Neurological early rehabilitation

The treatment is oriented towards the phases of neurological early rehabilitation. The initial focus is on acute treatment (phase A). During this time, a tracheotomy, a feeding tube through the abdominal wall (PEG) and often also a urine diversion through the abdominal wall (SPDK) are usually inserted in order to secure vital functions and enable optimal nursing care (including nutrition). Already during this time, however, rehabilitation-oriented offers should be made, especially physiotherapy and speech therapy. This can prevent contractures or pneumonia and improve swallowing function. After the end of mechanical ventilation, the function of swallowing is decisive for whether the tracheal cannula can be removed. After completion of the acute treatment, early rehabilitation phase B follows. The range of therapies is expanded to include occupational therapy and neuropsychology. In addition, music therapy can be used. The aim is to improve motor, mental and psychological functions. The treatment must be carried out in a team under medical supervision; this is also demanded and verified by the cost units. The concept of basal stimulation has become widely accepted, which is intended to convey a perception of the environment and support of simple bodily functions (e.g. movements) in an integrated pedagogical and nursing concept adapted to the pattern of damage. In this phase, which lasts between one month and one year, the prognosis of the affected person is decided. If there is a noticeable improvement in physical and mental performance, further phases of rehabilitation can follow (phases C/D/E). However, if he remains unconscious, it is necessary to move on to phase F (permanent “activating treatment care”).

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