The depth of physical therapy can be compared to that of an ocean, deep and diverse. For an average man, the first thing that comes to mind when he hears the word physiotherapy is usually a job that deals with musculoskeletal conditions. Still, little do they know that that’s not the only field a therapist can specialize in. Physiotherapy is a healthcare profession concerned with human function and movement and maximizing physical potential. Physical potential can be reduced in individuals who suffer from a wide variety of diseases, hence, there arises a need for multiple specializations. However, today we are going to discuss one field in particular, that is, neurological physiotherapy.
Neurological Physiotherapy is a specialist area of physiotherapy focused on the treatment of individuals with neurological conditions. Neurological disorders affect the functioning of the brain, spinal cord, and nerves. Neurological physiotherapists are experienced and trained to treat neurological conditions to provide interventions that assist an individual to regain or maintain their maximum movement and functional independence. This is achieved by aiding in the development of new pathways through repetition and exercise. Neurological conditions are extremely tricky to deal with, which is why neurological physiotherapists must have the following traits –
- Patience towards patients – A physiotherapist in general must have patience to a certain degree, but for neuro specialists, patience is key to providing quality care. A neuro PT on average spends around an hour and a half for each stroke patient, and an average of forty-five minutes for bell’s palsy. The amount of time they spend on individuals suffering from these conditions is substantial. Without a cool head and copious amounts of patience, a neuro PT cannot formulate accurate treatment protocols and execute them.
- Time Management – With neurological conditions being tricky to deal with, it takes a lot of time to manage every patient therapeutically. Without a good sense of time management, it is impossible to provide care for every patient that walks in. If not for time management, therapists cannot organize and efficiently produce quality care.
- Being Realistic – This trait is a must for neuro PTs. No matter how skilled and trained a therapist is, they must attain realistic and achievable goals. A patient suffering from a stroke may not improve in a couple of days, months, or even years. A neuro PT needs to be realistic in setting their goals.
- Teamwork – Neurological conditions do not generally present with just musculoskeletal impairments. They usually present with dysphagia which should be treated by a speech therapist. Since the nature of neurological conditions are complex and requires different fields of treatment, a therapist needs to have qualities of teamwork. Teamwork allows for the implementation of a holistic approach that facilitates the formulation of better treatment protocols.
- Observational Skills – Neuro PTs, in particular, must have fantastic observational skills. They need to observe the tiniest of movements to restrict unwanted movements and facilitate wanted movements. This skill is not easy to attain, hence making neuro PTs special.
- Creative Thinking – There are hundreds if not thousands of ways to implement exercises in a physiotherapy protocol. For example, grasping activities for stroke patients can be done through the usage of tongs, therapeutic putty and even popping a bubble wrap. Creative thinking is important to have because it allows a therapist to make the best use of what is available to them.
Neurological PTs have a hectic schedule and a very high set of responsibilities. They must have all the qualities mentioned above and most of all, need to be flexible. Now, let us dive into what a typical day as a neurological physiotherapist looks like.
Two Neuro PTs were interviewed and interrogated about their daily life. They were questioned about their schedule, difficulties, likes and dislikes, etc. The answers to those are as follows.
- Physiotherapist 1 – “My typical day starts at 9 am by entering into the OPD and going through the case list of the previous day. By doing so, I expect who comes in for the day. The first patient typically enters at 10 am. I start by re-evaluating the patient and altering the treatment protocol if necessary. I usually spend around an hour per patient and I see around three patients a day.
My day is usually very hectic because I have to pay a visit to the neurosurgery ICU every day. The time I start ICU duty depends on what shift I am in. Currently, I start ICU at 12:30 and finish by 2:00 and then go for my lunch break.
The typical cases I see are stroke, traumatic brain injury, and bell’s palsy. I try to keep myself updated by reading articles and talking with the head of the department frequently.
Usually, the difficulties I face on a day-to-day basis are the inability to manage my time and keep my goals realistic. I generally try my best to manage my time the best I can so I can give patients the best care I can give.
The best advice I can give to those aspiring to become neurological physiotherapists is, never think about the outcome, always think about what your responsibilities are, and how ethical you are. The patient benefits from these immensely and will certainly progress when it comes to health.”
- Physiotherapist 2 – “I start my day at 7 am, where I go to the neurosurgery ICU and treat a wide variety of patients suffering from life-threatening conditions. Our job is to make sure that the patient’s lungs are clear of secretion and also that no bed sores form on them. After two hours of treatment, I eat breakfast and continue my day providing patient care.
A patient who suffers from spinal cord injuries or traumatic brain injuries usually undergoes surgery. After the surgery, they are admitted into the general wards of the hospital. Here, I must perform patient transfers and actively mobilize patients if they can do so. It takes a lot of effort and time to safely shift patients from their beds to their wheelchairs and vice-versa.
The main difficulty I face is that quite literally, you need a certain amount of strength to shift patients. No matter how good the technique, I find it difficult sometimes to muster up enough strength to shift a patient, especially if I’m alone.
I advise aspiring physios to always keep their passion burning but never be unrealistic when it comes to patient care. It is one the, if not the most important thing a physiotherapist should have. To those who are already in the field, keep up the good work, and always remember that your contributions to society are immense and will always be appreciated.
Receiving regular physiotherapy not only improves patients physically, but also psychologically, building patient and family members’ confidence, positivity, hope, and belief. Neuro PTs are not only important in terms of providing patient care but also in providing patients’ loved ones with a glimmer of hope. Neurological physiotherapy is one of those fields which plays a major role in reducing the amount of disability an individual suffers from, which is nothing short of miraculous.
