Neurological physiotherapy
Neurological physiotherapy
This domain tests neurological examination and rehabilitation reasoning: tone, strength, sensation, coordination, cognition, function and safety. Expect questions on stroke, Parkinson’s disease, multiple sclerosis, spinal cord injury, vestibular and balance disorders.
Core concepts
- Assess before facilitating: tone, reflexes, power, sensation, proprioception, coordination, vision, neglect, cognition and function.
- Use task-specific, repetitive practice with feedback and progression; neuroplasticity is driven by meaningful practice and challenge.
- Manage secondary complications: shoulder pain, contracture, pressure injury, falls, spasticity and deconditioning.
- Screen cognition and safety before transfer or mobility practice.
- Use standardised measures where appropriate, such as gait speed, balance scales or functional independence measures.
Worked example
A patient after stroke has left neglect and veers right when walking. Rather than only strengthening the weak leg, you scan the environment, use cueing to attend left, practise safe mobilisation with appropriate assistance, and involve the team in consistent strategies. You document the neglect and safety risk. Reasoning: functional mobility depends on attention and perception, not strength alone.
Traps
- Missing neglect, cognition or visual field deficits.
- Over-facilitating instead of building active practice.
- Ignoring shoulder protection and pressure areas.
- Setting goals without functional meaning.