10 most common mistakes made by neurological physiotherapists.
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A neurological physiotherapist is one of the essential professions in the rehabilitation of patients with neurological conditions. However, like any professional group, physiotherapists also make various kinds of mistakes.
Some mistakes have no bearing on the rehabilitation process, while others affect it considerably. A therapist’s mistake does not mean therapy slowing down because of natural differences between patients — it means acting in a way that hinders the whole therapeutic process. It is worth setting these alongside the mistakes made by patients and carers during stroke rehabilitation.
10 most common mistakes made by neurological physiotherapists
MISTAKE 1: Having no plan for the patient.
The most common mistake in the long-term care of a patient is the lack of a defined goal, a strategy for improving motor and sensory function, and a realistic aim to achieve within a given course of therapy.
MISTAKE 2: Giving the patient all the information about their deficits at once.
Young therapists often want to tell the patient the whole truth about how they are functioning, which can leave them demotivated. It is better to release information gradually, so that the patient works towards a realistic goal and improves their deficits at the same time, without being emotionally overwhelmed.
MISTAKE 3: Good advice given in the wrong way.
When working with a patient and their family, you should use plain language. Instead of medical jargon, it is better to give instructions in a way that is easy to understand and possible to apply at home and outside the treatment room.
MISTAKE 4: Moving on to the next task without preparing the body for movement.
You should not force the point by trying to prove that a patient will quickly stand or start walking if they have not yet mastered the earlier positions. Motor re-education within neurological rehabilitation programmes has to be carried out in stages: from lying down, through half-sitting and sitting, up to higher-level functions.
MISTAKE 5: Performing movements the patient will never use in everyday life.
Exercises should be practical and possible to repeat at home. If a task is too complicated or requires special equipment, the patient usually will not do it, and this brings progress in therapy to a halt.
MISTAKE 6: A lack of cooperation between therapists.
If a team or a second therapist is working with the patient, a failure to listen to and learn from one another can lead to regression. Cooperation helps to spot the ineffective elements of therapy and to maintain its continuity.
MISTAKE 7: For patients with minimal awareness, doing only passive exercises while lying down.
Even if a patient does not yet show clear responsiveness, therapy should not be limited to passive activities. They should be motivated and treated as capable of progress, because active work may bring results in time.
MISTAKE 8: A lack of a holistic view of the patient.
Focusing solely on one part of the body — for example in therapy for paresis of the hand and upper limb — without considering the surrounding tissues and structures can stall the therapeutic process instead of improving function.
MISTAKE 9: Not giving the patient full attention during therapy.
Checking your phone, focusing more on other people than on the patient, or not giving your full attention undermines the quality of therapy. The most important thing during a session should be the patient’s health and their experience of the therapy.
MISTAKE 10: Dismissing the patient’s view of their own functional state.
A patient may not want help for reasons of their own or because of unresolved emotional problems. You need to see them not only as a medical case, but also as a person with their own psychological and personal context.
The basic principle that helps to avoid major mistakes is this: observe, listen and reflect, so that you can act as effectively as possible — not only as a physiotherapist, but as a person.
Author: Karolina Łozińska, MSc.
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