NEURO REHABILITATION --GIHS

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Slide 1:

NEURO REHABILITATION PRESENTATION BY PROF. KAVITHA VICE PRINCIPAL GANGA INSTITUTE OF HEALTH SCIENCES COIMBATORE

OUTLINE :

OUTLINE Definition Indicators Types Characteristics Components Physiotherapy Treatment Nurses role

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After the Stroke, traumatic brain injury, spinal cord injury, the medications were given or the appropriate surgical procedures were done,

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WHAT DO WE DO NEXT???

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Definition : “ A process whereby patients who suffer from impairment following neurologic diseases regain their former abilities or, if full recovery is not possible, achieve their optimum physical, mental, social and vocational capacity.”

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Common words used in Rehabilitation Impairment Disability Handicap

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INDICATIONS Vascular disorders Infections Structural Trauma Neuromuscular disorders Functional disorders Degenerative disorders

A SPINAL CORD INJURY ?:

A SPINAL CORD INJURY ? Loss of motor and sensory function bellow the level of injury Spasticity Pain Sexual dysfunction Loss of bowel & bladder control

SCI – related medical conditions:

SCI – related medical conditions Spinal shock Spinal cord syndromes Autonomic dys reflexia Neuropathic pain Spasticity Multisystem Organ failure RESPIRATORY NERVOUS ENDOCRINE IMMUNE GASTO-INTESTINAL GENITO-URINARY CARDIO-VASCULAR METABOLIC MUSCULO-SKELETAL PSYCHIATRIC SKIN REPRODUCTIVE

Head injury:

Head injury Subdural Haematoma Intracerebral Haemorrage / Haematoma Epidural/Subarachnoid lesions

Different Types of Injury:

Different Types of Injury Head Injury Cranial Injury Brain Injury

Intracranial Pressure:

Intracranial Pressure Vasculature Constriction Cerebral Edema Systolic Blood Pressure Low BP = Poor Cerebral Perfusion High BP = Increased ICP Carbon Dioxide Reduced respiratory efficiency

Characteristics of Rehabilitation:

Characteristics of Rehabilitation Inclusive Patient-focused Holistic Participatory Sparing  Lifelong Resolving Community-focused

Benefits of Rehabilitation :

Benefits of Rehabilitation

:

WHEN TO START REHABILITATION? DAY ONE

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Neurologist/neurosurgeon Nurse Dietitian Physical therapist Occupational therapist Speech/language therapist Social worker Psychologist/psychiatrist Recreational therapist Audiologist Vocational counselor Rehabilitation Team

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COMPONENTS

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Physiotherapy

Purposes :

Purposes Increase strength Safely improve mobility (such as walking, standing and sitting Promote the function of impaired limbs Return to functional and recreational activities Improve balance Improve coordination Promote independence

Balance retraining, Gait training Transfer training, Neuromuscular retraining, Orthotics consultations Aqua therapy.:

Balance retraining, Gait training Transfer training, Neuromuscular retraining, Orthotics consultations Aqua therapy. Physiotherapy

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Exercises ADL (Activities of Daily Living) AROM (Active Range of Motion) Self-Assisted Exercises Balance Functional Mobility Grasp / Release Positioning Reaching / Targeting Sensory Motor Strengthening Stretching Trunk Activation Weight Bearing

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Log – rolling exercise

Exercise Therapy to Develop Motor Control:

Exercise Therapy to Develop Motor Control

Hydrotherapy:

Hydrotherapy

Constraint-Induced Movement Therapy :

Constraint-Induced Movement Therapy (CIMT) EMG biofeedback

Mirror Therapy (sensory- motor learning (mirror neurons) are activated :

Mirror Therapy (se nsory- motor learning (mirror neurons) are activated

SENSORY STIMULATION ENHANCES PLASTICITY! Electrical stimulation/ functional electrical stimulation Stroking, massaging Neuromuscular facilitation exercise techniques Stimulate all the senses! :

SENSORY STIMULATION ENHANCES PLASTICITY! Electrical stimulation/ functional electrical stimulation Stroking, massaging Neuromuscular facilitation exercise techniques Stimulate all the senses!

Functional Electrical stimulation:

Functional Electrical stimulation

Dynamic Finger Extension Splint:

Dynamic Finger Extension Splint

Convent method for mobility:

Convent method for mobility A cane and ankle-foot orthosis (AFO)

TREAD MILL GAIT TRAINING:

TREAD MILL GAIT TRAINING Therapists assist in controlling the trunk, pelvis and weak leg.

Balance Training :

Balance Training

Coordination Training Bully Therapy:

Coordination Training Bully Therapy

Sports & assistive devices:

Sports & assistive devices

Assistive devices:

Assistive devices

Virtual Reality :

Virtual Reality This approach to user-computer interface that involves real time stimulation of an environment, scenario or activity that allows for user interaction via multiple sensory channels. Engaging & Entertaining Fun (+) Visual and Auditory Feedback from TV monitor

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OCCUPATIONAL THERAPY

Areas of Assessment & Treatment:

Areas of Assessment & Treatment Areas of Occupation Activities of Daily Living Instrumental Activities of Daily Living Rest and Sleep Education Work Play Leisure Social Participation HOMEMODIFICATION CLIENT AND CAREGIVER GUIDANCE COGNITIVE FACTORS

ASSESSMENT:

ASSESSMENT Client Factors- Performance Skills Context and Environment

Treatment MODE:

Treatment MODE Acute & Long Term Care Facilities Residential and Day Programs Skilled Nursing Facilities Community-Based Mental Health Centers Schools Military Installations Employment Practice

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Psychology

Stress management Emotional support:

Stress management Emotional support Psychology

SUPPORT AND COMMUNITY INTEGRATION:

SUPPORT AND COMMUNITY INTEGRATION

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DIET

Multivitamin supplements:

Multivitamin supplements Omega 3 fatty acids

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Language lip reading Speech(who are not able to speak, expressing their thoughts, oral communication in general Swallowing Communication

Special education:

Special education

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Restorative Compensatory Environmental Behavioural Cognitive rehabilitation

Nurses role in rehabilitation team:

Nurses role in rehabilitation team HOLISTIC CARE STRONG COMMITMENT COMMUNICATION INTERACTION REINFORCEMENT COORDINATION EVALUATION RESOURCE PERSON ADVOCTE TEACHING

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The patient

Environmental stimulation:

Environmental stimulation

Technological improvements:

Technological improvements VIRTUAL REALITY ROBOTIC TECHNOLOGY VIDEOGAMES

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