acupuncture

Acupuncture is one of the oldest established forms of healthcare in the world. The focus is on you as an individual, not your illness, treating you holistically. Treatment involves the insertion of very fine needles through your skin at strategic points on your body. Traditional Chinese medicine explains this as a technique for balancing the flow of energy known as qui or chi.

Acupuncture can be used for pain relief as well as to improve blood flow and stimulate the nerves and muscles.

Functional Electrical Stimulation (FES)

FES is a technique used to produce contractions in paralysed muscles by the application of small pulses of electrical stimulation to nerves that supply the paralysed muscle. The stimulation is controlled in such a way that the movement produced provides useful function. FES is used as an aid to assist walking and also as a means of practicing functional movements for therapeutic benefit.

FES can be effective where movement has been lost due to nerve injury / disease within the brain or spinal cord.  This is called an upper motor neuron lesion.  This includes people who have:

  • Stroke
  • Multiple sclerosis
  • Spinal cord injury, T12 and above
  • Parkinson’s disease
  • Cerebral palsy
  • Head injury
  • Familial or hereditary spastic paraparesis
  • Other conditions affecting the spinal cord or brain

The most common use of FES is for the correction of dropped foot but it can also be used to strengthen and re-educate the movement of other muscles for example in the hand, arm or shoulder. FES can also be used in orthopaedic conditions where muscle weakness is due to disuse or inhibition.

By restoring lost functional activities such as walking and climbing stairs, independence and confidence as well as social interaction are greatly enhanced.

group work

There are a colourful variety of groups that will be an important part of your rehabilitation. These take place daily and they will be suited to individual needs. These groups will be a fun way of regaining lost skills as well as learning new ones during your stay.

  • kitchen skills
  • gardening group
  • book club
  • media/news/current affairs society
  • computer/IT skills
  • breakfast club
  • lunch club
  • music therapy
  • pilates
  • tai chi
  • creative hub
  • shopping  group
  • wheelchair skills
  • pub games
hydrotherapy

Our Hydrotherapy pool is fully accessible to wheelchair users or individuals with limited mobility via a ceiling hoist. We are able to assist with individuals getting dressed before and after sessions as required. The changing rooms are also fully accessible, with one having a shower bed for ease of showering for those people with reduced balance.

Hydrotherapy is physiotherapy carried out in our-state-of-the-art stainless steel therapy pool with a water temperature of 34 degrees. This creates a wonderful environment for rehabilitation promoting pain relief, muscle relaxation and increased freedom of movement, thus aiding the rehabilitation process.

Hydrotherapy allows movement to be achieved in the pool that would otherwise not be possible on dry land. This gives confidence and motivation to enable further progression in the rehabilitation journey.

neuropsychology
  • Changes in thinking, such as: reduced attention span and greater distractibility, difficulties holding the thread of a conversation, poor short term memory, and problems with planning and problem solving can be common consequences following some form of acquired brain injury.
  • Neuropsychological testing is completed with the individual on admission to identify their current strengths and weaknesses, which will help guide the rehabilitation programme. Neuropsychological tests are paper and pencil tests that ‘tap’ into different areas of the brain, including memory, perception, language, and changes in the front part of the brain (including planning and problem solving and aspects of attention).
  • In addition to testing, time will be spent with the individual and family in order to complete a detailed history and background. The focus is always on: what is important to the individual and family (rehab goals have to be meaningful); and ways of increasing independence.

Development of a rehabilitation programme

Following team assessment, a rehabilitation programme will be developed by all members of the team to ensure joint working towards identified goals. A thorough behavioural and emotional assessment will also be completed. Each individual will be provided with a rehabilitation timetable of daily activities, which will enable individuals to practise skills learned in therapy sessions and within the structured unit environment.

Cognitive rehabilitation

The main focus of cognitive rehabilitation is to create a detailed understanding of an individual’s strengths and weaknesses and find alternative ways (often by playing to an individual’s strengths) of functioning in daily life. Neuropsychology works closely with Occupational therapy and Speech and Language therapy to identify appropriate strategies.

occupational therapy

Occupational therapy provides practical support to empower people to facilitate recovery and overcome barriers to doing the activities (or occupations) that matter to them. This support increases people’s independence and satisfaction in all aspects of life.

“Occupation” as a term refers to practical and purposeful activities that allow people to live independently and have a sense of identity. This could be essential day-to-day tasks such as self-care, work or leisure.

Occupational therapists play a critical role in helping people of all ages overcome the effects of disability caused by illness, ageing or accident so that they can carry out everyday tasks or occupations. They consider all of the patient’s needs – physical, psychological, social and environmental. This support can make a real difference giving people a renewed sense of purpose, opening up new horizons, and changing the way they feel about the future.

Occupational Therapy assessment will consider:

  • assess a client’s ability to function at an optimal level, despite barriers
  • how activities which the person needs or wants to do can be modified or adapted to make them easier
  • how clients feel about themselves and their ability to tackle problems
  • how the physical and social environment can be altered so that restrictions are reduced
  • work with individuals, families and support workers so they understand the importance of taking part in everyday activities

Occupational Therapy interventions may include:

  • enabling people improve their self-care, e.g. by supporting them to use washing machines or to cook for themselves
  • enabling people to manage their money by learning budgeting skills and how to use banks
  • support people to live independently by providing systems to assist in dealing with, for example, mail and bills or negotiating with neighbours
  • enabling people to get involved in activities around the home, such as cooking
  • supporting people to develop parenting skills
  • work with people to identify and improve work skills, apply for jobs and stay in employment
  • enable people to access and use mainstream leisure activities
  • provide advice on how much assistance a person may need to live independently in the long-term

Occupational therapists help people to develop a personally satisfying routine of everyday activities that creates a sense of purpose and enhances the person’s recovery journey. RCOT 2017

Workplace Rehabilitation

Workplace Rehabilitation, also known as vocational rehabilitation, is a process which helps a person with a health problem remain in work, or prepare to get back to work after illness or injury. Within occupational therapy, work is considered to include paid employment and unpaid employment. For example, unpaid employment can include volunteering, studying, housework, gardening, and leisure activities.

Workplace Rehabilitation enables a person to identify physical or mental health issues which may cause them difficulty in tasks either at their work, in their home or in the community. We consider carefully all the influencing factors in a person’s daily activities, and work in partnership to try and find solutions to the problems they are experiencing.

Workplace rehabilitation may include:

  • assessment and treatment of the person to maximise their ability to work
  • assessment of home and work environments and make recommendations for equipment or adaptations which will support the person to keep working or return to work
  • provision of information and links to other key resources that may support them, e.g. other agencies (Job Centre Plus, Citizens Advice Bureaux, Healthy Working Lives), equipment resources, information about their health condition or information about legislation that may support them
  • completion of AHP Advisory Fitness for Work Reports for employees, employers or doctors
  • Transferable Skills Analysis – a set of tests or logic to determine what positions a person may fill if their previous position no longer exists in the local job market, or they can no longer perform their last position, because of an injury, for example. Transferable skills are determined by analysing past accomplishments or experience. For instance, a stay-at-home parent might find they have skills in budgeting, child development, food services, property management etc
  • work site assessment/job demands analysis – understanding the demands a particular job places on the person. The process grades the task components in detail and provides a thorough analysis of the processes enabling the assessor to provide advice on work role adjustments
physiotherapy

Physiotherapy is a physical medicine and rehabilitation specialty that remediates impairments and promotes mobility, function, and quality of life through examination, diagnosis, prognosis, and physical intervention. We have a team of neuro and orthopaedic specialist physiotherapists and will use a variety of different “hands on” treatment techniques and assisted technology.

psychological therapies

Depression and anxiety can be common following some form of acquired brain injury. Without treatment, these symptoms can lead to greater difficulty coping and increased distress. Cognitive behavioural therapy and related interventions can help individuals reduce their symptoms of anxiety and depression. CBT can also be helpful when addressing chronic pain, as part of a wider multidisciplinary team approach. Approaches to management of mood are considered within the overall rehabilitation programme.

Trauma work 

For individuals who have experienced a significant trauma and are presenting with post traumatic stress symptoms, following assessment, individuals will be offered some form of trauma focused psychological treatment. Evidence based interventions recommended by NICE include:

  • Trauma focused CBT – a course of therapy whereby individuals learn new skills to help process thoughts and feelings related to the traumatic event
  • Eye movement desensitisation and reprocessing (EMDR) is a treatment that uses eye movements to stimulate the brain. It’s been shown to make distressing memories feel less intense. EMDR can help a person deal with traumatic memories, such as those that occur after an accident, or after sexual, physical, or emotional abuse. In particular, NICE recommends EMDR for treating post-traumatic stress disorder (PTSD)

Other psychological therapies offered, dependent on an individual’s presenting problems and outcome of assessment can include:

  • Interpersonal Therapy – a time limited therapy, supporting individuals to manage depressive symptoms associated with grief and loss / role changes.
  • Acceptance and Commitment Therapy (ACT) – a unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behaviour change strategies, to increase psychological flexibility.
  • Mindfulness approaches – help to focus on thoughts and feelings without becoming overwhelmed by them. They can be used to help treat depression, stress, anxiety, and addiction. Techniques such as yoga, meditation and breathing exercises can also be incorporated. NICE recommends mindfulness-based therapies to help people avoid repeated bouts of depression. (NHS Choices)
  • Compassion Focused Therapy – CFT is used to treat underlying self criticism and shame, which can be at the core of mental health problems
  • Counselling – a type of talking therapy that allows a person to talk about their problems and feelings in a confidential and dependable environment. A counsellor is trained to listen with empathy (by putting themselves in your shoes). They can help you deal with any negative thoughts and feelings you have. Sometimes the term “counselling” is used to refer to talking therapies in general, but counselling is also a type of therapy in its own right. (NHS Choices)

 

 

psychological arts therapies

STEPS are delighted to be working with award-winning Chroma, a national provider of specialist neuro-rehabilitation therapeutic services. Through their team of art psychotherapists, neurologic music therapists and dramatherapists, Chroma’s experienced team work closely alongside our team at STEPS. Chroma work to shared patient goals by designing arts-based interventions that seek to optimise rehab outcomes and re-frame the client’s relationship with rehabilitation. Chroma currently offer group and individual therapy programs, which include working with families and the next of kin. 

speech and language therapy

Speech and language therapists (SLT) assess and treat speech, language and communication problems in people of all ages to help them better communicate. They also work with people who have eating and swallowing problems and require tracheostomy care.

spasticity management

Botox (Botulinum Toxin) injections can be used to treat clients with severe muscle stiffness (spasticity) or abnormal limb positioning following stroke, or as a result of other neurological conditions, including multiple sclerosis or dystonia.

These injections are given via a special needle into the muscle or muscles that are over active. Physiotherapy is then needed to provide exercises and stretches and in some cases wearing a splint is also necessary. Botox only works when it is carried out in conjunction with physiotherapy.

It takes 7-10 days to take effect and usually injections are repeated every 3-4 months if found effective.  The STEPS spasticity management clinic  offers this service to residential and day clients.

vestibular rehabilitation

Vestibular Rehabilitation uses a range of specialist exercises and manual techniques to treat dizziness and balance difficulties. These difficulties may arise due to problems with the inner ear such as BPPV (benign paroxysmal positional vertigo) or Vestibular Neuritis or alternatively due to head injury, concussion or vestibular migraine. Two of our Physiotherapists have completed post graduate training in Vestibular Rehab and have a keen interest in this area. More information can be found here or visit vestibular.org