What is neurological rehabilitation?
It is physiotherapy for conditions that affect the brain, spinal cord and nerves. These conditions can change strength, feeling, balance, coordination and the way a person walks or uses their hands.
The aim is to help you do more for yourself, more safely. A physiotherapist works on movement, and also on how to make daily tasks like getting out of bed, dressing and going to the toilet manageable.
Who is it for?
It is for people living with stroke, Parkinson’s disease, spinal cord injury, traumatic brain injury, multiple sclerosis, Guillain-Barre syndrome, Bell’s palsy and similar conditions. It also helps people whose balance or strength has dropped after a long illness.
It is for the family too. A daughter lifting her father in and out of bed, a wife worried about her husband’s freezing steps and a helper learning to guide a weak arm all need guidance.
Why does the home setting help?
Because rehabilitation works when it is repeated in the places life happens. Practising to stand up from your own chair and walk to your own bathroom is more useful than doing it on a clinic mat.
Travel is hard when someone tires quickly, when a wheelchair has to be loaded into a car or when a person freezes in crowded places. At home, the session uses its time for treatment, not for the journey.
How big is stroke in Malaysia?
Stroke changes a family’s life overnight. In Malaysia in 2019 there were an estimated 47,911 incident stroke cases and 443,995 prevalent cases [1].
Those numbers are people and families. Some need help with movement in the months and years after a stroke, which is why rehabilitation matters. Our page on stroke rehabilitation at home goes into more detail.
What do we check and work on?
We look at what has changed and what the person wants back. Common focus areas include:
- Getting in and out of bed and on and off the toilet.
- Sitting balance, standing and walking, with or without an aid.
- Weakness, stiffness and tightness in the arm or leg.
- Hand use, reaching and holding.
- Fear of falling and falls prevention.
- Fatigue and how to pace the day.
For swallowing and speech problems, we refer to a speech therapist or your doctor, because that is their area.
What about Parkinson’s disease?
The World Health Organization (WHO) estimates that over 8.5 million people had Parkinson’s disease in 2019, and that rehabilitation including physiotherapy can improve function and quality of life [2].
A Cochrane network meta-analysis found little evidence of differences between exercise types, so the best exercise is the one a person will keep doing [3]. We pick movements that suit the person and the home. See Parkinson’s disease rehabilitation for more.
How does a first home visit work?
We listen to the story, check your papers, and then watch you move. We test strength, tone, sensation, balance and walking, and look at the home layout and any equipment.
Together we agree a few goals, such as “walk to the front gate” or “dress without help”. You get a small set of exercises, and we show the family how to support them. Over the following visits we make the tasks harder as you improve.
When is it an emergency?
Call an ambulance or go to the emergency department at once for sudden facial droop, arm weakness, slurred speech, severe headache, sudden loss of vision or sudden confusion. Time matters, so do not wait for a physiotherapy visit.
Our guide on stroke warning signs explains how to recognise them. Report new swelling in one calf, chest pain, fever or a new fall to your doctor.
Home visit or our centre?
For most people with a new or serious neurological problem, a home visit is the practical start. It avoids tiring journeys and lets us see the real setting.
Our Canning Garden centre, opening soon, will suit people who travel well and want a gym setting. Both routes have separate quotes on WhatsApp. Read home physiotherapy or the guide to bedridden patient physiotherapy for more.