Copthorne Reablement Therapy

Copthorne Reablement Therapy We believe home is where independence is built. Based in Shrewsbury, our reablement approach is tailored to where you are now.

Whether you're finding your feet after a health setback or looking to proactively strengthen your future.

What does it really mean to be an Advanced Practice Physiotherapist?In modern healthcare, the term "Advanced Practice" i...
26/08/2026

What does it really mean to be an Advanced Practice Physiotherapist?

In modern healthcare, the term "Advanced Practice" is not a job title or an automatic reward for long service. It represents a distinct level of practice defined by national standards.

A Changing Landscape

Over recent years, the understanding of Advanced Practice has fundamentally shifted from a single-specialty silo to a level of practice. Historically, advanced physiotherapy was viewed through a lens of sub-specialties, such as Physiotherapists running injection clinics. Today, national bodies recognise that advanced practice is defined by a clinician's level of autonomy, diagnostic reasoning, and ability to manage complex episodes of care. This change is supported by unifying national standards such as recent CSP guidance and the updated NHS England Multi-Professional Framework.

How is Advanced Practice Evidenced?

To be formally recognised as an Advanced Practitioner, a clinician must complete post-graduate MSc education and demonstrate verified capability across the four pillars:

1. Clinical Practice - advanced diagnostic reasoning, holistic assessment, autonomous case management, positive clinical risk-taking

2. Leadership and Management - driving service innovation, collaborating across healthcare boundaries, improving clinical safety

3. Education - upskilling patients, families and MDTs through evidence based training

4. Research - translating clinical literature into patient level care, and contributing to peer-reviewed health research

What Are The Benefits for You and Your Family?

Whether navigating recovery after illness, building confidence after a recent fall or working to maintain your mobility over the longer term, having an Advanced Practice Physiotherapist in your corner means receiving the highest standard of evidence-based care.

Here at Copthorne Reablement Therapy, you will be assessed and treated by an Advanced Practice Physiotherapist as standard. You will receive a comprehensive, whole-person view, considering your recovery in the broader context of your medical history, polypharmacy, functional independence, home environment and, most importantly, your individual wants and needs. Our interventions are rooted in the latest rehabilitation science, focusing on restoring functional capacity and building physical resilience.

To see whether our Advance Practice approach can help you or a loved one, get in touch today for a no obligation telephone assessment and to discuss your options

www.copthornereablement.com
[email protected]
07359 729030

Hola!After a short break taking in the awe-inspiring solar eclipse in España, we are officially back to it!We spent a wo...
23/08/2026

Hola!

After a short break taking in the awe-inspiring solar eclipse in España, we are officially back to it!

We spent a wonderful fortnight together as a family, appreciating nature's performance. We have recharged our batteries and have returned home with new ideas, enthusiastic about what the coming months will bring.

Gracias to our existing clients for your patience and understanding, and to our new clients for reaching out while we were away. It's been lovely to catch up with you all in person.

Alex and Siobhan

🌞SUMMER HOLIDAY NOTICE🌞Just a quick update to say that we are taking a short summer break. We will be away from Saturday...
07/08/2026

🌞SUMMER HOLIDAY NOTICE🌞

Just a quick update to say that we are taking a short summer break.
We will be away from Saturday 8th August - Thursday 20th August 2026.

Whilst we will not be routinely monitoring our inboxes, please feel free to reach out to us on email, WhatsApp or Messenger, and we will be back in touch with you as soon as we return.

Thank you for your continued support and understanding. We look forward to seeing all our wonderful clients soon!

Alex and Siobhan

☎07359 729030
📩[email protected]
🌐copthornereablement.com

Hey therapists, it’s CPD time!Reflect on an ageing patient with impaired balance. How do you systematically consider the...
29/07/2026

Hey therapists, it’s CPD time!

Reflect on an ageing patient with impaired balance. How do you systematically consider the deficits that might be at play, and target your interventions for the maximum clinical effectiveness?

Deconstructing "Balance" Beyond the Tandem Stance

In clinical practice, we hear: "How is their balance?"
However, biomechanically, balance is just a state of static equilibrium, achieved when the net forces acting on a body equal zero (Po***ck et al., 2000).
In reablement and human movement, what we actually assess and treat is Postural Control (Horak, 2006).

🔬 The Clinical Triad: Sensorimotor Inputs & Age-Related Decay

Postural control relies on real-time integration across three primary inputs, each undergoing distinct physiological changes with age.

1. 👁️ Visual Processing: Provides spatial orientation relative to surrounding objects and visual horizons. Ageing brings decreased contrast sensitivity, reduced depth perception, and cataracts. Structural ocular changes are irreversible, but vision is highly modifiable through refractive corrections, lighting, and visual-fixation retraining.

2. 🦶 Somatosensory & Proprioceptive Input: Feeds data regarding surface compliance, foot contact forces, and joint position. Ageing causes a loss of cutaneous mechanoreceptors and intrinsic foot muscle atrophy, directly impairing postural stability (Wang et al., 2024). Crucially, this system is reversible through targeted "foot core" loading and dynamic foot-ground mechanics (McKeon et al., 2015).

3.👂 Vestibular System: Senses gravity, linear acceleration, and angular head movements. Ageing leads to a progressive loss of otolith and semi-circular canal hair cells. This can affect the relationship between head movements and reflexive eye movements, causing transient visual instability (i.e.: when looking both ways to cross the road). Peripheral hair cells cannot regenerate, but functional deficits are highly modifiable via CNS neuroplasticity through targeted Vestibulo-ocular reflex adaptation, gaze fixation and habituation protocols.

🧠 CNS Integration & Sensory Re-Weighting

The CNS acts as an integrator. When one sensorimotor input degrades, the CNS must rapidly sensory re-weight the remaining inputs to maintain stability (Peterka, 2002).

💡 Clinical Insight: This compensation explains why so many falls occur at night. When vestibular or proprioceptive inputs are compromised, the CNS over-relies on vision. Turn off the lights, and the client suddenly loses their primary anchor for dynamic stability.

⚙️ Predictive vs. Reactive Postural Control

To build true physical resilience, we must address two distinct motor control pathways (Horak, 2006):

• Anticipatory Postural Adjustments (APAs): Feedforward control. Pre-programmed postural muscle activation occurring prior to voluntary movement (e.g., stabilising the trunk before reaching into a cupboard)

• Reactive Postural Adjustments (RPAs): Feedback control. Rapid motor responses triggered by unexpected external perturbations via ankle, hip, or stepping strategies.

The Copthorne Reablement Approach

Standard, low-velocity static drills predominantly train predictable feedforward balance. But real-world falls don’t happen in predictable situations. At Copthorne Reablement Therapy, our 4-Pillar Neuro-Kinetic Method goes further to mirror real life:

- Active Biomechanics: Strengthening the foot core and intrinsic foot muscles to maximise proprioceptive feedback and digital grip force from the base of support (Menz et al., 2006; McKeon et al., 2015).

- High-Velocity Power: Retraining rate of force development so recovery steps can be generated rapidly.

- Graded Perturbations & Dual-Tasking: Directly challenging feedback (RPA) pathways in safe, real-world home environments to achieve real-world fall reduction (Sharma et al., 2025).

Contact us to see how together we can improve your balance in the comfort of your own home.
📍Serving Shrewsbury & Surrounding Areas
☎️Phone: 07359 729030
🌐Website: copthornereablement.com
📩Message us today to discuss our custom multi-week reablement packages or flexible pay-as-you-go options

👏 Join me in congratulating our very own Alex Pitas on graduating with his MSc in Advanced Practice from Keele Universit...
13/07/2026

👏 Join me in congratulating our very own Alex Pitas on graduating with his MSc in Advanced Practice from Keele University this afternoon 🎓

We are so very proud of all you have achieved and how tremendously hard you have worked since starting this journey in 2023. Now let's see what the next three years brings!

👟 Hey therapists, it’s CPD time!We often talk about walking speed as the "sixth vital sign" in geriatric medicine, heavi...
10/07/2026

👟 Hey therapists, it’s CPD time!

We often talk about walking speed as the "sixth vital sign" in geriatric medicine, heavily correlating with hospital avoidance, fall reduction, and long-term autonomy.

But what is the most evidence-based way to rehabilitate it?

Recent high-level evidence and clinical guidelines suggest two proven methods. Reflecting upon your own exercise prescriptions, which technique do you favour?

🔬 Jiang et al. (2025)
A robust RCT tracked older adults over 24 weeks across three streams: Combined Resistance & Balance Training (RBT), Resistance Training (RT) alone, and a non-exercise control group.

The Clinical Highlights from Jiang et al.:
🏆 The Core Winner: While both active groups gained strength, the combined RBT group demonstrated vastly superior gains in dynamic balance and lower limb muscle function.
⚡ The Vital Sign Shift: Only the group doing combined resistance exercises on unstable, high-proprioceptive support surfaces achieved a statistically significant improvement in normal walking speed.

🧠 The Plot Thickens: Expanding the Evidence Base
Does the wider literature agree that standalone strength work fails to improve gait speed? Not necessarily. It all comes down to how you prescribe it.

The Supporting Evidence: The Power of Synergy
Corroborating Jiang’s findings, a 2026 study by Aminirakan et al. highlighted that multi-mode exercises delivered by physiotherapists produce far superior, synergistic effects on working memory, dynamic balance, and walking speed in older adults compared to single-mode physical exercise. Separating strength and balance into isolated silos limits real-world functional transfer.

The Counterpoint: The Prescription Nuance
However, the landmark 2026 American College of Sports Medicine (ACSM) Position Stand on resistance training prescription offers a nuanced counter-view. Synthesising data from over 30,000 participants, the ACSM overview established that progressive resistance training alone significantly improves gait speed and balance.

The Catch?

To achieve these functional gait gains via standalone resistance training, the prescription must strictly feature:
🏋️ Heavy loads: ≥80% of 1-Repetition Maximum (1RM).
🚀 Power resistance training parameters: Utilising a high-velocity, fast concentric phase.

🔬 The Takeaway for Clinical Practice
If you are handing out generic, lower-intensity, single-modality exercise sheets, you simply aren't going to shift systemic gait metrics or improve walking speed. To truly optimise a reablement pathway, you have two clear, evidence-based choices:

Choice A: Weave progressive resistance directly into unstable, multi-pillar balance environments to drive deep neuromuscular adaptations (The Jiang / Aminirakan approach).

Choice B: Drastically increase your RT parameters to true high-intensity heavy loading or high-velocity concentric power work (The ACSM approach).

🛡️ How We Practice
Our Four Pillars approach at Copthorne Reablement Therapy listens directly to the evidence. By developing structural strength with progressive loading and applying it directly to dynamic, reactive balance scenarios, we prepare our clients to deal with the unexpected.

👇 Over to you, fellow Physios: Which side of the fence do you lean towards for gait correction? Are you utilizing unstable-surface multi-pillar work, or are you pushing your frailty caseloads into heavy, high-velocity 80%+ 1RM loading?

copthornereablement.com
[email protected]
07359 729030

👋 It’s time to meet the other half of the duo!Meet Siobhan Harding, Co-Founder and Advanced Practice Physiotherapist for...
05/07/2026

👋 It’s time to meet the other half of the duo!

Meet Siobhan Harding, Co-Founder and Advanced Practice Physiotherapist for Copthorne Reablement Therapy.

In 2013, Siobhan graduated with a BSc in Physiotherapy and the School of Health and Rehabilitation Award for Academic Performance from Keele University. Siobhan spent her early career as a rotational physiotherapist at SaTH, gaining expertise in inpatient discharge planning and rehabilitation in the emergency department, medicine, orthopaedics, respiratory, cardiology and stroke. She went on to lead the launch of a multidisciplinary, interagency front-door frailty admission avoidance team, before graduating as an Advanced Clinical Practitioner (ACP) in Frailty in 2021.

Drawing on her interest in falls prevention and extensive background in delivering Comprehensive Geriatric Assessments in the acute sector, Siobhan is bringing her high-level clinical excellence directly into the community. She is deeply passionate about transforming life after having a setback—whether that be a hospital discharge or a fall at home. She uses evidence-based practice, including her own published research in the international journal Age and Ageing, to ensure older adults achieve their true physical potential at home. Furthermore, as a strong advocate for education, Siobhan is making it a core part of Copthorne Reablement Therapy's to provide specialist training to those looking after older adults living with frailty, including care agencies and residential care settings. She believes we can work together to enhance the care experience for everyone.

Outside of healthcare, Siobhan is mum to a little boy and soon-to-be step-mum to Alex's sons (with a wedding planned for Summer 2027!). She belongs to The People's Show Choir in Shrewsbury, plays crown green bowls, takes the boys on adventures far and wide, and happily taste-tests Alex's Italian cooking!

Unsure if advanced physiotherapy is the right fit for you and your family? We would love to hear from you. Siobhan is always happy to give honest, no-obligation clinical guidance. Book in for a free 15-minute phone call directly with her to discuss your personal needs.

Alternatively, working with a care home or agency? Get in touch about our training packages.

Website: copthornereablement.com
Email: [email protected]
Call or message: 07359 729030

You might be wondering who will be guiding your rehabilitation journey. We've been here a while now, so it's time to int...
02/07/2026

You might be wondering who will be guiding your rehabilitation journey. We've been here a while now, so it's time to introduce ourselves...

Meet Alex Pitas, co-founder and Advanced Practice Physiotherapist for Copthorne Reablement Therapy

Originally hailing from Wisconsin, USA, Alex moved across the pond and completed his BSc in Physiotherapy from Keele University in 2010. Alex has worked in the local healthcare economy ever since. He has taken on a variety of roles during his time with SaTH including physiotherapist, therapy quality improvement lead, service manager for frailty, discharge liaison and, most recently, advanced practitioner in acute medicine.

Drawing on his extensive experience managing acute recovery and navigating complex hospital discharges, Alex is brings his clinical expertise directly into the community. He is passionate about transforming rehabilitation for older adults, driving recovery through evidence-based interventions tied to each patient's unique functional goals.

Outside healthcare, Alex is a busy dad to three boys and his cat Artemis. You'll usually find him planning elaborate adventures, hiking the Shropshire Hills, tending to the garden, or cooking up delicious Italian food (carbonara is his specialty).

Unsure if advanced physiotherapy is the right fit for you and your family? Alex is always happy to give honest, no-obligation clinical guidance. Book in for a free 15-minute phone call directly with him to discuss your personal needs.

Website: copthornereablement.com
Email: [email protected]
Call or message: 07359 729030

Hey therapists its CPD time! 🧠📉 Let’s reflect on a presentation we see every single day in older adults: Dynapenia. Iden...
30/06/2026

Hey therapists its CPD time! 🧠📉 Let’s reflect on a presentation we see every single day in older adults: Dynapenia.

Identify one older adult on your caseload who exhibits signs of dynapenia rather than sarcopenia. Have you identified dynapenia as the problem? Are you just training for hypertrophy, or are you challenging their neuromuscular system with power and velocity?

What is Dynapenia?

Sarcopenia refers to the age-related loss of muscle mass. Dynapenia is the age-related loss of muscle strength and power. The issue isn’t necessarily a loss of contractile tissue; it is a failure of the nervous system to optimally recruit the muscle fibres they do have.

The evidence here is stark. Longitudinal data shows that while older adults lose approximately 1% muscle mass per year, they lose muscle strength at a massively accelerated rate of up to 4% per year (Goodpaster et al., 2006).

The Compounding Risks

We can't ignore the broader clinical picture when weakness sets in:

The Ultimate Predictor: Muscle strength is a far more reliable independent predictor of all-cause mortality and mobility limitations than muscle mass alone (Newman et al., 2006).

Dynapenic Obesity: Profound weakness plus excessive adipose tissue, compounds clinical risks. Community-dwelling older adults with dynapenic obesity face a 50% to 73% higher risk of all-cause mortality (Scott et al., 2017) and significantly heightened fall risks (Lv et al., 2022).

Multimorbidity: This isn't just a musculoskeletal issue. Older adults with dynapenia have 1.38x higher odds of developing two or more chronic diseases over 10 years (Veronese et al., 2023).

Clinical Manifestations

🪑The Sit-to-Stand Struggle: Relying heavily on upper limb momentum or armrests to get out of a chair.

🐢Reduced Gait Speed: An inability to accelerate.

💪"Heavy" Limbs: Patients reporting disproportionate fatigue during low-intensity ADLs.

⚠️Impaired Balance & Near-Misses: A reduced ability to generate the rapid, high-velocity force needed to recover from a trip or slip.

Why Neuromuscular Retraining is Non-Negotiable

If the primary deficit is neural drive and a lack of fast-twitch Type II muscle fibres, isolated traditional hypertrophy training isn’t helpful. Foundational research clearly links these strength deficits to central activation failure and reduced motor unit discharge rates (Clark & Manini, 2008).

🏃‍♀️To combat this, we must prescribe high-velocity resistance training. Training with a focus on the speed of the concentric phase forces the central nervous system to recruit those high-threshold Type II motor units. We have to train the brain-to-muscle connection to fire faster and harder, not just build a bigger muscle.

Here at Copthorne Reablement Therapy, we use up-to-date clinical evidence to carefully inform your personalised exercise prescription. Neuromuscular power stands as one of the four core pillars of our programs, which are specifically designed to help you achieve your personal functional outcomes, whatever your baseline may be.

📍Serving Shrewsbury and the surrounding areas
☎️ 07359 729030
💻 copthornereablement.com
Message us today to discuss our custom multi-week reablement packages or flexible pay-as-you-go options

🕒 Need Help Fast? We’re on the Way!​At Copthorne Reablement Therapy, we know that when you call, you need personalised s...
28/06/2026

🕒 Need Help Fast? We’re on the Way!

​At Copthorne Reablement Therapy, we know that when you call, you need personalised support quickly. Your recovery shouldn't have to wait for Monday morning.

​We pride ourselves on our responsiveness and dedication to your journey

​Timely Responses: We get back to you on the same day as your enquiry.

​Weekend Urgent Visits: If the situation is urgent, we make home visits happen, even on Saturdays and Sundays.

​Completely Personalised: We tailor every aspect of our care to your unique needs and goals.

​Don't let the calendar delay your progress. Get in touch to see how we can help you or your loved one today!

​Message us or call to learn more
🌐 copthornereablement.com
☎️ 07359 729030
💻 [email protected]

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Copthorne Road
Shrewsbury
SY38LP

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+447359729030

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