Orthopedic, Neurological, and Cardio-Respiratory Rehabilitation

Orthopedic Rehabilitation

When is orthopedic rehabilitation necessary?

Orthopedic rehabilitation addresses patients who have suffered trauma, injury, or surgery that has partially compromised their motor skills, to help them regain these functions. Events that can cause disability and therefore often require rehabilitation intervention include:

• Stroke;
• Heart attacks;
• Femur or knee fracture;
• Amputation of one or more limbs;

Who is orthopedic rehabilitation for?

Orthopedic rehabilitation primarily addresses patients with sequelae from major orthopedic surgery, particularly:

• Sequelae of hip prosthesis due to osteoarthritis or femoral neck fracture;
• Sequelae of knee prosthesis for gonarthrosis;
• Osteosynthesis of the pelvis, femoral neck, and other segments of the lower limbs;
• Sequelae of polytrauma with multiple fractures of the lower and upper limbs;
• Sequelae of any surgical intervention requiring rehabilitation;

Neurological Rehabilitation

What is neurological rehabilitation?

Depending on the severity of the neurological impairment, even dressing can become a complex activity. The multidisciplinary approach of neurological rehabilitation aims to improve motor functions, reduce symptoms due to neurodegenerative diseases, and consequently work on the patient's psychological well-being.

Neurological rehabilitation aims to help the patient regain as much autonomy as possible, improving specific damage where possible or trying to implement a functional alternative. This involves exercises dedicated to improving gait, muscle strength, resolving balance or speech problems, and managing pain.

Neurological rehabilitation is dedicated to patients suffering from strokes or aneurysms, Parkinson's disease, multiple sclerosis, cerebral hypoxia, traumatic brain injuries, and many other neurological disorders that lead to problems with balance, coordination, gait, and memory, attention, and language disorders.

How does neurological rehabilitation proceed?

There are many different forms of neurological rehabilitation. Depending on the situation, specialists may perform different types of intervention. Here are the main ones:

• Proprioceptive Neuromuscular Facilitation (PNF): This technique uses the body's proprioceptive system to facilitate or inhibit muscle contraction. It is a method of promoting neuromuscular response through neuromuscular stimulation. PNF is indicated to improve the range of motion of all joints reduced by atrophied muscles, improve endurance, and improve agility;
• Cognitive therapeutic exercise: This technique is dedicated to patients who have suffered brain lesions, not muscles. The exercises stimulate the cognitive processes at the origin of spasticity, for example. Lost movement can be stimulated by external stimulations of various types: tactile, movement, pressure, and visual. The goal is to allow the nervous system to readapt to the new condition, adjusting movements and controlling body reactions;
• The Bobath Method: The concept of this method is known as a form of observation, analysis, interpretation, and treatment following cerebral palsy, brain lesions, and other neurological lesions of the central nervous system affecting the sensorimotor system;
• Mirror therapy: This is a type of therapy that uses vision to treat the pain that amputees sometimes feel in their missing limbs. To do this, mirror therapy tricks the brain: it gives the illusion that the missing limb is moving when the person looks at the remaining real limb in a mirror;

Such treatments usually last 3 to 6 months, depending on the extent of the damage. To accelerate recovery, it is important to intervene in the acute post-traumatic period.

Cardiac or Cardio-Respiratory Rehabilitation

Cardio-respiratory rehabilitation: what is it?

Cardio-respiratory rehabilitation is a process that includes many factors and aims at the patient's clinical stability, reduction of disabilities resulting from the disease, resumption of normal activities, and prevention of future cardiovascular problems. Cardiac rehabilitation programs follow a multidisciplinary approach, involving cardiologists, cardiac surgeons, and physiatrists, as well as qualified physiotherapists. Programs are individualized, with constant and precise monitoring using the best diagnostic tools such as basal electrocardiogram, stress electrocardiogram, and cardio-respiratory ergometric tests.

What are the objectives of cardiovascular rehabilitation?

Here are the main objectives of cardiovascular rehabilitation treatment:

• Reduce the risk of respiratory diseases;
• Improve muscle tone and efficiency and functional autonomy;
• Reduce or control disease symptoms;
• Motivate the patient to change their lifestyle and combat risk factors;

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Phases of Rehabilitation

The rehabilitation process involves several phases, depending on the severity of the acquired disability. The first phase, carried out in hospital or specialized centers, varies in duration depending on the type and degree of the pathology and the patient's general condition. This is followed by a phase during which the patient continues their therapy at home or moves to the nearest territorial structures.

Rehabilitation, depending on the functional area it will address, can rely on different therapeutic techniques, including:

• Physical therapies for the recovery of strength and mobility;
• Occupational therapy for the recovery of the ability to perform daily activities;
• Speech therapy for the recovery of swallowing control, the ability to speak, and the ability to write or read;
• Pain management therapy;

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