extensive specialist skills in working with individuals in a Prolonged Disorder of Consciousness. We are able to carry out detailed and comprehensive assessments that will be able to provide a diagnosis of the level of consciousness. We are trained in the use of the Sensory Modality Assessment and Rehabilitation Technique (SMART) and are also able to use other assessment tools such as the Wessex Head Injury Matrix (WHIM) and the Coma Recovery Scale – Revised (CRS-R). Following assessment we are able to formulate a specific treatment programme or sensory stimulation programme.
To be able to carry out a detailed assessment of levels of consciousness we will need to spend time with the individual over a number of weeks. The SMART assessment is carried out over a period of 3 weeks during 10 face to face sessions. It is also recommended in the Royal College of Physician (RCP) Guidelines that the WHIM and the CRS-R are also carried out over a period of 10 sessions. The therapist will come to where the individual is living and carry out the assessments within their normal environment.