Beds of early stroke rehabilitation
Medical care, therapy
Early NEUROREHABILITATION - The goal is to promote spontaneous healing, prevent early and late complications, intensify recovery and remaining brain plasticity.
Principle of integrity - the basis for therapy in rehabilitation is not a diagnosis, but an accurate analysis of the functional deficits and abilities of the patient
The principle of timeliness and longevity - Rehabilitation begins in the acute phase of hospitalization.
The principle of teamwork - multidisciplinarity - because of the complexity of functions that are disturbed in central nervous system disease, the interaction of therapists of different qualifications and the use of specialized complex therapeutic concepts is necessary.
Early rehabilitation requires 4-6 hours of targeted rehabilitation and nursing care every day - in this case, activating care, of which 3-4 hours is functional therapy, where all therapists with different specialization work together (it is also advisable to schedule visits to the department , as therapies run until 4:00 pm).
Medical care, chief therapist
Doctor together with the team participates in diagnostics and therapy of affected functions, indicates drug and rehabilitation intervention, co-ordinates therapists. Together with other team members, they participate in a rehabilitation conference once a week and plan appropriate rehabilitation goals. In cooperation with a physiotherapist and an occupational therapist, he / she prescribes suitable compensatory aids for home release.
Once a week, therapists who work with the patient at a rehabilitation meeting meet to share the results of the examination and work with the patient, to inform each other and to develop (based on the patient's wishes) rehabilitation goals together.
Based on the patient's needs, his main therapist is appointed to coordinate the other team members working with the patient.
Meetings with family
Working with the patient is part of the work with the patient, as well as continuous information about the course of therapy and the goals of the therapy. The patient and family coordinate with the family with the head therapist or the treating physician.
Physiotherapy is a part of comprehensive rehabilitation that deals with diagnostics, treatment and prevention of locomotor system disorders. In essence, physiotherapy uses standardized procedures based on the latest scientific knowledge and empirie together with natural energy sources. Physiotherapist chooses treatment from a range of methodologies with a focus on patient needs. As part of physiotherapy on our beds, we use a wide range of techniques on a neurophysiological basis, based on current knowledge of neuroplasticity support of the brain. In addition to established methods and concepts (PNF, Vojta method, Bobath concept, DNS…) we use eg exercises in vision, observation, mirror (Mirror) and physiotherapy using robotic therapy and visual feedback on the PC. We use the principles of spastic paresis rehabilitation according to GSC (Guided self rehabilitation contract).
The therapist performs routine daily activities. It strives for the greatest possible degree of self-sufficiency and independence for people with various types of disability. The neurorehabilitation focuses mainly on four key areas:
Improving the mobility of affected limbs, especially the hand
Grip, fine motor skills and graphomotorics, work activities with compensation aids (eg cutting, buttoning, working on PC) are practiced. We use a variety of aids in therapy, such as inflatable splints and mirror therapy.
Training Daily Activities - ADL daily activities such as dressing, personal hygiene, food preparation and consumption. If the momentum of the affected upper limb does not allow the holding of objects during daily activities, we practice with the patient the so-called functional one-armed.
Selection and recommendation of suitable compensatory aids
The therapist also suggests and tests the use of various compensatory aids in consultation with the doctor and other collaborators.
Examples of Compensation Aids for Independence:
- Bathroom and toilet - bath and shower seat, toilet attachment, non-slip mats.
- Kitchen - special cutlery, plates, mugs, openers, scrapers, cutting boards with spikes, anti-slip pads, etc.
- Dressing up - sock thighers, button fasteners, self-tying laces, hooks, elongated buckets.
- Other - Sliding plates, handles, Swedish feeders, textile ladders, extended handles (for toothbrush, cutlery, etc.).
Cognitive Training (in collaboration with a psychologist)
The clinical speech therapist is part of a multidisciplinary team of experts and has an irreplaceable role in both diagnostics and therapy. Speech therapy in the neurorehabilitation of adults mainly involves the diagnosis and therapy of these forms of impaired communication skills:
fatal function disorder - aphasia (affecting understanding and making speech, extending to different degrees all levels of the language system), incl. alexie and agraphy - reading and writing disorders
speech motor disorder:
- acquired dysarthria (to varying degrees of disruption of respiration, phonation, resonance, articulation and prosody of speech)
- oral and verbal apraxia (scheduling failure or programming of movements required for verbal production)
Furthermore, the speech therapist devotes comprehensive care to patients with dysphagia - swallowing disorder.
The clinical speech therapist is trying to cooperate with all the expertise within the rehabilitation team. In the process of communication, the family and the patient's close relatives, with whom the speech therapist tries to work closely together, educate them and create an individual rehabilitation plan based on the information obtained for the patient, and choose the most appropriate form of communication, also has an irreplaceable position.
In our department, psychological care focuses on the diagnosis and treatment of changes in cognitive (cognitive) functions and affective (mood, experiencing) after acquired brain damage.
Cognitive (cognitive) functions is one of the basic functions of our brain. Through these functions, we explore the world and control our behavior. They are generally defined as processes of receiving, processing and storing information.
Cognitive functions include, in particular, memory and executive functions, but also speech, visual-spatial functions, attention, psychomotor pace, judgment, abstract thinking, etc. Cognitive deficits include reduced cognitive performance over normal and corresponding norms, which may be caused by just acquired brain damage. Thanks to the neuroplasticity of the brain, we can train these disturbed functions to speed up their return to normal.
Furthermore, psychology deals with current experience hospitalized persons facing life stress events. We find out how a person with a new situation is coping with, whether the rehabilitation process is affected by depression, anxiety, lack of motivation or other psychological difficulties. If so, we try to work with these sensitive topics, strengthen the patient's strengths and his ability to overcome obstacles.
High-quality nursing care is a comprehensive health care, health promotion and self-reliance development to prevent complications. The nursing team evaluates the patient's needs, the level of self-sufficiency, the manifestations of the disease and the risk factors. It provides basic and specialized nursing care through the nursing process with an emphasis on individual approach. Ensures the collection of biological material, evaluates and records the patient's condition, physiological functions, evaluates and treats skin integrity disorders, performs self-training, educates the patient. It prepares, administers and administers medicines and controls their action. In our department, we put emphasis on rehabilitation nursing, where a nursing team is part of a rehabilitation team and working with therapists to achieve specific patient goals.
A clinical nutritional therapist assesses and monitors the multidisciplinary team nutritional parameters, actively seeks out patients at risk and provides specialized nutritional care. Nutrition status is assessed by help biochemical and anthropometric indicators - body mass index (BMI), fluid and diet intake, nutritional administration (oral, non-oral - enteral or parenteral). It recommends a suitable choice of diets or a modification of the diet, types and method of administration of enteral / parenteral nutrition, including dietary supplements in an appropriate combination, and seeks to maintain adequate intake of all food and fluid components to provide adequate nutrition and hydration to the patient. In the case of care for patients with dysphagia, she closely cooperates with a clinical speech therapist.