©James Diccon Clarke, The Royal
Buckinghamshire Hospital, Buckingham Road, Aylesbury, Bucks, United Kingdom,
HP19 9AB
مستشـفى رويـال باكنـهام شـير .
ΔΙΕΘΝΕΣ ΚΕΝΤΡΟ ΣΠΟΝΔΥΛΙΚΩΝ ΚΑΚΩΣΕΩΝ ΚΑΙ ΑΠΟΚΑΤΑΣΤΑΣΗΣ .
The Marguerite Centre . Links
Stroke Services
The Rehabilitation Process: Rehabilitation can be identified as a whole
process of managing disability, with the aim to enable individuals,
their families and carers to adjust and cope with their change in
circumstances. It must
be based on on-going assessment, planning and evaluation and involve
partnership between the individual, their social network and the
health and social care team. It typically needs to involve a range of
essential disciplines such as a Specialist Consultant,
Physiotherapists, Occupational Therapists, Specialist Rehabilitation
Nurses/Nurse Consultant, Doctors, Psychologists, Speech and Language
Therapists, Psychiatrists, Social Workers, Community Staff and
Employers. However
effective rehabilitation is dependent on this group of people
functioning as a team, engaged in collaborative goal planning,
focusing on the disabled person and their family. At the
Royal
Buckinghamshire
Hospital we focus our rehabilitation
upon the trends in Rehabilitation Policy in order to deliver an
effective quality service to patients we are aiming to help.
We strive to provide effective rehabilitation services based
upon the following principles: Providing interdisciplinary assessment in
the acute setting to provide specialist support and advice to
prevent secondary complications developing. Staffed by a team of specialist
professionals who work as a co-coordinated interdisciplinary
team to enable people to transfer skills acquired during therapy
sessions to their daily living activities.
The team is currently working towards an
interdisciplinary approach.
In rehabilitation this approach is shown not only to be
effective, but cost effective in reducing the need for long term
care. Delivering well planned, goal orientated
rehabilitation programmes to the appropriate intensity for the
person concerned, whilst supporting their family and carers to
contribute to the rehabilitation process. Having links to the community including
social services and housing departments to provide
co-coordinated transition of care. Working with wheelchair services and integrated
community services to co-ordinate provision of specialist
equipment to meet peoples changing needs. A stroke is caused by a clot or a bleed in the
brain which causes brain cells to die. A stroke is the third most
common cause of death in the UK and remains the most common cause of severe
disability with more than 250,000 people living with disability as a
result of Stroke. Following stroke people may experience: Motor impairment, Weakness or paralysis - this
can lead to difficulties in walking, movement or coordination.
These often affect one side of the body – known as hemiparesis
or hemiplegia. Lack of feeling - or loss of awareness of
objects on one side of the body, known as left- or right-sided
neglect, depending on the side affected. Swallowing difficulties - these can cause
trouble with eating or drinking which, if not managed, can
result in chest infections including pneumonia as food or liquid
passes into the windpipe and lungs instead of the gullet.
Dehydration or constipation may also result . Speech or language difficulties - including
difficulties in understanding, speaking (dysphasia, aphasia),
reading, writing and calculation. Speech and language problems
are usually a result of damage to the brain's left hemisphere. Problems of perception - these can include
trouble recognising or being able to use everyday objects such
as a kettle or teapot, difficulties telling the time, and
problems interpreting what the eyes see, even where vision is
not affected. Cognitive difficulties - these include
problems caused by damage to areas of the brain controlling
mental processes such as thinking clearly and logically,
learning, paying attention, memory, decision-making and forward
planning. Behaviour changes - these may include being
slower to react than before the stroke, excessive caution,
disorganisation, finding it difficult to adjust to change and
becoming confused or irritated. Difficulties with bowel or bladder control
(urinary or faecal incontinence) - these may be caused by a
variety of different problems following stroke. These can often
be considerably improved or overcome with medical help and
physiotherapy. Fatigue - although a recognised phenomenon,
the reason for fatigue is not fully understood. There may be
sleep disturbance caused by damage to areas of the brain
controlling the body's sleep-wake cycle and it could also be
linked to depression. Psychological impairment / mood changes,
depression, and changes in cognitive functioning. This can
include mood swings, irritability, laughing or crying even when
you do not feel particularly happy or sad. Depression is
extremely common following a stroke, with symptoms such as loss
of appetite, insomnia, crying, low self-esteem and anxiety that
can all be signs of depression. Post-stroke pain - a small number of people
develop a burning, shooting, throbbing pain that does not
respond to painkillers following a stroke. Epilepsy - 7-20 per cent of people who have
strokes develop epilepsy. This can usually be treated with
anti-epileptic drugs. RECOVERY FROM STROKE AND REHABILITATION: Of people who survive a stroke around half will be left with
significant disability Having said that, the brain is remarkably
adaptable and in the months or years after a stroke many cells that
have sustained damage recover some of their function. At the same
time other areas of the brain take over the functions performed by
the cells that have died. The time it takes to recover is extremely
variable. However, commonly people have a surge of recovery in the
weeks following a stroke followed by a slower recovery over the next
year to 18 months or so. Rehabilitation following stroke is about the
process of achieving the best level of independence as possible by: Learning new skills. Relearning skills and abilities. Adapting to the physical, emotional and
social consequences of the stoke. Multiple
Sclerosis: Between 3 and 7 people per 100,000 of the
population are diagnosed with MS each year and usually starts in
early life, there is no cure and the person lives with the diagnosis
for life. MS is a
disease of the central nervous system and where the white matter
within the brain or spinal cord becomes inflamed and then destroyed
by the person’s own
immune system. This
results in scarring to some areas of the brain or spinal cord.
Many of these episodes do not cause symptoms, but when sudden
symptoms occur the person is said to have had a relapse. Parkinson Disease It is estimated that 100-180 per 100,000 of the
populations are effected by Parkinson’s Disease.
PD is a progressive neurodegenerative condition leading to
the death of dopamine containing cells of the substantia nigra.
People generally present with bradykinesia (slowness of
voluntary movement and speech), rigidity and rest tremor.
Though it is predominantly a movement disorder, though people
can develop psychiatric problems such as depression and dementia.
Our interdisciplinary team of Consultant, Neurological
Physiotherapist, Occupational Therapist, Nursing Staff, with access
to Speech and Language Therapist and Neurological Psychology aim to
provide a client centred, goal orientated approach to
rehabilitation. The
patient is enabled to play an active part in making informed
decisions in all aspects of their rehabilitation, empowering them to
set realistic goals to achieve their optimum rehabilitation
potential. Our skilled
nursing team is able to assist the patient to plan their care on a daily basis,
including personal care, bladder and bowel management and wound care. SPINAL
INJURY: A spinal cord injury is damage or trauma to the spinal cord that results in a loss or
impaired function resulting in reduced
mobility or feeling. It is often caused by trauma e.g.: a car accident, gunshot, falls, sports injuries, or
a disease e.g.:Transverse Myelitis, Polio, Spina Bifida, Friedreich's
Ataxia, The resulting damage to the cord is known as a lesion,
and the paralysis is known as quadraplegia or tetraplegia if the injury is in the
cervical
region (see diagram), or as paraplegia
if the injury is in the
Thoracic,
Lumbar
or
Sacral
region. It is estimated that there are 40,000 people in
the
UK
alone that are paralysed through spinal cord injury.
The spinal cord is part of the central nervous system and
carries signals to and from the brain, controlling almost every
function of the body. When there is damage or trauma to the spinal cord it will result in
loss or impaired function causing reduced mobility and/or feeling.
The effects of spinal cord injury depend on the type and
level of the injury. Injuries can be divided into two areas:
Complete - means that there is no function, (no sensation or
voluntary movement) below the level of the injury.
Incomplete – there is some function below the level of
injury. A person may
be able to feel parts of the body that cannot be moved, they may
be able to move one limb more than the other. HOW WE CAN HELP: Our interdisciplinary team of Consultants,
Nurses, Occupational Therapist and Physiotherapist offer full
assessment and comprehensive inpatient rehabilitation programmes.
The rehabilitation programmes are patient centred, goal
orientated to enable the patient to play an active part in making
informed decisions in all aspects of their rehabilitation.
Our skilled nursing team is able to assist the patient to
plan their care on a daily basis, including personal care, bladder
and bowel management and wound care.
Along with the physiotherapist and occupational therapist the
team encourage patients to participate in and return to normal
living, including return to work, family or education. Rehabilitation Services
include Bowel and Bladder Management, Calliper Training, Driving
Assessments and Lessons, Fertility Advice, Functional Electrical
Stimulation, Hydrotherapy, Mobilisation after Surgery, Occupational
Therapy, Physiotherapy, Psychological Counselling, Skills Honing and
Top-up Rehabilitation, Speech and Language Therapy, Splinting,
Teaching Activities of Daily Living, Treadmill Therapy, Wheelchair
and Cushion Assessments, and Wound and Pressure Care.
