Welcome to

Your path to recovery

Meet Sheetal and Lisa

Physical and Occupational Therapist Duo

Lisa and Sheetal have worked alongside each other for almost 8 years, bringing a wealth of experience and expertise to their clients. They have not only collaborated at one of the top ranked NY Rehabilitation facilities but have also worked side by side to deliver care to clients and their families within the home, offering personalized and compassionate support every step of the way. Lisa and Sheetal work closely on each case to provide interventions that guide clients closer to their goals. Working with Lisa and Sheetal as a team offers a number of benefits, including their combined expertise, personalized approach, and exceptional level of care. Clients can trust that they will receive the highest quality treatment, tailored to their individual needs, from two experienced and dedicated therapists from NEUROPATH | Expert Neurological Rehabilitation & Therapy.

What We Specialize In

Rehabilitation

Advise

Individualized care plans

Integrative approach

Support

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Testimonials

‘I can't recommend this team more. After spending a month in the hospital, I came home with low to no expectations on when I would feel somewhat better. Lisa and Sheetal quickly assessed my situation, came up with a multi month plan to get me back on my feet. Double vision, balance and stamina issues were overcome quickly and effectively considering my situation and I'm so thankful for these two. I would highly recommend them to help overcome some of the toughest things someone needs to face.”

BRAIN INJURY SURVIVOR, 46
RYE, NEW YORK
WORKED WITH NEUROPATH IN 2023

My husband (a 10 year stroke survivor with paralysis of the right side and expressive aphasia) and I endorse Lisa Spinelli and Sheetal Thayil, of NEUROPATH, without reservation. Their respective professionalism, skill set and empathy provide him with the physical maintenance he requires but also with the motivation to keep “trying.” Their knowledge of outside resources to access is a tremendous help to me as a caregiver for someone with a severe disability. Lisa and Sheetal work in tandem to develop the best comprehensive plan to address his needs incorporating occupational and physical therapy techniques but with compassion and patience. As a result of their communication with him and each other, effective “atta boys” and “tough love” are delivered as needed. We are very grateful for their expertise and dedication.

WIFE/CAREGIVER OF STROKE SURVIVOR
WHITE PLAINS, NEW YORK
WORKING WITH NEUROPATH SINCE 2022

Our family feels fortunate to have Sheetal and Lisa providing occupational and physical therapy to my husband following his severe brain injury. They are enthusiastic and proactive in their treatment regimen. They are unfailingly cheerful even on the most difficult of days. They are knowledgeable and receptive to questions and concerns about any particular aspect of the rehabilitation process. They are creative and open to suggestions to help further tailor their treatment to the patient's needs, personality, and sensibilities. They have an abundance of professional and personal qualities that makes us very happy to have them in our homecare team.

WIFE/CAREGIVER OF BRAIN INJURY SURVIVOR
GREENWICH, CT
WORKING WITH NEUROPATH SINCE 2024

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We love a device that has multiple uses…especially in stroke recovery! The level of motor planning, digit isolation and concentration this required for our stroke survivor was the perfect challenge this Monday morning! Comment “TOOL” for link! #StrokeSurvivor #NeuroPlasticity #BrainInjuryRecovery #HandTherapy #StrokeTherapy #PhysicalTherapy #OccupationalTherapy #MotorRecovery #RewireTheBrain #NeuroHealing #StrokeSupport #CVARecovery #RegainIndependence #NeuroPT #NeuroOT #StrokeRehab #HandFunction #DexterityTraining #TherapyWorks #SmallWins

Ataxia significantly impairs trunk stability which leads to postural instability. Therefore, incorporating trunk stabilization with proximal stability is one of the layers to treating someone with ataxia. Focusing on closed chain exercises further enhances proprioceptive feedback and joint stability prior to open chain/gait training can help set them up for success!

We love coming up with easy exercises that a patient and their caregiver can follow through at home. We love anything plantigrade as HEP especially for someone with ataxia as it gets the patient to stand, weight shift, while still working on their core and being safe! We love referencing this article by Amy Bastian for HEP, A Home Balance Exercise Program Improves Walking in People with Cerebellar Ataxia, but still keeping in mind ways to individualize them! Also, if you are into the cerebellum - read anything by Amy Bastian - it will not fail!

#neurorehab #neurorehabilitation #occupationaltherapy #physicaltherapy #neuropt #physicaltherapystudent #occupationaltherapystudent #ataxia

Over the weekend we listened to a very interesting podcast on protein and it's multifaceted role that goes beyond just skeletal muscles.

Once again this conversation comes up frequently with patients and their family members, this specific podcast encompasses everything - from energy levels, to daily requirements, from plant vs animal protein, to supplements and use of protein powders!

Last year we listened to another podcast on medbridge with @jjmowderpt and Dr Carole Lewis on the importance of assessing frailty, deconditioning and sarcopenia. It all comes full circle! Our role goes beyond just doing sets and reps with our patients. They rely on us for so much more information and trust us to provide that as well!

#neurorehab #neurorehabilitation #physicaltherapy #occupationaltherapy #geriatricphysicaltherapy #patienteducation

You asked, and here it is! This post is a mix of insights from research and various podcasts we’ve explored. Fast forward to the last slide—we’re especially curious about where this could go in the future. What are your thoughts? Have you seen anything clinically that adds to the conversation?

We took a deep dive into this topic because more patients on GLP-1 agonists—or those considering it—have been asking us questions. While some were best directed to their endocrinologist or primary care provider, many fell within our scope of practice. Let’s discuss! ⬇️

#NeuroRehab #StrokeRecovery #BrainHealth #GLP1 #NeuroPT #NeuroOT #PhysicalTherapy #OccupationalTherapy #HealthcareInnovation #BalanceTraining #Neuroplasticity #RehabScience #ClinicalPractice #TherapistLife #EvidenceBasedPractice #MedicalResearch

These sessions always end up being the most incredible! Let’s end the week strong 💪 #medicalhumor #therapyjokes #neurorehabilitation #physicaltherapist #occupationaltherapist #therapyhumor #physicaltherapyhumor

When your stroke survivor with Lateropulsion self corrects to midline without cueing after weeks of working on it! #medicalhumor #therapyjokes #neurorehabilitation #physicaltherapist #occupationaltherapist #therapyhumor #physicaltherapyhumor #occupationaltherapyhumor #ot #pt #neurorehab #pushersyndrome

Did you know there are two types of pushing ?!

Both conditions affect postural control differently and require tailored rehabilitation strategies.

Which do you see more of in your practice?

#PusherSyndrome #BalanceTraining #StrokeSurvivor #NeuroPlasticity #VestibularRehab #CerebellarAtaxia #NeuroRehab #StrokeRecovery #BrainInjuryRehab #PhysicalTherapy #OccupationalTherapy #NeuroPT #NeuroOT #RehabLife #TherapyWorks #StrokeAwareness #PTlife #OTlife #NeuroScience #NeuroEducation

You asked and here it is - some ideas if you are working with a patient with lateropulsion. Videos for all these coming up!

Rationale for all exercises
1. Increasing sensory input into the intact side

2. Facilitating visual scanning to the affected side

3. Active reach/weight shift towards the unaffected side (we never “push a pusher”)

4. Encouraging weight shift into the affected lower extremity by minimizing the “push” of the unaffected leg

5. Facilitating crossed extension patterns into the affected lower extremity

Consider ways to gamify these interventions or make them a circuit, and think about ending with anything functional at the end e.g. walking.

#pusher #lateropulsion #ot #pt #neurotherapy #neurorehab

When we think of motor recovery we need to look at the whole picture.

For this specific arm, there is some underlying apraxia, hemiparesis, decreased proprioception & edema limiting movement.

🔺The use of a target allows the stroke survivor to judge where his arm is during the task and improves overall attention to the task

🔺The gentle resistance not only provides some strengthening (this only works if there is enough motor output to overcome the resistance) but it also helps with motor planning and by bringing some awareness to where the limb is in space. Overcoming the appropriate amount of resistance (appropriate amount being the key word) allows this survivor to recruit more muscle fibers and receive additional feedback as to which movement I am requesting him to do.

🔺Using these strategies also benefits the carryover you will see in movement for functional tasks. Not filmed and shown here was this same survivor repeating the initial video without a target and resistance with much better results.

#OccupationalTherapy #strokerehab #ArmRecovery #OTStrokeInterventions #StrokeRecovery #NeuroRehabilitation #OTRehabilitation #ArmFunction #OTGoals #RehabilitationJourney #FunctionalRecovery #OccupationalTherapist #OTLife #ArmStrength #OTInspiration #neurotherapy #strokerehab

We LOVE bouncing ideas off each other! This allows for more practice, more reps, more plasticity and overall benefits!

We combined a series of upper extremity proprioceptive exercises (mentioned below) during active recovery in between our crawling circuit (added bonus weight bearing into the left arm just before these!)

1. Arms in neutral ball rolling
2. Arms flexed, ball rolling with eyes open and closed
3. Resisted L Arm extension into the wall to gradual release (away from the wall)

Goals
✅ Sensory integration
✅ Object manipulation
✅ Motor control

#neurorehab #neurorehabilitation #physicaltherapy #occupationaltherapy #physicaltherapystudent #occupationaltherapystudent #strokerehab

HAPPY VALENTINE’S DAY FROM NEUROPATH TO YOU! #rehabjokes #valentinesday

In honor of Valentine’s Day….give yourself and your coworkers some love for all your incredible ideas! #medicalhumor #therapyjokes #neurorehabilitation #physicaltherapist #occupationaltherapist #therapyhumor #physicaltherapyhumor #occupationaltherapyhumor #ot #pt #neurorehab

Part one of the session -
Clock yourself app (multidirectional stepping)
2min on, 1min off

Part two of the session -.
- Gait training at fast speeds while holding her phone and reading an article loud, first with the right hand then the left (weaker arm)
- Above performed with turns to the right and left at random

Goal achieved -.
✅ Intensity
✅ Dual task
✅ External focus
✅ Strength training
✅ Proprioceptive input
✅ Balance
✅ Tone reduction
✅ Functional use of upper extremities

#neurorehab #neurorehabilitation #physicaltherapy #physicaltherapystudent #balancetherapy #strokerehab

When we first had our patients with lateropulsion - we were baffled. We didn't know what to do especially if they were at a low level! These interventions in sidelying really helped set our patients up for success.

So next time you have someone with lateropulsion, try some of these and then follow it with transfer or gait training, and notice the difference!

Nolan et al 2023 in their article Clinical practice recommendations for management of lateropulsion after stroke determined by a Delphi expert panel highlighted the benefits of incorporating sidelying into treatment guidelines.

Over the next few days, we'll be talking about various interventions, techniques and strategies we have incorporated into our practice over the years from this article that have been beneficial!

Stay tuned!

#neurorehab #occupationaltherapy #physicaltherapy #strokerehab

When you can use the kids play room for all your crazy interventions! Double win! Thanks @jjmowderpt for the ataxia intervention pyramid!
#neurorehab #physicaltherapy #occupationaltherapy #strokerehab #physicaltherapystudent #occupationaltherapystudent

Tag your work BFF to give them a good laugh before bed! #medicalhumor #medicalmemes #healthcarehumor

Sorry not sorry?!
Jokes aside, we see and know their true potential, this started out with him giving me 10 reasons not to do the car transfers today, to him trying to convince us that we need to listen to an entire song on the radio before we continue, to him finally completing the entire thing with minimal assistance, minimal verbal cues and minimal rest in between.

It's important to switch things up while still making it challenging for your patient! And sure we get told we are torturing them, but at this point, that's a compliment! 😂

#neurorehab #neurorehabilitation #physicaltherapy #neuropt #physicaltherapystudent #occupationaltherapy #occupationaltherapystudent

We posted this as a story a few weeks ago, and got a few requests to make this a reel - so here it is!

Kneeling to walking on knees are great activities to work on stability and controlled mobility. The rationale for specific techniques used in this reel are -

1. Resistance reinforces learning, and can also provide irradiation into weaker muscles
2. Quick stretch at hip flexors to facilitate excitation
3. Approximation to stimulate postural muscle activation, and improve stability
4. Weight bearing helps with normalizing tone.

(Modified and inspired by @dr.trevor.neuropt kneeling post, with application of PNF principles)

#neurophysicaltherapy #neurorehabilitation #physiotherapy #physicaltherapy

A message to our fellow healthcare workers as we enter a new week. Share with your favorite healthcare hero’s and remind them of how special they truly are ❤️ #healthcare #healthcareworkers

Where are our neuro lovers? #neuro #neurorehablitation #neurotherapy #neuropt #neuroot #stroke #tbi #medicalhumor

External and internal rotation are often overlooked in neuro rehab of the upper extremity post stroke. Incorporating these into your treatment plan early and as tolerated (pain free is critical) can lead to less pain and better motor recovery of the UE during long term recovery. #strokerehab #strokerehabilitation #armrecovery #neurorehablitation #neurorehab

Part 2 to yesterday's reel - follow up to manual therapy ✨ NEURO RE-ED✨

1. Yellow theraband assisted exercise to simulation PNF for hamstring and DF recruitment (added bonus core and irradiation)
2. Eccentric control towards an external target that's challenging (light enough to move, and the beads made it loud when it was pushed)
3. Closed chain to simulate the demands of gait

The biggest thing to consider with these exercises in a Homecare setting are -
1. Can my patient do it frequently at home?
2. Can they set themselves up?
3. Is it fun?
4. Can it be built into their routine?

All of these things can help increase compliance!

#neurorehab #physicaltherapy #physicaltherapystudent #neuroreeducation

If someone told me I'd be doing joint mobs and functional mobilization when I was in PT school - I would have gagged! But fast forward, you really can't make significant gains without working at the joints and tendon level first.

Here, our patient just completed a round of gastroc botox and here are a few things we worked on -
1. TA mobs
2. Calcaneal mobs
3. Calcaneal distraction
4. Hold relax
5. MWM towards DF
6. PNF for hamstring and DF recruitment with irradiation
(Detail of videos of each to follow)

Follow these with neuro re-ed and you truly set your patient up for success!

#neurorehab #physicaltherapy #manualtherapy #strokerehab

During the first 10min of the evaluation - he mentioned being fearful because he was dizzy for almost one year, feeling frustrated that he has seen 6 different healthcare providers, completed 2 MRIs and still without answers

During the last 25 minutes of the evaluation - we identified all his problem areas, talked about interactions with one another, it's impact on function and dizziness, explained hearing loss and tinnitus in detail, discussed lifestyle factors as we discovered those could be his triggers

End result - a very happy appreciative patient, felt reassured, felt motivated, felt empowered!

We spend the most time with our patients than any other healthcare provider and on a frequent basis, healing starts in the mind and if they know and understand what's happening within them - that journey to recovery has already begun!

#patienteducation #vestibularrehabilitation #dizziness

Maybe some of you are resetting goals, or maybe some of you are back to your old routine, or some are being motivated to create new chapters and routines. And that's perfectly normal at the start of the new year. But that also comes with a sensation of defeat on the days when we can't stick to our goals, we get too hard on ourselves.

We see this with our patients as well - when they are challenged, they get frustrated "Why can't my body listen? Why can't I move it like before? Why don't I feel like doing therapy today? I missed doing my exercises for a week and now it's pointless" and we always remind them that "it's ok, it's a process, it's not perfection, we can pick up where we left off"

The reality is: Kindness is cool. Patience is in. Loving yourself is demure.

Whether you are a survivor or caregiver or therapist that is reading this, we hope you find peace in the "down" days. And reassurance that you will and can have good days after. It truly is a marathon and not a sprint!

#therapymotivation #physicaltherapy #occupationaltherapy #goals #newyearresolution

Assessing isolated components of the Fugl-Meyer Lower Extremity (FMA-LE). Are you familiar with performing the Fugl-Meyer Lower Extremity (FMA-LE)? Drop a ⭐️ if you’re using it in your practice! Research links pinned in the comments #research #goldstandard #fmale #fuglmeyerassessment #fuglmeyer

We love trialing new interventions before 9am! Thanks @dr.trevor.neuropt for the inspo! Original video linked! https://www.instagram.com/reel/DCzD31WJpQy/?igsh=MWRqMXU0bXB6b3dxOA== #neurorehab #neurorehablitation #neuroOT #neuroPT

Send this to someone you love doing epic healthcare with even on a weekend/holiday! #medicalhumor #therapyjokes #neurorehabilitation #physicaltherapist #occupationaltherapist #therapyhumor #physicaltherapyhumor #occupationaltherapyhumor #ot #pt #neurorehab

⚪ Mental practice strengthens neural pathways
⚪ Electrical stimulation or vibration facilitates sensory feedback and movement

Adding the two together with movement - increases multi-sensory input and improved motor output (as seen here!!!)

We also love kneeling and this is a great position/exercise to work on great toe extension ALSO required for walking and terminal stance phase!

#neurorehab #neurophysiotherapy #neurophysicaltherapy #strokerecovery #ptexercises #physicaltherapy #physiotherapy

Looking for a way to help educate patients & family members about Lateropulsion? We got you! We use a combination of visual aids, drawings, and demonstrations to help them understand why this is happening. We’ve incorporated these strategies in family meetings, discharge planning meetings, and have even helped some social workers understand the process, as they spend time with the families too.
We discuss specific brain centers involved in this process, and connect it to what we’re doing in therapy. This is especially important if the patient is expected to receive hands-on care at home. These small educational insights go a long way in a caregiver’s journey and a patient’s recovery.

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