Neurorehabilitation - What is it about?
What is neurorehabilitation?
While today high-tech equipment is used in addition to direct treatment of the person's body by therapists, the history of neurorehabilitation started long time ago. The term "rehabilitation" goes back to the Latin "habilitare" or "reconcilio," meaning "to restore" or "to rebuild". At that time, however, the term was used not only for the recovery of a sick person, but also when a person regained his or her rights and standing in society.
Who needs neurorehabilitation?
The aim in medicine today, is to restore lost functions in neurologically ill people. This means that patients should be so well prepared for their lives that, in the best case, they regain their independence completely or at least to such an extent that they can master life again as far as possible without support and in a self-determined manner. Neurorehabilitation is often provided for the following conditions, among others:
- tumors of the central nervous system
- brain hemorrhage
- traumatic brain injury
- infectious diseases of the brain
- multiple sclerosis
- muscle related diseases
In the acute phase of treatment, the aim is to bring the main symptoms of the diseases under control, for example, in the case of a cerebral hemorrhage, to stop the bleeding and remove the blood from the brain. The consequences of the diseases and their symptoms usually only become clear afterwards and differ from patient to patient.
At this point neurorehabilitation becomes important.
The symptoms that are treated very frequently in neurorehabilitation and often occur in neurological diseases are the following:
- Paralysis, e.g. in the hands, arms or legs
- cognitive problems/ problems with thinking and behavior, e.g. difficulties with memory, attention or action planning
- disturbances of the sense of balance
- psychiatric diseases, e.g. depression
- problems with speech e.g. aphasia
- spatial perception disorders and limitations of the visual field
Treatment of these symptoms is usually focused on preparing patients for everyday life. This requires, for example, abilities such as the movement of arms and legs, the ability to speak or to concentrate.
Therefore, regaining these critical functions is often a basic prerequisite for returning to everyday life. That is why the treatment spectrum in neurorehabilitation is as diverse as it is varied. There are different treatment approaches for each of the limitations mentioned. In neurological rehabilitation, physiotherapists often meet with speech therapists, occupational therapists, neuropsychologists or psychotherapists. The therapy offered is always oriented to the specific needs of the individual, in order to enable a return to everyday life without hurdles.
Which phases of rehabilitation are existing?
What sounds simple is often more difficult than one might imagine: Some patients have difficulty following their previous occupation, but are otherwise largely mobile and free to perform everyday activities such as preparing meals or dressing. Others suffer from not being able to follow a conversation. So there is no such thing as "THE" patient in neurorehabilitation. What stage patients are in their rehabilitation is mapped by means of the phases of neurological rehabilitation. These phases are described as follows:
- Phase A - Acute care: In this phase, patients receive acute treatment, for example, because they have had a stroke. The aim is to treat the symptoms that have occurred; this usually takes place in the intensive care unit.
- Phase B - Early stage rehabilitation: Through intensive care and early therapies, patients are prepared to receive further therapies directly after acute care. Often, patients are still in a coma or have impaired consciousness here. Severe health impairments such as bone fractures or brain hemorrhages have already been treated here and the patient is stable.
- Phase C - Continuing rehabilitation: Patients are now already able to actively participate in therapies. They no longer require intensive care and gradually regain independence.
- Phase D - follow-up treatment: The patient is already able to cope with essential activities of daily living again. Therapies are oriented to the remaining difficulties.
- Phase E - Vocational rehabilitation and aftercare: Patients usually return to their home environment. Rehabilitation is now placed in the hands of outpatient therapists, and the focus is on consolidating therapy successes already achieved.
- Phase F - Activating long-term care for condition maintenance: Patients whose rehabilitation successes do not allow them to master a return to everyday life receive therapies oriented toward maintaining their previous condition in order to counteract renewed deterioration.
- Phase G - Assisted and Supported Living: For some patients, transition to assisted living is an option. Here, targeted care, therapy and support services continue to be provided.
Which phase patients are in determines which therapies they receive and which technologies are used. This can range from physiotherapy to speech therapies to computers to robots. What is easy for one person is still a big challenge for another. Not every therapy is suitable for everyone. Therefore, precise planning and adaptation of therapies is important. Therapy planning always takes into account the patient's individual therapy goals.
How important it is to combine rehabilitation exercises with a meaning is something that we talk about in our next post, where we are talking about context sensitivity!