Cerebral palsy is the general term for a number of neurological conditions that affect movement and co-ordination.

Neurological conditions are caused by problems in the brain and nervous system.

Specifically, cerebral palsy is caused by a problem in the parts of the brain responsible for controlling muscles. The condition can occur if the brain develops abnormally or is damaged before, during or shortly after birth.

Causes of cerebral palsy include:

• an infection caught by the mother during pregnancy
• a difficult or premature birth
• bleeding in the baby’s brain
• changes (mutations) in the genes that affect the brain’s development
• Lack of oxygen to the brain 

There are types of cerebral palsy:
Spastic cerebral palsy the most common form of cerebral palsy which appears in around 75% of cases. The most common symptom of spastic cerebral palsy are rigid limbs which varies from person to person. Movements tend to be stiff and jerky and as the condition matures, muscles may get shortened. The child may also suffer from learning disabilities.

Spastic cerebral palsy can also be sub-divided by the extent to which the body is affected:

• Hemiplegia both the arms and legs of one side only are affected.
• Diplegia both legs are affected. Arms may/may not or mildly be affected.
• Quadraplegia both legs and arms are affected and may be in varying levels

Athetoid cerebral palsy also known as dyskinetic cerebral palsy or dystonic cerebral palsy and present in around 20% of cases. The common symptoms are unintended movements, wriggle and writhe. This type of Cerebral Palsy have good intelligence and understanding.

Ataxic cerebral palsy the least common type of cerebral palsy with approximately 5% of overall cases. People suffering from ataxic cerebral palsy have less obvious symptoms than the other two. Symptoms include difficulty with balance, spatial awareness and have shaky and unsteady movement

Mixed cerebral palsy Many are affected by more than one type of cerebral palsy and the symptoms affect varying degrees.

How can rehab Basics Help?

There are many different ways which cerebral palsy effect children and adults.

The severity of the symptoms may determine the type and amount of physiotherapy which is required and what outcomes are achieved. Physiotherapy is normally started when your child is diagnosed with cerebral palsy. It’s one of the most important ways of helping your child manage their condition.

The main goals of physiotherapy are:

• Gait Training
• Encourage movement which may involve walking aid or orthotics
• Encourage and improve strength and prevent the weakening of muscles.
• To prevent muscle shortening and losing their normal range of movement (known as a contracture).
• Encourage stretching of muscles due to muscle stiffness which can lead to deformities, causing pain and discomfort.
• Working with the doctors to help with prescription of medication such as Diazepam, Baclofen, Botulinum toxin

A physiotherapist will encourage and engage your child to strengthen and stretch their muscles, which can be carried out at home by parents as instructed. Orthoses may also be used to help stretch muscles and improve posture.

Treatment Sessions are offered in clinics across Northamptonshire and Milton Keynes or at Home Environment.

 For further information about our service or to book an appointment with Rehab Basics please contact us

Good balance is often taken for granted. Most people don’t find it difficult to walk across a gravel driveway, transition from walking on a sidewalk to grass, or get out of bed in the middle of the night without stumbling. However, with impaired balance such activities can be extremely fatiguing and sometimes dangerous. Symptoms that accompany the unsteadiness can include dizziness, vertigo, hearing and vision problems, and difficulty with concentration and memory.

What is balance?

Balance is the ability to maintain the body’s center of mass over its base of support.

A normally functioning balance system permits humans to see clearly while moving, perceive orientation in relation to gravity, determine direction and speed of movement, and automatically make postural adjustments to maintain posture and stability in various conditions and activities.

Balance is attained and maintained by a complex set of sensorimotor control systems that include Sensory Inputs and Motor Outputs from:

Sensory Inputs:

• Eyes – vision (sight),
• Proprioception (touch) – from eyes, muscles and joints
• The vestibular system (motion, equilibrium, spatial orientation);
• Integration of Sensory Input
• Processing conflict sensory input

Motor Outputs:

• Muscles and joints
• Eyes

In addition to the contributions from Sensory Input and Motor Output; other factors that affect sense of Balance includes:

• Injury
• Disease
• Certain drugs
• Aging process or
• Psychological factors

How does our balance system work?

The ear has three main parts: the external or outer ear (the visible part on the outside), the middle ear (the main function of which is to transmit sound from the outer to the inner ear), and the inner ear (the labyrinth). The balance system is a complex system of nerves, small tubes called semicircular canals, and fluid inside the labyrinth. It includes parts of the brain and other components.

Maintaining balance is a complex function. The brain needs to know how feet and legs are positioned in relation to chest and shoulders. This information is conveyed to the brain by movement and position detectors located in muscles, tendons and joints, particularly in the neck, ankles, legs and hips.

Causes of Balance Disorder

Post-traumatic vertigo this is generally seen after Trauma to the head or Minor Head Injuries.

Central neurological disorders People with Neurological Conditions such as Stroke, M.S, inflammation, or tumours can cause dizziness and balance problems. Other less common causes are bony deformities at the back of the head and the top of the spine.

How can rehab Basics Help?

Rehab Basics will work with the client to plan a personalised treatment sessions once detailed assessment is carried out. Treatment Plan will include some of the following exercise’s:

• Hydrotherapy
• Vestibular Rehabilitation is to help the development of vestibular compensation by doing Vestibular Rehabilitation exercises.
• Cawthorne-Cooksey exercises include relaxing the neck and shoulder muscles, training the eyes to move independently of the head, practising good balance in everyday situations, practising the head movements that cause dizziness (to help the development of vestibular compensation.
• Gaze stabilization exercises is to improve vision and the ability to focus on a stationary object while the head is moving.
• Canalith repositioning procedures (CRP) involves a series of head and upper body movements performed by a trained specialist who watches your eye movements with each change of position.

Treatment Sessions are offered in clinics across Northamptonshire and Milton Keynes or at Home Environment.

 For further information about our service or to book an appointment with Rehab Basics please contact us

During the early years there can be some obvious gait abnormalities in children. Many of these disturbances are quite common and correct themselves on their own.

Some require medical assistance if there is a considerable variation in normal gait patterns which may be due to age, family history and Musculoskeletal or Neurological condition.

Abnormal gait patterns in children

The following is a list of abnormal gait patterns which may be seen in children and which may need further evaluation:

Antalgic gait (caused by pain)

• A multitude of possible causes.
• A smaller child may just present with unwillingness to weight-bear, so an index of suspicion is required.
• May be observed in Juvenile Idiopathic Arthritis (JIA), although children do not always complain of pain.

Circumduction gait

• Excessive hip abduction as the leg swings forwards
• Typically seen with a leg length discrepancy, with a stiff/restricted joint movement as in Juvenile Idiopathic Arthritis (JIA), or with Unilateral Spasticity as in hemiplegic Cerebral Palsy.

Spastic gait

• Stiff, foot-dragging with foot inversion. This is often seen in upper motor neurone neurological disease (eg, Diplegic or Quadriplegic Cerebral Palsy,Stroke).

Ataxic gait

• Instability with an alternating narrow-to-wide base.
• Seen in Ataxic Cerebral Palsy affecting the cerebellum, inCerebellar ataxia, and in Friedreich’s ataxia.

Trendelenberg’s gait

• Results from hip abductor muscle weakness or hip pain. While weight-bearing on the ipsilateral side, the pelvis drops on the contralateral side, rather than rising as is normal. With bilateral hip disease, this leads to a waddling ‘rolling sailor’ gait with hips, knees, and feet externally rotated.
• May be observed inLegg-Calvé-Perthes disease, slipped upper femoral epiphysis, developmental dysplasia of the hip, arthritis involving the hip, muscle disease (eg, inherited myopathies), and neurological conditions.

Toe-walking gait with absent heel contact

• Persistent toe walking is observed in spastic upper motor neurone neurological disease (eg, cerebral palsy). It can (rarely) be a presentation of mild lysosomal storage disorder.

Stepping gait

• The entire leg is lifted at the hip to assist with ground clearance.
• Occurs with weak ankle dorsiflexors, compensated by increased knee flexion.
• Observed in lower motor neurone neurological disease (eg,spina bifida, polio) and peripheral neuropathies (eg, Charcot-Marie-Tooth disease).

‘Clumsy’ gait

• This term is commonly used to describe difficulties in motor co-ordination (fine and gross motor skills).
• The child may present with frequent falls, and with difficulty in self-help skills such as dressing or feeding at school.
• Poor handwriting and learning disabilities may be noted.
• It is important to exclude specific, albeit mild, neurological disabilities (cerebral palsy, cerebellar ataxia, or lower motor neurone disorders), inflammatory arthritis or myopathies, and orthopaedic problems such as in-toeing.
• Dyspraxiais a term for children with delayed motor development who fall in the bottom 5% for their age group. By definition this includes 5% of children and is a late-maturation problem which tends to be familial and is more common in boys. It causes ‘clumsiness’ but there is no specifically altered gait.

How Can Rehab Basics Help?

We appreciate that every child is an individual and hence a personalised treatment plan will be agreed and implemented on discussion with parents and other professionals (if involved).   

Treatment plan will/may include:

• Hydrotherapy
• Encourage joint range of movement
• Improve Muscle strength and endurance
• Gait Analysis and Training
• Help with balance and co-ordination.
• Vestibular rehabilitation
• Posture management.
• Wheelchair assessment
• Improve stiffness and contractures
• Functional electrical Stimulation (FES)
• Working with the doctors to help with prescription of medication such as Diazepam, Baclofen, Botulinum toxin
• Splints/orthosis referral to appropriate department.
• Personalized home exercise programs.
• Recommendation to other services.

Depending on the condition Rehab Basics will work with the child and family to achieve child’s full potential.

Treatment Sessions are offered in clinics across Northamptonshire and Milton Keynes or at Home Environment.

 For further information about our service or to book an appointment with Rehab Basics please contact us

Hypotonia is the medical term for decreased muscle tone. Hypotonia is a symptom rather than a condition. It can be caused by a number of different underlying health problems, many of which are inherited.

Neurological conditions that affect the Central Nervous System and can cause central hypotonia include:

• Cerebral Palsy 
• Brain and Spinal Cord Injury – including bleeding in the brain
• Serious Infections – such as Meningitis (an infection of the outside membrane of the brain) and Encephalitis (an infection of the brain itself)

Neurological conditions that affect the Peripheral Nervous System and can cause peripheral hypotonia include:

• Muscular Dystrophy 
• Myasthenia Gravis 
• Spinal Muscular Atrophy
• Charcot-Marie-Tooth disease 

Non-neurological problems that can cause hypotonia in newborn babies and young children include:

• Down’s syndrome 
• Prader-Willi syndrome 
• Tay-Sachs disease 
• Congenital Hypothyroidism
• Marfan syndrome and Ehlers-Danlos syndrome 
• Connective Tissue Disorders 
• Being born prematurely (before week 37 of pregnancy) 

Hypotonia in later life

Hypotonia can sometimes occur in older children and adults, although this is less common. It can be caused by some of the problems mentioned above, but other possible causes include:

• Multiple Sclerosis 
• Motor Neurone Disease 

How Can Rehab Basics Help?

We appreciate that every child is an individual and hence a personalised treatment plan will be agreed and implanted on discussion with parents and other professionals (if involved).   

Treatment plan will/may include:

• Hydrotherapy
• Improve Muscle strength and endurance
• Gait Analysis and Training
• Help with balance and co-ordination.
• Vestibular rehabilitation
• Posture management.
• Wheelchair assessment
• Splints/Orthosis referral to appropriate department.
• Personalised home exercise programs.
• Recommendation to other services.

Depending on the condition Rehab Basics will work with the child and family to achieve child’s full potential.

Treatment Sessions are offered in clinics across Northamptonshire and Milton Keynes or at Home Environment.

 For further information about our service or to book an appointment with Rehab Basics please contact us

Also known as Functional Movement Analysis

Functional movement disorders (FMDs) are clinical syndromes defined by the occurrence of abnormal involuntary movements that are in congruent with a known neurological cause and are significantly improved on neurological exam with distraction or non-physiologic maneuvers.

People may have pain during a simple functional movement such as sitting to standing or may get pain after completing more complex movements required during their sport. In either case, it is useful to look and analyse how the body moves in order to investigate if there is a dysfunctional movement pattern present. For example, a person attending with ongoing low back pain may demonstrate poor flexibility in their hip during a squat. This causes compensatory and undesirable movement through the lower back and pelvis.

You may experience a number of symptoms, including:

• Tremor: Shaking in a limb that you cannot control is called a tremor. Tremors range from very minor to severe, which can be disabling. Some individuals have tremors that come and go.
• Jerks/twitches: You may experience jerky movements or twitching.
• Spasm/contractures: With spasms/contractures, your limbs may freeze in an awkward or uncomfortable position.
• Gait (walking) problems: You may encounter a variety of problems while walking (gait). For example, difficulty standing up straight when walking. You may walk unsteadily, drag one leg or be very afraid of falling.

The symptoms of functional movement disorders are very common and can be reversed. Research has shown that getting treatment can improve the chance that your symptoms will resolve.

How Can Rehab Basics Help?

Once a dysfunctional movement has been identified a treatment plan can be devised to correct and normalise the movement. An emphasis is placed on education and movement patterning re-training as well as exercise prescription and manual therapy to reduce pain and promote improved range of movement and flexibility.

Treatment may include the following:

• Hydrotherapy
• Retraining movement with diverted attention demonstrate normal movement in the context of meaningful activity such as walking.
• Stimulate automatically generated movement and prevent cognitively controlled movement. This can be achieved by altering the focus of motor attention, such as thinking about a different part of the movement or trying fast, rhythmical, unfamiliar or unpredictable movement.
• Task-orientated exercises to improve function and encourage implicit motor control. Meaningful automatic movement and muscle activity can be generated by weight bearing or automatic postural responses such as when sitting on an unstable surface (eg, a therapy ball). 
• Pain and Fatigue management. 
• Biofeedback technique such as Visualisation and Mirrors which can be help provide feedback to patients about their movements, posture or gait pattern which are often significantly different from how they imagine them to be. Moving in front of a mirror may also help distract attention from monitoring body sensations.
• Sensory Stimulation
• Transcutaneous Electrical Nerve Stimulation (TENS) 
• Functional Electrical Stimulation (FES)
• Assess, refer and encourage use of adaptive equipment to improve independence and quality of life. 
• Falls management. 

Treatment Sessions are offered in clinics across Northamptonshire and Milton Keynes or at Home Environment.

 For further information about our service or to book an appointment with Rehab Basics please contact us