Understanding Neurophysiotherapy: A Personal Perspective

For most of my life, I believed the physical changes I experienced with cerebral palsy—tightness, weakness, and declining mobility—were simply something I had to accept. 

I have spastic diplegia cerebral palsy, which primarily affects my legs. This means I experience muscle tightness (spasticity), reduced strength, and difficulty with balance and coordination. Walking has never been automatic for me, but over time it became more difficult, more exhausting, and less reliable. 

I had always been told that I would experience the effects of ageing earlier than my peers. So when my mobility declined, I assumed this was just the beginning of that process. I thought what I was experiencing was inevitable. 

It wasn’t. 

Realising something wasn’t right 

The turning point came when my youngest child no longer needed a pram. 

Without it, I suddenly realised I could no longer walk safely without support. My balance and coordination had deteriorated so much that I would sometimes freeze on the spot, unable to initiate movement. What I hadn’t realised was that the pram had quietly become my mobility aid. 

When I lost that support, I also lost my stability and confidence. 

At the time, I believed this confirmed what I had always been told—that I was experiencing early decline. I feared I was on an inevitable path towards needing a wheelchair in the near future. 

Trying different options 

I began trying to find ways to keep walking safely. 

I first tried using a walking stick on my stronger side, but it offered very little stability. I remained slow and unsteady and was constantly worried about falling. 

Next, I tried a rollator walker. Not only did it make me feel decades older than I was, but it didn’t meet my needs. Because of how spastic diplegia affects my legs, they couldn’t keep up with the walker, which caused me to fall forward and sustain injuries. Rather than helping me walk, it seemed determined to introduce me to the ground as often as possible. 

At the same time, I was trying to find the right medical support. Having grown up outside the Australian medical system, I had no clear pathway to follow. It felt like searching for a needle in a haystack. I went through multiple referrals and dead ends, without finding answers that explained what was happening in my body. 

Photo provided curtesy of CPSN

Finding the right help 

Eventually, I was connected with a surgeon at Royal Children’s Hospital who also treated adults with cerebral palsy. He recommended tendon-lengthening surgery, which became a turning point in my journey. 

After surgery, I completed a year of intensive rehabilitation. It was during this time that I was introduced to neurophysiotherapy for cerebral palsy—a specialised approach that simply didn’t exist when I was growing up. 

For the first time, I began to understand what was happening in my body. 

I learned that my muscles were not only weak, but often failed to activate properly, or at all. In my case, spasticity had been masking that weakness for years. While it created a sense of stability, it also meant that my underlying muscle strength and movement patterns were gradually becoming less effective. 

What is neurophysiotherapy? 

Neurophysiotherapy is different from general physiotherapy. 

It focuses on retraining the communication between the brain and the body. Through highly repetitive, task-specific practice, it promotes neuroplasticity—helping the brain form new pathways and more efficient movement patterns. 

Instead of only strengthening muscles, it works on how movements are planned, coordinated, and carried out. 

For me, this meant reducing spasticity, strengthening weak muscles, and retraining my brain to produce more coordinated and efficient movement patterns. 

Rebuilding how I walk 

Through ongoing neurophysiotherapy, I began to rebuild the way I moved. 

I progressed from using forearm crutches, to walking poles which is what I use  to walk independently and confidently every day. I now walk for an hour each day, having gradually increased my distance as my strength, balance, motor planning, and confidence have improved. 

This didn’t happen quickly or easily. There were falls, setbacks, pain, and fatigue along the way. At times it felt like one step forward and two steps back. But over time, the repetition, guidance, and consistency made a difference. 

What once felt like an inevitable loss of mobility has been replaced with the ability to walk confidently and independently again. 

Understanding motor planning 

Another key challenge of my CP is motor planning. 

My brain often knows what it wants to do, but it cannot always send the right signals in the right order. This affects how I start movement, change direction, respond to uneven ground, or recover from a trip. 

Because spastic diplegia already affects my balance, these motor planning difficulties further increase my risk of falling. 

Even when therapy improves my physical range of motion, my brain still needs to learn entirely new movement patterns before those gains translate into everyday function. That process requires repetition, time, and expert guidance. 

Why ongoing therapy matters 

Neurophysiotherapy is not something you can do once and then manage on your own. 

Because of the way cerebral palsy affects my muscles and movement patterns, I need ongoing support to maintain progress. Without it, abnormal movement patterns return, fatigue and pain increase, and the risk of injury grows. 

I often need what I think of as a “reset” between sessions to ensure I continue moving safely and efficiently. 

Even though I walk every day and follow my exercise program, I cannot independently identify or correct these patterns. I rely on my neurophysiotherapist to guide my movement and make adjustments that prevent me from developing new compensations. 

A personal reflection 

Seven years ago, before I restarted physiotherapy, that I hadn’t had since I was a teenager,  I believed I was inevitably losing my ability to walk. 

Today, I walk independently for an hour every day. I am able to move more safely, with greater confidence, and with far less fear of falling. 

These changes are not accidental. They are the result of years of consistent neurophysiotherapy, intensive rehabilitation, and daily effort. What I once thought was permanent decline has, in many ways, been something I could improve with the right support. 

Neurophysiotherapy hasn’t just changed how I move—it has changed what I believed was possible. 

If you are noticing changes in your mobility, balance, or fatigue—particularly if you have spastic diplegia or another form of cerebral palsy—it may help to explore supports such as neurophysiotherapy. 

You can learn more about how different symptoms connect to the right health professionals using the My CP Guide symptom matrix.