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What is the Carr and Shepherd approach?

The motor learning approach developed by Carr and Shepherd is used in the treatment of individuals with neurological difficulties. This approach is based around the principle that the brain is dynamic and capable of reorganisation and adaptation following injury to the brain or spinal cord. The Carr and Shepherd approach encourages active participation of the patient making treatment functional and task orientated in order to achieve the best possible recovery following injury. For example, stair mobility, getting in and out of the bath and making a cup of tea.

mobilisation and stretch exercises to the hip, knee and ankle applied by a specialist physiotherapistAbove: mobilisation and stretch exercises to the hip, knee and ankle applied by a specialist physiotherapist

Principles of Carr and Shepherd

The Carr and Shepherd approach believes that rehabilitation should commence as soon as possible following injury. Immediate treatment helps to prevent non-use of the affected side, muscle weakness, loss of endurance and mental and perceptual deterioration. Early rehabilitation also helps stimulate the patients learning abilities in both motor and cognitive function.

The principles of the Carr and Shepherd approach include the following:
  • Treatment is task orientated
  • Importance of cognitive and perceptual function as well as motor function
  • Use of affected side to carry out movement
  • Use of verbal and visual prompts to encourage the patient to think about task and learn from treatment
  • Discourage compensatory movement
  • Prevent muscle shortening as this leads to spasticity and abnormal movement.
  • Active participation of patients – doing exercises in between treatment sessions and monitoring their practise.
  • Treatment is context specific in a stimulating, functional environment based around daily tasks.

Benefits of Carr and Shepherd

The Carr and Shepherd approach believe that patients will learn more easily in familiar everyday situations that have meaning. This kind of environment will facilitate retrieval of previously stored functions. This type of treatment will help:
  • Increase muscle strength
  • Stretch tight muscles and prevent soft tissue contractures
  • Improve cognitive function
  • Regain motor control
  • Relearn function of affected side
  • Improve functional tasks such as sit to stand, walking, reaching and grasping
  • Improve the sequence of functional activities in order to achieve a specific aim.
  • Improve posture
  • Increase independence
The Carr and Shepherd approach also emphasises the importance of verbal and visual cues, instructions and explanations which help patients think things through. These cognitive strategies also help re-imprint previously stored functions.

How use Carr and Shepherd

The specialised neurological physiotherapists at commonly use the Carr and Shepherd approach to the rehabilitation of patients with different neurological disorders. This approach is used in conjunction with other types of treatment depending on the individual their symptoms and their goals. This allows the physiotherapists at to maximise the potential of every patient we treat. Physiotherapy treatment using the Carr and Shepherd approach will improve independence with daily tasks and quality of life.

Carr and Shepherd treatment is currently used to treat many neurological conditions including: Carr and Shepherd physiotherapy will help improve motor and cognitive function by actively involving the patient using movements in a functional way in an environment that is meaningful for the patient. This approach will therefore make everyday activities a great deal easier and increase independence.

At, our physiotherapists understand that having a neurological condition can be life changing for both you and those close to you. Physiotherapy treatment will be fun and effective. Many patients enjoy treatments sessions and develop close relationships with our physiotherapists. This, combined with increased function and independence, allows our patients to lead as fulfilling lives as possible.

If you would like to know any more information about the Carr and Shepherd Concept or would like to book an assessment, please contact today on 0330 088 7800. You can alternatively book an appointment online!

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