BRAIN TUMOUR SUPPORT GROUP

Physiotherapy Information

Most patients with brain tumours are high functioning so this talk is not to scare anyone.

It is to help you understand and access services should you need to.

Talk outline:

Role of the Physiotherpist

General advice on exercise and safety issues i.e. falls prevention

How to access Physiotherapy Services

Your brain tumour – or the surgery, radiation therapy or chemotherapy you may have had to undergo- can affect the amount of control you have in moving your body.

You or your family members may notice changes such as how easy it is to move a limb e.g. an arm, or how easy it is to walk.

That’s where physiotherapy comes in…

PHYSIOTHERAPY- CAN BEGIN AT ANY STAGE OF YOUR JOURNEY DEPENDING ON YOUR INDIVIDUAL NEEDS

Diagnosis

On treatment

After treatment

Survivorship

ROLE OF PHYSIOTHERAPY

1. To assess your physical problems

2. Help you maintain your independence

3. Help you to move safely

4. Provide equipment

5. Get you exercising and functioning again

ASSESSMENT:

Subjective (Your story) Tell the Physiotherapist about your

specific difficulties and safety concerns, as well as what you would like to achieve with physiotherapy.

Present condition (including surgery and chemotherapy or radiotherapy)

Past Medical History Old fractured ankleSocial history stairs, toilet, bathPrevious functional ability

ASSESSMENT:

Objective (Us looking at you)Strength arms, legs, trunkMovement of limbsSensation and co-ordinationBalance sitting, standing, with

movementWalking assessmentFunctional assessment sit-stand, in-

out of bed, stairs (Tip: Lead up with strong leg, down with weak leg- 2 rails)

FROM THE ASSESSMENT WE CAN

1. Help you set realistic Goals

2. Tailor a treatment plan to suit your individual needs

MAIN PROBLEMS A PHYSIOTHERAPIST TREATS

Muscle weakness (often on one side of the body)

Problems with co-ordination Problems with balance during movement,

standing or sitting Altered walking pattern may be unsteady,

may need to use a walking aid Reduced ability to perform everyday tasks such as getting in and out of bed,

standing up from a chair, climbing stairs. Provide Equipment

GENERAL SAFETY ADVICE FOR WALKING Start off slowly Have 1 person with you if you feel

unsteady or unsure Try to look ahead Turn slowly –many falls occur while

turning Try and walk little and often If you are unable to go outdoors, place a

chair at either end of a corridor and walk between them. Sit down and rest as needed.

Progress as you feel able. If you have any concerns about your walking or feel

unsteady/unsafe please contact your doctor

TIPS TO MANAGE PROBLEMS WITH BALANCE

The aim of physiotherapy is to allow you to continue with the activities you enjoy doing at home, but make you safe while doing them.

For standing activities at home you may feel it useful to perch on a high stool or sit in a chair

Example- Sit down to prepare vegetables Sit down to get dressed Sit down to load the washing machine

FALLS PREVENTION (PREDICTABLE SAFETY CONCERNS) Footwear- is often the cause of falls. NO flipflop slippers

or shoes that are too big, (they present an unstable base on which to walk). We would advise enclosed light footwear

Eliminate obstacles- Walk through your environment at home with

a family member and look at everything knee level and lower. Look out for short coffee tables that may become unseen obstacles, mats, especially in the bathroom (tape down edges, replace with non-slip mats or remove temporarily)

FALLS PREVENTION…..CONTINUED

Pay close attention to the bathrooms- Consider a secure stool to sit on in the shower, a non-slip surface on the shower floor, and grab bars in the shower and adjacent to the toilet.

(Occupational Therapy referral may be appropriate)

Going to the toilet at night- Consider nightlights to help with safe movements

during the night or a urine bottle beside the bed if you feel unsteady walking at night.

Avoid bending down- Loading washing machine, bending down to turn on TV- place seat in front.

Consider a mobile phone for safety- keep it on you!

HAND FUNCTION EXERCISES

If you have problems with a hand activity, make the task a little bit easier and practice it.

If you don’t use it you loose it……. Remember to use both hands.

Opening and closing zips Doing/undoing buttons Sketching with pencil and pad Writing with pen/pencil- Puzzles or

Crosswords Reading-turning the pages in a book or paper Opening and closing bottles

FATIGUE

It is common to experience fatigue following surgery or during Radiotherapy (70-100%)

Managing fatigue is a balance between rest and exercise

Note- If you are not sleeping at night this will leave you tired the next day and you will not be as able physically. Talk to your Dr. if you are having trouble sleeping. Attending Psycho-oncology relaxation session may help.

TIPS ON FATIGUE MANAGEMENT Pace yourself, Save your energy for the most important

things.

Schedule activities at times of peak energy and put off non-essential tasks

Try easier or shorter versions of activities you enjoy. For example- Take short walks or do light exercise if possible.

Rest- Plan your day so that you have time to rest. Take short naps or breaks that do not interrupt night-time sleep

Become comfortable asking others to help with things that you used to be able to do alone.

Minimise visitors

Try to develop consistent sleep habits (go to bed and get up at the same time every day).

HOW TO ACCESS PHYSIOTHERAPY: WHILE ON TREATMENT

After surgery or while on Radiotherapy or chemotherapy: -if you are in hospital receiving your treatment (In-

patient) or attending the hospital/centre daily for your treatment (outpatient) physiotherapy is normally available.

If you think you would benefit from physiotherapy, talk

to your medical team to arrange a referral. Ask them again if you don’t hear from a physiotherapist.

Rehabilitation may be: - gym based (space, treatment beds, bike,

parallel bars and other specialist equipment available) - ward based- Exercise programme (bed or

chair) and walking program

HOW TO ACCESS PHYSIOTHERAPY:AFTER FINISHING TREATMENT After finishing your treatment or later, you may still

have physiotherapy needs.

If so you may need to be linked in with your local physiotherapy community services

You can access these by asking your GP or Public Health Nurse to refer you

- Physio. may visit you in your home or - You may be given the option to attend an out- patient gym or day hospital

USEFUL LINKS:WWW.ISCP.IEWWW.FINDAPHYSIO.IE