Acupuncture is one of the oldest established forms of healthcare in the world. The focus is on you as an individual, not your illness, treating you holistically. Treatment involves the insertion of very fine needles through your skin at strategic points on your body. Traditional Chinese medicine explains this as a technique for balancing the flow of energy known as qui or chi.

Acupuncture is one of the many skills used within physiotherapy as an integrated approach to the management of pain and inflammation and as a means of stimulating the body's own healing chemicals in order to aid recovery and enhance rehabilitation.

All therapists practicing Acupuncture are members of the Acupuncture Association of Chartered Physiotherapists (AACP) and Steps is registered with Sheffield City Council as an Acupuncture provider.

FES is a technique used to produce contractions in paralysed muscles by the application of small pulses of electrical stimulation to nerves that supply the paralysed muscle. The stimulation is controlled in such a way that the movement produced provides useful function. FES is used as an aid to assist walking and also as a means of practicing functional movements for therapeutic benefit.

FES can be effective where movement has been lost due to nerve injury / disease within the brain or spinal cord. This is called an upper motor neuron lesion. This includes people who have:

  • Stroke
  • Multiple sclerosis
  • Spinal cord injury, T12 and above
  • Parkinson’s disease
  • Cerebral palsy
  • Head injury
  • Familial or hereditary spastic paraparesis
  • Other conditions affecting the spinal cord or brain

The most common use of FES is for the correction of dropped foot but it can also be used to strengthen and re-educate the movement of other muscles for example in the hand, arm or shoulder. FES can also be used in orthopaedic conditions where muscle weakness is due to disuse or inhibition.

By restoring lost functional activities such as walking and climbing stairs, independence and confidence as well as social interaction are greatly enhanced.

Ottobock with FES

Functional electrical stimulation systems activate your nervous system using electric impulses so your muscles do what you want them to do. It’s been used in medicine for decades, including for rehabilitation after a stroke or for patients with multiple sclerosis, and it can also be used to improve your mobility on an ongoing basis.

FES is recommended by both NICE and the Royal College of Physicians as an effective treatment for drop foot (dorsiflexor weakness). This is a common problem, particularly after stroke, that can affect your walking and general mobility.

How FES works

FES can either work indirectly, with electrodes placed on the surface your skin, or directly on your nerves using implanted electrodes. If you would like to know more about FES treatment for stroke or MS related drop foot and walking problems, please refer to the FES leaflets by the Different Strokes and MS Trust.

With an FES system, when you lift your foot, a switch under your heel transmits a wireless signal to a stimulator, which in turn activates nerve pathways controlling the muscles of the lower leg. This provides a controlled lifting of your foot and toes at the right moment as you’re walking. The result is a smoother, safer and faster gait, and a reduced risk of falling – so you can step out with confidence.

There are a colourful variety of groups that will be an important part of your rehabilitation. These take place daily and they will be suited to individual needs. These groups will be a fun way of regaining lost skills as well as learning new ones during your stay.

  • kitchen skills
  • gardening group
  • book club
  • media/news/current affairs society
  • computer/IT skills
  • breakfast club
  • lunch club
  • music therapy
  • pilates
  • tai chi
  • creative hub
  • shopping group
  • wheelchair skills
  • pub games

Hydrotherapy is the use of water in the treatment of a variety of medical conditions. More specifically, aquatic therapy is a programme utilising the properties of water, designed by a suitably qualified physiotherapist specifically for an individual to maximise function, which can be physical, physiological or psychological.

Our aquatic therapy treatments are carried out in our state-of-the-art stainless steel hydrotherapy pool with a water temperature of around 34 degrees. The warm water creates a wonderful environment for rehabilitation promoting pain relief, muscle relaxation and increased freedom of movement, which aids the rehabilitation process.

As you would expect, our hydrotherapy pool is fully accessible to wheelchair users or individuals with limited mobility via a ceiling hoist.

To read more, please click here.

  • Changes in thinking, such as: reduced attention span and greater distractibility, difficulties holding the thread of a conversation, poor short-term memory, and problems with planning and problem solving can be common consequences following some form of acquired brain injury.
  • Neuropsychological testing is completed with the individual on admission to identify their current strengths and weaknesses, which will help guide the rehabilitation programme. Neuropsychological tests are paper and pencil tests that ‘tap’ into different areas of the brain, including memory, perception, language, and changes in the front part of the brain (including planning and problem solving and aspects of attention).
  • In addition to testing, time will be spent with the individual and family in order to complete a detailed history and background. The focus is always on: what is important to the individual and family (rehab goals have to be meaningful); and ways of increasing independence.

Development of a rehabilitation programme

Following team assessment, a rehabilitation programme will be developed by all members of the team to ensure joint working towards identified goals. A thorough behavioural and emotional assessment will also be completed. Each individual will be provided with a rehabilitation timetable of daily activities, which will enable individuals to practise skills learned in therapy sessions and within the structured unit environment.

Cognitive rehabilitation

The main focus of cognitive rehabilitation is to create a detailed understanding of an individual’s strengths and weaknesses and find alternative ways (often by playing to an individual’s strengths) of functioning in daily life. Neuropsychology works closely with Occupational therapy and Speech and Language therapy to identify appropriate strategies.

Occupational therapy provides practical support to empower people to facilitate recovery and overcome barriers to doing the activities (or occupations) that matter to them. This support increases people’s independence and satisfaction in all aspects of life.

“Occupation” as a term refers to practical and purposeful activities that allow people to live independently and have a sense of identity. This could be essential day-to-day tasks such as self-care, work or leisure.

Occupational therapists play a critical role in helping people of all ages overcome the effects of disability caused by illness, ageing or accident so that they can carry out everyday tasks or occupations. They consider all of the patient’s needs – physical, psychological, social and environmental. This support can make a real difference giving people a renewed sense of purpose, opening up new horizons, and changing the way they feel about the future.

Occupational Therapy assessment will consider:

  • assess a client’s ability to function at an optimal level, despite barriers
  • how activities which the person needs or wants to do can be modified or adapted to make them easier
  • how clients feel about themselves and their ability to tackle problems
  • how the physical and social environment can be altered so that restrictions are reduced
  • work with individuals, families and support workers so they understand the importance of taking part in everyday activities

Occupational Therapy interventions may include:

  • enabling people improve their self-care, e.g. by supporting them to use washing machines or to cook for themselves
  • enabling people to manage their money by learning budgeting skills and how to use banks
  • support people to live independently by providing systems to assist in dealing with, for example, mail and bills or negotiating with neighbours
  • enabling people to get involved in activities around the home, such as cooking
  • supporting people to develop parenting skills
  • work with people to identify and improve work skills, apply for jobs and stay in employment
  • enable people to access and use mainstream leisure activities
  • provide advice on how much assistance a person may need to live independently in the long-term

Occupational therapists help people to develop a personally satisfying routine of everyday activities that creates a sense of purpose and enhances the person’s recovery journey. RCOT 2017

Physiotherapy is a physical medicine and rehabilitation specialty that remediates impairments and promotes mobility, function, and quality of life through examination, diagnosis, prognosis, and physical intervention. We have a team of neuro and orthopaedic specialist physiotherapists and will use a variety of different “hands on” treatment techniques and assisted technology.

Depression and anxiety can be common following some form of acquired brain injury. Without treatment, these symptoms can lead to greater difficulty coping and increased distress. Cognitive behavioural therapy and related interventions can help individuals reduce their symptoms of anxiety and depression. CBT can also be helpful when addressing chronic pain, as part of a wider multidisciplinary team approach. Approaches to management of mood are considered within the overall rehabilitation programme.

Trauma work

For individuals who have experienced a significant trauma and are presenting with post traumatic stress symptoms, following assessment, individuals will be offered some form of trauma focused psychological treatment. Evidence based interventions recommended by NICE include:

  • Trauma focused CBT – a course of therapy whereby individuals learn new skills to help process thoughts and feelings related to the traumatic event
  • Eye movement desensitisation and reprocessing (EMDR) is a treatment that uses eye movements to stimulate the brain. It’s been shown to make distressing memories feel less intense. EMDR can help a person deal with traumatic memories, such as those that occur after an accident, or after sexual, physical, or emotional abuse. In particular, NICE recommends EMDR for treating post-traumatic stress disorder (PTSD)

Other psychological therapies offered, dependent on an individual’s presenting problems and outcome of assessment can include:

  • Interpersonal Therapy – a time limited therapy, supporting individuals to manage depressive symptoms associated with grief and loss / role changes.
  • Acceptance and Commitment Therapy (ACT) – a unique empirically based psychological intervention that uses acceptance and mindfulness strategies, together with commitment and behaviour change strategies, to increase psychological flexibility.
  • Mindfulness approaches – help to focus on thoughts and feelings without becoming overwhelmed by them. They can be used to help treat depression, stress, anxiety, and addiction. Techniques such as yoga, meditation and breathing exercises can also be incorporated. NICE recommends mindfulness-based therapies to help people avoid repeated bouts of depression. (NHS Choices)
  • Compassion Focused Therapy – CFT is used to treat underlying self criticism and shame, which can be at the core of mental health problems

Counselling – a type of talking therapy that allows a person to talk about their problems and feelings in a confidential and dependable environment. A counsellor is trained to listen with empathy (by putting themselves in your shoes). They can help you deal with any negative thoughts and feelings you have. Sometimes the term “counselling” is used to refer to talking therapies in general, but counselling is also a type of therapy in its own right. (NHS Choices)

Neurologic Music Therapy (NMT) uses music and its components to treat neurological conditions. This specialised therapy utilises techniques like Rhythmic Speech Cuing (RSC), Vocal Intonation Therapy (VIT), Patterned Sensory Enhancement (PSE), and Therapeutic Musical Performance (TIMP) and more to facilitate improvements in movement, speech, cognition, and emotional well-being.

NMT sessions are personalised, based on clients’ goals to optimise rehabilitation outcomes. By integrating music into therapy, clients actively engage in their recovery journey, experiencing empowerment, positive reinforcement, and social connection. This holistic approach not only enhances physical rehabilitation but also fosters emotional resilience and coping skills essential for navigating the challenges of neurological rehabilitation. You can witness examples of NMT sessions with Rebekah here.

Art Therapy or Art Psychotherapy is a recognised and effective mental health treatment, the practice uses psychodynamic or person-centred counselling methods alongside the use of art and art making as a preverbal tool of communication. Art Therapy can help a client explore and express certain emotional experiences that are difficult or troubling to talk about. Art Therapy works with the communicative benefits of the Triangular Relationship, consisting of the client, therapist, and the image created by art making and exploring art materials. An Art Therapist provides a contained and compassionate yet creative environment for a client to express presenting difficulties, they may talk with the therapist and make art besides them. Art Therapy is used to treat various mental health conditions from depression to schizophrenia, it can be a supportive practice and can work with other disciplines involved in client care such as Occupational Therapy and Clinical Psychology.

Through art making in Art Therapy a client may experience a new sense of self, that can encourage better self-esteem and understanding, a goal of the treatment is for a client to discover a new perspective that promotes cause for recovery. Art Therapy is known to help with and counter feelings of low motivation, mood and reduced interest in socialising and culture, Art Therapy can be received in groups or in individual one to one session.

Speech and Language Therapists assess and treat a wide range of needs, across communication and swallowing domains.

Our therapists support people with communication difficulties to work towards their personal goals. Speech and Language Therapy can support people to rebuild skills and confidence with talking when a condition has impacted on their language, voice or motor speech abilities. We can support people to use a variety of Augmentative and Assistive Communication Methods, including eye gaze and switch access, and have links with local Assistive Technology Services.

We also assess people with Dysphagia (swallowing difficulties), providing therapy and advice on strategies to manage their eating and drinking safely.

Biozoon®

Air with flavour allows persons who are unable to eat and drink the ability to taste again. The flavoured foams are designed for persons who have difficulty swallowing, have dysphagia or who are usually PEG tube fed. The air with flavour sachet is mixed with your chosen liquid and aerated with micro air bubbles to create a light airy foam. This can then be spooned off and served to provide an intense taste experience! The foam instantly disappears leaving no liquid or solids in the mouth.

Ampcare ESP™

Ampcare’s Effective Swallowing Protocol (ESP™) is a new treatment that combines electrical stimulation with specially selected resistance exercises to help rehabilitate the swallow function to help patients swallow safely.

find out more

Botox (Botulinum Toxin) injections can be used to treat clients with severe muscle stiffness (spasticity) or abnormal limb positioning following stroke, or as a result of other neurological conditions, including multiple sclerosis or dystonia.

These injections are given via a special needle into the muscle or muscles that are over active. Physiotherapy is then needed to provide exercises and stretches and, in some cases wearing a splint is also necessary. Botox only works when it is carried out in conjunction with physiotherapy.

It takes 7-10 days to take effect and usually injections are repeated every 3-4 months if found effective. STEPS can arrange for a consultant review of spasticity and offer this service when appropriate.

Vestibular Rehabilitation uses a range of specialist exercises and manual techniques to treat dizziness and balance difficulties. These difficulties may arise due to problems with the inner ear such as BPPV (benign paroxysmal positional vertigo) or Vestibular Neuritis or alternatively due to head injury, concussion or vestibular migraine. Two of our Physiotherapists have completed post graduate training in Vestibular Rehab and have a keen interest in this area. More information can be found here or visit vestibular.org

Solution Focused Hypnotherapy is a recognised and useful tool in neurological rehabilitation for clients recovering from conditions such as a stroke, traumatic brain injury or multiple sclerosis. It involves a collaborative approach that combines psychotherapy and hypnosis.

The therapy is short-term and goal-focused and incorporates positive psychology principles and practices to help clients instigate change by constructing solutions rather than focusing on problems.

During a session, clients are guided into a state of trance, where they are more receptive to suggestions and can make changes at a subconscious level and adopt new positive solutions. By equipping individuals with resources and tools, they can feel more in control during what is often a difficult time in their life.

The benefits of hypnotherapy are vast and include:

  • Reduced pain intensity and improved pain coping skills.
  • Improved motor function performance and reduced spasticity.
  • Improved cognitive function including attention, memory, and executive function.
  • Reduced anxiety and depression.
  • Improved sleep quality.