What is NEUROFIT and how can we use it in clinical practice?

Updated: 14 Jul 2019 | Posted in: Therapy

The Neurofit Concept has been developed by specialist neurological physiotherapists alongside personal trainers and musculoskeletal physiotherapists to bring together aspects of strength training and how this can be applied to the neurological population. As the lead physiotherapist at Access to Rehab I took the opportunity to spend a weekend in sunny Brighton with other physiotherapists and personal trainers learning the answer to this very question. Bob Wood has many years experience in treating elite and olympic athletes, over recent years he has worked closely with Nikki Penny a leading neurological physiotherapist to develop the concept of NEUROFIT.

Neurofit uses dynamic movement as a screening tool rather than single muscle groups in isolation.  We can gain more information from a dynamic movement, it is multi-directional, multi joint, requires balance reactions, kinetic chain integration, easily reproducible as a test of progression and requires minimal equipment.

Following a neurological event or when living with a neurological condition we are striving to get efficient movement but this can often be a huge challenge as efficient movement requires all aspects of the ‘Functional Continuum’;

Mobility – we need flexibility but not of one muscle, for a chain or sequence of muscles. Muscles need to be mobile to then be able to strengthen. So we need to make stretching and mobilising a ‘dynamic movement’.

Stability/balance –  is very task specific and has its own potential pathway. From ‘static balance to reactive balance to dynamic balance’. All of this can be challenged with 3 dimensional functional movements.

Strength – Strengthen first then strengthen according to function, known as ‘Functional strength training’. Strengthen through different planes of movement, full body range, sequencing, with and without load.

Sequencing –  means getting the right body parts in the right place at the right time. Strength training in sequence through different movement patterns to maximise effectiveness.

Power is built through progression of simple to complex movement patterns.

Mobility, stability, strength and sequencing are movement foundations to efficient POWERFUL movement!

Following a dynamic movement assessment considering all the above factors we can use functional and corrective exercise techniques to enhance performance. Tailoring these to an individual’s capabilities but at the same time challenging them with meaningful tasks.

Why should the neurological population not challenge their fitness? A progressive training programme can empower people with a neurological condition to challenge their physical fitness. This training programme needs to be dynamic, life is not 2 dimensional but 3 dimensional, so this is what our rehab should be as well!

This course is over 2 weekends, at the end of the first weekend not only did I feel exhausted from challenging my own fitness levels and establishing which parts of the movement continuum i needed to work on, to develop efficient powerful movement! I felt excited about trying these ideas out with my patients and sharing the knowledge with the rest of the Access to Rehab team. Really looking forward to consolidating this learning at the next weekend in Brighton where the principles of exercise prescription will be applied to the concept.


Claire Clarke

Claire is a highly specialist physiotherapist with over 15 years of experience working within the field of neurology and rehabilitation. She has extensive experience of working with adults who have complex neurological needs from the early stages in their rehabilitation to helping them manage their condition long-term. She feels privileged to share the journey with her patient’s, spending time to understand what is important to them to create an individually tailored treatment approach, maximising independence in the tasks that are important to them. Claire prides herself on her excellent communication skills, understanding the importance of this at every stage of rehabilitation from close working relationships with local hospitals to community teams and family members. She is a highly skilled therapist who has particular expertise in the areas of spasticity management, gait re-education, postural management, upper limb rehabilitation, hydrotherapy and exercise therapy. Claire has gained a wealth of knowledge and specialist skills in her career working in acute hospitals and rehabilitation settings such as the Oxford Centre for Enablement where the vision for Access to Rehab began. Claire now devotes her time solely to Access to Rehab, so that rehabilitation doesn’t have to stop in the hospital but can continue into your own home and the local community.