Chapter 7.

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REHABILITATION

Note:
Rehabilitation has its own medical and social aspects and it is to be begun with as early as in bed in the acute phase.

Contents:
7.1.: Outcome assessment after brain injuries
7.2.: Physiotherapy
7.3.: Neuropsychological rehabilitation
7.4. Logopaedic care

STANDARD 7.1.: OUTCOME ASSESSMENT Hvezdicka.GIF (147 bytes)

For outcome assessment of long-term state of the patients we recommend the Extended Glasgow Outcome Scale (GOSE). We recommend to use the Questionnaire of the Czech Brain Injury Register from the very time of admission of the brain-injured patient to hospital.

STANDARD 7.2.: PHYSIOTHERAPY Hvezdicka.GIF (147 bytes)

In the intensive care unit (ICU) rehabilitation should begin already in the acute phase of severe brain injury by the proper positioning of the patient to prevent complications, mainly decubitus ulcus.

 STANDARD 7.3.: PSYCHOTHERAPY Hvezdicka.GIF (147 bytes)

The rounded-off neuropsychological rehabilitation of the patients after brain injuries, practiced by psychologist, consists of four regions, which are necessary for majority of patients (if there is not any contraindications) and they create as one package.  They are: 1. psychodiagnostics, 2. cognitive rehabilitation, 3. psychological guidance and 4. psychotherapy.

STANDARD 7.4.: LOGOPAEDIC CARE Hvezdicka.GIF (147 bytes)

If a patient after brain injury is suffering from aphasia, the reeducation of speech by clinical logopaedigs should be started as early as possible. In acute phase the stimulation of the speech production is vital from everybody who is in touch with patient (doctor, medical personel, family, visits and others). The degree of speech failure and extent of communication loading is very variable in that acute phase and it demands an entirely individual access.

Coordinated by Jan PFEIFFER, M.D., Ph.D.

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Last updated: 2000-08-04