Spasticity or tone management can include many different treatment techniques, such as 24 hour positioning, stretching programmes, strength training of weaker muscles groups, use of electrical stimulation, identifying triggers and minimising these. As well as offering these interventions we can refer and liaise closely with the consultants and other professionals in NHS spasticity clinics.
Following a neurological event or when living with a neurological condition the tone in your muscles can change, this might be that they become floppy or weaker in tone but often they can become tight and increase in tone or your muscles can have involuntary spasms; this is collectively called spasticity. Spasticity is very individual and changes to your muscle tone can make daily tasks more challenging. It also means that regular stretching and positioning become essential to prevent secondary complications of stiff joints and contractures. Anyone who has spasticity should have a spasticity management programme tailored to them to optimise independence in daily tasks and maintain good muscle length and joint range of movement; in conjunction with any medical management they may need.
A 24 hour postural programme considers all the postures that you need to be in over a 24 hour period. It ensures that these are suitable for you to maintain good alignment of your muscles and joints as well as ensuring you are comfortable and have optimum pressure relief. Access to Rehab are able to work with you and those who support you to put into place a 24 hour postural programme and ensure that your postural needs are being met.
24 hour postural programmes are designed to assist those with physical difficulties after their illness/injury. You may have reduced range of movement in some or your joints, have difficulty maintaining skin integrity or feel uncomfortable in certain postures. We are able to partner with and work alongside wheelchair services, specialist postural services and other equipment providers to ensure that your needs are being met.
Upper limb rehabilitation is for individuals whose arm/arms have been affected by their neurological condition. Access to Rehab are experts in assessing how your arm has been affected and how this impacts upon your daily life and your ability to do things that are important to you. Following a thorough assessment of your difficulties, we are able to devise a specific upper limb rehabilitation programme for you and support you through this. We use evidence-based treatments that have proven through research to be beneficial. These treatments may include;
Mirror box therapy: This is a technique used to create the illusion of your affected limb working normally. You carry out a range of exercises and movements with your unaffected arm, whilst looking in a specially designed mirror that hides your affected arm.
Motor imagery: This is the technique of imagining a task or movement in ones ‘minds eye’ and has been proven to be effective in the treatment of upper limb difficulties following stroke.
Sensory re-education: Sensory difficulties after neurological illness/injury is common and has an impact upon the ability to use your arm. Access to Rehab are skilled at assessing for sensory impairments and are able to design specific sensory re-education programmes for individuals arms.
Movement science: This is a treatment technique that involves careful analysis of an individual’s movements and what components are missing or weak following neurological illness/injury. Access to Rehab are then able to design a specific exercise programme to target weak muscles and assist you in repetitive task practice that strengthens muscles that are weak and therefore affecting your movement and ability to use your arm.
Constraint-induced movement therapy: This treatment approach involves constraining the use of your unaffected limb so that your affected limb has to work intensively. This is not appropriate for everyone. Access to Rehab can assess and recommend this treatment approach if it is clinically indicated and support you throughout your treatment programme.
Saeboflex/saebo reach and saebo glove: The SaeboFlex, SaeboReach and Saeboglove allows individuals suffering from neurological impairments, such as stroke, the ability to incorporate their arm and hand functionally in therapy and at home. These unique orthoses position the wrist and fingers into extension in preparation for object manipulation. The user is able to grasp objects by voluntarily flexing his or her fingers. Once the fingers relax (stop gripping), the extension spring system assists in re-opening the hand to release the object. Access to Rehab are able to signpost you to services that may be able to offer a trial of equipment prior to consideration of purchase or organise for a trial through the Saebo company.
Neuromuscular Electrical stimulation: This is a technique used to elicit muscle contractions using electrical impulses. Electrodes, controlled by a unit, are placed on the skin over a predetermined area and repetitions of the muscle contraction are carried out. Electrical stimulation can help to maintain range of movement, decrease pain and spasticity and re-educate or strengthen a muscle group. Electrical stimulation can not be used by everyone so our therapists will assess you and determine if it is indicated.
Upper limb rehabilitation is suitable for anyone whose arm/arms have been affected by their injury or illness. Whether you have a non-functioning arm or an arm that has begun to recover, we can help to maximise your potential.