My Mum suffered a bad stroke in September 2014 resulting in significant loss of strength and movement in the entire left-hand side of her body.

I employed Karen McGillicuddy on recommendation and because of her specialism in treating patients with neurological conditions to help with Mum’s rehabilitation immediately after her discharge from hospital. When Karen started working with Mum she was unable to walk or support her own weight and she needed to use a manual stand lift to transfer between bed, commode and wheelchair.

In addition to her physical weakness Mum’s problems were exacerbated by her negative moods, emotionalism and severe post-stroke pain syndrome which all hindered her recovery. Karen took a holistic approach to dealing with all these complex conditions treating both the physical and emotional aspects with kindness, understanding and empathy.

Karen has been fantastic and we cannot thank her enough.

She has been encouraging and persistent throughout Mum’s treatment setting challenging yet realistic goals at each stage.

Due in most part to the treatment sessions with Karen over the last 3 to 4 months, Mum is now able to support her own weight, walk steps with the aid of a walking stick, is suffering much less pain and is starting to become more optimistic about the future.

Mum and I have tremendous faith in Karen’s skill, knowledge and approach and we would highly recommend her to anyone looking for a physiotherapist, particularly to those suffering from neurological conditions.

Kenton, Ringwood

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1) Foot drop
This is a very common problem and it refers to weakness of the muscles on the front of the lower leg (called ankle dorsiflexors), which are responsible for pulling your toes up towards your head. As with any muscle weakness following stroke, the severity varies between individuals. You may have a mild weakness, and find that your toes catch on the ground occasionally when you have walked a long distance, or you may not be able to lift your toes at all. If the weakness is severe, you may find that you compensate for it by lifting your knee up towards your chest, so that your foot does not catch the floor. The treatment for foot drop varies depending on the severity of it. If you are unable to clear your toes then it may be appropriate to wear an ankle foot orthosis. This is commonly referred to as an AFO. An AFO is a splint, which helps to support the ankle joint during walking. There are a huge variety of AFO’s available on the market, being made from different materials. An AFO should always be fitted/ prescribed by a trained therapist. Another treatment which is available is functional electrical stimulation (referred to as FES). With FES an electrical current is used to stimulate the ankle dorsiflexors to contract and clear the toes from the floor. Again there are many companies which produce these machines and you should be assessed by a trained therapist.

Exercise is very important for the treatment of foot drop. Strengthening exercises for the ankle dorsiflexors with or without the use of equipment, such as theraband, may be appropriate. Stretching of the calf muscles is often important, as increased tone in these muscles and stiffness can compound foot drop. Gait (walking) retraining is also a key part, so you may need to focus on a specific part of the walking cycle in order to improve your walking.

2) Knee hyperextension
This is another common problem that is seen when bearing weight on the affected leg. The knee will be seen to overextend (straighten). This usually occurs due to muscle weakness of the knee. There are two main muscle groups at the knee joint, the quadriceps (which run down the front of the thigh) and the hamstrings (which run down the back of the thigh). The quadriceps straighten and the hamstrings bend the knee. Weakness of either of these muscle groups can cause reduced stability at the knee in walking. Knee hyperextension is often associated with pain. Treatment of this problem will involve lots of strengthening exercises, and working in different positions in order to activate the weaker muscles.

Repetitive practice is the key for all functional recovery following stroke. It is the same for walking, – the more you walk, the more likely your walking is to improve.

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