Next up in our Neuro series from Sarah is a number of other conditions that we see in clinic…
Multiple Sclerosis
Multiple sclerosis (MS) is a long-term condition where the body's immune system mistakenly attacks the protective coating (called myelin) on nerves in the brain and spinal cord. This attack on the nerves disrupts the way messages travel between your brain and the rest of your body, leading to symptoms such as weakness, fatigue, vision problems, sensory changes, coordination issues and difficulty walking. Each person with MS presents differently and symptoms can change over time.
Physiotherapy is beneficial for people with MS as it uses tailored exercises and movement techniques to maintain muscle strength, assist with walking and balance and reduce fatigue – all in turn helping to make everyday tasks easier and reducing a person’s risk of falls. Studies have shown that structured physiotherapy and exercise programs can noticeably improve mobility, muscle strength, overall fitness and quality of life in people with MS.2
Cerebral Palsy
Cerebral palsy (CP) is a lifelong condition that starts when a child’s developing brain is affected before or shortly after birth6. This means the brain doesn’t communicate as smoothly with the muscles, leading to challenges with movement, balance, posture, and coordination6. Some people with CP have mild difficulty walking or speaking, while others may need more support. CP can impact on a person’s independence across the lifespan – from participation in play, school, sports, social or community activities6. CP is non-progressive (it doesn’t get worse over time) and can’t be cured, but with the right help and support, people with CP can achieve their best potential6.
Research demonstrates how physiotherapy can play a key role in helping people with CP improve their movement and ability to do every day activities3. This research suggests that goal-orientated functional training, where therapy is focused on meaningful tasks unique to the individual, are effective ways to improve movement and walking speed in children who have CP3. High quality research has also demonstrated that hydrotherapy showed significant improvements in gross motor function, balance, muscle tone, and quality of life in children with CP11.
Peripheral neuropathy
Peripheral neuropathy is a condition where there is damage to the nerves outside the brain and spinal cord. This disruption to the signals between the body and brain can lead to different symptoms such as sensory changes, pain, balance problems, and muscle weakness especially in the hands and feet.
Physiotherapy plays an important role in people who have peripheral neuropathy by using exercises and movement strategies to help improve walking, balance, and muscle strength. Research shows that targeted exercise programs – such as strength, balance, and gait training – can improve mobility, reduce symptoms, and enhance quality of life for people with diabetic or chemotherapy-induced neuropathy.5,8,9
Spinal Cord Injury
A spinal cord injury (SCI) happens when the nerves in the spinal cord are damaged, usually from trauma or sometimes from an illness. As the spinal cord carries signals between the brain and the body, damage can cause weakness, paralysis, altered sensation, or problems with bladder or bowel control. The effects depend on where the injury is in the spial cord and how severe it is – some people may lose movement in their legs (paraplegia), others may have changes in both arms and legs (tetraplegia). Physiotherapy can often help people with SCI manage symptoms such as weakness, poor motor skill and cardiorespiratory function, and decreased joint movement.
Research suggests that exercise-based physiotherapy can help improve strength, cardiorespiratory fitness, contracture management, and quality of life for people with SCI, while also reducing complications like pressure sores and secondary health issues4.
Traumatic Brain Injury
A traumatic brain injury (TBI) happens when the brain is damaged by a sudden force – such as a blow to the head, fall, car accident or sports injury. Depending on how severe it is, TBI can cause problems with thinking, memory, movement, balance, speech or emotions. Some people fully recover, while some may have long-term challenges with daily activities.
Physiotherapy intervention after TBI helps people to regain strength, coordination and balance, while also re-training movements required in everyday life. Research shows that structured, task-specific physiotherapy can improve walking speed, mobility, and independence in people with TBI, supporting better quality of life and long-term recovery.7
References
Ali A, Tabassum D, Baig SS, Moyle B, Redgrave J, Nichols S, McGregor G, Evans K, Totton N, Cooper C, Majid A. Effect of Exercise Interventions on Health-Related Quality of Life After Stroke and Transient Ischemic Attack: A Systematic Review and Meta-Analysis. Stroke. 2021 Jul;52(7):2445-2455. doi: 10.1161/STROKEAHA.120.032979.
Amatya, B., Khan, F., Galea, M. Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews. Cochrane Database of systematic Review 2019, Issue 1. Art. No.: CD012732. DOI: 10.1002/14651858.CD012732.pub2.
Das SP, Ganesh GS. Evidence-based Approach to Physical Therapy in Cerebral Palsy. Indian J Orthop. 2019 Jan-Feb;53(1):20-34. doi: 10.4103/ortho.IJOrtho_241_17.
Glinsky JV, Harvey LA. Physiotherapy management of people with spinal cord injuries: an update. J Physiother. 2024 Oct;70(4):256-264. doi: 10.1016/j.jphys.2024.09.008.
Gracia-Sánchez A, López-Pineda A, Nouni-García R, Zúnica-García S, Chicharro-Luna E, Gil-Guillén VF. Impact of Exercise Training in Patients with Diabetic Peripheral Neuropathy: An Umbrella Review. Sports Med Open. 2025 Jun 15;11(1):75. doi: 10.1186/s40798-025-00863-4.
Jackman, M., Sakzewski, L., Morgan, C., Boyd, R.N., Brennan, S.E., Langdon, K., Toovey, R.A.M., Greaves, S., Thorley, M. and Novak, I. (2022), Interventions to improve physical function for children and young people with cerebral palsy: international clinical practice guideline. Dev Med Child Neurol, 64: 536-549. https://doi.org/10.1111/dmcn.15055
Leanne Hassett, Physiotherapy management of moderate-to-severe traumatic brain injury, Journal of Physiotherapy, Volume 69, Issue 3, 2023, Pages 141-147, ISSN 1836-9553, https://doi.org/10.1016/j.jphys.2023.05.015.
Melese H, Alamer A, Hailu Temesgen M, Kahsay G. Effectiveness of Exercise Therapy on Gait Function in Diabetic Peripheral Neuropathy Patients: A Systematic Review of Randomized Controlled Trials. Diabetes Metab Syndr Obes. 2020 Aug 5;13:2753-2764. doi: 10.2147/DMSO.S261175.
Streckmann F, Balke M, Cavaletti G, Toscanelli A, Bloch W, Décard BF, Lehmann HC, Faude O. Exercise and Neuropathy: Systematic Review with Meta-Analysis. Sports Med. 2022 May;52(5):1043-1065. doi: 10.1007/s40279-021-01596-6.
Studenski S, Duncan PW, Perera S, Reker D, Lai SM, Richards L. Daily functioning and quality of life in a randomized controlled trial of therapeutic exercise for subacute stroke survivors. Stroke. 2005 Aug;36(8):1764-70. doi: 10.1161/01.STR.0000174192.87887.70. Epub 2005 Jul 21. PMID: 16040590.
Tao Y, Cao Z, Shin MC, Chen M, Han S. The effects of hydrotherapy on athletic ability in children with cerebral palsy: A systematic review and meta-analysis. PLoS One. 2025 Jun 10;20(6):e0325517. doi: 10.1371/journal.pone.0325517.
Tomlinson CL, Patel S, Meek C, Herd CP, Clarke CE, Stowe R, Shah L, Sackley CM, Deane KHO, Wheatley K, Ives N. Physiotherapy versus placebo or no intervention in Parkinson's disease. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD002817. DOI: 10.1002/1