Comprehensive Assessment and Intervention for Neurological Conditions such as Stroke and Traumatic Brain Injury

Following a stroke or brain injury patients may have problems affecting movement, posture, function and pain.


Neurological Physiotherapy aims to tap into the body’s own ability to recover called Neuroplasticity. Neuroplasticity occurs when unused circuits or synapses develop new connections allowing the brain and the nervous system to reorganize itself. Neurological Physiotherapy works by targeting stimulation of the brain through movement and activation the limbs and muscles and also through repetitive practise of everyday tasks. This allows these new connections to be as effective and efficient as possible. Detailed assessment including the utilization of outcome measures allows progress to be monitored and assists with determining which treatments are the most effective.


Treatments may also involve the stretching of tight muscles, strengthening of weak muscles, improving efficiency through the realignment of joints, practising balance tasks, walking re-education and sensory rehabilitation.

Assessment of Vestibular and Balance Problems

Our ability to balance is coordinated by three systems - the visual system, the vestibular system in the inner ear, and the somatosensory system which consists of sensors in our joints, muscles and skin, particularly of the feet and ankles. Patients can be disorientated and their balance affected if there is a problem with one or more of these systems. An accurate assessment can determine which factors are contributing to balance problems and programs developed to target any identified issues and reduce falls.

Spinal Cord Injury

Following Spinal Cord Injury, Neurological Physiotherapy assists with maximizing recovery and achieving optimal function. The maintenance of flexibility, posture, and respiratory function, and the prevention of osteoporosis are a priority. Treatment may consist of practising transfers and wheelchair skills, and standing programs and walking re-education if appropriate. Physiotherapists can assist with the prescription of equipment and aids.

Vestibular System Dysfunction

Problems with the vestibular system in the inner ear can lead to problems with vertigo, dizziness and imbalance. Head or body movements, movements of the environment, uneven ground, crowds, supermarket aisles and escalators can all provoke these problems. A detailed assessment (utilizing infrared goggles) can determine which part of the vestibular system is not functioning correctly. Problems with the Vestibular System include Benign Paroxysmal Positional Vertigo, (BPPV) Unilateral or Bilateral Vestibular Hypofunction, Labyrinthitis or Neuronitis, Vestibular Migraine, Vestibular Schwannoma (Acoustic Neuroma), Central Vestibular problems including Stroke, MS or brain injury and age related vestibular problems. Treatment techniques include repositioning or liberatory manoeuvrers for Benign Paroxysmal Positional Vertigo, or Vestibular Rehabilitation for other forms of vestibular dysfunction

Progressive Neurological Conditions such as Parkinson’s Disease and MS

The aim of Physiotherapy in progressive neurological conditions such as Parkinson’s and Multiple Sclerosis is to preserve independence and quality of life. Physiotherapy can slow disease progression through maintaining muscle length, muscle strength, balance, posture and mobility for as long as possible. Exercise can be given to improve the efficiency of pathways, techniques can be given to make movement easier and falls prevention programs are offered. Referral to other Practitioners for assistive aids can be advised and facilitated.

Vestibular Rehabilitation

Vestibular Rehabilitation is the utilization of specific exercises to eliminate or reduce vestibular problems. Some exercises aim to facilitate vestibular compensation, or allow for repeated exposure or habituation to provoking symptoms. Balance exercises assist in the co ordination and functioning of the systems that control balance graduating through progressively challenging circumstances and complex environments.

Hypertonicity Management

Often following an injury or damage to the brain and spinal cord, hypertonicity can result. This presents as stiffness, spasming or posturing of one or more body parts. Neurological Physiotherapy can assist with reducing or managing hypertonicity through specific rehabilitation to correct muscle imbalance after Botox injections and/or serial casting to progressively lengthen tight muscles.

Aquatic Physiotherapy

Aquatic Physiotherapy or targeted physiotherapy interventions in a water environment is incredibly beneficial in patients with neurological conditions. The assistance or resistance of water can be manipulated to strengthen muscles. The support and warmth of the water can help to relieve pain and for patients with balance problems it can minimise the fear of falling. It is an ideal and safe environment for improving cardiovascular endurance.

Education and Advice

Following a stroke or accident, or being diagnosed with a progressive neurological disease, can be an extremely anxious and confusing time. With over twenty years’ experience working within the field of neurological physiotherapy, Libby can offer education and advice about specific neurological conditions. As well as lifestyle management and fatigue management, Libby has developed professional relationships with treatment providers in the Toowoomba region and can refer patients if required. This collaborative approach reduces duplication of services and ensures that all providers are working towards the achievement of patient’s goals.

Improving Cardiovascular Endurance or Fitness and Prevention of Secondary Complications

One problem common to most patients with Neurological or Vestibular dysfunction is lack of cardiovascular endurance or fitness. Due to the risk of provoking symptoms many people with vestibular dysfunction avoid movement leading to neck stiffness, head tension, reduced ability to exercise and access environments outside the home. For patients with neurological dysfunction often fatigue is a major problem. There is an increase risk and fear of falling and anxiety about exercising safely. For heart and lung health, weight management and general wellbeing, it is vital these patients are given the opportunity, the appropriate programmes and safe environments in which to exercise. Reclaim! Neurological Physiotherapy can offer advice and assistance to ensure any secondary complications are minimised.

Home Exercise Programs

To maximise neuroplasticity and recovery, a specific home exercise programme is crucial to build on the skills learnt in Physiotherapy sessions.

Medicolegal Reports

The provision of independent and objective reports for Law Firms and Insurance Companies to assist with determining the extent of an injury, impact on function, treatment and equipment needs.


Concussion is a traumatic brain injury that can cause lasting effects on brain tissue and change the chemical balance of the brain. Concussion may cause both short-term and long-term physical, cognitive, and behavioural symptoms. Some of the most common problems experienced by patients following a concussion include dizziness, balance problems, and problems with motion and motion sensitivity. Physiotherapists can assist with recovery following a concussion by offering advice and education about the amount of rest required to allow the brain to heal and resolve symptoms in a timely manner. Problems with intolerance to exercise as well as weakness and a lack of endurance (following a period of rest) can occur after a concussion and your physiotherapist will devise a programme to ensure that your return to work/study and sport is as safe as possible, while closely monitoring symptoms. Physiotherapists can offer treatment for dizziness, headaches and imbalance that may result from a concussion, including stretches, strength and range of motion exercises, vestibular rehabilitation and eye exercises, hands-on techniques, including mobilization and massage, and balance re-education.

Home or Community Based Rehabilitation

Physiotherapy interventions are not restricted to the practice scenario. Achievement of goals, return to work, sport and leisure pursuits are strongly encouraged. Therefore, treatments are offered in an environment to ensure this is a reality.