Rehabilitation Department

Our Neurological Rehabilitation Center provides occupational and physical therapy for patients from around the world. Our specially designed rehabilitation center ensures the patient's privacy so they can receive rehabilitation treatment in a comfortable environment. Our facilities include the most advanced state-of-the-art rehabilitation equipment from around the world. Our well-trained Senior Occupational Therapists are from the China Rehabilitation Treatment Center and our Physical Therapists are from the Capital University of Medical Sciences. The Chief Doctors in the Neurology Department provide an individualized, integrative, and effective rehabilitation training plan. The comfortable environment, combined with advanced biotherapy and professional staff, assist in the patient's recovery process which greatly improves the patient's ability to live a healthy and independent life.

Rehabilitation Therapy For Spinal Cord Injuries

With the development of the economy, increased travel, and growing industries, the rate of spinal cord injuries is increasing on a daily basis. The following is a summary of the different rehabilitation therapies we offer to our patients. By providing better treatment services to our patients, their ability to take care of themselves increases along with their overall quality of life.

SCI definition: The trauma or disease has lead to the spinal cord injury, and as a result, the patient has developed paraplegia or tetraplegia. Neck injuries may lead to tetraplegia, which refers to the paralysis of the four limbs and the torso, either in a complete or incomplete manner. If the patient has damaged their chest, waist, or shinbone, this may lead to paraplegia. Paraplegia refers to the lower limbs and torso being completely or incompletely paralyzed.

SCI related appraisal: 1.Damage plane ; 2. Respiratory function; 3. Surviving myodynamia ; 4. Joint movement; 5. Perception; 6. Reflection; 7. Feces and urine function; 8. Convulsion; 9. Motor function (turning over, sitting up, sitting balance, propping up, movement in bed, shifting, ability to use a wheelchair , standing up, walking).

We will not perform rehabilitation training under the following circumstances:

1. The patient's body temperature is higher than 38 C.

2. Under low stress conditions, the patient's pulse surpasses 100 beats per minute.

3. Blood pressure is too high or too low.

4. Cardiac dysfunction.

5. The trauma wound has not healed.

6. There is pain in the area that requires rehabilitation.

7. The patient is very weak.

8. The patient has serious osteoporosis, which may cause a pathological fracture.

9. The patient is experiencing confusion and is not able to participate properly with the training.

10. Serious convulsions.

11. Liver functioning is not normal.

12. Infectious diseases.

13. Any other circumstances that would have negative effects.

Rehabilitation Training- Main Methods:

1. Physical Therapy: To improve the functioning of the entire body, including joint activity and the surviving myodynamia, attempt to balance coordinated actions and body posture exchanges and shift movements (for example: from a recumbent position to a sitting position, turning over, transitioning from a bed to a wheel chair, from a wheel chair to a toilet and so on). We also use hydrotherapy, phototherapy, biofeedback and other therapies to promote rehabilitation.

2. Occupational Therapy: This form of therapy focuses on the activities of daily life (the essential skills, including putting on clothes, eating meals, walking and so on), movements involved with physical work, skills associated with craftsmanship, for example, weaving. After the patient leaves the hospital, they can adapt to individual living skills, family life, social life and professional life. Furthermore, the occupational therapy department provides simple auxiliary therapy to the patients to help them adapt to family life.

3. Psychotherapy: With consideration to the different psychological stages (for example denial, anger, and so on), we cooperate with the patient and family members to provide the most appropriate psychological care.

4. Rehabilitation Project: The patient can order essential braces to assist them while practicing walking and standing and we can provide some mobility aides, along with specialized equipment.

5. Clinical Rehabilitation: We use medications and other methods to prevent complications. We also perform some medical clinical processing to reduce the symptoms and promote the recovery of proper functioning.

6. Chinese Medicine Rehabilitation: Using Chinese Traditional Medicine, including acupuncture, massage therapy, and acusector, we induce ions, along with other methods to promote recovery. We also use Chinese Traditional Medicine for external use, to treat any complications.

7. Nutrition Treatment: To meet the recovery requirements, we formulate appropriate recipes with nutrition.

 

Cerebral Palsy

Definition of Cerebral Palsy : The syndrome is caused by non-progressive brain damage occurring before birth or within 1 month after birth.

The damage is to the brain's motor control centers, inhibiting the development of movement and causes abnormal posture.

Diagnosis of cerebral palsy has several essential factors: Bodily movement shows obvious signs of impairment, dystonia, unusual posture and abnormal motion patterns, abnormal reflexes (unconditional reflex, sets up straight reflection, balanced reflection).

Primary high-risk factors for cerebral paralysis: suffocation, premature birth, nuclear jaundice, congenital heteroplasia.

Cerebral palsy complications: Mental handicap, barrier to cognitive development, epilepsy, sensory impairments.

Cerebral palsy classifications:

      Spastic type

      Involuntary athletic type: athetoid , myodystony, fremitus

      Ataxia type

      Mixed type

      Atonia type

 Characteristics of the spastic type:

 Upper limbs: increased muscle tension, shoulder joint adduction, elbow flexing, forearm pronation, bending of the finger joints and palm, thumb adduction

The lower limbs extensor tension is increased, hip adductor group, quadriceps femoris, triceps surae muscle tension is increased, hip joint flexure, adduction and involute, knee joint flexure, sharp foot, strephenopodia, strephexopodia

Seat: pelvis caster, round back when sitting with legs extended, "W" sitting posture

Standing: sharp foot, walking with a scissors gait, hemiparalysis towing gait

Characteristics of involuntary athletic:

The muscular tone is unstable, increases when anxious, during the infant stage polymyarian tension is low, and the symptoms are obvious when the patient is two or three years old

Involuntary body movements, especially in the face, arms and torso, uncoordinated movements, loss of motion increases

A  lack of continuous control over posture

Restricted movement in the oral-facial muscles affecting the tongue, the throat and swallowing capability, dyslalia, dysphonia, laryngeal stridor, disturbance of food intake, increased salivation

Movement range is large

A  characteristic symptom is dehise yawning with effort

Unusual posture with low muscular tone:

1. Frog position posture

2. While in a sitting position, there is difficulty raising the head

3. Sitting with upper body anteversion

4. Inverted "U" posture while the patient is bolstered up horizontally

5. Winged shoulder posture

Unusual posture with hypermyotonia:

1. Head dorsiflexion

2. Opisthotonos

3. Upper limbs: shoulder joint adduction and involute, forearm pronation and extended back, hand makes a fist, hand too far extended

4. Lower limbs: Rigid extension, scissors shaped, sharp foot (6 months later)

5. Kneeling warrior, sitting with legs extended straight

6. TLR (buttocks is higher while the head is low), ATNR posture (asymmetrical tonic neck reflex) Because of the high muscle tone of the neck, the posture mimics the pose of an archer

Methods to treating cerebral palsy:

 Physical therapy, PT

 Occupational therapy, OT

 Speech therapy, ST

  Education therapy

 Pharmacotherapy: neurophic medication infusion , botulinus toxin A infusion

 Chinese traditional treatment: Medicinal bath, wax therapy, massage, acupuncture

 Surgical therapy-neural stem cells transplantation and surgery

The treatment principle with regards to cerebral palsy:

The convulsions (including infant hemiparalysis) mainly reduces muscular tone, promotes the infant's motor ability growth, and encourages the infant to become more active.

Movement principle of involuntary movement: stabilize, median line, flexure pattern, controlling the posture

During daily treatment the nurses should pay special attention to:

 Training time

  Helping to correct the posture while the patient is seated

  Making sure there is plenty of opportunity to practice standing and walking

 Focusing on oral cavity mastication, question movement difficulties as soon as possible

 Raise the infant's level of intelligence

Rehabilitation of a Stroke

When should the rehabilitation of a stroke start ? For the past 10 years, the academic community has said rehabilitation should start as soon as possible. The characteristics of a stroke include varying degrees of functional barriers, such as movement, language, and cognition. With the chronic nature of a stroke, secondary barriers may be generated. The main goal of rehabilitation after a stroke is to reduce the primordial function barrier, along with preventing any secondary barrier occurrences. The rehabilitation of a stroke is divided into three stages: the acute stage, the recovery stage and the chronic stage.

1. Acute stage recovery treatment:

The therapist should consult with the doctor; participate in the prevention of sequential complications positively, such as implementing body posture changes, maintaining good positioning of the extremities, working on passive activities with the joints, training the patient to breathe and swallow properly, and other measures. It is important to prevent arthrogryposis, bedsores, and possible dislocation of the shoulder joint, pneumonia and other complications.

2. Recovery period training:

Assist the patient in turning over and sitting comfortably. Once the patient can sit for more than 30 minutes, the recovery treatment must continue in the recovery training room. This will include vertical positioning training, vertical position gravity shift training, motion control training, daily life ability training, balanced bar walking training and gait correction training.

3. Chronic training:

This is done when the patient leaves the hospital and returns to their normal, everyday life. The main questions concerning the chronic patient is how to maintain and continue to improve the patient's functioning, increase the patient's ability to participate in normal activities and improve their overall quality of life. The therapist should tell the family members to encourage the patient to engage in activities that promote healthy movement, like going outside regularly, taking short walks, etc. When the patient loses confidence, family members should encourage them to learn effective ways to prevent falls which could lead to serious injury.

Parkinson's, multiple system atrophy and amyotrophic lateral sclerosis' recovery treatment

1. Parkinson's disease (tremor artuum): This is the most common disease with the central nervous system denatured; most of the patients are middle-aged or elderly. The substantia nigra cells are located in the mesencephalon area and when the pathology changes, this leads to dopamine synthesis reduction, inhibition of the functioning of acetylcholine, and the relative increase of acetylcholine excitation. These imbalances result in "tremor artuum."

The patient's clinical performance includes increased tension in all four limbs, trembling of the hands, balanced function reduction, gravity anteversion and "flustered gait."

Therefore, in recovery training, primary focus is on alleviating the trembling of the patient's four limbs, increasing the patient's muscular strength in the upper limbs, improving muscular control of the upper limbs, improving balance through the use of the balance plate, bobath ball and other tools, and getting to the point where the patient' balance is good enough without the need for support. Furthermore, the patient's gate is continuously corrected throughout the course of treatment. The patient is also trained to restore oscillation arm functioning when walking.

2. Multiple system atrophy: The causes are unclear. This is a multiple-spot nervous system denatured disease; it affects the extrapyramidal system, pyramidal system, the cerebellum and the parasympathetic system, and so on. Multiple system atrophy involves corpus striatum- substantia nigral denaturation which mainly presents with Parkinson's type symptoms, Chinese olive - pons - cerebellum atrophy as well as parasympathetic system's functional barrier, which mainly presents with Shy-Drager syndrome.

MSA patients'clinical symptoms are similar to those of Parkinson's patients. Therefore, the training method is also quite similar. We can arrange some recreational activities according to the patient's particular case, but we recognize that some MSA patients may be presented with body posture hypotension, which is different with Parkinson's patients.

3. Amyotrophic lateral sclerosis is the most common type of motoneuron disease. It affects the ventricolumna cells, brain stem, coordination, movement, nerve nucleus and pyramidal tract. There will initially be damage to the upper motor neurons or lower motor neurons, eventually leading to the development of lower motor neuronal lesions.

Patient's clinical presentation includes muscular atrophy, decreased muscular strength; some patients may also have anarthria, difficulty with swallowing and chewing, tongue amyotrophy and affective disturbance. Treatment will focus mainly on enhancing the patient's muscular strength through support training as well as methods designed to restore language and swallowing functioning.

All three are characterized as nervous system diseases, and the cause and mechanisms of all three diseases is not explicit. During the recovery treatment, besides the symptomatic treatment, communication with the patient is extremely important. It is also important to encourage the patient to set realistic goals. All three of these diseases may have a relation to long-term nutrition imbalance; therefore serious consideration goes into planning each patient's diet.

Our comprehensive treatment plan is focused on improving the overall quality of life for each patient. 

Speech Therapy

Our speech therapy refers to the methods we use to treat patients with paralalia. Our methods include using alternative communication devices like exchange boards, exchange handbooks, sign language and so on. The goal is to improve the spoken language function, and to restore exchange ability.

The sooner we are able to treat the patient, the more effective the results will be. The early discovery of logopathy is key to the success of the treatment program. We perform a comprehensive spoken language function evaluation before we start the speech therapy, in order to understand the type and degree of logopathy. We then plan a therapeutic schedule.

During the course of treatment, regular evaluations are made, and according to the evaluation results, any needed adjustments to the therapeutic schedule are made. The speech training process proceed in an orderly, structured way, from simple to complex. If the patient has functional barriers to hearing, speaking, reading or writing, the treatment should start with listening and comprehension skills with an emphasis on the training of spoken language. The content and time of the treatment must be suitably arranged, to avoid the patient from getting weary and making too many mistakes. The therapist should, according to the patient's responses to the treatment, give feedback promptly, praising the correct responses, while downplaying the incorrect responses.

Furthermore, speech therapy is a kind of exchange process. The patient needs to actively participate, and a two-way exchange must exist between the therapist and the patient, as well as with the patient's family members. The exchange process is a crucial part of the overall treatment.

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