Approximately two million people are living in the UK with neurological conditions including: Parkinson’s disease, multiple sclerosis, motor neurone disease, polio, spinal cord injury, traumatic brain injury and cerebral palsy. Participation in physical activities may benefit people with neurological conditions (1); conditioning, improving mobility, self-esteem and confidence, helping to manage stress, reduce feelings of depression and anxiety, improve thinking, increase enthusiasm and optimism and improve sleeping (2).

Participating in different activities can also provide a way to share time with family and friends, and the opportunity to meet new people and have fun.

Some neurological conditions are slowly progressive (neuromuscular conditions and Parkinson’s disease), some deteriorate at a faster rate (motor neurone disease), some have a sudden onset (stroke and traumatic brain injury) with some expected recovery, and some may relapse and remit (multiple sclerosis). The disease presentation and progression needs consideration when profiling and planning a programme for an individual. The underlying pathological process and possible co-morbidities also require consideration but are beyond the scope of this article. Considering the range of neurological conditions and complexity of their medical management, as in other exercise referral specialties, good communication and close working with appropriate health professionals can be extremely helpful.

Typical symptoms experienced by people with neurological conditions include: l Ataxia or coordination problems: This is where parts of the nervous system that control movement and balance are affected and cause problems with coordination. These symptoms are common and training to improve coordination, balance and skills should be considered in exercise programmes.

l Spasticity and rigidity: Spasticity – a velocity dependent increased resistance to passive lengthening of the muscle, when the faster you stretch the muscle the greater the resistance. Rigidity – increased resistance to passive lengthening of a muscle or muscle group. Both may be present in some muscles. Both spasticity and rigidity increase

22 The REPs Journal 2012;23(January):22-25