Neurological physiotherapy at home: a guide for NDIS participants and families

If you live with a neurological condition, such as stroke, multiple sclerosis (MS), Parkinson's disease, acquired brain injury or cerebral palsy, physiotherapy may be part of your NDIS plan. This guide explains what neurological physio is, why some people choose to have it at home, what the research says, and how to use your NDIS funding for it.

What is neurological physiotherapy?

Neurological physiotherapy focuses on movement and physical function for people whose nervous system has been affected by a condition or injury. A physiotherapist assesses things like strength, balance, walking, transfers (for example getting in and out of a chair or bed), fatigue and how you manage everyday tasks. Together you then agree on goals and a plan, which usually includes exercise and practice of the activities that matter to you.

Neurological conditions are different from each other, and each person's situation is different too. A good plan is built around you: your diagnosis, your goals, your energy levels, your home, and the people who support you.

What does the evidence say?

Research consistently supports active, task-specific practice and exercise for many people with neurological conditions:

  • Stroke. Australia's Living Clinical Guidelines for Stroke Management (Stroke Foundation) recommend repetitive practice of walking (or parts of walking) for people who have difficulty walking, and repetitive task-specific training for people with arm weakness [1]. The Stroke Foundation also encourages regular physical activity after stroke [11]. A large review of physical therapy research after stroke found evidence for many interventions that involve practising functional tasks with high repetition [2].

  • Multiple sclerosis. A 2019 review describes exercise as safe and effective as a symptomatic treatment in MS, and suggests it be individually prescribed and tailored to each person [3]. MS Australia provides information on exercising with MS [4].

  • Parkinson's disease. A Cochrane review of 39 trials found that, compared with no intervention, physiotherapy improved measures such as walking speed and balance over the short term (under three months); the differences were mostly small, and there was no difference in falls [5].

Research results describe averages across groups of people. They can't tell you how you will respond, which is why assessment and regular review matter.

Why physio at home?

Many people choose home visits for practical reasons: travel can be tiring, transport can be hard to arrange, or fatigue makes clinic visits difficult. There are also therapy reasons to work at home:

  • Practising in the real place. The stroke guidelines highlight the value of practising real tasks [1]. At home, that might mean your own stairs, shower, bed, kitchen or front step.

  • Your own equipment. Your physio can check how you use your walking aid, wheelchair, rails or other equipment where you actually use them, and help you raise questions about equipment with your team.

  • Involving your supports. Family members or support workers can be present and learn the exercises, if you want them to be.

  • Safety checks. A home visit gives a chance to talk about trip hazards and safe ways to move around your space.

Home visits aren't right for everyone. Some people need equipment only available in a clinic or hospital, or benefit from a group setting. Your physio should tell you if another service would suit you better.

What happens at a home visit?

A typical first visit includes:

  1. A conversation about your health, history, goals and what a good week looks like for you.

  2. An assessment of movement, balance, strength and how you manage key tasks at home.

  3. A plan you agree on, often including a home exercise program written or recorded in a way that suits you.

  4. Follow-up visits to practise, review and adjust the plan. How often depends on your goals and your NDIS funding.

Bring along (or have on hand) any reports from your doctor, hospital or previous therapists, and a list of your medications.

Exercising safely between visits

Exercise between sessions is usually an important part of physiotherapy. Do only the exercises your physio has set for you, and stop and seek advice if you notice new or worsening symptoms such as chest pain, dizziness, new weakness or a fall. For new stroke-like symptoms (face drooping, arm weakness, speech problems), call 000 immediately [6]. The Safe Exercise at Home website, an Australian physiotherapy-led resource endorsed by the Australian Physiotherapy Association, has general guidance and exercise programs for older people and people with mobility limitations [7].

Using your NDIS plan for physiotherapy

Physiotherapy is commonly funded under Capacity Building – Improved Daily Living in an NDIS plan, where it relates to your disability and goals [8]. Thrive charges in line with the NDIS Pricing Arrangements and Price Limits [9].

How you can use providers depends on how your plan is managed [10]:

  • Self-managed and plan-managed participants can choose registered or unregistered providers.

  • NDIA-managed (agency-managed) participants must use registered NDIS providers.

About Thrive United Physio: we provide home-visit physiotherapy for adults with NDIS plans in Melbourne's south-east, inner south and west, and right across Melbourne, and we're currently taking new referrals. We are not a registered NDIS provider (registration is in progress), so we can only see self-managed and plan-managed participants. Visits are delivered by an Ahpra-registered physiotherapist.

To ask about a referral, use the form at thriveunitedphysio.com.au or call 0426 207 796. We reply within 48 hours.

This article is general information, not medical advice. Talk to your doctor or physiotherapist about your situation.

Sources

  1. Stroke Foundation. Living Clinical Guidelines for Stroke Management, Chapter 5: Rehabilitation. https://informme.org.au/guidelines/living-clinical-guidelines-for-stroke-management

  2. Veerbeek JM, et al. What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PLoS One. 2014;9(2):e87987. https://doi.org/10.1371/journal.pone.0087987

  3. Dalgas U, Langeskov-Christensen M, Stenager E, Riemenschneider M, Hvid LG. Exercise as medicine in multiple sclerosis—time for a paradigm shift: preventive, symptomatic, and disease-modifying aspects and perspectives. Current Neurology and Neuroscience Reports. 2019;19(11):88. https://doi.org/10.1007/s11910-019-1002-3

  4. MS Australia. Exercise. https://www.msaustralia.org.au/health-and-wellbeing/exercise/

  5. Tomlinson CL, et al. Physiotherapy versus placebo or no intervention in Parkinson's disease. Cochrane Database of Systematic Reviews. 2013;(9):CD002817. https://doi.org/10.1002/14651858.CD002817.pub4

  6. Stroke Foundation. Signs of stroke. https://strokefoundation.org.au/about-stroke/learn/signs-of-stroke

  7. Safe Exercise at Home. https://www.safeexerciseathome.org.au

  8. NDIS. What are capacity building supports. https://www.ndis.gov.au/participants/using-your-funding/different-budget-types/what-are-capacity-building-supports

  9. NDIS. Pricing arrangements. https://www.ndis.gov.au/providers/pricing-and-payments/pricing/pricing-arrangements

  10. NDIS. What is a provider. https://www.ndis.gov.au/participants/working-providers/get-know-your-providers/what-provider

  11. Stroke Foundation. Mobility and exercise after stroke (fact sheet). https://strokefoundation.org.au/what-we-do/for-survivors-and-carers/after-stroke-factsheets/mobility-and-exercise-after-stroke-fact-sheet

Ask about neurological physiotherapy at home

For NDIS self-managed and plan-managed participants. We reply within 48 hours.

Submit a Referral Enquire About Our Service