Upper Limb Rehabilitation

Often feared by physiotherapists- the upper limb can be challenging to rehabilitate after neurological damage.

Why? It needs more rehab, takes more time, and sometimes it can be so complex that physiotherapists don't know where to start.

At Cortex Neuro Rehab, Upper Limb rehabilitation is one of our strengths. We confidently manage upper limb impairments for all neurological conditions, and all levels of severity.

Constraint-Induced Movement Therapy

CIMT is the most researched and best supported upper limb rehab therapy in the world!

So if you're eligible, it's the gold-standard treatment and the best rehab option we can offer you.

CIMT is for people with 'mild to moderate' upper limb impairment. That means you need some movement in your hand- if you can grasp and release with your hand (like a tissue or facewasher), then you likely have enough movement in your hand to benefit.

CIMT has evidence for improving arm function in people who've had a stroke and other brain injuries, multiple sclerosis, incomplete spinal cord injuries and Parkinson's disease.

Ashan Weerakkody from Cortex Neuro Rehab is an expert in CIMT and has delivered over 100 CIMT programs to patients in Perth.

He also provides training to physiotherapists across Australia to learn how to provide this effective therapy.

Hemiplegic shoulder pain

Shoulder pain is common in neurological conditions.

Just because it's common, doesn't mean it's ok.

Several factors contribute to shoulder pain.

Weakness
Muscle imbalances
Spasticity/muscle tone changes
Contracture (muscle shortening)
Subluxation (partial dislocation)
Poor joint alignment
Joint restriction
Altered pain processing
Tendon pathology

Shoulder pain can be due to one or many of these factors.

At Cortex Neuro Rehab, we are experts at diagnosing the cause of your shoulder pain and then developing an evidence-based plan to treat and manage your pain.

Severe upper limb impairment

This is a huge area of challenge in neurological rehab, where we're still waiting on the research to give us conclusive guidance on how best to manage people with very little movement in their arm and hand. (If you've got some movement, we should be providing CIMT!)

But there are some trends we see in the research. Firstly, the dose and intensity of rehab is most important. That means you need to use and move your arm, a lot, like 2-3 hours a day a lot!

Functional task practice is key, but it's important to incorporate active strength training into any upper limb rehabilitation program- because it's usually weakness that's stopping you using your arm.

But what happens when you don't have enough movement to practice tasks? Other tools that we can use include electrical stimulation, particularly EMG-triggered stimulation, mirror box therapy and active motor training.

At Cortex Neuro Rehab, we strongly believe that all upper limbs have the potential to improve and work with you towards realistic, achievable goals.

Get in touch!

PO Box 52

North Beach, WA 6920

0421 796 268

Ashan@cortexneurorehab.com.au