Survey to find out the situation of neurological physiotherapy in Catalonia

The Commission of Neurology of the College of Physiotherapists of Catalonia has made a survey with the objective of knowing the situation of neurological physiotherapy in Catalonia.

This survey is addressed exclusively to those and those physiotherapists who currently work with stroke patients (minimum 1 patient per week).

The survey lasts approximately 10 minutes and can be accessed:


stroke in young people


A stroke, scientifically known as a cerebrovascular accident, is defined as an alteration of the cerebral circulation that causes a transitory or permanent deficit in the functioning of one or several brain areas.

This health problem is more common in older people. It is also more frequent among males and in the Asian race. This frequency is known from epidemiological studies, but in truth, the probability of suffering a stroke or not is related to many factors. They are modifiable and non-modifiable factors.


Modifiable factors

Modifiable factors are all those behaviors and habits that we can modify and control in our day to day. Are they:

  • smoking
  • Obesity
  • sedentary lifestyle
  • Alcohol
  • Stress
  • Hypertension
  • Cholesterol
  • Diabetes
  • drugs


Non-modifiable factors

The non-modifiable factors are all those factors we do not know how to alter. Are they:

  • Age
  • Race
  • Gender
  • Family background


With this explanation, we can more easily understand why there are also cases of stroke in young people like Kiko Rivera or Hailey Bibier. Specifically, about 50% of hemorrhagic strokes, due to the rupture of a cerebral blood vessel, occur in people under 45 years of age.

The Spanish Society of Neurology says that this increase in cases may be due to the association with the coronavirus. There are other possible causes of the increased incidence of stroke in young people, such as:

  • Malformations, atrial fibrillation, or undiagnosed ventricular dysfunction
  • Substance abuse such as alcohol or drugs
  • Obesity
  • uncontrolled diabetes
  • Stress
  • Consumption of certain medications (eg: contraceptive pill)

Improve movement with core stability exercises

How to improve movement after a neurological injury?

The functional movement, such as the movement of the segments, arms and legs, can be improved by the work itself or by the influence that the trunk musculature and trunk functionality exert on them. That is, the trunk influences balance, the way we walk and move our arms. Let’s remember that it is the center of the body and where the different parts of the body come together, including the head.

In neurological injuries, such as stroke, multiple sclerosis, Parkinson’s disease and many others, the movement of people who suffer from it is altered. For this reason, people with loss of mobility seek different solutions and options to improve their body movements.

What exercises are there to work the trunk in case of having a neurological and/or brain injury?

The main function of the trunk is balance in sitting or stabilization. Lumbo-pelvic stability or core stability exercises are strongly recommended to strengthen the trunk muscles and improve their functionality.

What are the principles of exercises for the trunk?

Let’s agree that the stabilizing muscles, in this case we are talking about the lumbar and pelvic muscles, do not have to be powerful or strong, they must be resistant. The main principle is to enhance trunk extension by activating the multifidus and transversus abdominis muscles. This musculature is usually directly or indirectly affected by different neurological diseases.

Breathing should not be interrupted. People who cannot coordinate their breathing with the exercises should work on their diaphragm, diaphragmatic breathing.

Can electrostimulation be used on the trunk muscles?

If trunk exercises, lumbopelvic stability exercises or core stability exercises with the help of electrostimulation, such as TENS, are intended to be performed, the electrodes must be placed in the lumbar region in parallel. If you want to use electrostimulation on the abdominal muscles, in this case, on the transversus muscle, the placement of the electrodes must be very lateral. Once the electrodes are placed, the different stability exercises recommended by the physiotherapist should be performed.

Is there any trick to do the exercises well?

Apart from strengthening the stabilizing muscles by itself, rotations between the lower and upper trunk must be incorporated or even use the arms and legs to produce the necessary rotations. The physiotherapist or occupational therapist responsible for the treatment and rehabilitation must adapt the exercises to the capacities of each person.