Physiotherapy for neurological diseases: challenges and opportunities
Sometimes our own body throws a spanner in the works. Sudden paralysis, shaking legs - according to the WHO, more than a billion people worldwide suffer from a neurological disease. At the top of the list are strokes, Parkinson's disease and epilepsy. These and other diseases often have a very serious impact on the lives of those affected and lead to a significant reduction in quality of life.
As a physiotherapist, you play an important role in the treatment of these diseases. But how can you best help your patients? Which therapy methods are most effective? In order to answer these questions, it is very important to always stay up to date with the latest research.
In this blog post, we would like to share with you the latest research on the effectiveness of physical therapy in treating neurological disorders. We hope that this post will provide you with valuable insights and help you to provide the best possible support to your patients.
Find out here:
- How do neurological diseases arise?
- How can physiotherapy help?
- The latest research results
- Challenges and limitations
1. How do neurological diseases arise?
Our brain is the control center of our body. It coordinates our movements, thoughts, emotions and sensory perceptions. But sometimes disruptions can occur in the system.
Neurological diseases can arise from a variety of factors such as 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 occur due to a sudden loss of blood supply to the brain and cause serious damage.
2. How can physiotherapy help?
A diagnosis of a neurological disorder can turn life upside down. Everyday tasks suddenly become a challenge and movements that were once second nature can be difficult or impossible. But there is hope. Physical therapy can help relieve symptoms and improve mobility.
Through specific exercises and techniques, physical therapy 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 physical therapy are used for neurological diseases?
There are different types of physical therapy that can be used for neurological conditions. Some of the most common are:
- Bobath therapy: Bobath therapy is a special form of physical therapy that focuses on the treatment of patients with neurological diseases. The aim 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. The technique can be used to improve movement control and balance in patients with neurological diseases such as stroke, Parkinson's disease or multiple sclerosis.
- Functional electrical stimulation (FES): FES uses electrical stimulation to produce muscle contractions and assist movement. The 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 is about improving 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 that analyzes and improves 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 results
The treatment of neurological diseases through physiotherapy is currently being intensively investigated. The available results show promising effects, which indicate that physiotherapy can play an important role in improving the quality of life of patients with neurological diseases.
Specifically, it has been shown that physiotherapy achieves significant improvements in physical function in conditions such as stroke, Parkinson's disease and multiple sclerosis. Various methods are used, such as movement exercises that improve muscle strength and balance, as well as specific exercises that promote mobility and coordination.
Furthermore, technologies such as robotics and virtual reality have been shown to have a positive impact on the effectiveness of physical therapy.
We have summarized some interesting studies for you here:
Parkinson's disease
A systematic review and meta-analysis by Mehrholz et al. from 2018 examined the effectiveness of physical therapy 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 physical therapy can bring about significant improvements in mobility, balance, gait and quality of life in Parkinson's patients. In particular, physical therapy improved walking speed and walking distance. Balance also improved and the risk of falls was reduced. The results of the meta-analysis also showed that the longer and more intensive the treatment, the greater the effectiveness of physical therapy.
multiple sclerosis
In 2021, a team of researchers from the University of Cologne conducted a study that examined the effectiveness of physiotherapy in patients with multiple sclerosis. The patients performed exercises that were specifically tailored to their individual physical limitations. These included, for example, strength exercises for the legs, 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 confirms the importance of individually tailored physiotherapy for patients with multiple sclerosis and shows that targeted exercises can improve physical functions and quality of life.
stroke
A study published in the Journal of NeuroEngineering and Rehabilitation investigated the use of a robotic exoskeleton combined with virtual reality to treat stroke patients. The study included 60 participants who were randomized to receive either the robotic exoskeleton group or a control group that received standard rehabilitation.
Participants in the robotic exoskeleton group underwent six weeks of rehabilitation during which they performed specific movement exercises assisted 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 robotic exoskeleton group had significantly improved motor functions and walking ability compared to the control group. The study therefore suggests that the combination of robotics and virtual reality can be a promising method for the rehabilitation of stroke patients.
epilepsy
There is limited research to date on the use of robotics and virtual reality to treat epilepsy. However, a recent 2021 systematic review examined the use of virtual reality as an adjunct to standard treatment for epilepsy 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 treatment for epilepsy can lead to a significant reduction in seizure frequency and intensity.
For example, some of the virtual reality technologies studied included immersive virtual environments aimed at reducing stress and anxiety, as well as interactive games and simulations used to improve cognitive abilities.
Although further research is needed in this area, these results show that virtual reality may be a promising approach as an adjunct to standard treatment for epilepsy.
4. Challenges and limitations
As you can see, physical therapy is an important tool in the treatment of neurological diseases. But science is far from finished on the subject.
For this article, we sat down with the Leipzig neurologist Jens Schäfer, who himself conducts research into the effectiveness of physiotherapy. He now shares his knowledge with us in an interview.
Mr. Schäfer, why do you think there are so few studies examining the effectiveness of physiotherapy in neurological diseases?
Jens Schäfer: "The effectiveness of physiotherapy in neurological diseases has not yet been sufficiently researched. One possible reason for this could be that such studies are often very complex and costly 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 patients' progress."
How can physiotherapists use and implement the research results?
Jens Schäfer: "By individually adapting the therapy plans, physiotherapists can recommend specific exercises and movements that are tailored to the patient's specific deficits and limitations. It is also advisable to familiarize yourself with the latest technologies. Robots and exoskeletons are a valuable addition to the practice and can support patients in their motor rehabilitation."
Would you also recommend interdisciplinary collaboration?
Jens Schäfer: "Absolutely! I personally work with physiotherapists, but occupational and speech therapists can also support the treatment. By working together with other specialists, physiotherapists ensure 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 limits that must be taken into account. In cases of severe neurological diseases, such as advanced stages of multiple sclerosis or severe traumatic brain injuries, physiotherapy may not be enough to provide adequate support to the patient. Even if the damage is very severe and the affected area of the brain is irreversibly damaged, physiotherapy can only help to a limited extent. Therefore, physiotherapy alone is not a suitable treatment approach and should instead be considered as a valuable supplement."
Conclusion
The effect of physiotherapy in the treatment of neurological diseases is a broad field that still raises many questions. However, studies that have already been carried out promise a positive outlook for the future.
As a physiotherapist, you have many opportunities to use the latest research findings to support your patients in your practice. Be it special exercises, robotics or virtual reality. By working with specialists in neurology, occupational therapy and speech therapy, new ways can be found to alleviate the symptoms of multiple sclerosis, Parkinson's and the like.