Continuing our series with specialist neurological physiotherapist Taher Dhuliawala of Neuroability Ltd we talked to Taher about managing post-neurological injury fatigue through a paced approach. This method aims to enhance long term quality of life by avoiding the pitfalls of alternating between intense activity and subsequent exhaustion.
“Alternating periods of over exertion and rest – what I call the ‘boom and bust’ cycle – can seem a reasonable approach to take to fatigue following a neurological injury. But it can perpetuate a cycle of peaks and troughs which lead to increased fatigue and decreased functionality over time. There is a tendency to overexert oneself which can then increase exhaustion. This can the lead to needing extensive rest which in turn leads to a decrease in overall stamina.”
Taher has instigated a strategy with patients to ensure that they learn to manage to avoid this cycle of ‘boom and bust’. This method enables them to engage in meaningful activities and social interactions which in turn improves overall well-being. And this involves a paced approach.
Taher’s key elements of a Paced Approach:
Task Management: One of the key elements is to prioritise and plan, so that essential tasks are undertaken throughout the day and not in a burst of activity. “It is better to break these tasks down into manageable jobs so that regular breaks can be undertaken in between each task”.
Use of assistive devices:
Utilise devices that conserve energy, making daily activities more manageable. “In addition I am a great advocate of assistive devices which will conserve energy during the course of the day.”
Arrange living spaces for easy access to frequently needed items, minimising unnecessary movement. “It’s also a good idea to arrange the living space for easy access to items most frequently required, reducing the need for unnecessary movement.”
Healthy lifestyle: “There are other important fundamentals of day to day living such as a healthy diet and lifestyle which also play a vital role in a paced approach.
A nutritious diet will help sustain energy levels.
Tailored exercise or physical therapy will improve stamina and reduce fatigue in the long run.”
Consistent sleep schedule and mental relaxation: Taher is also a great believer in a consistent sleep schedule with relaxation techniques incorporated to improve sleep quality. Mental relaxation is a key element of a paced approach so practicing mindfulness and meditation can also help alleviate stress.
“The paced approach can help the patient, as well as their family, in dealing with and solving how to live with post neurological injury fatigue. By understanding personal limits, pacing activities, adopting healthy lifestyle habits and seeking support, individuals can regain control over the lives once again, gradually rebuilding stamina without falling into an exhausting cycle of over exertion and excessive rest.”
Taher stressed the importance of seeing a professional who can teach individuals tailored pacing strategies considering their type of injury and the severity of their problems but also strongly advocates seeking support from support groups and other professionals: that is where an Emma Way Associates case manager can play their part as helping implement these strategies and seek the best assistive devices and therapies are just a part of a case manager’s role.
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