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Neuro physio

The role of Activity-Based Rehabilitation in para-sport

Neurokinex look at ABR and its benefits for spinal cord injured patients taking part in sport

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Following a spinal cord injury, many people look for a sport to play in order to be a part of a team, achieve specific goals and to improve their health. But how does activity-based rehabilitation facilitate the transition into para-sport? 

Activity Based Rehabilitation (ABR) is an exercise-led whole body neurorehabilitation programme, tailored to an individual’s needs and goals.

The benefits of ABR are: 

  • Improvements in neurological function
  • Increased muscle strength and endurance
  • Increased cardiovascular fitness
  • Increased balance and stability
  • Improved skin integrity and increase circulation
  • Maintenance of bone density
  • Reduction in spasticity
  • Improved active or passive range of movement
  • Increased independence in Activities of Daily Living
  • Increased psychological wellbeing
  • Increased confidence
  • Increased independence
  • Aiding community re-integration

ABR uses periodised training programmes created by a multi-disciplinary team. Training programmes are individualised and centred around client goals both in the short and long term.

Training is moderate to high intensity and follows strength and conditioning theories of motor control and coaching strategies. Sessions are often focused on sport-specific tasks which can spark an interest and help ignite a passion for training and crossover with para-sport.

Taking up a new sport 

When a client becomes involved with a particular sport, ABR can progress their interest and skills through training programmes focusing on key areas of the body related to that sport. 

For example, our Neurokinex client Ellen Field was a keen boxer looking to complete a degree in strength and conditioning before her injury. Post injury her passion remained and ABR was able to facilitate boxing for her. Furthermore, it was also able to introduce Ellen into new training methods that she had not experienced before, including CrossFit – a functional training method focused on weightlifting and gymnastics.

Ellen’s ABR programme now facilitates these skills by working on areas such as core stability, muscle strength and muscle endurance in order for her to perform at the highest level. Many CrossFit workouts are based on High Intensity Interval Training under load which is now replicated in her sessions.

As Neurokinex is made up of a multidisciplinary team, trainers are able to coach weightlifting in a safe and effective way in a controlled environment. Ellen is now registered to a CrossFit gym and has competed in local national and international competitions, including the CrossFit Open in 2020.  

From charity challenge to competition

Another client example of the power of para sport is Luke Applegate who has been attending Neurokinex since 2012. His main focus was on gaining upper body strength, allowing his body to be in the best shape that it can be. In 2018 Luke entered his first triathlon as part of a charity event to raise money for Neurokinex so his training programme shifted towards training for this sport. Luke enjoyed the new focus and took to the training well.

He has since competed at the British Championships in Triathlon where he came third. Tailored ABR programmes have allowed him to reduce his body weight and train specific muscle fibres to meet the demands of this particular sport, rather than focus solely on hypertrophy and muscle strength. 

Whilst a person’s motivation and goals may change towards para-sport, the fact they are attending Neurokinex as part of an ABR neurorehabilitation programme is not forgotten. Even when working on specific ranges of motion, sport specific tasks or strengthening certain muscles we ensure that the whole body is targeted in order to activate the entire nervous system to promote neurorecovery.

ABR uses adjuncts such as locomotor training and wide pulse stimulation in order to promote excitation both above and below the level of injury. ABR sessions are always completed out of the chair and in varying loadbearing positions such as kneeling or standing. These variations in training allow for greater adaptability, maintenance of bone density and promote skin integrity. This aspect of ABR allows for a person to be in the best possible health both mentally and physically when crossing over to para-sport which, in turn, can avoid secondary complications and increase their quality of life outside of competing. 

Mental health as well as physical gains 

ABR sessions are completed at a moderate to high intensity which research has shown can help improve a person’s mental wellbeing due to the release of endorphins. People who suffer a spinal cord injury often have neuropathic pain and the release in endorphins has been found to alter people’s perception of pain and decrease its impact even if only for the short term. 

The role of ABR in maximising neurorecovery and physical and mental wellbeing after a spinal cord injury is clear. When it is taken a stage further to act as a springboard into para-sport, its ability to prepare the body and mind for training and competition is nothing short of exciting. 

Neuro physio

New high-tech centre ups the ante on neurorehab

Marking an investment of £400,000, its focus on robotics and VR is attracting neurorehab patients from across the country

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A new technology-led neurorehabilitation centre has opened to offer high-intensity programmes of physiotherapy, advancing the recovery of people with neurological injury or illness from across the UK. 

The Rehab Physio has created a specialist centre of excellence which uses an array of robotics and virtual reality rehab technology to up the ante on traditional neurophysio programmes. 

The new 3,500sq ft centre, in Wirral, Merseyside, marks a £400,000 investment for the business and its second expansion into new premises, and builds on The Rehab Physio’s growing reputation and status in the neurorehab sector since its creation in 2011. 

Its commitment to high-intensity programmes to maximise outcomes has seen it attract clients from well beyond its native North West, with its new centre seeing strong interest from across the UK. 

Now, with investment in its new suite of technology, which includes a number of Tyromotion devices, The Rehab Physio can increase the breadth of neurorehabilitation opportunities for clients even further. 

“We know from research how vital intensity and volume is, and we can achieve new levels with this new technology. It isn’t possible to replicate that through traditional physiotherapy,” says Christopher Wynne, who spent a decade in the NHS before founding The Rehab Physio. 

“We’ve been running clinical sessions for seven or eight years now and technology has advanced greatly in that time, we’ve seen the impact it has made and the evidence that shows the effect of volume and repetition, which is why we decided to create this centre. 

“Technology allows us to work in a different way, so we can be delivering the intensity of rehabilitation that people want and need. We can massively increase what they can achieve even in an hour.” 

The Rehab Physio has created new 80-hour packages for clients, which are bespoke to their needs, and can be completed during a specially-created programme of between four and seven weeks and will see clients receiving a minimum of four hours of specialist neurophysio each day.

The business has also partnered with local hotels to offer a ‘residential’ programme for those travelling from across the UK. 

“We have tried to create programmes which are suitable to offset against day to day life, for those people locally who want to spend time focused on their rehab while they’re here and then go home, but also for those from further afield who really want to dedicate themselves to it,” says Christopher. 

“Really intense rehabilitation does take commitment so we want to support people to achieve the outcomes they want as much as we can. We’re keen to be as far reaching as possible so people can come to us from across the UK. 

“Opportunities for this level of rehabilitation can be limited by a lot of things, but we are trying to offer something to everyone, regardless of budget.”

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Neuro physio

Define your boundaries or boundaries will define you

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How many times have you laughed at someone skidding, tripping, losing their balance or falling flat on their face?

Accidents can be funny, but sometimes they cause serious life-changing injuries in a matter of seconds. In 2019, 47-year-old Tim Jones experienced exactly that.

A Freak Accident

Tim suffered a C5 incomplete spinal cord injury while wakeboarding – an activity he had done 100s of times. His injury resulted in him being paralysed from the neck down and he was hospitalised. Tim was initially admitted to John Radcliffe Hospital where he had an operation to decompress his spine. Two months later he moved to Stoke Mandeville spinal unit where he had four months of rehabilitation.

Stepping up to the challenge

Tim is a family man from Hertfordshire. A lover of outdoor sports, he enjoys a variety of pursuits including tennis, cycling and trekking. He also has a passion for poker and holds poker nights/weekends through his events company Prestige Poker.

Tim struggled to sit still and was always out and about with family and friends. Suffering this type of injury was devastating and Tim wondered whether he would be able to walk again, play tennis or poker, as his arms, legs, and hands were all affected.

He attended daily physio sessions at Stoke Mandeville spinal hospital which included basic Pilates and weight sessions to prevent further deterioration. On December 19, 2020, Tim was discharged from Stoke Mandeville.

Forward-thinking mindset

After leaving Stoke Mandeville, Tim was keen to continue his rehabilitation.

He’d never been to a gym before his accident and didn’t know where to turn to as the NHS does not have an aftercare rehabilitation system in place.

Before his discharge from Stoke Mandeville, one of the consultants recommended Neurokinex. It was important to Tim that after his injury his rehabilitation was tailored to his challenging needs and intense to maximise his recovery. After completing an initial assessment with our training expert Stephen, he was keen to get started.

Road to Recovery

On January 25, 2021, Tim embarked on his road to recovery through the Neurokinex Step-Up Scheme. Designed for newly injured people, it offers six free sessions with a unique rehabilitation approach.

Tim came to Neurokinex with a hunched posture and aching shoulders, limited mobility in his arms and hands and back pain. He was keen on learning some new physical techniques to help his mobility but soon learned the most effective technique was setting small challenges to build up to a realistic goal.

Neurokinex created a tailored activity-based rehabilitation programme that encompassed Tim’s posture issues, mobility and strength.

Fast forward eight months and Tim is now able to drive giving him back his independence. His posture has also improved, irradicating the dull aching sensation in his shoulders that he used to live with. His arms and hands are becoming more mobile and stronger which has allowed Tim to return to playing poker. He even got a compliment from his wife that his back had changed and how muscular it was looking.

Define your boundaries or boundaries will define you

When we think about boundaries, we tend to think of limitations. However, with the right advice and support, those limitations can be changed into adaptations.

Tim combined his competitive nature from sport and outdoor activities with a willingness to better himself to adapt to what he wanted to do. His passion and goals are to be back playing poker, enjoying weekends out with family and friends and resuming his outdoor pursuits. His activity-based rehabilitation goals were to increase mobility and strength in his upper body and to be able to be more independent and less reliant on his wife.

Setting small, achievable targets has helped Tim pick up playing poker again and he is well on his way to ticking off the rest of his goals.

“I am so glad I found Neurokinex and can honestly say without their help, my recovery would be nowhere near where it is now,” says Tim. “Stephen has been amazing at understanding my needs and goals and makes every session fun and different – I didn’t know there were so many ways to work the same muscles!

“For me, Neurokinex is a game changer, and I would recommend them to anyone who finds themselves in an unfortunate position such as my own.”

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Community rehab

Therapy centre pioneers Long COVID study

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A community gym is playing a crucial role in supporting patients with Long COVID through a pioneering study into how power-assisted exercise can help in their rehabilitation. 

West Berkshire Therapy Centre is set to support 100 people living with the post-COVID syndrome through a 20-session programme, with its evaluation of their outcomes set to be some of the first research into rehabilitation for the debilitating condition. 

The centre has raised over £19,000 to fund the study, titled ‘The role of power-assisted exercise in the rehabilitation of Long COVID’, with a further £10,000 grant secured by Dr Deepak Ravindran, who runs Berkshire Long COVID Integrated Service, which will enable the study to be bigger than initially planned. 

Dr Ravindran, a pain consultant at the Royal Berkshire Hospital, has referred patients to the physio-led West Berkshire Therapy Centre since its creation in 2014, and its ability to deliver both physical and psychological benefits to its clients has led to it now supporting the rehabilitation of people with Long COVID. 

To date, the centre’s work has been proven to improve client mobility by an average of ten per cent and psychological outlook by 15 per cent, with hopes that may extend into its new cohort of Long COVID patients. 

“For several years we have worked with clients with fibromyalgia and we have the equipment here which can support them, so we wanted to use our experience and equipment to offer some help,” says John Holt, trustee at the centre who was instrumental in its creation.

“If you go back to March 2020, myself and the team were stuck at home feeling useless, but now all of a sudden, we have this opportunity to help clients living with this new condition.

“People tell us it helps them and that’s all we need to know, but now through our evaluation, we hope this could mean something to researchers. We’re completely geared up for it, our staff are all on a high. 

“We will be referred 100 Long COVID clients with a variety of complexities, they may have mental effects or heart impairment or reduced mobility, some will have mild disability and for others that will be more significant. We will look at all of that and then do our assessments to see what is safe. 

“We will be guided by the clients – we know a bit, Dr Ravindran knows a lot, but they know most about this condition. We may discover our service makes no difference to Long COVID – we’re not trying to set out to show what a brilliant service we offer, we want to continue to make a difference to people’s lives through finding out what can work.”

The project is being part-financed by the fundraising of the team at the centre, with John himself using the power-assisted equipment to cycle the last stage of the Tour de France and climb the world’s tallest building. The first £5,000 they raised was double match funded by Greenham Trust. 

“I climbed the world’s tallest building in an hour – the world record is six hours. One of my colleagues rowed the English Channel. It shows the impact our equipment can have on exercise and rehabilitation without the physical exertion,” says John. 

The centre, which was founded in 2014 to bridge a gap in community resources, undertook various fundraising activities last month to finance the project, has grown significantly to play a role at the heart of its community. 

Initially open for 20 hours a week with ten items of equipment, it has since expanded into premises twice the size of its initial home, with 17 items of equipment which clients can access for 35 hours each week.

While the centre was forced to close during lockdown periods, the investment in its offering has continued, with a further £17,500 being spent to upgrade equipment. It has now re-opened, but at 60 per cent capacity and social distancing and the wearing of PPE will remain in place even beyond July 19. 

“We are keeping the two-metre distancing, even though that means some of our equipment is out of commission, and the wearing of PPE will continue,” adds John. 

“We will have a very slow relaxation and are happy to lag behind the rest of the country. We want our clients to be confident this is one of the safest places they can go to – people deserve that.”

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