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Concept of early neurosurgical rehabilitation
HostUniversitas Kristen Indonesia
Date/Time 04-11-2009
DetailsObjectives: Today, increasingly more patients with brain lesions survive the acute stage, however, suffering from severe impairment of higher cerebral sensory motor and/ or mental cognitive functioning (WHO-ICF). Early neurorehabilitation can significantly improve functioning and patients’ reintegration.

Methods: Functional rehabilitation is an original task of neurosurgery. Impairments refer to loss of structures and functions. Disabilities refer to limitations or participating restrictions. Functioning is an umbrella term encompassing all body functions, activities and participation. Neurorehabilitation needs a multidisciplinary team approach We introduced for the first time a new concept of neurosurgical rehab. according to the Guidelines of the German task force.

Results: The essential aspect in early rehabilitation is the integration of disciplines and consistent goal setting to regard individual patients’ needs. Good structural organization of the team, notice of basic communication rules, conflict management and a definite decision making increase productive interdisciplinary working. I will give some basic ideas of our team approach and the daily work on our special ward that was designed for 20 patients on one floor of 1200 sqm, The early rehab. ward is part of the neurosurgical department. Team leader is the head neurosurgeon who educates and trains also the rotating resident neurosurgeons and the senior residents during weekly rounds. Social reintegration is demonstrated in two patients.

Discussion: Obviously the impairment of mental-cognitive and neurobehavioral functioning and not the loss of physical skills will cause patients’ loss of life transactions and final outcome. Early neurorehabilitation aims at functional restoration by fostering of the individuals’ neural plasticity.

Conclusion: Functional rehabilitation is a process whereby patients who suffer from impaired higher cerebral functions following brain injury and cerebral diseases regain their former abilities or, if full recovery is not possible, achieve their optimum physical, mental, social and vocational capacity. It aims at patients’ social reintegration. In order to facilitate such goals neurosurgeons should start with a multidisciplinary team approach as early as possible. The have to be educated in rehabilitation to understand the restorative processes and have to learn working in close collaboration with the neuropsychologist and all other members of the team day by day.

Narasumber :
Klaus R.H. von Wild

Professor of Neurosurgery, Medical Faculty University of Münster, Professor of Neuro-rehabilitation and Re-engineering of brain and spinal cord lesions at the INI, Hannover, German
MCU IP202.58.168.50
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