Dr Gita Ramdharry is helping community physiotherapists gain tools to support people with neuromuscular conditions.
Tell us about your job
I have a dual role as a clinical academic. I am an Associate Professor of Rehabilitation Sciences at the Faculty of Health, Social Care and Education at Kingston & St George’s University of London, where I teach undergraduate and master’s level students and I supervise three PhD students. I am also a specialist neuromuscular physiotherapist at the Centre for Neuromuscular Diseases at UCLH (University College London Hospitals), conducting rehabilitation research studies of adults with nerve and muscle disease.
I find that my experience treating patients at the centre hugely influences the research questions I eventually work up into funded studies.
What drew you to this area of practice?
Having worked clinically in neurology for many years, I developed an interest in the nerve and muscle patients that I treated at the National Hospital for Neurology and Neurosurgery, UCLH. I eventually studied a PhD looking more closely at gait parameters in one of the more common conditions, Charcot-Marie-Tooth disease (CMT), which I completed in 2008.
How does physiotherapy help people with muscle-wasting conditions?
There are many different neuromuscular diseases and as a group, they can be highly variable. A large number are life-long and progressive. A key role for physiotherapists is helping people to manage their condition over their life-span. Dedicated intervention can help with focused issues such as balance and falls, orthotic management, fatigue management, or maintaining muscles’ length. We also have a very important role in general exercise for wellbeing and life-long physical activity, which can be challenging to problem solve with patients if they have limited mobility.
I personally find this field very rewarding clinically, and have built up some excellent relationships with people who have made significant changes to their lifestyles that impact greatly on their wellbeing.
Is it only for specialists?
A knowledge of the pathophysiology of the conditions is very helpful to understand the range of impairments people present with. There have been questions around safety of interventions such as exercise, for example, so knowing the background to this is helpful in busting some myths.
However, most neurological or community physiotherapists have the skill set to work effectively with adults with neuromuscular diseases. Sometimes people may feel thrown if they come across a condition they haven’t heard of. It’s just a matter of providing more information on conditions and highlighting key areas of practice, or where additional specialities may be required, as with respiratory issues, wheelchairs and orthotics.
There is a whole separate branch of paediatric practice in neuromuscular diseases, but I treat adults, and I would need to defer to my specialist paediatric colleagues on best practice for children!
Tell us about Muscular Dystrophy UK’s new training programme
I have led a small team of specialist physiotherapists to develop an online module for physiotherapists who may come across adults with neuromuscular diseases in their practice. This covers respiratory management, transition and mobility, postural management, contracture management and how people with neuromuscular diseases present, as well as exercise, orthotics, fatigue and outcome assessment.
The module is available through Muscular Dystrophy UK, which has commissioned the work as part of the Department of Health-funded Bridging the Gap project. It can be accessed by any physiotherapist who wants to sign up.
Any plans for the coming break?
Break? What’s that? In-between house renovations and the paper and grant writing that is expected of academics, I’ll be setting up a new study of fall interventions for people with inherited neuropathies and completing a study of aerobic exercise training in two neuromuscular conditions in the new year.” fl
You can find out more about the adult neuromuscular care eLearning module for physiotherapists, produced by Muscular Dystrophy UK, here.
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