Sensorimotor Integration

For each movement (responsibility of the motor system) that we make, there is a signal (responsibility of sensory system) that comes from the brain. This relay is impaired post stroke which causes muscle weakness and subsequent functional impairments. It is important to restore the sensorimotor system to achieve any improvement in the physical functioning of the body by the use of the following techniques:

• Proprioceptive Neuromuscular Stimulation: To improve orientation of the body position and movement by the use of icing, brushing and therapeutic hammer techniques.
• Positioning: Various round the clock positioning techniques are done to restore the correct muscle synergy patterns.
• Electrical Stimulation: Therapeutic galvanic currents are used to restore the relay of sensory signals from the brain to the muscles .

Strength Training 

Restoring correct sensory signals from the brain induces movement in the muscles for various functions of the body. Targeted approach to movement improves the range of motion and subsequently the strength in the upper and lower limb along with the trunk. Neuro physical therapists uses the following techniques to improve strength:

• Functional Electrical Stimulation (FES): These are low level therapeutic currents which mimics the electrical signals from the brain to the muscle to contract and move. Repetitive FES improves the gradual strength in the muscle.
• Hydrotherapy: Portable exercise therapy pool uses movement against the pressure of the water to induce strength in the muscles. It is a low impact exercise which reduces stiffness and prevents spasticity post stroke.
• Graded Exercise Program: These exercises range from simple forms to increase internal strength of the muscles to resistive techniques with the use of Thera bands, Thera tubes and weight cuffs.

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Functional Training: 

Restoring correct functional patterns of movement is very important for the Neuro physical therapist to focus as the brain is in a re-learning stage. Any wrong movement learnt or practiced at this stage leads to permanent impairments and restrictions in movements. The following aspects are covered in functional training:

• Balance and Coordination: These exercises focus on improving stability and preventing risk of fall using a body weight balance system.
• Constraint Induced Movement Therapy: Preventing the non-affected part from moving and focusing the affected part to be used for targets helps improve functioning of the affected part. This is especially effective for rehabilitation for fine movements of the hand.

Gait Training: Practicing walking patterns is the key part in the stroke rehabilitation program.