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Neurological rehabilitation: articles and guides
Stroke, brain injury, spinal cord injury, multiple sclerosis and Parkinson's — the conditions most people travel here for.
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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 moreNeurological Can you walk again after a stroke?
Many people walk again after a stroke, including many who cannot stand at first. The chances are highest when some leg movement returns early and when walking practice starts as soon as it is safe. Walking often comes back before full arm recovery, sometimes with a stick, splint or other support.Read moreNeurological Will my arm and hand recover after a stroke?
Arm and hand recovery after a stroke varies more than walking recovery. Early return of some shoulder or finger movement makes useful recovery much more likely. Repeated, meaningful practice of reaching, grasping and releasing is what drives improvement, and even a partly recovered hand can be trained to help with daily tasks.Read moreNeurological Why am I so tired after a stroke, and what helps?
Fatigue after a stroke is a recognised effect of the brain injury, not laziness or ordinary tiredness. It can appear even after a small stroke and may not improve with a night's sleep. Checking for treatable causes, pacing activity, improving sleep and treating low mood are the main ways to manage it.Read moreNeurological What causes shoulder pain after a stroke, and how is it treated?
Shoulder pain on the weak side is common after a stroke. It usually comes from a combination of muscle weakness that lets the joint slip, stiffness, strain from lifting or pulling the arm, and spasticity. Careful positioning and handling help prevent it, and treatment targets the specific cause found on examination.Read moreNeurological How is spasticity treated, and does botulinum toxin help?
Spasticity is muscle stiffness caused by damage to the brain or spinal cord. It is treated when it causes pain, limits movement or care, or risks permanent shortening of muscles. Stretching, positioning and exercise come first; tablets help widespread stiffness, and botulinum toxin injections reduce stiffness in specific muscles for several months at a time.Read moreNeurological What is foot drop, and can it be treated?
Foot drop is difficulty lifting the front of the foot, so the toes catch the ground when walking. It is a sign rather than a disease, caused by a problem in the brain, spinal cord, spinal nerve roots or the nerve below the knee. Treatment depends on the cause and often combines exercise, an ankle brace or electrical stimulation.Read moreNeurological How can walking and freezing be improved in Parkinson's disease?
In Parkinson's disease, walking becomes slower with shorter steps, and some people suddenly freeze as if their feet are glued to the floor. Medication timed well, specific physiotherapy using cues such as lines on the floor or a rhythm, strength and balance training, and home changes that reduce triggers can make walking safer.Read moreNeurological What kind of exercise is safe with multiple sclerosis?
Exercise is safe for most people with multiple sclerosis and does not trigger relapses. Aerobic activity, strength training, balance work and stretching can improve fitness, walking, fatigue and mood. The key is to start at a comfortable level, progress gradually, manage heat sensitivity and adapt activities to mobility.Read moreNeurological Is it an MS relapse or a pseudo-relapse?
Under NICE guidance, an MS relapse is new or clearly worsening symptoms lasting more than 24 hours, caused by new inflammation in the nervous system. A pseudo-relapse is a temporary return of old symptoms triggered by heat, infection, stress or fatigue, without new inflammation. This matters because treatment differs: triggers are treated, and steroids are reserved for true relapses.Read moreNeurological What can be recovered in the first year after a spinal cord injury?
Most neurological recovery after a spinal cord injury happens within the first year, and it is usually greater when the injury is incomplete. The level and completeness of injury, measured with the ASIA scale, guide expectations. Rehabilitation aims to use every recovered function and to build independence even where movement does not return.Read moreNeurological What are the stages of recovery after a traumatic brain injury?
Recovery after a moderate or severe traumatic brain injury often moves through stages: reduced consciousness, a period of confusion called post-traumatic amnesia, active rehabilitation, and return to home and community life. People move through these stages at different speeds, and the length of post-traumatic amnesia is one of the most useful guides to severity.Read moreNeurological Why do concussion symptoms last for weeks or months?
Most people recover from a concussion within a few weeks, but some have headaches, dizziness, fatigue, poor concentration or low mood for longer. Persisting symptoms usually reflect several overlapping problems, such as neck strain, balance system disturbance, disrupted sleep and anxiety, and each can be treated. Gradual return to activity helps more than prolonged rest.Read moreNeurological Can speech come back after aphasia?
Speech and language often improve after aphasia, especially in the first months after a stroke, and many people keep improving for longer with therapy. Speech and language therapy improves everyday communication, understanding, reading and writing compared with no therapy. The amount and intensity of practice matter, and families play a major role.Read moreNeurological Why does swallowing go wrong after a stroke, and how is it retrained?
A stroke can weaken or slow the muscles and reflexes that move food and drink safely from the mouth to the stomach. This is called dysphagia and can cause choking, coughing or chest infections. Early screening, specialist assessment, adapted food and drink, positioning and swallowing exercises help many people return to normal eating.Read moreNeurological How does peripheral neuropathy affect balance and walking?
Peripheral neuropathy damages the nerves that carry sensation from the feet, so the brain receives less information about where the feet are and what the ground is like. People then rely more on vision, which makes them unsteady in the dark or on uneven ground. Balance and strength training, foot care, good footwear and home safety measures reduce falls.Read moreNeurological What is BPPV, and how do repositioning manoeuvres work?
Benign paroxysmal positional vertigo, or BPPV, causes short bursts of spinning dizziness when the head moves, such as rolling over in bed or looking up. It happens when tiny calcium crystals in the inner ear move into the wrong place. A simple head repositioning manoeuvre carried out by a trained clinician usually moves the crystals back and relieves symptoms.Read moreNeurological Is depression after a stroke common, and does it slow recovery?
Depression is common after a stroke, and it can appear early or months later. It reduces energy and motivation for rehabilitation and is linked to poorer recovery. It is treatable with psychological support, medicine, activity and social contact, so low mood should be asked about rather than accepted.Read more
