Conditions

An Acquired brain injury describes a range of issues resulting from trauma to the brain. The causes of an acquired brain injury include, but are not limited to, concussion, hypoxia (loss of oxygen), and major vessel bleed. Acquired brain injuries can result in reduced independence for activities of daily living, mobility issues, reduced balance and falls, reduced exercise tolerance and challenges with thinking, memory, and speech. Treatment of an acquired brain injury requires a team of health professionals working collaboratively to achieve an individual’s goals.

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Benign Paroxysmal Positional Vertigo is a common cause of dizziness. People with this condition experience brief episodes of vertigo (dizziness) triggered by changes in head position. This can occur with activities such as rolling, turning your head, or dressing. It can cause significant impairments in a person’s quality of life and interrupt participation in work and in daily activities. BPPV can also contribute to an increased risk of falls.

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Brain tumours can cause a vast array of symptoms dependent on the location of the tumour within the brain. Symptoms can include headaches, dizziness, loss of strength, mobility issues, reduced balance and challenges with thinking, memory, and speech. Treatment requires a team of health professionals working collaboratively to achieve an individual’s goals.

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Cerebellar Ataxia is a condition impacting the area of the brain called the Cerebellum and can result in difficulty executing voluntary movements. It can present with a range of physical symptoms, including difficulty with coordination, reduced balance, reduced strength, impaired ability to stand and walk, visual and speech issues.

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Cerebral Palsy is a condition that results from a brain injury early in life; before, during or shortly after birth. It is considered non-progressive whereby it does not worsen over time, however the symptoms can vary over time as the body ages. There are four main types of cerebral palsy, however we treat each individual according to their specific needs.

The four main types of cerebral palsy:

• Spastic: people with this type present with stiffness, weakness, difficulty moving
• Dystonic or athetoid: people with this type present with involuntary or uncontrolled movements of their body
• Ataxic: people with this type present with poor coordination and balance
• Mixed: a combination of these types

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Charcot-Marie Tooth (CMT) is a disorder that causes damage to the peripheral nervous system. The peripheral nerves transmit information from the brain and spinal cord to the rest of the body. They also transmit sensory information such as touch and proprioception (position) back to the spinal cord and brain. This can cause difficulty with muscle contraction, weakness, difficulty with mobility and reduced or altered sensation.

CMT usually becomes noticeable in adolescence or early adulthood, but the onset of disease can occur at any age.  Because longer nerves are affected first, symptoms usually begin in the feet and lower legs and then can affect the fingers, hands, and arms. CMT, also known as hereditary motor and sensory neuropathy, is one of the most common inherited neurological disorders.

The therapists at Steps have an expert understanding of your condition and will provide a comprehensive and compassionate assessment of your goals and your needs.

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Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a condition that results in progressive weakness and loss of sensation in the arms and legs. It is caused an abnormal immune response, resulting in damage to the peripheral nervous system.

People with CIDP often present with reduced independence in daily living activities, weakness, balance disturbances and falls, reduced co-ordination especially with fine motor tasks, reduced or altered sensation, reduced exercise tolerance and cardiovascular fitness, complex assistive technology needs, and home modification needs.

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Friedreich’s Ataxia is a genetic disorder that causes damage to the nervous system. Ataxia describes a loss of coordination, which results from the degeneration of nerve tissue in the spinal cord and the nerves that control muscle movement. Individuals with Fredereich’s Ataxia often present with reduced independence for activities of daily living, walking difficulties, balance disturbances and falls, weakness, reduced co-ordination, movement difficulties, poor spinal posture and foot posture and associated pain, reduced exercise tolerance, complex assistive technology and home modification needs, and speech difficulties.

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Functional Neurological Disorder (FND) is a problem with the functioning of the nervous system and how the brain and body send and receive signals. The resulting symptoms can affect an individual’s quality of life in a way that is similar to other neurological conditions. Symptoms of FND are variable but may include physical, sensory, and cognitive symptoms. A neurologist can make an FND diagnosis with a detailed history and positive signs.

At Steps, our clients with FND often present with reduced independence for activities of daily living, weakness, cognitive difficulties, balance disturbances and falls, paralysis, reduced coordination, seizures, movement and sensory issues.

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Guillain-Barre Syndrome (GBS) is an autoimmune disease, resulting in degeneration of the peripheral nervous system. This causes weakness and changes in sensation, which usually starts in the arms and legs, and if left untreated can progress to the rest of the body. The onset of symptoms can occur rapidly over hours or days, or slowly over weeks.

At Steps, our clients with GBS often present with reduced independence for activities of daily living, weakness, balance disturbances and falls, reduced co-ordination, poor sensation, pain, reduced exercise tolerance and complex assistive technology and home modification needs.

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Hereditary Spastic Paraparesis (HSP) is an inherited, degenerative disorder that causes progressive weakness and stiffness of the lower limbs. At Steps, our clients with Hereditary Spastic Paraparesis often present with reduced independence for activities of daily living, weakness, balance disturbances and falls, movement difficulties, reduced exercise tolerance and cardiovascular fitness, complex assistive technology and home modification needs.

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Hereditary Spinocerebellar Ataxia (SHA) is an inherited condition which impacts the cerebellum, an area in the brain involved in coordinating movement. Individuals with HAS often present with reduced balance and coordination, muscle stiffness, reduced sensation, reduced upper limb function, and cognitive changes amongst other symptoms.

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Huntington’s disease is a degenerative condition of the central nervous system. This causes changes with cognition, voluntary movements, physical and emotional function. A common symptom of Huntington’s disease is “chorea” which is involuntary muscle movements.

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Hypoxic Brain Injury occurs when there is insufficient oxygen supply to the brain, which causes permanent damage. This damage can cause a range of issues including medical complications, movement and mobility issues, speech disturbances, cognitive impairments, and behavioural and personality changes.

At Steps, our clients with hypoxic brain injuries often present with reduced independence for activities of daily living, weakness, balance disturbances and falls, reduced co-ordination, movement difficulties, reduced exercise tolerance and cardiovascular fitness, complex assistive technology and home modification needs, and memory and thinking issues.

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Motor Neurone Disease is a collective term for a range of conditions. These diseases impact motor neurones, which are involved in activating muscles and producing voluntary movements. The primary symptom of Motor Neurone Diseases is muscle weakness.

There are different types of Motor Neurone Diseases including:

• Amyotrophic Lateral Sclerosis (ALS)
• Progressive Bulbar Palsy (PBP)
• Progressive Muscular Atrophy (PMA)
• Primary Lateral Sclerosis (PLA)

At Steps, our clients with Motor Neurone Diseases present with reduced independence for activities of daily living, weakness, movement difficulties, difficulty with speech and swallowing, respiratory issues, complex assistive technology and home modification needs.

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Multiple Sclerosis (MS) is a neurodegenerative condition, characterised by progressive muscle weakness. In individuals with MS, the immune system causes deterioration of the nervous system. Visual, motor, sensory, cognitive, psychological, and bowel and bladder systems can be affected.

There are three main types of MS:

• Relapse-remitting MS
• Secondary progressive MS
• Primary progressive MS

At Steps, our clients with MS often present with reduced independence for activities of daily living, sensory disturbances, muscle weakness, gross and fine motor incoordination, fatigue, and cognitive challenges.

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Muscular dystrophy (MD) is a group of genetic conditions that results in progressive weakening of the muscles. There are many types of MD with specific signs and symptoms. Common symptoms include decreased strength, generalised progressive weakness, reduced gross motor skills.

At Steps, our clients with Muscular Dystrophy present with reduced independence for activities of daily living, weakness, movement difficulties, difficulty with speech and swallowing, respiratory issues, complex assistive technology and home modification needs.

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Parkinson’s Disease is a degenerative disorder of the central nervous system. It impacts an area of the brain which produces dopamine. This results in a range of motor issues including tremor, difficulties with coordinating movement, rigidity, issues with walking and balance.

At Steps, our clients with PD present with uncontrollable movements such as shakiness, stiffness, difficulty with balance and coordination, gait disturbances, difficulties with activities of daily living.

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Poliomyelitis is a disease caused by the Polio virus, which affects the nervous system. Individuals who have had Poliomyelitis can develop Post-Polio Syndrome, which is not contagious but can cause a range of physical issues. Post-Polio Syndrome is a degenerative condition which can result in weakness, joint pain and stiffness, fatigue and muscle tightness.

At Steps, our clients with Post-Polio Syndrome often present with reduced independence with mobility, muscle weakness, reduced range of motion, fatigue, reduced cardiovascular fitness, joint and muscle pain.

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Spinal Cord Injury refers to damage to an area of the spinal cord. They can have a traumatic, or atraumatic cause. Spinal Cord Injuries are classified using the ASIA system, which identifies the motor and sensory impairment associated with the level of injury. They can be complete or incomplete injuries, leading to a wide range of physical presentations.

At Steps, our Spinal Cord Injury clients present with reduced independence with mobility and transfers, muscle weakness and tightness, shoulder pathologies, complex assistive technology and home modification needs.

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Spinal Muscular Atrophy is a genetic disease which impacts motor neurones. Motor neurons are essential in producing voluntary muscle activation. In this condition, signals from the brain to activate peripheral muscles unable to transmit properly, causing weakness over time.

At Steps, our clients with Motor Neurone Diseases present with reduced independence for activities of daily living, weakness, movement difficulties, difficulty with speech and swallowing, respiratory issues, complex assistive technology and home modification needs.

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A stroke occurs when there is an interruption of blood supply to the brain, causing permanent damage to an area of the brain. This can be localised to one area or more widespread, and often will impact one side of the body more than the other. Stroke can cause a range of issues including muscle weakness and tightness, speech and swallowing difficulties, cognitive and memory impairment, reduced independence with mobility and transfers.

At Steps, our clients with Stroke present with reduced independence with walking, standing and transfers, weakness, difficulty with memory and cognition, difficulty with speech and swallowing, complex assistive technology and home modification needs.

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A Subarachnoid Haemorrhage occurs when there is bleeding in the membranes surrounding the brain. This is commonly caused by a burst blood vessel, which causes blood to collect in the space between the brain and the skull, and results in pressure on the brain.

At Steps, our clients with Subarachnoid Haemorrhage present with reduced independence with walking, standing and transfers, weakness, difficulty with memory and cognition, difficulty with speech and swallowing, complex assistive technology and home modification needs.

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Transverse Myelitis is an inflammatory disorder of the spinal cord. This interferes with signals from the central nervous system (brain and spinal cord) traveling to and from the peripheral nervous system. The result of which includes muscle weakness and abnormal sensory input. Individuals present with reduced muscle strength, sensory symptoms, pain, impaired thermoregulation amongst other symptoms.

At Steps, our clients with transverse myelitis present with reduced independence with walking, standing and transfers, weakness, pain, complex assistive technology and home modification needs.

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Traumatic Brain Injury occurs when there is direct trauma to the head, causing damage to the bran. This damage can be localised to one area of the brain or cause more widespread damage. Common causes of traumatic brain injuries include motor vehicle accidents and falls. This brain damage causes a range of issues including medical complications, movement and mobility issues, sensory issues, speech disturbances, cognitive impairments, behavioural and personality changes.

At Steps, our clients with traumatic brain injuries often present with reduced independence for activities of daily living, weakness, balance disturbances and falls, reduced co-ordination, movement difficulties, reduced exercise tolerance and cardiovascular fitness, complex assistive technology and home modification needs, and memory and thinking issues.

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The vestibular system is a sensory system that is part of your inner ear. It controls your balance, parts of your vision and your ability to know where your body is in space. The vestibular system coordinates with your sensory system and your vision, to provide the information to your brain for normal balance, vision and perception of where you are in space (spatial awareness). Dysfunction of the vestibular system causes, dizziness, loss of balance, walking with a lack of coordination, risk of falls, blurred vision and increased anxiety.

Vestibular dysfunction is caused by many different presentations:

• BPPV (Benign Paroxysmal Positional Vertigo)
• Vestibular migraine
• Labyrinthitis/vestibular neuritis
• Meniere’s disease
• Stroke

Vestibular rehabilitation is a patient centred, evidence based treatment that uses exercises for balance, movement (to reduce motion triggered dizziness), and eye exercises to help the brain adapt to a new normal.

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