How physiotherapy is improving the lives of learning disabled people

Physiotherapist Sian is a valued member of the team at our Evesham service

For Clare, the visits she enjoys each week from physiotherapist Sian Midwinter are lifechanging.

Sian, who runs Midwinter Physiotherapy, visits Clare each week at Hft’s Clementi Court in Evesham, a residential service for adults with learning disabilities who have a range of complex needs.

Clare, 45, has Rett syndrome, making her susceptible to reccurring chest infections which can often result in her being hospitalised.

Sian – who is a specialist in respiratory physiotherapy – visited Clare for the first time in 2014 for chest physio.

More than a decade later she continues to be an important part of Clare’s weekly care.

“Clare had suffered a lot of chest infections and hospital admissions,” said Sian.

“And this in turn was increasing her risk of mortality.”

Due to having Rett syndrome, Clare, who is non-verbal, suffers with a high level of chest secretions and finds it difficult for her to clear mucus herself.

Sian’s physiotherapy sessions with Clare sees her assess her breathing and manage her oxygen levels while treatment includes administering chest percussions and vibrations, to reduce and loosen any secretions from her lungs.

Sian’s twice weekly visits help Clare manage her conditions and prevent hospital stays.

“There was a time when Clare’s admissions to hospital were far more regular,” said Sian.

“Now, with the intervention of the physiotherapy, they are far less frequent.

“The treatment is keeping her well and more comfortable and able to carry on and do the things she enjoys.”

As well as the respiratory work, Sian also works on Clare’s posture with a physiotherapy regime using a series of stretching exercises to keep her body position from deteriorating.

Due to the fact that Clare is unable to mobilise herself, she uses a specialist wheelchair, which ensures correct postural positioning and this is a key part of making sure she is comfortable and her skin integrity is maintained.

Sian has also trained Hft’s support practitioners at Clementi Court to use equipment and techniques.

The team are now competent in how to use suction to keep Clare’s chest free of secretions and also to use a special vibrating vest – known as the ‘giggle vest.’

The vest is fitted around Clare’s torso twice a day and vibrates. In turn it shakes the chest area and loosens secretions so they can be expelled

“It’s called the giggle vest because when we put it on Clare and it starts vibrating, she starts to giggle,” smiled Sian.

As well as the ‘giggle’ vest, Sian has also trained the team to use a Lung Volume Recruitment (LVR) Bag which administers deep breaths to Clare, allowing her to clear secretions from her chest.

Clare also enjoys twice weekly massage sessions with visiting therapist Emily Papirnik, who has been seeing her for 19 years

As well as Clare’s twice weekly sessions, Sian provides physio support to other adults with learning disabilities at Clementi Court.

One of the individuals supported by Sian is Sarah, 46, who has Cerebral Palsy, scoliosis and a complex anatomy.

The physiotherapy sessions, which involve stretching to reduce further deterioration to Sarah’s posture, help to ensure she is comfortable and keeps infections at bay.

“Sarah is also someone who is at high risk of chest infections due to her conditions,” said Sian.

“Not only does treatment help support her wellbeing, it also supports in de-sensitising her from clinical environments.”
Sian’s support does not stop there.

She also works with partners across the health sector, including occupational therapists, to ensure the people supported at Clementi Court have access to equipment and other services.

She has also supported in the planning of hospital discharges ready for return to Clementi Court.
Clementi Court Service Manager Kelly Jones said: “Sian is a very important part of the family at Clementi Court.

“Not only do her treatments make a real difference to lives of the people we support, she has built trusted relationships with all the individuals at the service and has a deep and real personal understanding of their needs.

“She is not just a physiotherapist – she is their friend and champion.”