About

 

 

Who We Are

The Clarence Centre was established in 1987 by Evi Sideri Logothetis, a Consultant Physiotherapist and Senior Bobath Tutor. We have been treating children and adults with cerebral palsy and other neurological and developmental health conditions for over 30 years.

We work together with children and their families living with cerebral palsy and other neurological health conditions to help improve and maintain quality of life. Our ethos is that everyone should have the chance to live life to its fullest and to achieve the things they want to achieve. Whilst function is at the heart of what we do for some individuals our therapy simply gives the freedom to move; to allow our clients to be comfortable in their bodies, to live life without pain to focus on achieving the things that are important to them.

Recent research shows that babies and children learn through carrying out goal directed movements independently (Morgan et al 2015) and there is a strong focus on this during therapy sessions to ensure carry over from therapy into daily life. Babies and young children come to our therapy centre to play; older children come to learn the functional activities they or their families have identified or carry out exercises whilst listening to music, playing games or carrying out activities that are both enjoyable and meaningful to them.

Our main intervention is the Bobath Concept which was specifically developed to treat cerebral palsy and other neurological conditions. We use it in conjunction with other physiotherapy treatments and work closely with children and their families to carry out goal directed, task specific therapy for optimum learning and to ensure carry over from therapy into daily life.

We work closely with local and NHS therapists to promote a holistic approach to each child’s or young person’s needs and local therapists are welcome to observe sessions.

Although we are mainly a Physiotherapy Centre we can provide occupational therapy and speech and language therapy when needed.

Who Do We See

  • Babies, children and young people with cerebral palsy and other neurological conditions;

  • Premature babies and post neo-natal care follow up;

  • Babies and young children with developmental delay or those who are not reaching their milestones;

  • Children before and after selective dorsal rhizotomy (SDR), botox or surgery;

  • We also see babies and children with other neurological conditions or those who do not yet have a diagnosis.

Many of the health conditions the children and young people we work with have are lifelong conditions and many of our clients continue to come to us as they grow into adults; we therefore have the experience to consider referrals from adults with cerebral palsy and other neurological conditions. 

 

What is Cerebral Palsy

Cerebral palsy is one of the commonest childhood disabilities (Oskoui et al. 2013). It is an umbrella term that describes a group of disorders caused by damage to the developing brain before, during, or for up to two years after birth. Cerebral palsy is defined primarily as a disorder of movement and posture as the signals to and from the brain that control movement are affected to varying degrees. There is increasing recognition about the accompanying disorders that may be present in cerebral palsy such as visual, sensory, perceptual, cognitive difficulties, communication and behaviour, epilepsy and musculoskeletal difficulties (Rosenbaum et al. 2006).

Cerebral palsy can make everyday activities difficult for the growing child. While some children are severely affected others may only have a mild condition.

Some babies might need help learning to roll or crawl so they can move towards a toy or they might need help learning how to sit independently so they can use their arms to reach, explore and play; while others might need to practise their head control or find the best ways to be held or seated to be able to use their eyes most effectively or to help them align their airways to help them eat and drink more safely. School age children might want to find ways to move around their environment more easily so they can play with their friends whilst others might need strategies to help keep their joints and muscles mobile so they can sit comfortably and pain free in their chairs to be able to go on family or school trips.

We use the GMFCS and MACS / Mini MACS to classify what functional level each child is at for their gross and fine motor skills. These are evidence based classification systems and can help to predict future functional levels.

The Bobath Concept

The Bobath Concept was developed by Dr and Mrs Bobath in the 1940's and continues to be used extensively throughout the world today. Many NHS therapists are trained as Bobath therapists.

The Bobath Concept is a problem-solving approach that uses in depth knowledge of human movement and the development of human movement to understand why an individual might experience difficulty carrying out functional activities to be able to participate in daily life.

It is based on detailed observation and analysis of movement whilst also considering associated difficulties that may be present such as visual, sensory and perceptual difficulties and an individual’s environmental factors (e.g. the make-up of their family and home environment, the institutions they are part of such as nursery, school or groups).

Therapeutic handling techniques or changes to the environment are applied to find ways for individuals to be able to carry out the activities that are important to them; the aim whenever possible is to gradually remove handling techniques and to adapt the environment for activities to be carried out more independently. The Bobath Concept focuses on increasing the variety of movement and independent movements to allow individuals to learn through new experiences that might not otherwise be available to them. Recent research shows that babies and children learn through carrying out goal directed movements independently (Morgan, et al, 2015) and there is a strong focus on this during therapy sessions to ensure carry over from therapy into daily life.

There is a strong emphasis on teaching those around the child how to apply these techniques in their everyday lives, either through handling or through adapting the environment. Therapy priorities are determined together with the child where possible and the family or main caregivers.

At the Clarence Centre we use the Canadian Occupational Performance Measure (COPM) as part of our initial assessment to establish family centred goals and for progress to be reviewed at the end of treatment.

The Bobath Concept is a living concept that continues to develop; taking into account new and ever changing evidence within the field of neuroscience and physiotherapy practice.

“I have been coming to the Clarence Centre since I was 5 - I am now 34. The therapists are talented professionals who also have a real and rare understanding of and sensitivity towards disabled people. Coming to the Clarence Centre has helped me more than I can say in this short review. I cannot recommend it highly enough” (client).