THERAP I E Sat The London Clinic

T H E R A P I E Sat The London Clinic

The London Clinic has been the leading hospital at the heart of the medical community in and around Harley Street since 1932. In that time, the core ethos of providing exceptional patient care has remained, and is as fundamentally important to us now, as it ever was.

C O N T E N T S

Therapies at The London Clinic 1

Inpatient Physiotherapy 2

Outpatient Physiotherapy 4

Aquatic Therapy 6

Aquatic Therapy Classes 8

Management of Sports Related Injuries 10

First Contact Practitioner (FCP) Triage Service 11

Clinical Pilates 12

Joint Mobilisation and Manipulation 14

Vestibular Rehabilitation 15

Breathing Pattern Disorders and Hyperventilation Syndrome 16

Acupuncture 17

Cancer Services 18

Lymphedema Treatment 20

Women’s Health Physiotherapy 21

Biofeedback and Percutaneous Tibial Nerve Stimulation 22

Dietetics and Nutrition 23

Speech and Language Therapy 24

Occupational Therapy 26

Falls Prevention 28

Hand Therapy 29

Osteopathy 30

Sports and Exercise Medicine 31

Exercise Therapy 32

Strength and Conditioning 33

SPECIALIST ASSISTIVE TECHNOLOGIES 34

Biodex Isokinetic System 35

AlterG® Anti-Gravity Treadmill™ 36

Shockwave Therapy 37

Electrotherapy 38

Payment Options 39

How to Make an Appointment 40

The London Clinic’s team of experienced and recognised therapists, provide a wide range of treatments to patients who are staying at our hospital, and also to those who come to us for outpatient treatment.

Our therapists will provide you with a comprehensive assessment and treatment programme that takes into account your current capacity, lifestyle, activities and personal goals and aspirations.

Our therapists work across multiple sites and departments, utilising our innovative technologies to support all aspects of patient care.

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I N PAT I E N T P H Y S I OT H E R A P Y

Our Physiotherapy teams are present on every clinical floor across the hospital, dedicated to offering you tailor-made treatments by using innovative and evidence-based practice.

Our inpatient Physiotherapy team is made up of chartered, highly skilled and expert senior physiotherapists. The team is experienced in a wide variety of clinical specialities, which means you will get the right and best care for your situation.

Each of our physiotherapists works closely with the nursing staff and consultants to provide an integrated service, delivering personalised treatment throughout your stay at The London Clinic.

Physiotherapy can be included in your treatment at any stage, and we aim to ensure that you leave the hospital as safely and as soon as possible, so you can get back to your life.

Patients may be booked in for treatment in our on-site aquatic therapy pool, which provides a useful way to treat patients in a weightless environment, to exercise and rehabilitate joints and muscles.

The assessments and treatments carried out may include mobilisation, breathing exercises, rehabilitation, equipment prescription and health and well-being advice. Our therapists can also assist with discharge advice and support you with arranging follow-up care.

WHAT TREATMENTS AND ASSESSMENTS DO WE OFFER?

■ Pre-habilitation and rehabilitation following surgery

■ Neurological assessment and rehabilitation

■ Therapy before, during and after cancer treatment

■ Physiotherapy for rehabilitation and after a critical illness

■ Respiratory assessment and treatment to optimise lung function and airway clearance

■ Rehabilitation before and after amputation

■ Falls prevention■ Aquatic therapy■ Acupuncture and holistic therapies

■ Strength and conditioning training.

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O U T PAT I E N T P H Y S I OT H E R A P Y

Optimise your function, achieve your goals and maximise your performance in life, leisure and sport.

Our experienced, chartered physiotherapists will provide you with a comprehensive assessment and treatment programme that takes into account:

■ Your current capacity ■ Your lifestyle■ Any sporting activities and aspirations.

Once you have completed a course of treatment, we will provide a home programme of exercises and access to ongoing specialist advice and support.

THE EXTENSIVE RANGE OF FACILITIES IN OUR PHYSIOTHERAPY DEPARTMENT INCLUDE:

■ Private treatment rooms■ A well-equipped gymnasium with changing rooms and a shower

■ AlterG® Anti-Gravity Treadmill

■ Biodex Isokinetic testing equipment

■ An aquatic therapy pool with underwater treadmill

■ Free weights – Dumbbells from 2-20kg – Medicine balls – Barbell with rack

■ Two exercise bikes■ Keiser performance & functional trainer.

WHAT CONDITIONS DO WE TREAT?■ Back/spinal problems■ Cancer-related fatigue■ Breast cancer-related axillary web syndrome or cording■ Breathing disorders such as hyperventilation and asthma■ Challenges after planned surgery, trauma or a critical illness (fatigue, mobility, range of movement, etc.)

■ Hand and wrist injuries■ Pre-surgical issues/barriers to optimising recovery■ Poor balance or reduced strength following a fall■ Muscular weakness■ Neurological conditions ■ Vestibular system dysfunction ■ Scar tissue tightness (such as surgical or post-radiotherapy)■ Women’s health conditions including pelvic girdle pain and pregnancy-related lower back pain

■ Sports injuries ■ Upper/lower limb (arm and leg) problems■ Undiagnosed, newly diagnosed or long-standing conditions.

We also provide special ‘drop-in’ sessions for assessment and provision of equipment.

Each of our physiotherapists provide comprehensive and expert care that is right for you.

WHAT OUTPATIENT TREATMENTS DO WE OFFER?

■ Acupuncture■ Biodex muscle testing ■ Clinical pilates ■ Exercise therapy■ Falls prevention ■ Breathing retraining and airway clearance

■ Isokinetic assessment and treatment

■ Joint mobilisation and manipulation

■ Electrotherapy ■ Oncology physiotherapy for fatigue and symptom management

■ Sports injury management ■ Pain management■ Vestibular rehabilitation.

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A Q UAT I C T H E R A P Y

Aquatic therapy is an evidence-based specialist treatment that utilises the unique properties of water to rehabilitate patients with a wide range of conditions.

AQUATIC THERAPY CAN BE USED TO TREAT THE FOLLOWING CONDITIONS:

■ Orthopaedic conditions■ Acute or chronic back and neck pain

■ Osteoarthritis and rheumatoid arthritis

■ Chronic conditions such as ankylosing spondylitis

■ Neurological conditions■ Immobility, muscular weakness and reduced balance.

AQUATIC THERAPY CAN BE USED EFFECTIVELY FOR:

■ Strengthening of weak muscles

■ Re-education of muscle function

■ Development of self-confidence

■ Facilitation of balance, coordination and posture

■ Early rehabilitation of surgical and non-weight bearing patients

■ Improvement of exercise tolerance

■ Maintenance or improvement of joint range of movement

■ Relief of pain and muscle spasm

■ Stimulation of circulation.

AQUATIC THERAPY TREATMENT

Before starting aquatic therapy, you will have a comprehensive assessment on land to identify your needs and goals, as well as suitability for exercise in our pool.

The aquatic therapy physiotherapist will then formulate an individualised exercise programme specific to you. Aquatic therapy appointments last for 30 minutes and are supervised by a qualified chartered physiotherapist.

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A Q UAT I C T H E R A P Y C L A S S E S ( A I C H I )

Ai Chi is a graceful form of aquatic exercise that involves a series of slow, broad movements accompanied by deep breathing, created by Jun Konno, in 1990.

Ai Chi is a water-based, total body strengthening and relaxation programme and an important part of our programme. It is performed in a slow and focused manner and accompanied by deep breathing.

Ai Chi combines Tai-Chi and Qi Gong concepts, and is performed standing in shoulder-depth warm water, using a combination of deep breathing and slow, broad movements of the arms, legs and torso.

The Ai Chi progression moves from simple breathing, to the incorporation of upper extremities, trunk, lower extremities and finally total body involvement.

OUTCOME OF AI CHI PROGRAMME:

■ Promotes flexibility and strength

■ Reduces muscle weakness, pain and joint stiffness

■ Encourages slow, relaxed movement

■ Increases blood flow to joints, tendons and muscles

■ Minimises problems associated with conditions such as rheumatoid arthritis.

PATIENT TESTIMONIALS

“Aquatic therapy at The London Clinic really sets one on the path to full recovery.”

“Encouraging, supportive, and really effective – I would not hesitate to recommend the brilliant aquatic therapy at The London Clinic.”

“Thank you all for making my recovery such a positive experience – your aquatic therapy programme really does work, and every session in the wonderful pool has been both positive and enjoyable!”

SELF-MANAGEMENT AQUATIC THERAPY SESSIONS:

Following aquatic therapy treatment, you will be able to continue using our pool for maintenance or improvement during self-management sessions.

These sessions are suitable for individuals who wish to continue their therapy exercises unsupervised in our pool. A physiotherapist will not be present for these sessions.

Changing and showering facilities are available on site. Please arrive 10 minutes early to your appointment to allow time for changing and showering before entering the pool. Please bring swimwear to your aquatic therapy appointment. A towel and dressing gown will be provided for your session.

For patient safety, we have a maximum weight limit of 120kg for using our pool.

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M A N A G E M E N T O F S P O R T S I N J U R I E S

A sports injury can be frustrating, setting back training and even everyday life. Sport injuries can affect both recreational gym users and serious athletes.

Physiotherapy for the management of sports injuries aims to treat these injuries to help prevent recurrence, getting you back on track and ready for life, work and leisure.

Sports injuries benefit from early intervention to help prevent an injury from becoming chronic and to assist an early return to activity.

The London Clinic offers specialist rehabilitation from physiotherapists highly skilled in managing sports related injuries.

EXAMPLES OF SPORTS INJURIES THAT OUR PHYSIOTHERAPY TEAM CAN HELP TREAT:

■ Ankle sprains■ Knee ligament/cartilage injuries

■ Knee cap (patello-femoral) problems

■ Overuse running injuries■ Shoulder pain from throwing, swimming and overhead activities

■ Tennis/golfers elbow.

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Your First Contact Practitioner will assess you, give advice, re-assure you and ensure you are on the right path to get back to health as quickly as possible. They will also make sure you are referred for scans or x-rays if appropriate, as well as contacting your GP or consultant with recommendations for your future care. Our service is perfect for anyone struggling with muscle, nerve, joint or general pain, and is unsure who to turn to for support and advice.

WHAT SORT OF THINGS SHOULD YOU BOOK A TRIAGE APPOINTMENT FOR?

Even minor issues are suitable for assessment so that they do not develop into bigger problems.

The most common issues we see are:■ All soft tissue injuries, sprains, strains or sports injuries – upper and lower limb

■ Arthritis – any joint ■ Any spinal pain including lower back pain, thoracic and neck pain

■ Arm/leg symptoms, with or without neurological symptoms – pins and needles for example

■ Mobility changes ■ After orthopaedic surgery ■ Headaches.

Remember, we have the clinical expertise to assess, diagnose and treat patients with a wide range of musculoskeletal conditions, therefore, we are able to let you know if you need any professional help, or if you need no further intervention at all!

F I R S T C O N TA C T P R A C T I T I O N E R ( F C P ) T R I A G E S E R V I C E T H E R A P Y

This is a fast-access assessment clinic with a First Contact Practitioner to determine if you need physiotherapy or further assessment, perhaps with another specialist.

MASSAGE THERAPY MAY HELP WITH THE FOLLOWING CONDITIONS:

■ Aches and pains■ Disc injuries■ Back pain■ Postural issues■ Sciatica ■ Sports injuries■ Headaches ■ Neck pain ■ Shoulder, knee and ankle pain

■ Overuse injuries caused by repetitive trauma.

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C L I N I C A L P I L AT E S

Pilates is a unique exercise system of stretching and strengthening muscles, developed over a hundred years ago by Joseph Pilates.

Clinical pilates was developed by physiotherapists with expertise in anatomy, injury prevention and rehabilitation. It is a series of comprehensive exercises, addressing deep stability muscles within the body helping to improve posture, strength, flexibility, toning, balance and control.

Clinical pilates can be incorporated into your rehabilitation programme. Your physiotherapist is dedicated to providing you with a unique programme tailored to your specific needs and goals. The exercises will provide a logical progression from static stabilisation onto higher level and more functional dynamic stabilisation.

CLINICAL PILATES CAN BE USED EFFECTIVELY FOR:

■ Developing a strong and active core

■ Re-educating muscle function, improving co-ordination and muscle control

■ Recovering from injuries■ Prevention of injury onset and/or reoccurrence

■ Strength and conditioning■ Improving exercise tolerance■ Relief of pain ■ Maintenance or improvement of joint range of movement

■ Enhanced breathing control■ Reducing stress and tension■ Improving balance■ Improving posture.

CLINICAL PILATES CAN BE BENEFICIAL FOR PEOPLE WITH THE FOLLOWING CONDITIONS:

■ Back and neck problems■ Shoulder problems■ Hip and knee problems■ Osteoarthritis and rheumatoid arthritis

■ Neurological conditions■ Immobility, weakness and reduced balance

■ Pre and post-natal pregnancies.

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J O I N T M O B I L I S AT I O N A N D M A N I P U L AT I O N

Mobilisations and manipulations are common techniques used by physiotherapists to treat painful and restricted joints.

Joints can become stiff and painful following injury, an operation, or because of arthritis. A persistent circle of pain and stiffness can develop as you move less. Physiotherapy joint mobilisations and manipulations can help to reduce joint pain, stiffness and restore range of movement.

JOINT MOBILISATION AND MANIPULATION MAY HELP WITH THE FOLLOWING CONDITIONS:

■ Stiffness and/or achy joints

■ Painful and/or stiff joints following surgery

■ Muscle spasm ■ Acute/chronic injuries■ Sports injuries■ Arthritis■ Back pain■ Neck pain■ Headaches.

A joint ‘mobilisation’ involves repetitive and gentle motion to restore range of movement. A ‘manipulation’ is a short, fast pressure and may result in a ‘click’. Both of these techniques can alter nerve patterns within the surrounding muscles causing relaxation, improved local blood and lymphatic circulation, increased stretching and improved physical function.

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V E S T I B U L A R R E H A B I L I TAT I O N

Vestibular rehabilitation is a form of physiotherapy for people with inner ear (vestibular system) dysfunction.

Inner ear dysfunction can lead to dizziness, vertigo, balance problems, visual difficulties, hearing problems, reduced mobility and falls.

Assessment involves a detailed history of the condition and a physical examination. An initial assessment will take about an hour and will sometimes involve trying to aggravate any feelings of dizziness and/or vertigo. It can be necessary to rest for a while after assessment to allow any symptoms to settle.

Treatments for these disorders involve bespoke programmes of visual exercises, repositioning techniques, for benign paroxysmal positional vertigo, balance retraining, mobility and lifestyle changes. Exercises can improve gaze stability or desensitise the neurological system to aggravating stimuli.

Some treatments have an immediate effect, whereas others can take several months to become established.

THE TYPES OF CONDITIONS TREATED INCLUDE:

■ Vestibular neuritis■ Labyrinthitis■ Head injuries■ Benign paroxysmal positional vertigo (BPPV).

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B R E AT H I N G PAT T E R N D I S O R D E R S A N D H Y P E R V E N T I L AT I O N S Y N D R O M E

We can stabilise your symptoms and normalise your breathing through breathing, retraining, relaxation and management of your triggers.

A breathing pattern disorder (BPD) is defined as a chronic change in a breathing pattern that cannot be attributed to a specific medical diagnosis, causing respiratory and non-respiratory complaints. Changes can be very subtle and may happen over a period of time.

The symptoms, however, can be very unpleasant and often frightening, which can cause anxiety and perpetuation of the breathing pattern disorder. The symptoms are varied and can occur quickly for no apparent reason. In some, breathing pattern disorder leads to hyperventilation, which essentially means breathing too much and as a result, there is a chemical imbalance in the body.

ASSESSMENT AND TREATMENT

The first session will consist of an assessment and diagnosis of a breathing pattern disorder. This is done through detailed questioning to understand your symptoms, lifestyle and an assessment of your breathing

pattern. A treatment plan will be initiated to stabilise your symptoms and normalise your breathing. This will be done through advice and education, breathing retraining, relaxation and management of your triggers.

Other therapies such as acupuncture, acupressure, strength training, massage and osteopathy are also available and may be appropriate. A few appointments may be required to help manage the breathing pattern disorder, and we are always confident that we can help you regain full recovery and have confidence in any neccessary future management.

SYMPTOMS OF THESE DISORDERS INCLUDE:

■ Feeling exhausted■ Feeling breathless or that breathing does not feel satisfactory

■ Inability to concentrate■ Chest pains■ Palpitations■ Lightheadedness■ Tingling sensations■ Achy muscles■ High anxiety and phobias.

A C U P U N C T U R E

Acupuncture involves the insertion of very thin needles at specific points on the body for therapeutic purposes.

The technique is widely used in addition to physiotherapy to complement and support treatments such as joint mobilisation and exercises. It is a method of stimulating the body’s natural healing, in order to restore balance and function.

Acupuncture stimulates the nervous system, muscles and connective tissues to relieve pain, promote healing and well-being.

All of our physiotherapists who practise acupuncture have post-graduate training in this field and integrate evidence-based acupuncture into physiotherapy, for the benefit of the patient.

Acupuncture can be used to manage pain and muscle spasm in musculoskeletal disorders. It can also positively affect the endocrine, cardiovascular, digestive and neural systems and restores balance in terms of sleep, energy, digestion, anxiety and overall well-being.

ACUPUNTURE IS USED TO HELP TREAT VARIOUS HEALTH CONDITIONS INCLUDING:

■ Headaches■ Neck pain ■ Shoulder pain ■ Lower back pain ■ Osteoarthritis.

“I have no doubt that the first session of acupuncture enabled me to finally get a good night’s sleep and that it is helping to keep my peripheral neuropathy pain under control.”

“On the days when I have the acupuncture treatment my feet feel almost normal for many hours afterwards.”

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C A N C E R S E R V I C E S

Exercise is used to help with the physical effects of cancer or side effects of cancer treatment.

Cancer and its treatment can take its toll on a person’s health, function and wellbeing causing physical symptoms, which may include:

■ Cancer-related fatigue ■ Chemotherapy-induced peripheral neuropathy

■ Breathing pattern disorders■ Loss of strength■ Deconditioning■ Reduced fitness■ Reduced balance■ Reduced independence and ability to perform everyday activities

■ Reduced core stability.

These long-lasting symptoms may arise during treatment or even years later.

At The London Clinic, we want to improve the quality of life for all people who are living with or beyond cancer.

CANCER AND EXERCISE

Many people living with or beyond cancer have unmet physical or psychological needs. It has been proven that exercise improves quality of life for cancer patients, regardless of the type or stage of their disease.

A specialist cancer physiotherapist has the necessary skills and knowledge to help those with the physical effects of cancer or side effects of cancer treatment.

Our therapists can support you through every stage of your inpatient and outpatient journey.

Treatment can start from diagnosis, through chemotherapy and radiotherapy, and after completing treatment. The Cancer Services Physiotherapy team can help alleviate many distressing symptoms such as fatigue and breathlessness, which debilitate many cancer patients.

There is a strong emphasis on a team approach including referral within the Physiotherapy team for:

■ Acupuncture■ Clinical pilates■ Strength and conditioning training

■ Yoga*■ Lymphedema therapy

We aim to help improve mental and physical wellbeing by taking back control, working with patients closely to address their individual needs.

* For more information about yoga, please contact the Physiotherapy department directly or access our website.

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LY M P H E D E M A T R E ATM E N T

Specialist therapy prevents and manages lymphedema, a complex long-term condition associated with physical and psychological problems.

Lymphedema is caused by damage to the lymphatic system which results in swelling in the limbs or the abdomen.

It can be a primary lymphedema (genetic) or secondary lymphedema (caused by damage to the lymphatic system through disease or injury). There is no cure for lymphedema, however, it can be reduced and managed with appropriate specialist treatment. Early intervention is recommended.

Left untreated, lymphedema can cause severe swelling and a hardening of the limb, which can have an impact on quality of life.

ASSESSMENT AND TREATMENT AT THE LONDON CLINIC

Assessment and treatment for lymphedema is carried out by our specialist therapists. This will involve asking about your symptoms and taking a full history. It may also involve taking measurements of the affected limb to establish if it is enlarged.

TREATMENT INVOLVES A BESPOKE PROGRAMME INCLUDING A COMBINATION OF:

■ Compression bandages and garments

■ Medical lymphatic drainage (MLD)

■ Exercise■ Skin care■ Kinesio taping.

OUTCOMES OF PHYSIOTHERAPY FOR LYMPHEDEMA

■ Significantly reduced lymphedema

■ Improved quality of life■ Minimise risk of developing lymphedema.

W O M E N ’ S H E A LT H P H Y S I OT H E R A P Y

Our Women’s Health Physiotherapy team are highly specialised in treating specific women’s health conditions and offer treatments for:

■ Weak core stability muscles following gynaecological or abdominal surgery

■ Pregnancy and postnatal related pain

■ Pelvic girdle pain, low back pain, upper back pain, hand/wrist pain

■ Rectus diastasis (separation of abdominal muscles following child birth)

■ Scar management■ Cording and shoulder pain/stiffness following surgery for breast cancer.

The sessions may include exercise-based rehabilitation, pilates, manual therapy and advice and education on activity modification, posture and returning to work.

SYMPTOMS OF LYMPHEDEMA INCLUDE:

■ Swelling■ Sensation of fullness/heaviness

■ Tightness/stretching of the skin

■ Reduced movement of the joints

■ Thickening and dryness of skin

■ Discomfort and pain.

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B I O F E E D B A C K A N D P E R C U TA N E O U S T I B I A L N E R V E S T I M U L AT I O N

Biofeedback (bowel and muscle retraining) aims to regulate and normalise bowel function and percutaneous tibial nerve stimulation treats bladder and bowel incontinence.

BIOFEEDBACK

Bowel problems can be very isolating and embarrassing, and yet they are very common. Biofeedback is a hybrid therapy encompassing aspects of pelvic floor physiotherapy, dietetics, muscle and nerve stimulation.

This therapy involves an initial assessment by our specialist nurse or physiotherapist who obtains a detailed assessment of bowel symptoms, general health, diet, lifestyle and any other factors that may influence your bowel function.

It is a safe non-invasive and effective way to manage a variety of bowel problems and symptoms.

BIOFEEDBACK EFFECTIVELY TREATS:

■ Slow transit constipation■ Normal transit constipation

■ Evacuatory problems (bowel not emptying completely)

■ Irritable bowel syndrome (IBS)

■ Faecal incontinence (leakage from the bowel)

■ Bowel symptoms that occur as a result of cancer treatment (surgery, radiotherapy and/or chemotherapy)

■ Bowel symptoms that occur as a result of neurological problems

Most patients require 3-4 sessions and there is a high success rate in improving bowel function.

PERCUTANEOUS TIBIAL NERVE STIMULATION

Percutaneous tibial nerve stimulation (PTNS) is a well-established treatment for bladder and bowel incontinence (leakage from the bowel and bladder). It is a similar treatment to electroacupuncture and uses stimulation of the tibial nerve via a small needle in the ankle attached to a machine. The stimulation of the tibial nerve works via nerve pathways to improve sensation and muscle control in the pelvis.

Percutaneous tibial nerve stimulation is a low risk procedure and treatment consists of 12 30-minute weekly sessions and many patients begin to see improvements by the sixth treatment.

D I E T E T I C S A N D N U T R I T I O N

Dietetics uses diet and nutrition to prevent diseases and improve health conditions.

The London Clinic’s team of registered specialist dietitians provide a wide range of treatments to patients who are staying at the hospital and to those who come to us for outpatient treatment.

Our dietetics service is available for adults who require therapeutic dietary manipulation and advice, through to specialised artificial means of nutritional support, such as intravenous feeding.

Dietitians are the only healthcare professionals licensed to assess, diagnose and treat nutritional problems. The dietitians employed by The London Clinic are registered with the Health and Care Professions Council (HCPC) and are members of the British Dietetic Association (BDA).

Our dietitians work closely with our consultants and have key roles within the wider multi-disciplinary health care system, including our Nutrition Support team.

Our dietitians also offer specialist functional gut clinics for irritable bowel syndrome (IBS) which includes breath testing to aid with specific food intolerance diagnostics, specialist consultations on using the FODMAP diet plan and the correct dietary treatment thereof.

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THE LONDON CLINIC’S DIETITIANS CAN HELP TREAT VARIOUS HEALTH CONDITIONS INCLUDING:

■ Cancer ■ Before and after gastrointestinal (GI) surgery

■ Inflammatory bowel diseases such as Crohn’s and ulcerative colitis

■ Functional (GI) disorders such as irritable bowel syndrome

■ Diabetes – type I and type II

■ Heart conditions

■ Weight management and metabolic syndrome

■ Lipid disorders (such as high cholesterol levels)

■ Exclusion and elimination diets for food intolerances

■ Kidney conditions■ Liver conditions■ Respiratory conditions■ Polycystic ovarian syndrome (PCOS)

■ Nutritional deficiencies■ Anaemia.

S P E E C H A N D L A N G UA G E T H E R A P Y

Speech and language therapy manages communication, swallowing, language, and respiratory disorders.

The London Clinic’s team of specialist speech and language therapists provide a wide range of high quality, evidence-based treatments to patients who are staying at the hospital and also to those who come to us for outpatient treatment.

Speech and language therapy is available to adults with significant speech, language and communication needs and/or eating and drinking needs that can be improved through intervention.

Our team are recognised specialists in their fields. They are members of the Royal College of Speech and Language Therapists, highly skilled and experienced and regulated by the Health Care Professions Council (HCPC).

Our therapists work closely with the specialist multidisciplinary teams, including consultants, to provide a comprehensive assessment and individualised treatment programme. Your programme will include education, advice and

support for you, your family, and/or carers, so that you can maximise your communication, swallowing function and quality of life.

We also offer video fluoroscopy assessment jointly with our Radiology team to assess swallowing impairments/difficulties and fiber-optic endoscopic evaluation of swallowing (FEES).

THESE MAY BE A RESULT OF:

■ Complex health needs (such as a tracheostomy requiring a swallowing assessment or a weaning programme and ventilator dependency)

■ Cancer and the side effects of cancer treatments such as chemotherapy, radiotherapy or surgery

■ Specific language impairment

■ Specific speech difficulties■ Voice disorders

■ Acute neurological disorders/progressive diseases (such as a stroke, head injury, Parkinson’s disease, multiple sclerosis, motor neurone disease)

■ Airway disorders, including airway stenosis and laryngeal dysfunction

■ Respiratory problems (such as chronic obstructive pulmonary disease (COPD) or chest infections)

■ Swallowing impairment/difficulties.

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O C C U PAT I O N A L T H E R A P Y

Occupational therapy enables individuals to engage in the activities that matter to them.

Occupational therapy focuses on developing, recovering or maintaining the daily living and working skills of people with physical, mental or cognitive impairments.

At The London Clinic, our occupational therapists have an exceptional understanding of the match between your needs, abilities and the environments in which you need to function. This assists with the successful transition from hospital to home. Occupational therapists collaborate closely with other healthcare professionals to create a plan of care and a coordinated and appropriate discharge plan.

Our Occupational Therapy team can work with you to improve your health and well-being by increasing confidence and independence in daily tasks. Your therapist will carry out an individual assessment and offer a customised treatment plan to enable you to meet your goals.

THE BENEFITS OF OCCUPATIONAL THERAPY INCLUDE:

■ Improved confidence and ability to manage your health condition(s) and daily life

■ Assessing potential risks in your home to reduce the risk of falls

■ Increasing the number of occupations that you are able to engage in

■ Support to remain safe and live independently at home

■ Symptom management such as energy conservation and relaxation techniques

■ Referring on for assistive devices and home adaptations

■ Increased awareness of services and support available.

HOW TO BE REFERRED:

A member of the Health Care Professional team can refer you to be seen by an occupational therapist, as an inpatient or an outpatient. However, if you are aware that you are having difficulties managing everyday activities then talk to your consultant or nurse directly.

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If you are at risk of falling or have a history of falls, our Therapies teams can provide individually tailored balance and strengthening exercise programmes, reviews of home safety, hazard assessments, nutritional assessment and advice from our dietitians.

These programmes have been shown to reduce the risk of falling by 54%. Our Therapies teams have a comprehensive range of facilities, including state of the art equipment, gymnasium and aquatic

therapy pool and patients can be seen in both inpatient and outpatient settings.

Our physiotherapists can also teach you how to get up from the ground following a fall and recommend you to other specialist services.

OCCUPATIONAL THERAPY

Occupational therapists will help you practice completing everyday tasks, such as showering and dressing, provide safe strategies to minimise risks and increase confidence. Alternate strategies to complete tasks may also be trialled to increase safety.

Occupational therapists can also help with falls prevention.

They will discuss your home environment and explore

ways to adapt furniture or recommend equipment that may prevent future falls, as well as facilitate referrals to external agencies to support patients once home.

DIETETICS

Our dietitians will assess your nutritional status and devise an individual programme to improve your nutritional well-being, further reducing the risk of falls.

WHY IS PREVENTING FALLS IMPORTANT?

As well as causing injury, falls can reduce confidence and independence.

The risk of further falls increases greatly after the first incident, particularly if you do not address the causes of the first fall.

FA L L S P R E V E N T I O N

Our Therapies teams recognise the many different reasons why people fall, and offer a wide variety of assessments, individualised intervention and treatment plans.

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Our hand therapists are chartered physiotherapists or occupational therapists specialising in the upper limb. They have a high level of specialisation thanks to advanced postgraduate education and extensive clinical experience.

Many diseases, deformities or injuries that affect the hand can be cared for, treated and returned to an optimal level of recovery through expert handling and guidance using a number of different skills.

The qualified physiotherapist/occupational therapist will accurately assess, identify

and treat problems affecting anywhere in the upper limbs from the shoulder through the upper arm and elbow, down to the forearm, wrist, hand and fingers.

You will get personalised advice on how to deal with any challenges you might face, and what you can do to maximise your recovery or function.

This might include detailed advice on adaptations you can make to your normal activities or useful pieces of equipment to help you with day to day tasks.

Our hand therapists work closely alongside our expert surgeons, helping to plan and deliver post-operative care in order to enhance patient recovery, including after the day of your surgery.

H A N D T H E R A P Y

Hand therapy with wrist, elbow and shoulder specialist care.

TYPES OF UPPER LIMB ISSUES TREATED:

■ Finger, thumb and forearm fractures/dislocations/deformities/surgeries/joint replacements/ligament injuries and more

■ Carpal tunnel syndrome■ Dupuytren's contracture■ Peripheral nerve injuries■ Work related upper limb disorders (WRULD)

■ Triangular fibrocartilage complex (TFCC) tears

■ Any upper limb trauma■ Skin grafts and scar hypersensitivity

■ Volar plate injuries■ Trigger finger.

WHAT KIND OF TREATMENT CAN YOU EXPECT?

■ Exercise programmes for home

■ Splinting■ Hands on treatment■ Evidence-based advice on all elements of your recovery.

The technique is a drug-free and non-invasive manual medicine. Osteopathy is based on the principle that the well-being of an individual depends on their bones, muscles, ligaments and connective tissue functioning smoothly together. Osteopaths use physical manipulation, stretching and massage with the aim of strengthening and treating the musculoskeletal framework.

Our osteopaths specialise in the diagnosis, management, treatment and prevention of musculoskeletal and other related conditions.

DIAGNOSIS AND TREATMENT

Our osteopaths treat the conditions and injuries, not just the symptoms. It is an effective approach that can be used for a wide range of conditions. They will restore a healthy function to your body with

hands-on treatment, intuitive care and personalised exercise programmes.

WHAT TREATMENTS DO WE OFFER?

■ Rehabilitation services■ Deep tissue massage■ Joint articulation and manipulation

■ Biomechanical assessments ■ Taping■ Dry needling and acupuncture ■ Exercise prescription.

THE KEY TOOLS FOR OSTEOPATHIC DIAGNOSIS INCLUDE:

■ Listening to the patient history ■ Examining muscles and joints■ Observing movements

You can be referred by your doctor or consultant, or alternatively you can choose to see an osteopath independently.

Sports and exercise medicine is designed to provide a wide range of non-surgical orthopaedic options and help anyone improve their physical fitness or capacity. It also promotes physical activity for health benefits including a reduced risk of chronic diseases and improved function for arthritis sufferers.

Sports and exercise medicine doctors will also help people return to sport safely and as fast as possible, managing musculoskeletal injuries in conjunction with the Physiotherapy team.

Our consultants specialise in lower back pain, physical activity, arthritis, sports injury, occupational trauma and ultrasound-guided injections. You can be assured that they always stay on the cutting edge of medicine through detailed research and dedication to their profession.

O S T E O PAT H Y S P O R T S A N D E X E R C I S E M E D I C I N E ( S E M ) C O N S U LTA N T S

Osteopathy is a complementary therapy that treats medical disorders by using massage, stretching and manipulation of the skeleton and musculature.

Sports and exercise medicine is a growing specialty that provides preventative and therapeutic expertise.

OSTEOPATHY CAN CONTRIBUTE TO THE TREATMENT AND MANAGEMENT OF THE FOLLOWING CONDITIONS:

■ Aches and pains■ Arthritic pain ■ Disc injuries■ General, acute and chronic back pain

■ Muscle spasms■ Neck pain, headaches and migraines

■ Pelvis, hip and leg problems

■ Postural issues■ Sciatica■ Shoulder or elbow pain (including frozen shoulder)

■ Sports injuries.

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This approach improves physical ability, provides prevention from injury and is used for the development of proper mechanics in physical performance. It addresses your entire development and what is needed to improve performance.

The treatment is widely used to make you more resilient and robust, to make you stronger and to allow you to cope with the physical demands placed upon you.

Strength training is provided to both inpatients and outpatients at The London Clinic.

Our well designed exercise programmes take place under the supervision of experienced rehabilitation therapists and focuses on multiple training methods.

TRAINING SESSIONS MAY INCLUDE THE FOLLOWING:

■ Strength ■ Plyometrics (jumping, hopping and bounding exercises, exerting maximal muscle force in short duration with the aim of improving power)

■ Speed ■ Agility ■ Endurance■ Core stability■ Cardiovascular fitness.

S T R E N G T H A N D C O N D I T I O N I N G

Strength and conditioning uses exercise prescription to specifically improve physical performance.

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E X E R C I S E T H E R A P Y

Exercise therapy is used for rehabilitation after injury, prevention from further injury and for the management of pain.

All our physiotherapists are experts in exercise prescription. Your physiotherapist will assess your problem and prescribe a tailored programme of exercises. These exercises will be progressed and modified according to your specific needs.

Extensive research into exercise therapy supports the use of specific exercise programmes for conditions such as back pain, arthritis, diabetes, osteoporosis and heart disease. During exercise, the brain releases powerful chemicals called endorphins that can help to boost mood and reduce stress.

EXERCISE THERAPY CAN HELP WITH IMPROVING:

■ Cardiovascular and physical fitness

■ Balance■ Spinal stability■ Range of movement■ Health and general well-being, confidence and body image

■ Boosting endorphins (happy hormones) for stress relief

■ Preventing injuries and injury reoccurrence.

Often it is difficult to judge how strong your muscles are or how weak they have become, even for a physiotherapist. Isokinetic assessment and treatment uses a highly sophisticated machine that produces a variable resistance to a movement, allowing your strength to be monitored.

The Biodex machine is a computer-controlled machine in which you sit and push a lever arm, either with your leg or your arm. The force you apply to the apparatus allows our physiotherapists to measure your exact strength. This value can be compared with the normal population or compared with the opposite limb. Not only will it diagnose the weakness, but also at what range of movement the weakness occurs and at what speed. This helps with the preparation of your exercise prescription.

This machine can also be used for specific strengthening exercises to target identified problem areas.

B I O D E X ™ I S O K I N E T I C S Y S T E M

The Biodex™ system is an isokinetic testing machine that provides valuable information to our physiotherapists about strength and muscle imbalances.

THE BIODEX CAN BE USED TO REHABILITATE THE FOLLOWING CONDITIONS:

■ Muscle weakness ■ Sports injuries■ Rotator cuff injuries ■ Neurological conditions■ Tennis elbow■ Patella tendinopathy■ Achilles tendinopathy■ Before and after surgery to walk, run and even jump without risk of injury.

Not only can the Biodex help with strength gains, it can also improve range of movement and loosen stiff joints.

S P E C I A L I S T A S S I S T I V E T E C H N O L O G I E SWhere needed, our physiotherapists can offer you the following technologies to support rehabilitation.

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After suffering an injury or operation, it can be difficult to return to simple tasks, such as walking, let alone running. The AlterG® is a special treadmill that you are zipped safely into. It fills with high-pressure air, gently lifting your bodyweight. It can be programmed to make you lighter, even as low as 20% of your body weight. You will literally be walking on air.

A LT E R G ® A N T I - G R AV I T Y T R E A D M I L L ™

The AlterG® Anti-Gravity Treadmill™ uses NASA technology to speed up your rehabilitation by getting you to move sooner in a pain-free environment.

A shockwave is an acoustic energy wave. It is created outside of the body (extracorporeal) by compressed air, which the physiotherapist then directs onto the affected tissue via a handheld device. This treatment complements your physiotherapy exercise management.

Shockwave therapy affects chronic tendon pain by:

■ Desensitising nerve endings, which often reduces pain immediately

■ Encouraging a proinflammatory reaction within the body, increasing blood circulation and metabolism, which promotes tendon healing.

Shockwave therapy is effective at treating chronic tendon problems and the associated pain, even when other conventional treatments have failed.

S H O C K WAV E T H E R A P Y

Shockwave therapy is a non-invasive, non-surgical, drug-free procedure for the treatment of chronic tendon pain.

THE ALTER-G MACHINE CAN HELP WITH THE FOLLOWING CONDITIONS:

■ Post-surgical rehabilitation

■ Gait and running training■ Weight control and reduction

■ Minimising stress-related and recurring injuries

■ Reduced impact training and athletic conditioning

■ Strength and condition training for older patients.

SHOCKWAVE THERAPY CAN BE USED TO TREAT THE FOLLOWING CONDITIONS:

■ Calcific tendonitis of the shoulder

■ Tennis/golfer's elbow■ Greater trochanteric pain syndrome

■ Hamstring tendinopathy■ Patella tendinopathy■ Plantar fasciitis■ Achilles tendinopathy.

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Electrotherapy can be used to support your physiotherapy treatment goals.

WE OFFER A WIDE VARIETY OF ELECTROTHERAPY TREATMENT MODALITIES, INCLUDING:

■ Transcutaneous electrical nerve stimulation (TENS)

■ Low-level laser therapy■ lnterferential therapy■ Neuromuscular electrical stimulation

■ Ultrasound■ Compex

Compex is one of the more popular treatments for physiotherapy and rehabilitation incorporating electrical stimulation of the muscles during recovery, injury prevention and pain management. It is an innovative treatment, well supported by research and clinical trials, and offers an

alternative option within your bespoke treatment targets. Your physiotherapist will introduce these different electrotherapy treatments to you, and, once you are comfortable using them, give you the option to use them at home, which will accelerate your recovery.

E L E C T R OT H E R A P Y

Electrotherapy uses electrical signals to interfere with the transmission of neutral pain signals into the brain.

PATIENTS WITH PRIVATE MEDICAL INSURANCE

We are recognised by all major insurers. Some insurers will cover all treatments and others only part of the treatment.

It is important to check your policy before the start of treatment, as certain conditions may be excluded from your insurance cover and a limit may be imposed upon the amount that can be reimbursed. You must also ensure that your insurer has pre-authorised your claim before you attend your appointment.

SELF-PAY PATIENTS

We offer the option to pay direct, for patients who do not have private medical insurance or if their treatment is not covered by their plan.

PATIENTS WHO ARE SPONSORED

We also welcome patients who are sponsored by their company or embassy. Once the sponsor has been approved by The London Clinic, and a Letter of Guarantee is received, the account will be settled with them directly.

INTERNATIONAL TEAM

Our International Office can assist patients from abroad with any questions they may have.

PAY M E N T O P T I O N S

ELECTROTHERAPY CAN BE USED EFFECTIVELY FOR:

■ Pain relief■ Tissue repair in acute ligament, tendon, muscular and capsular injuries

■ Reduction of swelling■ Resolution of haematoma■ Relief of muscle spasm■ Reduction of scar tissue■ Stimulation of weak muscles

■ Stimulation of denervated muscles.

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For more information about our self-pay prices, please call the Physiotherapy team on 020 7616 7651 or email physio@thelondonclinic.co.uk

You can contact our International Office by calling +44 (0) 20 3219 3266 or emailing internationaloffice@thelondonclinic.co.uk

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THE LONDON CLINIC PHYSIOTHERAPY DEPARTMENT

Sixth Floor 20 Devonshire Place London W1G 6BW

CONTACTS

T: 020 7616 7651 F: 020 7616 7652 physio@thelondonclinic.co.uk www.thelondonclinic.co.uk

Patients can easily refer themselves by calling, or they can be referred by a consultant, specialist, GP via letter or email. Please note that failure to attend your appointment without sufficient notice may still incur the cost of the appointment.

ONLINE REFERRAL FORM

Our online referral form can be completed when referring a patient to our Physiotherapy team and can be accessed via our website.

H O W TO M A K E A N A P P O I N TM E N T

To discuss your requirements or make an appointment, please contact us on:

The London Clinic is the trademark of Trustees of the London Clinic Limited. Registered company number 307579. Registered charity number 211136.

PATHOLOGY SERVICES AND CONSULTING ROOMSE

CONSULTING ROOMSD

C OUTPATIENT DEPARTMENT AND CONSULTING ROOMS

B THE DUCHESS OF DEVONSHIRE WING

MAIN HOSPITALA

EYE CENTRE AND CONSULTING ROOMS

ADMINISTRATION BUILDING

F CONSULTING ROOMS

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The London Clinic 20 Devonshire Place London W1G 6BW

T: 020 7616 7651 F: 020 7616 7652

physio@thelondonclinic.co.uk www.thelondonclinic.co.uk