neuro rehabilitation Definition Indicators Types Characteristics Components Physiotherapy Treatment Nurses role

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

3. OUTLINE
• Definition
• Indicators
• Types
• Characteristics
• Components
• Physiotherapy
• Treatment
• Nurses role

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

6. 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.”

7. Common words used in
Rehabilitation
Impairment
Disability
Handicap

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

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

10. 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

12. Head injury
• Subdural Haematoma
• Intracerebral
• Haemorrage/
Haematoma
• Epidural/Subarachnoid
lesions

13. Different Types of Injury
• Head Injury
• Cranial Injury
• Brain Injury

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

17. Characteristics of Rehabilitation
Inclusive
Patient-
focusedHolistic Participatory
Sparing
Lifelong Resolving
Community
-focused

18. Benefits of Rehabilitation

19. WHEN TO START
REHABILITATION?
DAY ONE

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

21. COMPONENTS

22. Physiotherapy

23. 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

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

25. 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

28. Log – rolling exercise

29. Exercise Therapy to Develop
Motor Control

30. Hydrotherapy

31. Constraint-Induced Movement Therapy
• (CIMT) EMG biofeedback

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

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

34. Functional Electrical stimulation

35. Dynamic Finger Extension Splint

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

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

38. Balance Training

39. Coordination Training
Bully Therapy

40. Sports & assistive devices

41. Assistive devices

42. 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

43. OCCUPATIONAL THERAPY

44. Areas of Assessment
& Treatment
• Areas of Occupation
1. Activities of Daily Living
2. Instrumental Activities of Daily Living
3. Rest and Sleep
4. Education
5. Work
6. Play
7. Leisure
8. Social Participation
9. HOMEMODIFICATION
10. CLIENT AND CAREGIVER GUIDANCE
11. COGNITIVE FACTORS

45. ASSESSMENT
• Client Factors-
• Performance Skills
• Context and Environment

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

47. Psychology

48. Stress management
Emotional support
Psychology

49. SUPPORT AND COMMUNITY
INTEGRATION

50. DIET

51. Multivitamin
supplements
Omega 3 fatty acids

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

53. Special education

54. Restorative
Compensatory
Environmental
Behavioural
Cognitive rehabilitation

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

56. The patient

57. Environmental stimulation

58. Technological improvements
• VIRTUAL REALITY
• ROBOTIC TECHNOLOGY
• VIDEOGAMES