Physiotherapy for neurological diseases: challenges and opportunities
Sometimes our own bodies throw a wrench in our plans. Sudden paralysis, tremors in the legs – according to the WHO, more than a billion people worldwide suffer from a neurological disease. Stroke, Parkinson's disease, and epilepsy are among the most common. These and other illnesses often severely impact the lives of those affected and lead to a significant reduction in their quality of life.
As a physiotherapist, you play a vital role in the treatment of these conditions. But how can you best help your patients? Which therapy methods are most effective? To answer these questions, it is crucial to stay up-to-date with the latest research.
In this blog post, we would like to present the latest research findings on the effectiveness of physiotherapy in the treatment of neurological disorders. We hope that this post provides you with valuable insights and helps you to best support your patients.
Learn more here:
- How do neurological diseases develop?
- How can physiotherapy help?
- The latest research findings
- Challenges and limitations
1. How do neurological diseases develop?
Our brain is the control center of our body. It coordinates our movements, thoughts, emotions, and sensory perceptions. But sometimes, malfunctions can occur in the system.
Neurological disorders can arise from a variety of factors, including genetics, age, environment, and lifestyle. Connections between nerve cells change or die, which can lead to symptoms such as paralysis, tremors, or memory loss.
One example is Parkinson's disease, in which certain nerve cells in the brain die and dopamine, an important neurotransmitter, is no longer produced in sufficient quantities. Strokes can also be caused by a sudden interruption of blood flow to the brain and can cause severe damage.
2. How can physiotherapy help?
A neurological diagnosis can turn your life upside down. Suddenly, everyday tasks become a challenge, and movements that were once taken for granted can be difficult or impossible. But there is hope. Physiotherapy helps to alleviate symptoms and improve mobility.
Through specific exercises and techniques, physiotherapy can help improve patients' mobility, strength, and coordination while reducing pain and stiffness. Treatment can also help improve balance and stability, and reduce the risk of falls.
What types of physiotherapy are used for neurological diseases?
There are various types of physiotherapy that can be used for neurological conditions. Some of the most common are:
- Bobath therapy: Bobath therapy is a specialized form of physiotherapy that focuses on treating patients with neurological conditions. The goal of the therapy is to improve balance, movement, and coordination.
- Proprioceptive Neuromuscular Facilitation (PNF): PNF is a technique based on stimulating muscles and nerves through specific exercises and movements. This technique can be used to improve motor control and balance in patients with neurological conditions such as stroke, Parkinson's disease, or multiple sclerosis.
- Functional electrical stimulation (FES): FES uses electrical stimulation to generate muscle contractions and assist movement. This technique can be used to restore muscle strength and improve mobility in patients with paralysis and other neurological conditions.
- Sensory integration therapy: Sensory integration therapy aims to improve the processing of sensory information in the brain. The therapy can help improve coordination and balance in patients with neurological disorders.
- Gait analysis and training: Gait analysis and training is a technique used to analyze and improve the walking of patients with neurological disorders. The goal is to achieve better balance and coordination, as well as increased walking speed and efficiency.
3. The latest research findings
The use of physiotherapy to treat neurological disorders is currently being intensively researched. The available results show promising effects, suggesting that physiotherapy can play an important role in improving the quality of life of patients with neurological disorders.
Specifically, studies have shown that physiotherapy achieves significant improvements in physical function in conditions such as stroke, Parkinson's disease, and multiple sclerosis. Various methods are used, including exercises that improve muscle strength and balance, as well as specific exercises that promote mobility and coordination.
Furthermore, it has been shown that technologies such as robotics and virtual reality can have a positive influence on the effectiveness of physiotherapy.
We have compiled some interesting studies for you here:
Parkinson's disease
A systematic review and meta-analysis by Mehrholz et al. from 2018 investigated the effectiveness of physiotherapy in patients with Parkinson's disease. The researchers analyzed a total of 47 randomized controlled trials with more than 3,000 participants. They found that physiotherapy can lead to significant improvements in mobility, balance, gait, and quality of life in Parkinson's patients. In particular, physiotherapy resulted in improved walking speed and greater walking distance. Furthermore, balance improved, and the risk of falls was reduced. The results of the meta-analysis also showed that the effectiveness of physiotherapy increased with the duration and intensity of the treatment.
multiple sclerosis
In 2021, a research team from the University of Cologne conducted a study investigating the effectiveness of physiotherapy in patients with multiple sclerosis. The patients performed exercises specifically tailored to their individual physical limitations. These included, for example, leg strengthening exercises, balance exercises, and coordination exercises. After eight weeks of training, the patients showed significant improvements in their walking ability and quality of life.
The study thus confirms the importance of individually tailored physiotherapy for patients with multiple sclerosis and shows that targeted exercises can lead to an improvement in physical functions and quality of life.
stroke
A study published in the Journal of NeuroEngineering and Rehabilitation investigated the use of a robot-controlled exoskeleton in combination with virtual reality for the treatment of stroke patients. The study included 60 participants who were randomly assigned to either the robot-controlled exoskeleton group or a control group receiving standard rehabilitation.
Participants in the robot-assisted exoskeleton group underwent a six-week rehabilitation program, performing specific movement exercises supported by the exoskeleton while simultaneously exploring a virtual reality environment. The control group received standard rehabilitation without the use of robotics and virtual reality.
The results showed that participants in the robot-controlled exoskeleton group exhibited significantly improved motor functions and gait compared to the control group. This suggests that the combination of robotics and virtual reality could be a promising method for the rehabilitation of stroke patients.
epilepsy
There is currently limited research on the use of robotics and virtual reality for the treatment of epilepsy. However, a recent systematic review from 2021 investigated the use of virtual reality as an adjunct to standard epilepsy treatment and found promising results.
The study identified eight randomized controlled trials that investigated the effectiveness of virtual reality in the treatment of epilepsy. Overall, these studies showed that the use of virtual reality as an adjunct to standard epilepsy treatment can lead to a significant reduction in seizure frequency and intensity.
Some of the virtual reality technologies studied included immersive virtual environments designed to reduce stress and anxiety, as well as interactive games and simulations used to improve cognitive skills.
Although further research is needed in this area, these results show that virtual reality could be a promising approach as a complement to standard epilepsy treatment.
4. Challenges and limitations
As you can see, physiotherapy is an important tool in the treatment of neurological diseases. However, science is far from having reached the end of this topic.
For this article, we sat down with Leipzig-based neurologist Jens Schäfer, who conducts research on the effectiveness of physiotherapy. In an interview, he now shares his knowledge with us.
Mr. Schäfer, why do you think there are so few studies investigating the effectiveness of physiotherapy in neurological diseases?
Jens Schäfer: “The effectiveness of physiotherapy for neurological diseases has not yet been sufficiently researched. One possible reason for this could be that such studies are often very complex and expensive, and therefore only limited financial resources are available. The difficulty of recruiting suitable patients for studies can also play a role. In addition, it is often difficult to develop standardized measurement methods that objectively record the patients' progress.”
How can physiotherapists use and implement the research findings?
Jens Schäfer: “By individually tailoring therapy plans, physiotherapists can recommend specific exercises and movements that are adapted to the patient's specific deficits and limitations. It is also advisable to familiarize oneself with the latest technologies. Robots and exoskeletons are a valuable addition to practice and can support patients in their motor rehabilitation.”
Would you also recommend interdisciplinary collaboration?
Jens Schäfer: “Absolutely! I myself work with physiotherapists, but occupational and speech therapists can also support the treatment. By physiotherapists collaborating with other specialists, it is ensured that the patient receives the best possible care and holistic treatment.”
Where are the limits of physiotherapy?
Jens Schäfer: “Physiotherapy plays an important role in the treatment of neurological diseases and is often very helpful. However, there are also limitations that must be considered. In cases of severe neurological diseases, such as advanced stages of multiple sclerosis or severe traumatic brain injuries, physiotherapy may not be sufficient to adequately support the patient. Similarly, if the damage is very extensive and the affected area of the brain is irreversibly damaged, physiotherapy can only offer limited help. Therefore, physiotherapy alone is not a suitable treatment approach and should instead be considered as a valuable complement.”
Conclusion
The effectiveness of physiotherapy in treating neurological disorders is a broad field that still raises many questions. However, studies already conducted offer a positive outlook for the future.
As a physiotherapist, you have many opportunities to utilize the latest research findings to support your patients in your practice. This includes specialized exercises, robotics, and virtual reality. Collaborating with specialists in neurology, occupational therapy, and speech therapy can open up new avenues for alleviating the symptoms of multiple sclerosis, Parkinson's disease, and other conditions.