How can you assist in implementing a physiotherapy programme for your client?

One of the potential sequelae of acquired brain injury is reduced initiation, poor compliance, reduced attention and distractibility. As a result of this, clients need support not only to carry out Activities of Daily Living (ADLs) but also prescribed exercise programmes.

Strategies which can assist in increasing compliance include:

1. Use of practice sheets or an exercise diary to monitor compliance and progress (Example: Attachment 2 )
2. Incorporating practice into other ADL activities (e.g. walking to local shops)
3. Communication with others involved in the care of the client (eg. GP; physiotherapist; case manager) if you feel there may be a change in behaviour or other reason why there is poor compliance
4. Structuring regular exercise sessions using a diary, calendar or timetable (Example: Attachment 1 )
5. Encourage active lifestyle and participation through activities that the client is interested and will engage in.

To manage aggression or agitation during the physiotherapy session:

• Avoid conflict and adopt a calm manner
• Provide reassurance and positive feedback where appropriate
• Don’t argue or force compliance
• Don’t ignore or dismiss concerns when they are raised.