Neurological Conditions

Balance and Difficulty walking

There are many different disorders and conditions that can contribute to difficulty with walking. Walking requires an incredibly complex interaction between the nervous system, muscles and posture of the body. Without these components, your ability to walk is compromised.

Many people do not realize how badly compromised their balance is or their limitations with walking, until they are quite degraded. It is often the fall, trip or loss of balance that is the wake up call to poor balance. In addition, the loss of being able to walk distances is a clear indicator that the balance and walking mechanisms are disrupted. Walking not only requires good balance, but the ability to know where your joints are in space (proprioception), and the ability to know how your joints are moving (kinesthesia), as well as good range of motion and strength.

As we age, with declining activity, or after an injury, walking and balancing can become difficult. With previous injuries, pain or neurological disorders, our walking pattern can also change. When walking patterns change, abnormal stresses and strains with everyday activities can be transmitted to areas it shouldn’t. For example, if you have knee pain and you begin to limp, the opposite hip and your spine now have to take double the weight. This can lead to pain and dysfunction in those areas. The good news is that if you have difficulty walking, you can be helped. Physical therapists are the experts uniquely trained to do so.

How therapy helps

One of the main specialties of physical therapy is helping people to walk normally. This takes a thorough evaluation of your walking patterns, posture, range of motion, strength, balance and coordination. Through this analysis, a treatment plan is then developed that will address your range of motion, pain, coordination, balance and strength. The end result is the ability to walk without the need of an assistive device such as a cane or walker, safely and smoothly. In cases with progressive diseases such as ALS, Multiple Sclerosis or Parkinson’s Disease, physical therapy is critical to maintaining function, independence and walking as long as possible. If your balance or walking is not what it used to be, call us today to discover how we can help you walk better!

Parkinson’s Disease

Parkinson’s Disease is a progressive disease that affects the central nervous system and the ability to coordinate movement in the body. Since Parkinson’s Disease affects many areas of the brain, symptoms can vary in individuals and progression can be either mild, moderate or aggressive. Parkinson’s Disease typically affects one’s ability to walk with slower movements (bradykinesia) and difficulty with starting or stopping walking. In addition, movements tend to become slower along with tremors that may occur in the hands. Muscles can become quite rigid, leading to loss of motion and poor posture. A dangerous symptom is called retropulsion, where the tendency of an individual is to fall backwards with little to no ability to protect oneself.

Speech can also be affected with Parkinson’s Disease becoming slurred and slow due to poor activation of the mouth, tongue and throat muscles. In addition, eating and drinking can become challenging due to difficulty with swallowing. Symptoms may also include difficulty with writing, becoming illegible or very small.

How therapy helps

Physical therapy, occupational therapy and speech therapy are essential therapies for people with Parkinson’s Disease. While there is no cure for Parkinson’s Disease currently, a tremendous amount can be done to improve one’s function and maintain gains. In coordination with your physician, rehabilitation focuses on improving movement, safety, independence with activities, transfers, cognitive and speech / swallowing. Physical therapists focus on improving range of motion, strength, stamina, safety with transfers from low surfaces, posture and movement in patients with Parkinson’s.

Occupational therapists focus on movements of the upper extremities, cognitive improvements, coordination with dressing and caring for oneself, and adaptions to be independent as possible with daily living activities. Speech therapists focus on improving speech, safety with eating / drinking, cognitive abilities and improving writing. It is important to note that our rehabilitation professionals work together as a team to help you reach goals along with family training for attaining maximum independence.

ALS (Lou Gehrig’s Disease)

Amyotrophic Lateral Sclerosis (ALS) is a progressive neurological disease that typically begins in the hands, feet and extremities, then progresses centrally. People may first discover that they have difficulty walking, tripping or poor balance. In addition, people may notice that they have weakness in their hands or legs, along with occasional muscle cramps.

As the disease progresses, it affects walking, use of the arms, speaking, swallowing and breathing muscles. While there is no cure for ALS, maintaining independence and function as long as possible is the goal of the rehabilitation team. Safety with walking and adaptation of assistive devices is critical to prevent secondary complications such as fractures from falls.

How therapy helps

Physical therapy, occupational therapy and speech therapy typically coordinate as a team for people with ALS, depending on their severity of symptoms and progression of the disease. Physical therapy focuses on improving and maintaining range of motion, strength, stamina, walking and balance. In addition, our physical therapists will focus on making recommendations for adaptive equipment such as canes, walkers, wheelchairs, braces and other devices. The goal of physical therapy is to maintain safety with walking and independence for as long as possible.

Occupational therapists focus on helping ALS patients with their upper extremity use, working on strength, stamina, range of motion and function. Recommendations for adaptive equipment with grasping, reaching and writing are part of care. In addition, training and adaptation of daily living activities, such as dressing, eating, cooking and work are modified as needed.

Speech therapists focus on the muscles of the throat, mouth and tongue as well as breathing. All this can help maintain safety with eating / drinking and improve the ability to communicate. Speech therapy also focuses on making adaptations for speech, communicating, eating and drinking.

Although ALS is a progressive disease, the use of physical, occupational and speech therapy can make a big difference in your quality of life, maintaining independence and function for as long as possible.

 

Multiple Sclerosis

Multiple Sclerosis (MS) is neurological disease that causes the body’s immune system to abnormally attack the covering of the nerve cells, called myelin. This causes scarring and decreases the nerve’s ability to transmit signals properly. The progression of MS is based on 4 different types of aggressiveness. Multiple sclerosis is categorized by bouts of activity, with periods of minimal to no activity, depending on the different type of MS you may be suffering from. Symptoms can vary person to person dramatically as different parts of the brain, spinal cord or peripheral nerves are affected, making no two cases alike.

Common symptoms of MS are fatigue, numbness or tingling in the face, body or extremities, weakness, dizziness or vertigo, pain, walking difficulties, loss of balance, bladder and bowel problems and emotional / cognitive changes.

Multiple sclerosis requires a multi-discipline approach with medical and rehabilitation management. The goal of helping MS is to decrease the severity of symptoms, make adaptive changes physically and in lifestyle to cope with the progression of the disease. Fatigue management and temperature management are critical components of managing MS.

How therapy helps

The rehabilitation process is critical to those suffering with MS. Physical therapy helps to address weakness, range of motion loss, balance issues, transfers and walking. Physical therapy can help significantly in improving function and independence in a person with MS. In addition, our physical therapists can help you with improving walking, balance and safety with daily movements. Furthermore, as needs change, we are with you every step of the way to teach you how to use assistive equipment such as canes and other devices.

Occupational therapy works closely with patients who have MS to help improve their quality of life. Occupational therapists evaluate the function and use of the hands and upper extremities. Furthermore, we help you evaluate the needs for adaptive techniques and equipment for work and everyday life activities. Occupational therapy can make a big difference in your quality of life.

Speech therapy may be required with changes that can occur in speech, swallowing or cognitive changes. Speech therapy is important if these symptoms are present to promote safety with eating / drinking, improving speech communication and helping with cognitive tasks.

Nerve Injuries, neuralgia and neuropathy

Nerve injuries, including neuralgia and neuropathy can present with a wide variety of symptoms in different parts of the body. The important aspect to investigate is why did these symptoms start? Typically symptoms occur from abnormal pressure or irritation to a nerve or group of nerves. For example, during an accident a nerve was overstretched in the neck from whiplash. This now sends tingling and numbness sensations to the outside arm and shoulder.

Peripheral nerve injuries can occur from accidents, constriction, surgical procedures, disease and repetitive actions. Common nerve injuries include carpal tunnel syndrome, whiplash, brachial-plexus syndrome, tarsal tunnel syndrome and surgical procedures. Nerves take a significant amount of time to regenerate and grow back together, depending on the severity of the nerve injury.

Neuralgia refers to pain caused by nerves. There are a variety of different causes for this pain from abnormal pressure, disease and even medication toxicity. Neuralgia often refers to non-specific pain that can occur in the arms or legs. Symptoms can vary from tingling, numbness, to even burning or sharp pains.

Neuropathy refers to a disease state of nerves. This typically occurs in people who suffer from diabetes as this damages the nerves, especially in the feet. In addition, circulation issues can cause neuropathy to occur in the feet, legs or hands. Various factors, which contribute to poor circulation, can often be improved. This in turn improves the neuropathy to varying degrees. Neuropathy can be especially problematic as the lack of sensation in the feet, can lead to cuts or injuries without the person knowing. Since circulation is usually compromised, the chances for infection become high

How therapy helps

Physical and occupational therapy are very good treatment options for people with nerve injuries, neuralgia and neuropathy. A thorough evaluation is done of nerve function including strength, sensation, coordination of movement, range of motion, dexterity and more. The body depends on feedback to heal properly and therefore, improving strength, range of motion, coordination and balance, nerves can heal better, muscles can function properly and pain can be reduced.

There are many different pain management strategies that our therapists can train you on and modalities that can help soothe symptoms quickly. In addition, any long-term adaptations to work, function and lifestyle can be done with bracing or assistive devices.

Stroke (CVA)

A stroke is referred to as a Cerebrovascular Accident and is the sudden death of brain cells due to lack of oxygen. This occurs when the blood flow to a particular portion of the brain is restricted from a clot or bleed. Depending on where the stroke occurred in the brain, how extensive the damage was and the duration, dictate the severity of the symptoms and recovery.

Common symptoms of stroke are a slurring of speech, facial droop, weakness or loss of function in one side of the body, either in the arm, legs or both. Immediate emergency medical attention is needed if these symptoms begin. Stroke can affect cognitive function, speech, the ability to swallow, walking, balance, strength and function.

After medical management, rehabilitation is needed to assist the person in regaining as much function as possible. The brain and nervous system is very plastic in it’s ability to adapt for the damaged area. Many people are able to regain most function in their affected limbs, speech and enjoy life with modifications.

How therapy helps

Physical therapy is a vital part of the recovery of a person who has suffered a stroke. A thorough evaluation is done in various stages of the rehabilitation process to determine progression in strength, transfers, walking, balance, range of motion and safety. Our physical therapists approach the care of each person as an individual adapting the best rehabilitative process to each case. A great deal is done to ensure the safety of the person with normal transfers from sit to stand, getting in / out of a car, stairs and uneven terrains. In addition, the strengthening and exercising of muscles provides positive feedback to the nervous system to accelerate adaptation and function.

Occupational therapists work very closely in the process to improve upper extremity and hand function. Learning to write, improving dexterity, movement of the elbow and shoulder are crucial components to functional use of the arm. In addition, occupational therapists assist in cognitive improvements, and especially adaptations to daily activities such as dressing, caring for oneself, cooking and work activities. Many of these skills we take for granted have to be re-learned.

Speech therapists work with muscle deficits of speech, swallowing and facial expressions. In addition, cognitive challenges can help increase the functioning of the brain to problem solve many of life’s daily activities.