I have just started my neuro placement, which is in a rehab setting, and thought I would share an issue that I have been introduced to. The focus at my facility is on a Bobath approach to treatment which is about encouraging normal movement as much as possible.
However, before patients are admitted they are treated in a more acute area, who often take a different approach. In these settings patients may be allowed to use whatever pattern or muscles possible to achieve a task e.g. rolling. This can hamper the rehabilitation process, as the brain relearns the wrong movement patterns, and can also result in increased overactivity in the "unaffected" side.
I believe it would be in the patients best interests to communicate between facilities in order to acheive the optimum outcome, although I'm sure I am not aware of all the issues involved, or the evidence behind it (but I'll save that for another post). Anyone?
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Hi Megan,
I had the same concern before but I have just realised as long as you’ve got a good understanding on patient’s impairments, the variation in treatment doesn’t really matter since a single impairment can be treated by different techniques.
Let’s use swelling as an example: You can either use US, cold pack, compression or elevation to ease of the swelling. As long as you know what the problem is, your treatment will help the patient.
hey megs, I have come across this situation as well and found the hardest thing was explaining to the patients why they now aren't allowed to move the way they have been for the past couple of months. The ones that noticed the change in treatment approach said initially they felt like they took a backwards step in their rehab. I found that with alot of patience and explanation they came to understand that they had reached a certain stage in their rehab and we were now focusing on 'fine tuning' their skills as much as possible. Lots of education was needed to help them realise the different approach would make movement easier for them in the long run, and that they were still moving forward
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