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Basics of Neurological Rehabilitation

Basics of Neurological Rehabilitation

The nervous system can become damaged by injury, tumors, infections, structural defects and degenerative and circulatory system disorders. These conditions may be helped by neurological rehabilitation, which is an interdisciplinary approach to helping the patient meet or exceed his goals for recovery. The neurological rehabilitation team is typically made up of neurologists, neurosurgeons, orthopedic surgeons, internists, physiatrists and rehabilitation nurses. In addition, psychiatrists, physical, occupational, recreational and speech therapists, psychologists, and audiologists play an important role on the neurological rehabilitation team. The vocational therapist and chaplain are also commonly involved as well.

The neurological rehabilitation team is responsible for gait and balance retraining, bowel and bladder retraining, helping the patient with his activities of daily living, or ADL's, and helping the patient regain his social skills. Furthermore, the dietary department is involved with nutritional counseling and the speech therapist assists patients with swallowing and eating issues and helps them improve their speech patterns.

Although similar, neurological rehabilitation is different from other components of neurology. The rehabilitation component of neurology focuses on educating the affected patient with the aim of helping him cope with his family, work environment and social situations. Furthermore, neurological rehabilitation focuses on getting the patient to regain as much independence as possible with the support and guidance of his team of professionals. What primarily differentiates neurological rehabilitation from neurology is that it cannot be achieved by the neurologist alone. It necessitates the active participation of the interdisciplinary healthcare and social services teams.

The basic concept of neurological rehabilitation is built on a series of goals. For some patients, one of their long term goals might be to return to a normal life. Other patients might simply wish to return home instead of a rehab facility or hospital. Once a realistic long term goal has been set, smaller steps that are needed to realize those goals will then be determined. For example, if one of those long term goals is to walk without the help of a cane or walker, steps to achieving that goal can be broken down into smaller goals such as sitting or standing without support, and the walking with the assistance of one person instead of two. Vague goals have no place in the neurological rehabilitation setting. Unless the goals are precise, they will be no use to the patient nor the team.

Although neurological rehabilitation is largely based in hospitals and in-patient rehab facilities, there is a push to bring the concept into the community. Many medical and social services professionals do not feel that the only patients able to benefit from neurological rehabilitation should be those in an in-patient environment. Patients affected with cerebral palsy, early Parkinson's disease and multiple sclerosis who are living at home could benefit from community-based rehabilitation. Although an increased number in community-based neurological rehabilitation models are emerging, they may never become as prevalent as in-patient models.

The intensity of rehabilitation services depends upon the extent of the patient's limitations. The patient with a moderate physical impairment or disability will require a less intensive program than the patient who has a profound handicap. The neurological rehabilitation model is not complicated. Instead, it takes a common sense and practical approach to basic principals. Neurological rehabilitation benefits those who are expected to make a full recovery over a short period of time as well the patient who will slowly improve, but may not make a full pre-morbid recovery. In addition, those who are expected to not recover fully from their disability and those who are expected to deteriorate are all candidates for this type of rehabilitative service. Finally, neurological rehab can even benefit the patient who will be rapidly deteriorating from malignant conditions of the brain or other catastrophic conditions.