Neurological rehabilitation seeks to restore health as fully as possible following the advent of neurological illnesses (such as multiple sclerosis or Parkinson's disease) or a stroke. The goal is to restore as much independence as possible to the patient.
A rehabilitation team develops a personalized treatment plan for each patient. Personal goals are defined during an initial evaluation. A typical recovery stay lasts four weeks. The patient will receive at least two to three hours of therapy per day during this time.
Neurological Rehabilitation Phase Model
Neurological rehabilitation is divided into seven stages. They are determined by the severity of the brain injuries as well as their symptoms. They are measured, for example, using the Barthel Index, which assesses independence in daily living. The treatment is determined on the patient's stage.
- Acute Treatment (Phase A): Intensive Care Unit;
- Early Rehabilitation (Phase B): The patient's consciousness is usually still significantly affected. Intensive care treatment is still required. The goal of rehabilitative measures is to improve one's state of consciousness. Permanent ventilation is no longer required, circulation is stable, injuries have been treated, and there is no intracranial pressure;
- Phase C - Continued Rehabilitation: The patient can already actively participate in therapy but still need intensive nursing care. Partial mobilization is the goal of rehabilitation.
- Phase D - Medical Rehabilitation: Begins after the completion of early mobilization and constitutes standard medical rehabilitation;
- Secondary Rehabilitation (Phase E): This focuses on professional, social, and domestic reintegration. The therapy outcomes must be preserved;
- Activating Rehabilitation (Phase F): Activating therapy care for patients in a vegetative condition;
- Phase G - Assisted and Accompanying Living: The patient is assisted in regaining his independence - assisting others to help themselves.
In What Cases Is Neurological Rehabilitation an Option?
- Stroke;
- Hemorrhages in the brain;
- Parkinson's disease and related disorders;
- Multiple sclerosis (MS);
- Inflammatory brain and spinal cord disorders;
- Tumors that are not cancerous;
- Atypical neurodegenerative disorders;
- Trauma to the cranium;
- Herniated discs;
- Polyneuropathy and polyradiculitis (e.g., Guillain-Barré syndrome) are two types of polyradiculitis;
- Myopathies;
- Recovery after cerebrovascular surgery.
What New Technological Therapy Possibilities Are Available?
Aside from the traditional forms of therapy, such as physical therapy, occupational therapy, speech therapy, massage therapy, and psychotherapy, various innovative technologies are now available:
Transcranial electrostimulation
This is the stimulation of the central nervous system through the use of externally applied electric fields. Electrodes placed to the front and back of the head conduct hardly noticeable electric currents via the skin to assist cerebral metabolism.
Functional electrical stimulation
It is the stimulation of muscles at a precise time to facilitate complex movements. The control of a paralyzed nerve is reactivated with small electrical impulses via attached electrodes, causing the muscle to move again. Motion sensors regulate the time of the stimulation.
When distinct neuronal networks (information channels) are fully and irrevocably disrupted, a "bypass" is employed to convey information from the brain to the periphery or from the periphery to the brain.
Brain-computer interface (BCI)
Brain-computer interfaces are predicated on the observation that even visualizing a behavior induces observable changes in brain electrical activity. Imagining moving a hand, for example, activates the relevant motor cortex area. During therapy, both the computer and the human learn which variations in brain activity are related to specific ideas, and the motions become increasingly precise.
This "brain-computer interface" gadget facilitates communication between the brain and a computer without stimulating the peripheral nervous system. The electrical activity of the central nervous system is recorded (through EEG or implanted electrodes) and transformed into movement by a computer. This can be accomplished through electrical stimulation of the patient's own muscles, but it can also be accomplished using external motors, such as driving a wheelchair or moving prosthesis.
The patient's head is fitted with EEG electrodes. Cerebral activity is visualized using EEG measurement. The patient receives audiovisual input that reflects back variations in cerebral activity via a screen. The therapeutic impact is adjusted by adjusting the electrode locations and the software.
The bottom line
A multidisciplinary team is required for neurological rehabilitation. This includes not only physicians and social workers but also bioengineers and computer scientists. The team's effort should take into account the changes that occur over the course of the disease process.
