Resources

Supporting Mobility and Independence with Neurological Conditions and Disability

Daniel Smit | Physiotherapist | Strides Health Group

Moving around home, getting out of a chair or taking part in a community activity can become more difficult when a health condition affects movement. Physiotherapy may help you work towards everyday goals, maintain abilities or adapt activities as your needs change.

This resource explains the role of physiotherapy, what an assessment may involve and how to prepare. The starting point is what matters to you, including your choices about assistance, equipment and participation.

Different people need different support

Neurological conditions affect the brain, spinal cord or nerves and can influence strength, balance, sensation, coordination or fatigue. Disability can involve a wide range of physical, developmental and other needs. Two people with the same diagnosis may have very different abilities and priorities.

A plan therefore considers your health, current function, environment and preferences. Depending on your condition, the focus may be learning or recovering skills, maintaining function, managing symptoms or finding a safer or more manageable way to do a task. Rehabilitation goals should be individualised. [1]

Start with an everyday goal

A meaningful goal might be transferring from a chair with less assistance, walking to the letterbox, participating in a class or feeling more comfortable during daily routines. Using appropriate assistance or equipment can support independence and choice.

The 2025 NICE guideline on rehabilitation for chronic neurological disorders recommends agreeing goals collaboratively and breaking longer-term goals into smaller steps. Goals and review timing should reflect the person’s condition and situation. [2]

For example, a goal of getting to a local café might involve transfers, walking or wheelchair access, endurance and transport. The plan may require more than one professional, and progress can be measured against participation as well as physical tests.

What an assessment may involve

We begin with your concerns, relevant medical history, current support and the activities you want to manage more easily. You can tell us what helps, what makes tasks harder and how symptoms vary through the day.

Depending on your needs, assessment may consider:

Strength, joint movement, sensation, coordination and balance.
Walking, wheelchair mobility or moving between positions.
Transfers, such as getting into or out of a chair or bed.
Pain, fatigue, falls and how these affect your daily activities.
Your current mobility aids, equipment and level of assistance.

The assessment is adapted to your abilities and communication needs. Tell us about helpful instructions, sensory preferences, rest breaks or support you would like during the appointment. A family member, carer or support worker can attend if you choose.

How physiotherapy may contribute

Depending on the assessment and your condition, care may include practice of meaningful tasks, tailored exercise, balance or walking activities, positioning advice and strategies for managing activity. The 2025 NICE guideline recommends developing exercise and activity programmes around physical function and individual barriers, including fatigue or pain. [3]

Some people need advice about mobility aids or equipment. Physiotherapy can contribute to assessment and practical use, with referral or collaboration where specialist equipment, wheelchair seating or home modifications are required.

There is no single exercise programme suitable for all neurological conditions or disabilities. The expected benefits, appropriate intensity and precautions depend on the diagnosis and the person. Any exercise plan should account for relevant medical advice and be reviewed over time.

Working with fatigue and changing needs

Fatigue may affect when and how activities are manageable. Tell your treating professional whether it follows physical effort, varies with sleep or medication, or has changed recently. A plan might adjust task length, timing, breaks or assistance rather than simply increasing exercise.

New or unexplained fatigue needs consideration by your GP or treating team. Changes in function should prompt review of the plan and, where appropriate, medical assessment. Rehabilitation may focus on maintaining participation or adapting support as well as improving physical abilities. [3]

Working with your wider team

Care may involve your GP, specialist, occupational therapist, speech pathologist, psychologist, orthotist or other professionals. With your consent, we can share relevant findings and coordinate goals. Family members and support workers can also help carry agreed strategies into everyday routines. [1, 4]

If another person assists with movement or transfers, the technique and equipment should be assessed for the individual situation. Ask for practical guidance before trying a new transfer method or changing the amount of assistance.

Preparing for your appointment

Bring relevant medical or therapy reports, a current medication list and the mobility aids you usually use, where practical. Think about one or two activities that matter most to you and any recent changes, falls or difficulties.

Contact the clinic beforehand about access, transfer assistance, communication support or other adjustments. This helps us plan the appointment and confirm whether the setting and available support suit your needs.

When medical care takes priority

Sudden new neurological symptoms should not wait for a routine physiotherapy appointment. Call 000 immediately for possible stroke symptoms such as new facial drooping, arm weakness or difficulty speaking, even if they resolve. [5]

Seek prompt medical advice for an unexplained deterioration in strength, walking or function, repeated new falls or a significant change from your usual symptoms. If symptoms are sudden or severe, seek emergency care.

Support at Strides Health Group

Strides Health Group provides physiotherapy for people with neurological conditions and disability at our Narre Warren clinic. We work with you to understand your needs, agree practical goals and review care as your circumstances change.

Contact the clinic to discuss your needs and arrange an appointment. We can also help identify when input from another professional or a specialist service is appropriate.

This resource provides general information and does not replace individual assessment or medical advice. The effects of treatment differ between conditions and people.

Free Resource: Supporting Mobility and Independence with Neurological Conditions and Disability

A practical guide for individuals, families and carers to better understand how neurological conditions and disabilities can affect movement, mobility and independence, with helpful advice on supporting everyday activities and knowing when to seek professional physiotherapy support.

Download the Supporting Mobility and Independence Guide (PDF)