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National Disability Insurance Scheme Physiotherapy

Updated: Apr 9


My name's Emma. I'm a Physiotherapist, Pilates & Fitness Instructor and Yoga Therapist.

I am based in West End, Brisbane, Queensland, where I provide face to face and online programs.




I work as a provider with NDIS participants assisting with their health & wellbeing, function and goals.


Physiotherapy has a significant impact on the lives of NDIS participants.



Image of Emma Najman, NDIS Physiotherapist


NDIS - What does it mean?


  • National: The NDIS is being introduced progressively across all states and territories.


  • Disability: The NDIS provides support to eligible people with intellectual, physical, sensory, cognitive and psychosocial disability. Early intervention supports can also be provided for eligible people with disability or children with developmental delay.


  • Insurance: The NDIS gives all Australians peace of mind if they, their child or loved one is born with or acquires a permanent and significant disability, they will get the support they need.


  • Scheme: The NDIS is not a welfare system. The NDIS is designed to help people get the support they need so their skills and independence improve over time.

NDIS key words


  • Permanent and significant disability: A permanent disability means your disability is likely to be lifelong. A significant disability has a substantial impact on your ability to complete everyday activities.


  • Supports and services: Assistance or products that help a person in their daily life and help them participate in the community and reach their goals.


  • Early intervention: Providing support to a person, either a child or an adult, as early as possible to reduce the impacts of disability or developmental delay and to build their skills and independence.



Image of a Participant working with her Physiotherapist on her exercise program

NDIS Purpose:


  • Nationally consistent access criteria and streamlined, high quality services.

  • Individual has choice over type and mix of supports, how they are delivered and managed.

  • Level of assistance is demand driven, with support when and where needed or wanted.


  • Funds support to promote the participants capacity to participate in daily life, community or employment.


  • A single pool of government funding managed by NDIA. Funding is managed by the participant, with the participant choosing how to best use funds, empowering the participant.

Accessibility to allow persons with disabilities to live independently and participate fully in all aspects of life ensuring equal access to:

  • Physical environments,

  • Information and technology,

  • Facilities and services in urban and rural settings,

  • Identification and elimination of barriers and obstacles,

  • Development of guidelines for accessibility, public for private,

  • Provision of accessible supports and information.

Physical and Environmental Barriers to Accessibility Include:

Social

Attitudinal

Organisational

Communication

Cultural

Inclusion:

  • To facilitate full enjoyment, inclusion and participation in the community;

  • To choose where and who persons live with;

  • To access supports for living and inclusion in community;

  • To access community services on an equal basis to the rest of the community.

Information Linkages and Capacity Building:

  • Enabling participation and contribution to the community;

  • Information to make choices and decisions;

  • Benefit from mainstream services like everyone else;

  • Benefit from community services like everyone else.

The role of the NDS (National Disability Strategy) is providing inclusive and accessible communities:

  • Rights, protection, justice and legislation.

  • Economic security.

  • Personal and community support.

  • Learning and skills.

  • Health and wellbeing.



Conditions which are likely to meet the disability requirements include:

  • Intellectual disability

  • Autism

  • Cerebral palsy

  • Genetic conditions

  • Spinal cord injury or brain injury resulting in paraplegia, quadriplegia or tetraplegia, or hemiplegia.

  • Permanent blindness in both eyes.

  • Permanent bilateral hearing loss

  • Deaf blindness

  • Amputation or congenital absence of two limbs.


Image of a Participant exercising on a Pilates Reformer in a Physiotherapy Session

Permanent conditions for which functional capacity are variable and further assessment of functional capacity is generally required include:

1.Conditions primarily resulting in Intellectual/ learning impairment including:


  • Intellectual disability

  • Pervasive developmental disorders not meeting severity criteria in List A or List C

  • Asperger syndrome

  • Atypical autism

  • Childhood autism.

Chromosomal abnormalities resulting in permanent impairment.

2. Conditions primarily resulting in Neurological impairment:


  • Alzheimer’s dementia

  • Creutzfeldt-Jakob disease

  • HIV dementia

  • Huntington’s disease

  • Multi-infarct dementia

  • Parkinson’s disease

  • Post-polio syndrome

  • Vascular dementia.


Systemic atrophies primarily affecting the central nervous system:


  • Adult-onset spinal muscular atrophy

  • Progressive bulbar palsy of childhood

  • Friedrich’s ataxia

  • Hereditary spastic paraplegia/ Infantile-onset ascending hereditary spastic paralysis/ spastic paraplegias, Huntington’s disease/Huntington’s chorea

  • Louis-Bar syndrome

  • Motor neuron disease/Motor neurone disease

  • Primary lateral sclerosis

  • Progressive bulbar palsy

  • Spinal muscular atrophy – all types

  • Spinocerebellar Ataxia


Extrapyramidal and movement disorders, including Parkinson’s disease.


Other degenerative diseases of the nervous system, including alzheimer’s disease.


Demyelinating diseases of the central nervous system, including multiple sclerosis.


Episodic and paroxysmal disorders, including strokes.


Polyneuropathies and other disorders of the peripheral nervous system.


Other disorders of the nervous system, including Hydrocephalus.

3. Conditions resulting in Physical impairment:



Image of a Participant exercising on a Pilates Reformer in a Physiotherapy exercise session

  • Amputations

  • Congenital absence of limb or part thereof

  • Juvenile arthritis / Stills Disease (excluding monocyclic/self-limited Adult Onset Stills disease)

  • Rheumatoid arthritis.


Diseases of myoneural junction and muscle including muscular dystrophy.


Cerebral palsy and other paralytic syndromes:

  • Cerebral palsy

  • Diplegia

  • Hemiplegia

  • Monoplegia

  • Paraplegia

  • Quadriplegia

  • Tetraplegia.

4. Conditions resulting in Sensory and/or Speech impairment

5. Conditions resulting in multiple types of impairment:


mucopolysaccharidoses.


Congenital conditions – cases where malformations cannot be corrected by surgery or other treatment and result in permanent impairment but with variable severity:

  • Arnold-Chiari Types 2 and 3/Chiari malformation

  • Microcephaly

  • Fetal alcohol syndrome

  • Spina bifida

6. Conditions resulting in psychosocial disability.




Image of Participant working with a Physiotherapist on his exercise program

NDIS Funding streams are self managed, plan managed or NDIA* managed.

*NDIA is the National Disability Insurance Agency.

Self Managed:

NDIA provides the participant with funding, participant manages all supports.

The participant can work with any provider, does not have to be NDIS registered.

Plan Managed Funding:

NDIA provides funding in the participant’s plan to pay for a plan manager who helps with managing finances and completes financial reporting.

Can use NDIS or non-NDIS registered provider, however plan-manager must be NDIS registered.

NDIA managed Funding:

NDIA pays providers on behalf of participants.

Participants can only work with NDIS registered providers.

NDIS Registration Groups:

1/. Specialist Disability Registration Groups.

2/. Professional Registration Groups, including Physiotherapy.

3/. Other Registration Groups.

4/. Home and Vehicle Modification Registration Groups.

5/. Assistive Technology and Equipment Registration Groups.


Key Stakeholders:

  • NDIA Planners

  • Support Coordinators

  • Plan Managers

  • Partners in the Community-Local Area Coordinators (LAC) and Early Childhood Early Intervention (ECEI).

  • Registered Providers

  • Non Registered Providers


Physiotherapy is in the capacity building NDIS Plan Funding Category under health and wellbeing.


Physiotherapy Can Include:

  • Functional assessment,

  • Participant goal setting,

  • Support worker, carer and family training,

  • Equipment assessment and recommendation,

  • Gym and hydrotherapy programs,

  • Liaison with the multidisciplinary team managing the participant and safeguarding.



Image of a Participant engaging in a Physiotherapy exercise program on a Pilates Reformer

How do I get started with Physiotherapy as an NDIS participant?

  • Complete an application with NDIS.

  • Once accepted meet with a planner.

  • Complete a statement and create goals.

  • An NDIS plan is developed with money allocated to core, capital or capacity building budgets.

  • Money is allocated to therapy and other budgets.

  • Therapy services can commence by choosing your Physiotherapist if you are self or planned managed.

  • Physiotherapy intervention, goals, outcome measures are established and you will work together to achieve your goals.


NDIS Decision Making Principles:


  • The request is reasonable and necessary.

  • Assisting the participant to achieve their goals.

  • Facilitating social and economic participation, (work/education).

  • Effective and beneficial for the participant.

  • Most appropriately funded by NDIS.

  • Value for money.

  • Reasonable expectation of informal networks.

  • Will vary over the lifespan of an individual.


Disability Intervention Theory:

  • Systems model of motor control is established by the complex interaction of multiple different body systems.


  • Posture and movement adapt to change to the body systems.


  • Feedback is essential to motor control.

Optimising Motor Performance:


  • Task orientated

  • Importance of cognitive and perceptual function

  • Use of verbal and visual prompts to think about task and learn from intervention

  • Active participation doing exercises in between therapy sessions and monitoring their practice

  • Intervention is context specific in a stimulating, functional environment based around daily tasks

  • Targets activity and participants level of function


Image of a Participant engaging in a Physiotherapy exercise program on a Pilates Reformer



Principles Of Rehabilitation:

Based on motor learning and brain plasticity mechanisms:


  • Repetitive practice

  • Dosage

  • Task specific practice

  • Goal orientated practice

  • Individualised intervention measures aligned to participant goals

  • Social interaction

The Whole Week Approach Is Used:

  • Focus is on facilitating independence from therapy

  • Utilising other supports, including home exercise programs carer programs and incidental therapeutic opportunities.

  • Includes setting up of the program

  • Monitoring the program

  • Feedback

  • Training of carers as applicable


Physiotherapy interventions include:

  • Skill development and capacity building

  • Functional rehabilitation

  • Supporting participation activities

  • Cardiovascular exercise

  • Sport and recreation

  • Impairment based interventions


Monitoring and modifying interventions includes:

  • Checking and reviewing with the participant

  • Checking and reviewing with a disability support worker and or family as applicable

  • Progressions

  • Outcome measurement to monitor efficacy

  • Identification of barriers to change


Image of a Participant engaging in a Physiotherapy exercise program on a Pilates Reformer


Physiotherapy Subjective Assessment Dependent On Condition Includes:


  • Diagnosis

  • Past medical history

  • Allergies

  • Investigations

  • Medications

  • Function

  • Social

  • Equipment

  • Psychological

  • Communication/swallowing

  • Posture

  • Vision

  • Hearing

  • Pain

  • Falls

  • Care/Support Team

  • Participant’s main perceived problems

  • Participant’s goals

Physiotherapy Objective Assessment Includes:


  • Gaining a clear understanding of all impairments at a body structure and function level.

  • Activity based assessment assessing performance and working out contributing impairments for further assessment.

  • Observational assessment of activity performance and working out contributing impairments for further assessment.



Body Systems Assessed:


  • Motor activity

  • Range of movement

  • Strength

  • Tone

  • Sensation

  • Proprioception

  • Coordination

  • Balance

  • Posture

  • Skin integrity

Functional Assessment Dependent on Condition Can Include:

  • General observations

  • Bed mobility

  • Transfers

  • Sitting

  • Standing

  • Walking

  • Wheelchair mobility



Image of a Participant working with her Physiotherapist on her exercise program

Assessment is by Goal Assessment Scale.

Outcome measures selected are specific and relevant to the function addressed by Physiotherapy.

Physiotherapists have an important role to play in identifying barriers and enablers to participation.

Physiotherapy is available face to face or via Telehealth.

End Physio NDIS Physiotherapy Programs are available face to face or online via an app.




Unsure where to start? Click the link below to get you started NOW:


NDIS Starter program: https://www.endphysio.com/ndisstarter



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