Tratamiento Individualizado

The Neurorehabilitation clinic from its origins in the year 1994 as a neurological physiotherapy clinic, has as a priority the conduct of individual treatment sessions, relationship 1:1 between the therapist and the patient. This applies in all disciplines that we offer, both physiotherapy, occupational therapy, neuropsychology, psychology and speech.

This aspect is one of our fundamental pillars since the fact of working only with a patient can help us to be very analytical in our evaluations and to be able to mark some really personalized therapeutic objectives. It is also important for the personalization of the treatments, that is, to adapt the therapeutic exercises to the needs of the patient, for example, a patient after a stroke with equine foot, in the sessions of physiotherapy reduces the spasticity causing Of the deviation and we promote the opposite movement so you can walk more easily.

Within the physiotherapy sessions we can focus part of the session on performing a manual therapy necessary to correct possible joint limitations, alterations of muscle tone (spasticity) or sensitivity alterations. A second part in which we devise exercises and functional activities, guided and facilitated continuously by the therapist. According to how each user responds we can adapt the difficulty or propose variations to be able to work the therapeutic objectives and maintain the motivation and active participation of the patient in the Neurorehabilitation sessions.

By having the help of the therapist we can perform an intensive and well oriented practice looking for the maximum potential of each patient after suffering a brain damage, medullary, or other damage of the nervous system.

After a brain damage is very normal to have variacines at the level of control over movements and balance. So it is very important to be able to adapt the therapy to the state of the person.

Terapia Acuática

Aquatic therapy is based on the realization of physical therapy in an aquatic environment, in such a way that the mechanical properties of water associated with the forms of intervention of physiotherapy are used in order to improve the function, activity and participation of the patients. One of the main fields in which we can apply this form of treatment is neurorehabilitation, directed, among others, to adult patients suffering from neurological processes, such as stroke, multiple sclerosis, Parkinson’s disease, brain damage, tumors cerebral, muscular dystrophy, spinal cord injuries, etc. or children with motor disorders for brain damage from birth or acquired.

Thus, we can intervene in a rehabilitative way, in a preventive way, of treatment, as a physical or sport activity or, simply, with the aim of providing a moment of well-being to the patient. Water provides us with a medium where the body acquires a large amount of freedom of movement and where it can carry out exercises and activities that are difficult to perform on firm ground, being able to act on balance, coordination, dexterity, walking, postural control, physical conditioning, lung function, etc.

Within many and diverse types of aquatic therapy, one of the most known and used is the Halliwick Concept. Its main objective is to give everyone freedom and independence to perform in the water. The idea is, then, to teach anyone, regardless of their pathology, to swim, providing the physical and mental foundations for that purpose. One of the characteristics that best define this concept is that one works with respect to the abilities that the person possesses in the water and not taking into account the disability that presents in “land”.

Even if one of the priorities is that the patient can swim independently, it is not the only thing that stands out within this concept. In Halliwick great importance is given to the relational aspect of the pool. For this reason, we work frequently in groups, mainly in the case of children, to encourage group stimulation, the demand for concentration of the participants and cooperation among them, also creating links between the members. Despite this, sessions can also be developed individually, often in the case of adults.

In the Clínica de Neurorehabilitación we have therapists trained in this Concept. Thus, the sessions will be adapted to the personal needs of each patient, either individually or in groups, counting with the help of family or friends who will also participate in the session in the water. Our objective will always be that the person becomes independent in the water as quickly as possible, so that he can even go to the pool as a physical activity or sport independently. Although we will always be willing to take a dip!

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http://www.halliwick.com.br/es_ES/a-filosofia
http://www.halliwick.com.br/es_ES/a-filosofia

Author: Jesús Márquez Neila

Reunión Anual 2017: Sociedad Española de Neurología

One more year, the Spanish Neurological Society celebrates the LXIX Annual Meeting in the city of Valencia. From 21 to 25 November 2017, experts from various branches of neurology and neurorehabilitation (physicians, psychologists, physiotherapists, etc.) will gather at the Congress Palace in Valencia. This international event will address current issues and the latest developments in this sector will be exposed.
The meeting, which will last several days, will feature presentations, workshops, exhibition of scientific studies and material among other activities. The neurophysiotherapy section, by Carolina Fernández (Madrid), Estela Diges (Zaragoza), Carina Salgueiro (Sant Cugat del Vallés) and Cristina Puig (Manresa) will present a program focused on movement disorders, a consequence of brain damage such as Parkinson’s disease or, less well known, Huntington’s. On that day will also be approached topics related to clinical cases of Friedreich’s Ataxia and his approach in physiotherapy. As a novelty, this year, the board of directors brings to the participants a Kinaesthetics workshop, a therapeutic approach oriented to the learning of sensitive and motor skills. This workshop will be taught by our well-known Mercedes Fernández (occupational therapist, Zaragoza).
In addition to the neurological physiotherapy section, the occupational therapy and neuropsychology study group also present very encouraging programs to the professionals of the Neurorehabilitation Clinic.
See you in Valencia!

programa de la sección de neurofisioterapia de la Sociedad Española de Neurologia
programa de la sección de neurofisioterapia de la Sociedad Española de Neurologia

Taller teórico-practico: Terapia espejo en neurorehabilitación

For: Physical Therapists and Occupational Therapists
Trainer: Jesus Marquez and Carina Salgueiro
Hours: 6 hours face-to-face
Dates: Saturday, April 14, 2018
Hours: 9-15h
Place: Neurorehabilitation Clinic (c / Asturias 1, Sant Cugat del Vallés)
Price: 60 €
Number of places: 20 (min. 8 students)

Course Objectives:
To expand the knowledge of the motor imagination and mirror therapy approach in patients affected by Central Nervous System patologies
To deepen knowledge on the physiology of the nervous system involved in the mirror therapy
To know several methods and procedures of the mirror therapy
Know or improve practical treatment procedures

Contents:

Theoretical class of neurophysiology
Theoretical-practical class of the procediminetos of action in mirror therapy with neurological patients
Exposure of current scientific evidence

Program:
9H: Submission of documentation, presentation of trainers and workshop program
9H30: Origins of mirror therapy
10H00: Neurophysiological mechanisms involved in mirror therapy
11H00: Coentificative evidence of mirror therapy in neurological patients
12H00: ​​Pause
12H30: Theoretical bases of treatment with mirror therapy
13H30: Demonstration and practice of procedures
14H30: Exhibition of alteranativa and complements to the mirror therapy
3PM: Delivery of certificates

Registration open until March 9, 2018. To register send mail to formacion@bobath-es.com with personal data (full name, contact phone, place of work), copy of the academic certificate and copy of the payment certificate (number of account: ES26 2100 2776 3801 0056 6981 Concept: full name + TE)

Taller de terapia espejo para fisioterapeutas y terapeutas ocupacionales

QUE ES LA NEUROPLASTICIDAD Y EN QUE NOS AYUDA TRAS SUFRIR UN DAÑO CEREBRAL

Neuroplasticity is the ability of the nervous system to modify its functioning and to reorganize itself during the stages of development and after a brain injury through experience and learning in response to the activity.
After suffering an Ictus or a traumatic brain injury, different mechanisms of neuroplasticity are activated that will produce changes in the short and long term.
The initial recovery (early days) is due to phenomena such as the reabsorption of edema, the opening of collateral vessels to the injured that guarantee cerebral irrigation and the awakening of pre-existing neural connections that were latent.
After a few weeks or months, brain plasticity processes like:
– dendritic growth (receptive parts of the neuron that are essential in the transmission of the nerve impulse)
neurona
– the formation of new synapses (connections between neurons)
sinapsis
– changes in the functioning of damaged areas
– increased activity of parallel pathways to the injured.
Thanks to these mechanisms the nervous system is reorganized to be able to maintain and recover the gait capabilities, the mobility of arms and legs, the ability to balance, etc.
But we must watch that the ability to reorganize the brain does not lead to problems such as spasticity or neuropathic pain, as these can harm us.
Therefore, it is very important that from the beginning we start with rehabilitation and continue for years to take advantage of these neuroplastic capabilities that will help us regain function and autonomy in the activities of daily living. In addition to curbing the onset of phenomena such as spasticity or neuropathic pain.
This ability that the nervous system has to adapt is infinite, it is known to decrease with age or over time after injury, but it does not run out, so we should not underestimate the capabilities of the nervous system.
As therapists it is very important to take into account where the injury has occurred, how long it has been and how it has worked so far to be able to plan therapeutic goals and practice new ways to achieve these goals in order to stimulate the creation of new connections.

Jornadas formativas en el Concepto Bobath

The Spanish Association of Therapists Formed in the Bobath Concept performs each year two training days so that partners and non-members are aware of the evolution of the Bobath Concept and new therapeutic tendencies with neurological patients such as stroke, traumatic brain injury, parkinson’s, ataxias, among others .
In November, specifically on November 11, will be held in the city of Leon one of these meetings with the theme of treatment of the patient with sequelae of traumatic cranioencephalic. For that they have different professionals specialized in the field of neuro-habilitation and neurosciences and who bring to the conference presentations related to the regeneration of the central nervous system against a neurological injury, as is the case of traumatic brain injury, or issues such as function and cerebral dysfunction.
The part will also touch on topics related to the practice of our profession, physiotherapists and occupational therapists, and therefore the treatment and recovery of patients after suffering a traumatic brain injury. Physiotherapy and occupational therapy in patients with cranioencephalic trauma are currently focused on recovering lost abilities, which depend on the location and severity of brain damage (balance, coordination, posture, movement of arms, etc.). In many cases, the neuropsychologist collaborates to deal with cognitive and emotional issues in order to strengthen the capacity for motor learning and the adaptation and management of the relationship between family, friends, school, work and others.

Programa jornadas en Concepto Bobath
Programa jornadas en Concepto Bobath

Terapia Espejo

Mirror therapy is a form of treatment that is applied primarily to patients suffering from single-limb or hemibody, or those in which the condition is most evident in one limb. This form of therapy emerged in the 1990s from the hands of Ramachandran and Rogers-Ramachandran as a means to treat phantom limb pain in amputated patients. Subsequently, it was proved useful in another type of pathology, such as chronic regional pain. It was in 1999, when Altschuler decided to use mirror therapy as an intervention in patients suffering from hemiparesis after a stroke, demonstrating that the motor component of these patients improved.

The principle of this form of therapy is based on providing a false sensation of movement of the affected limb from the healthy limb by means of a mirror located in the patient’s mid-sacral plane, perpendicular to it, which hides the affected limb and which reflects the healthy. Thus, the mirror therapy focuses on a visual stimulation in which it replaces the information that has of the extremity that is affected. With this arrangement, functional movements or activities that can be performed with the healthy side are reflected in the mirror giving the false sense that it is the affected member that performs them.

It is believed that the positive results in relation to this treatment can take place by changes in the level of the cerebral excitation, provoked when the patient sees its healthy member moving through the mirror, whereas its affected member is blocked visually. This visual illusion functions as the basis of a neurological mechanism to induce cerebral plasticity, and can accelerate recovery. The improvements have been described in the motor field, in sensory dysfunction, in hemineglect, in the daily living activities and in pain.

In the Clínica de Neurorehabilitación we have professionals trained in this form of treatment, who will adapt the sessions and the way of working to the needs of each patient. In addition, after several sessions of work with the therapist, this therapy can be performed autonomously by the patient at home.

IMPORTANCIA DE TRABAJAR EL EQUILIBRIO EN LOS PACIENTES CON ENFERMEDADES NEUROLÓGICAS

In everyday life we carry out many functional movements that involve the ability to maintain balance, not only in positions static as standing in a supermarket queue, but also dynamic such as walking on the street or with movement of the trunk, arms and legs. Some of them are transfers from bed to get standing, or bed to a wheelchair, or from the wheelchair to the toilet. When remain us stand also prescisamos of balance to dry our hair, or prepare food in the kitchen.When we perform daily daily activities we need that our brain is attentive to the activity that we perform (example: wash dishes, look at the mobile…), therefore the maintenance of the balance have to be automatic, it is saying, not consciously, we control the activity of the muscles that make us maintain posture. This ability to perform a task to balance while we carry out an activity as a reply to a message from the mobile, or manipulate a small object is called the capacity of dual task.

Neurorehabilitation clinic we attach great importance to the work of the balance. We focus therapies to prepare the muscles and improve sensitivity to the body perform a good postural responses to an imbalance. When we work the balance, at the same time, carry out a dual task, with the purpose of automating postural reactions and that we can divert our attention and concentration to other task (prepare a meal, check the mobile, maintaining a conversation).

When we have altered the ability of balance, is very important to monitor the situations of everyday life in which easily can lose the balance by focusing on the activity (use of the WC, shower, while we wear it). In these situations should monitor as the person may not maintain their attention in posture and therefore will have to be controlled by the brain in an automatic way. This is why rehabilitation sessions also have to work how to ensure a good balance to prevent falls of the patients with neurological injury such as stroke, Multiple Sclerosis, among others.

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Día Mundial de la Fisioterapia

Physiotherapy has thousands of years of evolution but only in 1958 did the World Health Organization officially define physiotherapy as “the art and science of treatment through therapeutic exercise, heat, cold, light, water, massage and electricity.” In addition to treatments, in physiotherapy, manual and computerized tests are used to determine the affectation and the degree of all those who come to this service, such as muscle strength, joint movement, balance, pain, among others. So what has been known as the treatment through physical agents has evolved not only curative but also preventive and evaluative skills.

As in medicine, in the nineteenth century, physiotherapy is divided into several therapeutic specialties in which we can find neurological physiotherapy. Neurological physiotherapy, as a service incorporated in the neurorehabilitation sector, aims to restore and maintain functional capacities to the maximum affected by the neurological disease or injury (eg, stroke, ALS among others) and in some cases to develop new strategies and capacities that allow the people affected to be as autonomous as possible in their activities.

Within this branch of physiotherapy, neurological physiotherapy, it is possible to find different concepts, methods and treatment techniques developed mostly after the 1950s. At the Neurorehabilitation Clinic of Sant Cugat del Vallés (Barcelona), the Bobath Concept is the most integrated approach in physiotherapy treatments and even if we use different strategies, we continue to celebrate physiotherapy, where everything has started.

Concepto Bobath: Curso Avanzado en Reconocimiento y Tratamiento de Personas adultas con Trastornos neurológicos

Topic: “Control posture as a requirement of the gait and functionality of the upper limb in people with incomplete spinal cord lesion and ataxia”

Aimed at: Physiotherapists and occupational therapists who have the title of the basic course of the Bobath concept by the IBITA.

Teacher: Bettina Paeth Rohlfs, physical therapist, tutor Bobath Senior IBITA
Hours: 35 face-to-face hours (accredited by the Commission of continuing training)
Dates: 21 – February 25, 2018
Hours: 9-18’30 h from Wednesday to Saturday
9-14 h Sunday
Place: Neurorehabilitation clinic (c / Asturias 1, Mirasol)
Price: €650
Number of places: 12

  • Deepen and broaden knowledge of techniques and tests for evaluation and treatment of adult patients with neurological as incomplete spinal cord injury and injury cerebellar disorders / Ataxia to make a clinical diagnosis;
  • Deepen and broaden knowledge on the physiology and pathophysiology of the nervous system to recognize symptoms and signs in affected individuals and classify them according to medical diagnosis;
  • Improve the clinical reasoning to determine treatment short-term goals and long-term mean level of structure and function and level of activities and participation;
  • Improve the practical techniques of treatment.

 

  • Lectures of neurophysiology and pathophysiology
  • Classroom for evaluation and tests: balance, postural control of the trunk, on the progress of the functionality of the upper limb
  • Facilitation of practical classes: balance, postural control trunk, the gait and the functionality of the upper limb
  • Demonstrations of people affected by Ataxia and spinal cord injury treatments.
  • Hours of treatment of people affected by the participants of the course under the supervision of the teacher.

Registration open until 15 January 2018. To enroll, send mail to formacion@bobath-es.com with personal data (full name, phone number, local work), copy of the certificate of the course basic in the Bobath concept and proof of payment (account no.: 2100 2776 3801 0056 6981 ES26 concept: name completo+CA).

carteal CA 2018