Articles
Articles
Explanations, guides and checklists from the people running the programmes — plus what changed, what we published and what we got wrong. Definitions and outcome measures are in the glossary.
Neurological 
NeurologicalWhen should rehabilitation start after a stroke?
Rehabilitation starts in the stroke unit, within days, as soon as the patient is medically stable. What the evidence cautions against is very high-dose out-of-bed activity in the earliest hours after stroke. The practical question for families is not whether to start early but what the programme delivers once it has started.Read moreNeurological How long does it take to recover from a stroke?
Most recovery after a stroke happens in the early months, when the brain is most able to reorganise, and it continues more slowly for a longer period after that. How far someone gets depends mainly on how severe the stroke was, where it happened and how much active therapy follows.Read more
OrthopaedicHow long does recovery take after a knee replacement?
Most people move quickly from a walking frame to managing without an aid indoors. The part patients are rarely told is that strength and confidence keep improving for a long time afterwards, and that the early weeks of the programme set how far that improvement goes.Read moreOrthopaedic How long does sciatica last?
Sciatica often improves substantially within a few weeks to a few months, especially when it is caused by a disc pressing on a nerve root, because the disc material frequently shrinks with time. Some people have symptoms for longer or recurrences. Staying active, exercise and targeted pain relief help, while sudden weakness or bladder changes need urgent care.Read moreOrthopaedic Can a herniated disc heal without surgery?
Yes, many herniated discs improve without surgery. The disc material that presses on a nerve often shrinks or is reabsorbed over weeks to months, and larger extrusions are more likely to regress than small bulges. Most people are treated with activity, exercise and pain relief, and surgery is reserved for specific situations.Read more
PaediatricIntensive blocks or weekly sessions: which helps a child more?
Neither is better in general, and the honest answer depends on the goal. Blocks suit a specific, trainable target within a few weeks. Weekly therapy suits goals that need daily life to change around them. What predicts progress in both is practice of the real task, not the format.Read morePaediatric Will my child with cerebral palsy walk?
Many children with cerebral palsy walk, with or without aids, but it depends on the severity of motor involvement. The Gross Motor Function Classification System helps predict likely mobility. Early milestones matter: in a large study of children not yet walking at age two to three, being able to sit or pull to stand strongly predicted later walking.Read morePaediatric What do the GMFCS levels mean in cerebral palsy?
The Gross Motor Function Classification System (GMFCS) describes how children with cerebral palsy usually move, in five levels. Level I means walking without limitations, level II walking with limitations, level III walking with a hand-held aid, level IV limited self-mobility often using powered mobility, and level V being transported in a wheelchair.Read more
Rheumatologic Should you exercise during a rheumatoid arthritis flare?
Yes, but not the same exercise. During a flare the work shifts to gentle range of motion, positioning and protecting the inflamed joint, while strengthening and loading wait. Stopping altogether costs strength that takes far longer to rebuild than the flare takes to settle.Read moreRheumatologic Is walking good for knee osteoarthritis?
Yes, for most people walking is safe and helpful with knee osteoarthritis. Exercise reduces pain and improves function, and in a large observational study people who walked for exercise were less likely to develop frequent knee pain. Start at a comfortable distance, build up gradually and combine walking with strengthening exercises for greater benefit.Read moreRheumatologic Which exercises help ankylosing spondylitis?
Regular exercise is a core part of managing ankylosing spondylitis alongside medication. Programmes that combine stretching, spinal mobility, strengthening, breathing and aerobic exercise can reduce pain and help maintain function. Exercise helps most when done consistently over the long term. Stiffness that improves with movement is typical of this condition.Read more
Topic
Sports
Sports When is it safe to return to sport after an ACL reconstruction?
Not on a date, and not on how the knee feels. The safest published approach combines time and testing: wait until the graft and muscles are genuinely ready, then pass a battery of strength and hop tests before returning to pivoting sport. Waiting longer, up to a point, reduced reinjury risk substantially.Read moreSports How long does a sprained ankle take to heal?
A mild ankle sprain often settles within a few weeks, while moderate and severe sprains can take considerably longer, sometimes months. Early movement, protected weight-bearing and exercise speed recovery more than prolonged rest. Balance training and, for some people, a brace reduce the risk of spraining the same ankle again.Read moreSports How long does a pulled hamstring take to heal?
Mild hamstring strains often allow a return to sport within a few weeks, while more severe injuries, particularly those involving the tendon, can take several months. A trial in elite sprinters found that lengthening-type exercises shortened return to training compared with conventional exercises. Nordic hamstring exercises reduce the risk of future injury.Read more
Geriatric What actually prevents a second fall?
Not being careful, and not a grab rail on its own. The interventions with the strongest evidence are challenging balance exercise done several hours a week and sustained, plus a review of medication, vision, blood pressure and the home. A first fall is the signal to start that review.Read moreGeriatric Which exercises are safe with osteoporosis?
Most people with osteoporosis can exercise safely, and exercise strengthens bones and muscles and reduces falls. A UK consensus recommends resistance and impact exercise for bone strength, strength and balance training to prevent falls, and back extension exercises for posture. People with spinal fractures should keep impact to the level of brisk walking and avoid heavy forward bending.Read moreGeriatric Can muscle lost with age be rebuilt?
Yes. Muscles respond to strength training at any age. In a trial of frail, very elderly nursing home residents, a short course of progressive resistance training substantially increased muscle strength and improved walking speed. Sarcopenia, the age-related loss of muscle strength and mass, responds to regular strengthening exercise and adequate nutrition.Read more
Cognitive Can memory and attention improve after a brain injury?
Yes, though not usually by restoring the damaged function itself. The approaches with the strongest evidence teach strategies and train attention in the tasks that matter, so the person manages daily life better even where the underlying memory has changed permanently. That distinction shapes the whole programme.Read moreCognitive Does exercise help people living with dementia?
Exercise may help people with dementia stay more independent in daily activities such as walking, dressing and getting out of a chair. Research has not shown that it slows memory decline or reverses dementia. Regular, adapted activity also supports balance, mood, sleep and fitness, and it can reduce the risk of falls.Read moreCognitive What is visual neglect after a stroke?
Neglect is a problem with attention, not eyesight, in which a person does not notice or respond to one side of space or their own body, usually the left side after a right-sided stroke. They may eat food from only one side of the plate or bump into doorways. Scanning training and practical strategies help, and safety measures are important.Read more
Lymphoedema and lipoedema Lipoedema or lymphoedema: why the diagnosis changes the treatment
They look similar and are managed differently. Lymphoedema is protein-rich swelling from a failing lymphatic system, usually asymmetrical, and it involves the foot. Lipoedema is a symmetrical, painful fat distribution disorder that characteristically spares the feet. Compression helps both; drainage and weight loss do not help them equally.Read moreLymphoedema and lipoedema How likely is lymphoedema after breast cancer, and can it be prevented?
Arm lymphoedema is a recognised risk after breast cancer treatment, with higher risk after removal of many lymph nodes and in people who are overweight. Keeping a healthy weight, gradually building strength and recognising early swelling help. Carefully progressed weight training did not increase lymphoedema risk in a randomised trial.Read moreLymphoedema and lipoedema How do compression garments help lymphoedema?
Compression garments apply steady pressure to a swollen limb, which reduces fluid build-up and supports lymph flow, especially during movement. They are used to maintain the reduction achieved with bandaging or therapy. A garment must fit correctly, be worn daily as advised and be replaced regularly. Garments are often worn during exercise.Read more
Oncologic Is it safe to exercise during chemotherapy?
For most people, yes. International cancer exercise guidelines conclude that exercise is generally safe during and after treatment and that everyone should avoid inactivity. Exercise can reduce fatigue, anxiety and depression and help maintain fitness. Programmes are adjusted around treatment cycles, blood counts and symptoms, and some situations need medical advice first.Read moreOncologic What helps cancer-related fatigue?
Exercise and psychological approaches have the strongest evidence for relieving cancer-related fatigue. A large meta-analysis found that exercise, psychological therapy and the combination reduced fatigue during and after treatment, while medicines did not significantly help. Pacing, sleep routines and treating causes such as anaemia also matter.Read moreOncologic What helps chemotherapy-induced peripheral neuropathy?
Chemotherapy-induced neuropathy causes numbness, tingling or pain, usually in the hands and feet. No medicine is recommended to prevent it, so doctors may adjust chemotherapy if symptoms become intolerable. Duloxetine is the only medicine with adequate evidence for painful neuropathy, with limited benefit. Balance training, foot care and safety measures help reduce falls.Read more
Cardiac Is it safe to exercise after a heart attack?
Supervised exercise after a heart attack is one of the better-evidenced treatments in cardiology, and reviews find it reduces cardiovascular death and hospital readmission. The risk of a serious event during a supervised session is very low. Unsupervised, unprescribed exertion is a different question with a different answer.Read moreCardiac What are the phases of cardiac rehabilitation?
Cardiac rehabilitation usually runs in stages: early mobilisation and education in hospital, a recovery period at home, a supervised exercise and education programme over several weeks, and long-term maintenance of an active, heart-healthy lifestyle. Exercise-based cardiac rehabilitation reduces hospital admissions and heart attacks in people with coronary heart disease.Read moreCardiac Is exercise safe with heart failure?
For people with stable heart failure, supervised and personalised exercise is safe and recommended. Exercise-based cardiac rehabilitation reduces hospital admissions and improves quality of life. Programmes start gently, are adjusted to symptoms and medicines, and gradually build aerobic fitness and strength. Worsening breathlessness, swelling or rapid weight gain need medical review before continuing.Read more
Pulmonary How does exercise help breathlessness in COPD?
Exercise does not repair damaged lungs, but it trains the muscles to use oxygen more efficiently, so everyday activities cause less breathlessness. Pulmonary rehabilitation, a supervised programme of exercise and education, improves breathlessness, fatigue, quality of life and walking distance in people with COPD. Benefits fade without continued activity.Read morePulmonary Which breathing techniques help with COPD?
Pursed-lip breathing, diaphragmatic breathing, breathing control and positions that ease breathlessness are commonly taught to people with COPD. A Cochrane review found that breathing exercises improved walking distance, although effects on breathlessness and quality of life were inconsistent. They are usually taught alongside exercise training in pulmonary rehabilitation.Read morePulmonary How can pacing help long COVID fatigue?
Pacing means balancing activity and rest to stay within your energy limits and avoid crashes. Many people with long COVID experience post-exertional malaise, a worsening of symptoms after physical or mental effort. Pacing, planning activities, and increasing activity cautiously and only when stable are safer than pushing through fatigue.Read more
Amputee How soon after an amputation can a prosthesis be fitted?
The first prosthesis usually comes weeks after surgery, once the wound has healed and the limb has stopped changing shape. What decides the date is healing, swelling and skin condition rather than a calendar. The rehabilitation that makes the prosthesis usable starts long before it arrives.Read moreAmputee What is phantom limb pain, and how is it treated?
Phantom limb pain is pain felt in the part of a limb that has been amputated. It is common after amputation. It is real pain arising from changes in the nerves and brain. Treatment combines medicines, residual limb care, prosthetic fitting, mirror therapy and other techniques that retrain the brain.Read moreAmputee How long does it take to learn to walk with a prosthetic leg?
Learning to walk with a prosthetic leg usually takes several months and continues to improve for a year or more. Progress depends on the amputation level, the cause, general fitness, the residual limb and the prosthesis. Rehabilitation starts before the prosthesis is fitted and focuses on strength, balance, walking practice and preventing falls, which are common.Read more
Obesity How can you exercise when your weight makes your joints hurt?
Low-impact activities such as water-based exercise, cycling, seated exercise and short walks reduce stress on painful joints while building fitness and strength. Water exercise improved pain and disability in people with knee and hip osteoarthritis. Starting gently, building up gradually and combining exercise with dietary changes gives the greatest benefit for joints.Read moreObesity How much weight loss is needed to reduce knee pain?
For people with overweight and knee osteoarthritis, a meta-analysis found that losing a modest amount of body weight significantly improved physical disability. Losing weight meaningfully reduces the load on the knee with every step. Greater weight loss combined with exercise gave more pain relief in a large trial.Read more
Topic
Burn
Burn How can scar contractures be prevented after a burn?
Scar contractures, where tightening scars limit joint movement, are common after significant burns, especially around the neck, hands and arms. Positioning, splinting, early and regular movement, stretching and scar management from the first days after injury help prevent them. Rehabilitation often continues for months while scars mature.Read moreBurn Do pressure garments and scar massage help burn scars?
Pressure garments and scar massage are widely used to manage raised burn scars, but the evidence is limited. A meta-analysis found pressure garments slightly reduced scar height without changing overall scar appearance. Scar massage showed preliminary benefits for scar height, pain and itch. Both are usually part of a broader scar management plan.Read more
Treatments and technology Does robotic walking training work?
After stroke, robot-assisted walking training combined with physiotherapy increases the chance of walking independently, especially for people who cannot walk soon after their stroke. It gives a small gain in walking speed but not walking distance. After spinal cord injury, evidence is inconclusive. Robots add to, rather than replace, conventional therapy.Read moreTreatments and technology Who benefits from exercise in water?
Water-based exercise suits people whose pain, weight, weakness or balance problems make land exercise difficult, including those with knee and hip osteoarthritis and fibromyalgia. Trials show small improvements in pain and function with aquatic exercise, similar to land-based exercise. Warm water can ease stiffness, while people with heat sensitivity may need cooler pools.Read moreTreatments and technology Does shockwave therapy work?
Shockwave therapy uses pressure waves to treat persistent tendon and soft tissue pain. For plantar heel pain that has not improved with conservative care, trials show it reduces pain more than placebo. Evidence for other conditions is more mixed. It is usually considered after exercise and simpler treatments.Read more
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