Physiotherapists in Southampton treat many different conditions including the issues profiled below.

Falls and Healthy Bones

Falling in adults is an important matter with involvement of around 30% of people over sixty-five years old and half of those over eighty-five years. There are significant risks to falling for elderly people, with many much older people dying and or suffering loss of mobility or other problems. Ninety percent of hip fractures are caused by falling and this comes with a very high cost both personally and financially. Only twenty percent of people who fracture their hip recover well enough to attain their previous level of functional abilities which includes walking. There may be many reasons for a person falling and the evidence for the many interventions proposed being effective is not very good.

Physiotherapists prescribe exercise programmes as part of their main arsenal of skills, with good evidence that well designed programmes which include training balance and strength can be effective at reducing falls in the community. Patient access to assessment and treatment by a physiotherapist is however variable in the UK, with hip fracture patients likely to receive this (due to admission to hospital) but patients with non-hip fractures are much less likely to receive this even when admitted. Physios have a much greater role in this matter which they have not taken up.

Fatigue and Tiredness - The Management of the Condition

Drug therapies given for arthritic condition, known as disease modifying anti rheumatoid drugs and the new biological treatments, have been shown to reduce the fatigue reported by patients, perhaps partly at least by reducing inflammation and pain levels which have some effects on fatigue levels. While fatigue can be improved by these drugs and by antidepressants, it can occur in the absence of depression or inflammation. Exercise therapy in groups has shown some trends towards improvement of fatigue, although the effects of exercise therapy on chronic fatigue syndrome are not clear.

Group therapy may be included in self management programmes which combine this with education and psychological interventions. Both these therapies have shown some effects in particular circumstances. Acupuncture however has shown no effect in chronic fatigue syndrome. Evidence for non-drug treatments is limited by the number of good quality research trials available, most of which are not set up to examine the fatigue nor the potential treatments for it. A good definition of fatigue does not yet exist nor is there any possibility of logically grading the degrees of tiredness from slight to exhaustion, limiting meaningful work on the condition. Pain management programmes, which often have a physiotherapist and a clinical psychologist, presently address these patients.