Initial assessment involves gathering information about you and the impact your illness/injury has had on you. Carla will ask for some medical information including any other conditions you have and your current medication. Carla will then assess your movement - this includes detailed analysis of your arm/leg/trunk, which muscles are working and which are not, and your current level of function e.g. your ability to stand/walk, if you are able. It may also include activities such as climbing stairs and balance, depending on your level of ability when we first meet. Some patients are not at this level yet, so assessment may be more focused on things like posture in the chair and being able to sit unsupported.
Maximise Rehab is a goal based service. This means we are always working with you towards your goals - all your treatment sessions and programmes will be designed to help you achieve them. In order for us to do that, we will need to establish some initial goals after your assessment. This allows us to plan your treatment and put in place the programmes to help you recover. This may involve a discussion about setting goals which are realistic.
Goals are vitally important to your progression. Recovery from injury or illness can be long in terms of time and hard work. If your goal(s) is not important enough to you, you will lack the motivation to keep going when you hit tough times. Work out you 'why' - WHY do you want your arm to move again?; WHY do you want to walk again? - keeping your WHY in mind will help drive you forwards.
Goals can be long term or short term. Often a number of short term goals will feed into your longer term goal. Setting your goals will be done with you, not for you, and recorded and reviewed on a regular basis. If you achieve some of your goals, you may wish to set new goals which reflect progress. Your therapy programmes will then be updated to reflect your new goals.
As well as having a record of your goals,outcome measures are an objective measure of your improvement over your time with therapy. These might include simple things like assessments of your level of function (e.g. walking, balance) before and after, or might include questionnaire's for you to complete. These can be useful for both the therapist and for yourself, as they can help to show you how much you've improved over time.
Your treatment plan will be based on where you are at at the time of your assessment, and the goals you wish to achieve. Carla will discuss how best to proceed with treatment and how best Maximise Rehab can support your recovery. Some patients have good support at home (e.g. from family, friends, carers) and are able to complete their programmes without direct supervision (self management). Others prefer more therapy input. You chose how you want your programme to be delivered - for example - a 'blended' approach of face to face visits and telerehab/virtual appointments, or all online or face to face.
Treatment is likely to include a number of different treatment modalities, all of which will be individually tailored to your needs. These might include:
- personalised exercise programme - this could include stretching, strengthening, movement control, balance; 'active-assisted' movements may be recommended if you are not able to move/control the limb yourself yet. Exercises can be progressed with use of weights/resistance bands where appropriate
- movement and gait retraining
- manual techniques (e.g. massage, mobilisations, myofascial release)
- use small pieces of equipment e.g. gym balls
- everyday activities to practise in a therapeutic way
- use of electrotherapy (e,g, as a muscle stimulators)
- advice on use of splints / orthotics
- mental imagery / visualisation techniques
- mirror therapy
- kinesio taping
- saebo products for upper limb retraining
- practise and progression of walking aids
- where it is safe to do so - walking practise (both indoors and outdoors), step and stairs practise, balance activities, and accessing the community.
We are always adding new treatment techniques and adjuncts (e.g. equipment) to our repertoire. Keep checking back for updates.
Once you have reached a point where you are no longer seeing further improvement, it is important to maintain your new level of function. Some of this can be done through repetition of daily activities and being mindful of constantly engaging your more affected side (stroke). Others may need a bespoke maintenance exercise programme. We encourage you to self manage this, perhaps with the support of your family/friends/carers, but we recognise that some people like to continue with regular access to their therapists, perhaps to maintain motivation. Maximise Rehab can deliver cost-effective maintenance programmes, which will assist you to stay at your optimum level of functioning, for as long as you want us to.