Key points

• A miscarriage is the early loss of a pregnancy.
• Recurrent miscarriage is when this happens three or more times.
• Around 1% of women have recurrent miscarriages.
• Most couples who have had recurrent miscarriages still have a good chance of a successful pregnancy in the future.
• If you have had recurrent miscarriages, you may be offered blood tests and a pelvic ultrasound scan to try and identify the reason for them.
• Despite careful investigations, it is often not possible to find a reason for recurrent miscarriage.
• Your doctors will not be able to tell you for certain what the outcome will be if you become pregnant again.

About this information

This information is for women and couples who have had three or more miscarriages. It is based on the Royal College of Obstetricians and Gynaecologists (RCOG) guidance, last reviewed in 2011. It explains:

• Some of the known reasons for recurrent miscarriage;
• The most effective ways of investigating and treating women who have experienced recurrent miscarriages.

National guidance aims to help you and your healthcare team make the best decisions about your care. It is not meant to replace advice from a doctor or midwife about your own situation.

This guidance does not look at reasons or treatment for a single miscarriage.

What is recurrent miscarriage?

A miscarriage is the loss of a pregnancy at some point during the first 23 weeks. There is a 10 - 15% chance of miscarriage with any pregnancy, and most miscarriages occur within the first 12 weeks.

Recurrent miscarriage is when three or more pregnancies end in miscarriage. 1% of couples who are trying to conceive have recurrent miscarriages, and for women and their partners it can be an incredibly distressing situation.

For some women experiencing recurrent miscarriage, there is a specific reason for their losses. For others, however, their repeated miscarriages may be due to chance alone.

For around half of women who have recurrent miscarriages, no underlying cause is found.

What are the reasons for recurrent miscarriage?

A number of factors may play a part in recurrent miscarriage. It is a complicated problem and more research is still needed.

Abnormalities in the embryo

An embryo is a fertilised egg. An abnormality in the embryo is the most common reason for single miscarriages. However, the more miscarriages you have, the less likely this is to be the cause of them.

Your age and past pregnancies

The older you are when you become pregnant, the greater your risk of having an abnormality in the embryo and therefore the greater your chance of having a miscarriage.

Having multiple miscarriages in the past may also increase the likelihood of having another one.

Lifestyle factors and weight

Smoking, excessive alcohol or caffeine intake, and having a body mass index (BMI) above 25 are all associated with increased risk of miscarriage, and may therefore be a factor in recurrent miscarriage for some women.

Genetic factors

For around 3 - 5% of women who have recurrent miscarriages, they or their partner have an abnormality in one of their chromosomes (the structures within our cells that contain our DNA and therefore determine the genetic features we inherit from our parents).

Although such abnormalities may cause no problem for you or your partner, they may sometimes cause problems if passed on to your baby, and therefore be a reason for recurrent miscarriage.

Autoimmune factors

Antibodies are substances produced in our blood in order to fight off infection. Some people produce antibodies that react against the body’s own tissues; this is known as an autoimmune response.

Antiphospholipid antibodies (aPL) are an example of antibodies that react against the body’s own tissue and are strongly associated with recurrent miscarriage.

About 15% of women who have had recurrent miscarriages have antiphospholipid antibodies in their blood, compared to fewer than 2% of women who have normal pregnancies. If you have antiphospholipid antibodies and a history of recurrent miscarriage, your chances of a successful pregnancy may be reduced.

Abnormalities in womb structure

It is not clear how far major irregularities in the structure of your womb can affect the risk of recurrent miscarriage. Women with serious anatomical abnormalities affecting their womb, and who do not have treatment for them, appear to have a higher risk of miscarrying or giving birth early.

Minor variations in the structure of your womb do not cause miscarriage.

Weak cervix

In some women, the entrance to the womb (the cervix) opens too early in the pregnancy and results in a miscarriage. This is known as a weak cervix, and is only recognised as a possible cause of miscarriage in the second and third trimester (from 13 weeks onwards).

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common condition in which an imbalance of hormones causes symptoms including irregular or absent periods, or changes in aspects of your appearance.

It is sometimes, but not always, associated with ovaries that appear larger than normal on an ultrasound scan and have more follicles (fluid filled spaces containing developing eggs) than normal ovaries. Having polycystic ovaries on an ultrasound scan does not necessarily mean you have PCOS, and not all women with PCOS have polycystic ovaries.

Having a diagnosis of PCOS has been linked with having an increased chance of miscarriage, however the exact association with recurrent miscarriage isn’t clear.

Diabetes and thyroid problems

Diabetes or thyroid disorders can be factors in single miscarriages. They do not cause recurrent miscarriage, as long as they are treated and kept well controlled.

What can be done to investigate and treat recurrent miscarriage?

Supportive pregnancy care

Women who have supportive care from the beginning of a pregnancy have a better chance of a successful birth.

There is some evidence that being under the care of a dedicated recurrent miscarriage service can reduce the risk of further miscarriage.

Blood tests

Hormone levels on day 2 - 3 of your first period after your most recent miscarriage may be measured. If this falls at a weekend, please attend the early pregnancy clinic (EPC) after the weekend, as these blood tests can be taken on day 1 - 5 of your period.

Other blood tests are carried out 6 weeks after your most recent miscarriage.

Hormone treatment

It has been suggested that taking progesterone early in pregnancy could help prevent a miscarriage. This may be offered to you in the recurrent miscarriage clinic depending on the results of your tests.

Treatment for antiphospholipid antibodies

There is some evidence that if you have aPL antibodies and a history of recurrent miscarriages, treatment with low-dose aspirin tablets and low-dose heparin injections (blood thinner) in the early part of your pregnancy may improve your chances of a live birth.

Screening for abnormalities in the embryo

If you have a history of recurrent miscarriage and you lose your next pregnancy, your doctors or the early pregnancy clinic may suggest checking for abnormalities in the embryo or the placenta afterwards.

They will do this by checking the chromosomes of the embryo through a process called karyotyping (although it is not always possible to get a result). They may also examine the placenta through a microscope.

The results of these tests may help them to identify and discuss with you your possible choices and treatment.

Screening for abnormalities in the structure of your womb

You will be offered a pelvic ultrasound scan to check for and assess any abnormalities in the structure of your womb, so that they can be treated if necessary.

Tests and treatment for a weak cervix

If there is a suspicion of a weak cervix based on your previous pregnancy history, you will be referred to the preterm labour clinic.

At the clinic, scans of your cervix will be undertaken in the second trimester of your pregnancy, and treatment may be offered if a weak cervix is confirmed.

Immunotherapy

Treatment to prevent or change the response of the immune system (known as immunotherapy) is not routinely recommended for women with recurrent miscarriage. It has not been proven to work, does not improve the chances of a live birth and can be associated with certain risks.

What could it mean for me in future?

Your doctors will not be able to tell you for sure what will happen if you become pregnant again.

However, even if they have not found a definite reason for your miscarriages, you still have a good chance (75%) of a healthy birth.

What to expect following a referral to the recurrent miscarriage clinic

• Whilst you are waiting for your first appointment in the recurrent miscarriage clinic, you are advised to avoid pregnancy if possible.
• It will not be possible to offer any additional treatment, scans or advice beyond routine pregnancy and miscarriage care, if you do become pregnant before being seen.
• When you come to the clinic, your investigations and possible treatment options will be discussed.
• After you have been seen, you may be offered any necessary treatment as well as repeat reassurance scans during the first trimester of future pregnancies, as part of your ongoing care.

Further information and support

You can find more information and support around recurrent miscarriage through the following organisations.

Tommy’s foundation

www.tommys.org/baby-loss-support/miscarriage-information-and-support/recurrent-miscarriage

Miscarriage association

www.miscarriageassociation.org.uk/information/miscarriage/recurrent-miscarriage

How to contact us

Early Pregnancy Clinic

0117 414 6778

www.nbt.nhs.uk/epac

If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.

If you’re an overseas visitor, you may need to pay for your treatment or you could face fraud or bribery charges, so please contact the overseas office:

Tel: 0117 414 3764

Email: overseas.patients@nbt.nhs.uk

© North Bristol NHS Trust. This edition published May 2024. Review due May 2027. NBT002544.

We are sorry that you have had a miscarriage

We are very aware that this a distressing time, and want to ensure you are well supported during this time. Everybody deals with miscarriage differently, and there is no ‘right way’ to be. Our aim is continuity of care, however this is not always possible, and when you are in hospital you will be looked after by a team of doctors and nurses.

Understanding the terms used for miscarriage

Complete miscarriage

This is when the scan shows that your womb is empty after a miscarriage. No further treatment is needed.

Incomplete miscarriage

This is when your scan shows that there is some tissue remaining in the womb.

Missed miscarriage

This is when your scan shows that the baby is not developing, or has not developed and there is no heartbeat. 

Some women will have already miscarried when we see them. A scan or a negative pregnancy test will confirm this. If a miscarriage has not already happened, there are a number of ways to treat you.

Expectant management of miscarriage (waiting for a natural miscarriage to happen)

Medical management of miscarriage

Surgical management of miscarriage

Frequently asked questions

How long will I bleed after the miscarriage?

Can we be told the sex of our lost baby?

What happens to the pregnancy, or pregnancy tissue after a miscarriage has happened?

When will my periods come back?

Why did I miscarry?

Will it happen again?

How soon can I resume my normal life?

When can we start having sex again?

Is there anything we can do to remember our baby?

If and when you feel ready to decide to plan another pregnancy you may wish to refer to the information below.

How soon can we try again?

Diet

Folic acid

Smoking

Medication

Pregnancy loss

Information and Support Services for patients and their families 

Grief and sadness are additional burdens for individuals, families, and other carers. Support may help you to manage more easily. The list of support agencies below is not exhaustive and inclusion does not imply endorsement. If the organisation you are seeking is not listed here it is worth looking in the front of the Yellow Pages where there is a list of useful national helpline phone numbers. It is also worth remembering that many GPs have counselling services attached to their practices.

Further help and advice

References

© North Bristol NHS Trust. This edition published January 2024. Review due January 2027. NBT002479

Following specialised X-ray procedures, it is possible that a small patch of skin may have been exposed to radiation for a long period of time; this can produce changes to the skin.

The changes depend on which area of the body the x-rays were pointing at (for example the head or the back) and the length of the procedure.

Skin reddening (also known as Erythema)

This is the first sign that the small patch of exposed skin has been affected. This looks like sunburn and can feel warm, sensitive and tight. This can happen anything from the first 24 hours up to 2 weeks later.

Temporary hair loss

This may also start up to three weeks following your procedure, depending on the exposed area of skin.

If any of these symptoms appear, please contact the Imaging department to let us and your referring consultant know, as we may need to arrange a follow up appointment.

Further recommendations

• Apply a creamy moisturiser (e.g. Epimax) sparingly to the affected skin. You can buy this or something similar from your pharmacist. Do not apply the cream to broken skin.
• Wash skin with lukewarm water and pat gently dry.
• Whilst symptoms persist, wear loose cotton clothing (if skin damage is to the body) and try to let air circulate around the affected area.
• Protect any affected skin from direct sunlight.
• If you contact your GP about this issue, please inform them of your radiology procedure.
• If you are required to have any further x-ray procedures within 14 days, please let the hospital staff know.

References

1. The Society and College of Radiographers (2020) Radiation Dermatitis Guidelines for Radiotherapy Healthcare Professionals

2. The Society of Interventional Radiology. Interventional Fluoroscopy-reducing radiation risks for patients and staff.NIH Publication No.05-5286. March 2005

How to contact us

Brunel building
Southmead Hospital
Westbury-on-trym
Bristol
BS10 5NB

If you have any queries please contact the number on your appointment letter.

Your doctor has requested that you have a myelogram. We hope that the following information will answer some of the questions you may have about this examination.

What is a myelogram?

A myelogram is an X-ray examination of the spinal cord and the space surrounding it. It provides a very detailed picture of the spinal cord and spinal column and of any abnormalities that may be present such as herniated or ruptured intervertebral disc.

Contrast medium (or ‘X-ray dye’) is injected via a small needle into the lower part of the spine. This is done by a radiologist (a doctor who specialises in X-rays used for diagnosis) into the fluid filled space around the spine called the subarachnoid space. This is called a lumbar puncture or LP.

The table used for a myelogram can be tilted so that contrast medium will run up and down within this space and surround the nerve roots that enter and exit the spinal cord.

Images are then taken as the contrast medium flows into the various areas of the spine. Far more information can be obtained from a myelogram than from plain spine X-rays.

Why do I need to have a myelogram?

A myelogram is performed when other tests such as Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) have not provided enough information, or when patients cannot have an MRI for any reason.

How do I prepare for the examination?

It is important that you drink plenty of fluids before your myelogram to help remove the contrast medium from your body and to prevent headache. You may also eat light meals prior to the procedure.

If you are on any medication which thins the blood (e.g. aspirin, clopidogrel, warfarin, rivaroxaban, apixaban, dabigatran) we ask you to call the Imaging department on the number on your appointment letter as we may need to adjust your medication before undergoing this procedure. 

These may need to be adjusted to keep the risk of bleeding to a minimum.

On the day of the procedure

You will arrive at the Imaging Department (Gate 19) and be accompanied to our day case area.

Please inform us if you have any allergies or if you think there is a chance you may be pregnant. 

You will then be asked to change into a hospital gown.

Once all the checks have been performed, you will be taken to the X-ray room on the trolley. There will be a doctor, radiographer and imaging support worker with you throughout the procedure. 

What will happen during the procedure?

• Before the examination begins, the radiologist will explain what they are going to do. You will be given the opportunity to ask any questions you may have.
• If you are happy to proceed you will be asked to sign a consent form.
• You will then be asked to lie on your front on the X-ray couch.
• The skin on your back will be cleaned and a small amount of local anaesthetic will be injected under the skin. This stings for a few seconds and the area then goes numb.
• A very fine spinal needle will be guided into the correct place using the X-ray machine. If needed, a small amount of cerebral spinal fluid can be withdrawn for laboratory studies.
• When the contrast medium is injected, you may feel slight pressure. It is common to experience heavy legs and a momentary increase in symptoms. Headache, flushing or nausea are other symptoms you may experience following the contrast injection.
• The X-ray table is slowly tilted to different angles and X-ray pictures are taken. Rests and straps (or supports) will keep you from sliding out of position.
• A CT scan is often performed after the myelogam while contrast is still present in the spinal canal. You will be brought to the CT scanner on the trolley.

Are there any risks associated with a myelogram?

Generally it is a very safe procedure. Potential complications are uncommon and include:

• Bleeding or haematoma (a bruise under the skin) around the injection site. (This should settle down by itself).
• Infection. Contact your GP if you experience any redness or tenderness at the injection site.
• An allergic reaction to the contrast medium. (RCR 2015). Please inform the radiologist performing the myelogram if you have any allergies.
• Headache (see information about this below).

X-rays are used in this procedure but with modern equipment the risk is low (NRPB 2014).

It is important that patients inform the Imaging Department if there is any possibility of pregnancy before attending for the examination.

Will I experience any serious side effects?

Serious side effects are rare but you should notify your GP if you experience:

• A high fever
• Excessive nausea and vomiting
• Severe headache for more than 24 hours
• Neck stiffness
• Numbness in your legs
• Trouble urinating or passing a stool.

Who interprets the results and how do I get them?

The results will not be available at the time of your myelogram.

The radiologist, who performed your myelogram, will examine your images in detail and forward a report to the doctor who referred you for the myelogram. You will be able to get the results from this doctor.

We hope this information is helpful. If you have any questions either before, during or after the procedure, the staff will be happy to answer them.

References

© North Bristol NHS Trust. This edition published July 2023. Review due July 2026. NBT002598

What is a varicocele embolisation?

A varicocele is an abnormality of the veins that take blood away from the testicle. The veins become bigger and more obvious, rather like varicose veins in the leg.

Embolisation is a way of blocking these veins. This makes them less obvious and causes the varicocele to disappear without an operation.

Who has made the decision?

The consultant in charge of your care and the radiologist carrying out the varicocele embolisation will have discussed your symptoms. They feel that this is the best treatment option. You will also have the opportunity for your opinion to be taken into account and if, after discussion with your doctors, you do not want the procedure carried out then you can decide against it.

Who will be performing the varicocele embolisation?

A specially trained doctor called a radiologist. Radiologists have special expertise in using X-ray equipment and also in interpreting the images produced. They need to look at these images while carrying out the procedure.

Where will the procedure take place?

This will take place in the Imaging Department, Gate 19, as described in your appointment letter.

What happens before the procedure?

• You will need to have a blood test a few days before the procedure to check your kidney function, that you are not at increased risk of bleeding and that it will be safe to proceed. This may be arranged to take place at your GP surgery.  
• You can continue taking your normal medication.
• If you are on any medication which thins the blood (e.g. aspirin, clopidogrel, warfarin, rivaroxaban, dabigatran, apixaban) we ask you to call the Imaging Department using the number on your appointment letter as we may need to adjust your medication before undergoing this procedure.
• You will also need to make sure that you have somebody to bring and collect you from the hospital, as you will not be able to drive immediately after the procedure.
• You must also ensure that there is a responsible person to be with you after and during the first night following the procedure in case you have any difficulties.

On the day of the procedure

• You should not eat anything from 4 hours before your procedure but you may continue to drink water.
• You will arrive at the Imaging Department, Gate 19, and be accompanied into our day case area.
• You may take your normal medication unless instructed otherwise.
• Please inform us if you have any allergies.
• A radiologist will discuss the procedure with you. You will have an opportunity to ask questions about the procedure and your treatment. If you choose to have the procedure you will need to sign a consent form.
• You will be asked to change into a hospital gown and a small plastic tube (cannula) may be put into a vein in your arm to allow us to administer medications or intravenous fluids during the procedure.
• Once all the checks have been performed and consent signed, you will be taken to the angiography suite on the trolley. There will be a nurse, radiographer and a radiologist with you throughout the procedure.

During the procedure

• You will need to lie on your back on an X-ray table for the duration of the procedure.
• The skin near the neck or groin will be cleaned with an antiseptic solution and covered with sterile drapes.
• Using an ultrasound machine, the radiologist will then inject local anaesthetic into the skin and deeper tissues over the neck or groin. This will briefly sting and then go numb. Most people will feel a pushing sensation.
• A catheter (thin tube) is guided into the testicular vein with the help of the X-ray machine. Small, metal coils are then used to block off the abnormal testicular vein.
• Once the procedure is complete, the radiologist will remove the catheter and press gently on the entry site for a few minutes to prevent bleeding.
• The whole procedure will take around 40-60 minutes although treating both sides will take longer.

What to expect after the procedure

• You will be taken back to the day case unit, so that nursing staff may monitor you closely. They will let you know when you can eat, drink and mobilise.
• If you are feeling okay and your checks are normal, you may go home.

Are there any risks or complications?

Varicocele embolisation is a very safe procedure, but there are some risks and complications that can arise:

• There may occasionally be a small bruise around the site where the needle has been inserted. This is quite normal and should improve itself in a few days.
• It is possible that the site of injection may become infected. Contact your GP if you notice any redness
  at the injection site as this may need treatment with antibiotics.
• Some patients experience mild discomfort in the left flank (lower left part of your back) for a day or two, needing no more than simple painkillers, if anything.
• There is always the possibility that, although the varicocele seems to have been cured to start with, months or even years later, it may come back again. If this happens, then the procedure may need repeating or you may be advised to have an operation.

Despite these possible complications, the procedure is normally very safe and is performed with no significant side effects at all.

What about the metal coils?

The coils are made of platinum and look a bit like light bulb filaments. They will show up whenever you have an X-ray or CT scan but will not activate airport metal detectors. As they do not contain iron, it is safe should you ever need a Magnetic Resonance Scan (MRI).

Further information

We hope this information is helpful. If you have any questions, either before or after the procedure, the staff in the Imaging Department will be happy to answer them. The telephone number for the Imaging Department can be found on your appointment letter. 

Reference

British Society of Interventional Radiology (2011) “Varicocele embolisation Patient information”. BSIR - British Society of Interventional Radiology Accessed on 15/05/2020

© North Bristol NHS Trust. This edition published July 2023. Review due July 2026. NBT002077

HIV Medicine Service

The North Bristol NHS Trust HIV Service is based at Southmead Hospital, Bristol.

An HIV test can be done in many different healthcare settings, including at the GP or Bristol Sexual Health Centre. Early diagnosis and treatment has many health benefits. Where there are particular concerns around HIV testing, our team would be happy to discuss this.

Where patients are known to be HIV positive they should be referred to the HIV specialist nurses via email at brecon.nurses@nhs.net, which is also our preferred route for non-urgent HIV related queries.

If there are patient HIV related queries for the HIV team at North Bristol NHS Trust (Southmead) then we would prefer that patients email brecon.nurses@nhs.net, or alternatively phone 0117 414 6400 if they cannot email.

For confidential HIV testing and sexually transmitted infection (STI) screening visit https://yunosexualhealth.co.uk/. Patients may order free STI testing kits online for home use (if aged 16 or over and living in Bristol, North Somerset or South Gloucestershire). For some people it may be more appropriate to get an HIV test in a sexual health clinic.

Acutely ill HIV patients should be discussed with the HIV team or the hospital HIV on-call team for admission, contactable via switchboard at Southmead.

Conditions Treated:

•    Suspected acute HIV infection.
•    Post-Exposure Prophylaxis after Sexual Exposure to HIV (PEPSE) - referrals taken from other healthcare providers.
•    Chronic HIV infection.

Note this service is only for patients living with HIV and for those referred from other healthcare providers for continuation/discontinuation of PEPSE.

Appointment Clinic Times are

Monday 12.30 – 16:00
Tuesday 14:00 – 17:30
Wednesday 12.30 – 16:00
Thursday 08:00 – 11:30

HIV Medicine Team

Specialty Director

Dr Philip Bright - Lead Clinician
Telephone (secretary): 0117 414 6395

Consultants

Dr Megan Jenkins
Dr Ankur Gupta-Wright
Dr Alexander May
Dr Bret Palmer
Dr Sathish Thomas-William
Dr Adele Wolujewicz

Clinical Nurse Specialists/Health Advisors

Liz Williams
Lizzie Richards
Phoebe Byrne

Specialist Pharmacists

Joanna Latimer
Arianwen Denham

Research Nurses

Louise Jennings – Lead
Andrea Watts
Sally Tillett
Rebecca Croydon

Medical Secretaries

Tel: 0117 414 6394
Danielle Coombs
Sharon Hemming
Bozena Zelazowska

Database Manager 

Chloe Whitlock

Management Team

Christina Fletcher
Nia Jenkins-Welch
Laura Webb

HIV Medicine Service Useful Links

The team at NAM (National AIDS Manual) produce and distribute accurate, up-to-date and evidence-based resources (printed, electronic, audio and online), covering both the medical and social aspects of HIV, to people living with HIV and to those who work to treat, support and care for them. Visit Aids Map for more information.

A medicines interactions checker is available.

A charity called Brigstowe, based in Bristol, are dedicated to the help of patients living with HIV. As well as lots of information about HIV Brigstowe offer the following to patients living with HIV:

• A one-to-one advice and support service.
• A migrant and asylum service.
• Group peer support and a range of group workshops.
• One-to-one peer support.
• Clinic peer support.

Please contact Brigstowe on 0117 955 5038 or visit Brigstowe for further information, advice and support.

Peer support at clinic is provided by Brigstowe peer mentors to patients living with HIV. These are trained volunteers, also living with HIV, who will meet patients in a safe and confidential space at clinic. They can:

•    Check in with patients about appointments and any concerns patients may have.
•    Chat with patients about treatment and managing side effects.
•    Be a listening ear.
•    Let patients know how Brigstowe can help.
•    Share their own experiences and knowledge of living with HIV.
•    Share coping strategies.

Last updated 18/07/25

The Workforce Disability Equality Standard (WDES) is a set of ten specific measures (metrics) which enables NHS organisations to compare the workplace and career experiences of Disabled and non-disabled staff.  NHS trusts use the metrics data to develop and publish an action plan. It will enable us to demonstrate progress against the indicators of Disability equality.

Making a difference for Disabled staff

The WDES enables us to understand the experiences of our Disabled staff and support positive changes for all existing employees. NBT is committed to creating a more inclusive environment for Disabled people working and seeking employment in our Trust.

2023

2020/2021

"The actions plans are still in draft format as we are still working with our relevant staff networks and other stakeholders to finalise them in due course"

Video 1 - Sensing location

In sitting with your eyes closed ask a friend/ carer to touch your bare arms. Try to sense and point to which area was touched. Does the feeling vary between your arms and with different locations touched? Are you accurate in sensing the area touched? Repeat the process as often as able.

Video 1 - Ball throwing and catching in sitting

In a seated position, throw a ball up in the air in front of you and catch it. Ensure you are catching two handed or with your affected arm. Try to control the pace and direction of the throw to keep it close enough to catch. Tip: To make the exercise harder try using a smaller ball or catching one handed.

Video 2 - Ball throwing and catching in standing

Position yourself standing up. Practice throwing and catching a ball with both hands.

Video 3 - Standing eyes closed

Standing with your feet shoulder width apart stand with your eyes closed. Gradually try to increase the time to which you can tolerate without having to adjust your feet.

Video 4 - Standing eyes open on unstable surface

Standing with your feet shoulder width apart on an unstable surface (Cushion, wobble board). Gradually try to increase the time to which you can tolerate without having to adjust your feet. Try to imagine a glass resting on the cushion / wobble board, you are aiming to keep your weight evenly spread so a glass wouldn’t fall over.

Video 5 - Standing eyes shut on unstable surface

Standing with your feet shoulder width apart on an unstable surface (Cushion, wobble board) stand with your eyes closed. Gradually try to increase the time to which you can tolerate without having to adjust your feet.

Video 6 - Perch STS

For this you need to find a high chair, or bed that allows you to sit “perched” on the edge. The idea is that you are in a position that is in-between sitting and standing. This makes standing up easier. Set your self a target of how many of these you want to do in a row and when you are finding it easy you might progress to STS from a normal height chair.

Video 7 - Single leg stand

Stand next to a kitchen counter. Hover your hands over the counter, and shift your weight on to your affected leg. Maintain this single leg pose for as long as possible, without use of your hands for balance.

Video 1 - Finding objects

Using a bowl of rice bury small household objects. With your eyes closed dig around and try to pick the objects out. As an extra challenge try to identify the objects before you open your eyes.

Video 2 - Light touch vs deep touch massage

Video 3 - Position testing

Sitting down with your eyes closed, ask a friend to move your strongest arm into a position. With your eyes still closed mirror the same position with your other arm. Keeping your arms in position open your eyes, are your arms held in the same position? 

Video 4 - Rice-bean bowl exercise

Put some rice or dry beans in a bowl. Using a pair of tweezer try to pick the individual grains up and transfer them to another bowl.
Tip: the smaller the beans are the more difficult it gets

Video 5 - Sensing temperature

In sitting with your eyes closed ask a friend/ carer to touch your bare arms. Try to sense and point to which area was touched. Does the feeling vary between your arms and with different locations touched? Are you accurate in sensing the area touched? Repeat the process as often as able.

Video 6 - Sensory re-education of textures

Look around your home and pick a variety of objects with differing textures. Rub them over both the palm and the back of the hand affected by sensory loss, or impairment. Make sure to go over the finger tips and sides of fingers as well. This will help to stimulate sensation messages to the brain. Close your eyes and see if you can guess what is being used. Try textures such as cotton wool, a flannel, velvet, hair brush/comb, tooth brush, a tooth pick, Velcro, fleece, a woollen jumper etc

Video 7 - Stereognosis Box

Select some smallish items from around your house. Put them in a box and cover with a pillow case (this is so you can’t see what you are touching). Reach your hand into the box, without looking and feel for an item. See if you can work out what it is just from how it feels in your hand. Is it heavy or light, smooth or rough? Manipulate it in your hand to try and touch every part of it to help you work out what it could be. Once you think you know the answer, pull it out and see if you are correct! You can make this harder, by putting small items in rice and then feeling around in the rice for the objects and trying to work out what they are before looking.
 

Video 8 - Functional UL tasks – applying hand cream