What Is Rehabilitation?
A comprehensive intervention for patients with chronic diseases who are symptomatic and often have decreased daily activities.
It is designed to
Optimize functional status
Reduces health care costs
Stabilises or reversing systemic manifestations of the disease
Address morbidities and their consequences through education and exercise
Why Rehabilitation is the Need of Hour
Chronic Disease Era
Associated Mental Health Concerns with Chronic Diseases.
Continuity in Healthcare delivery system
Who Can Benefit?
Chronic respiratory disease symptomatic with optimum drug therapy
Chronic cardiovascular diseases with breathlessness despite optimum intervention and drug therapy
Chronic neurological diseases
Chronic orthopedic diseases, pre & post operative conditions
Pre Natal and Post Natal Conditions
Chronic and Acute pain conditions
Alcohol Deaddiction & Smoking Cessation
What are Consequences of advanced chronic disease?
Peripheral Muscle dysfunction
Respiratory muscle dysfunction
What are the components of Rehabilitation program?
Proper education of Disease process
Breathing and Relaxation techniques
Medications, devices & specific therapy
What are the Possible Benefits?
Improved Exercise Capacity
Reduced perceived intensity of dyspnoea and stress
Improve health-related QOL
Reduced anxiety and depression
Improved limb function and ADL’s
Benefits extend well beyond immediate period of training
For a successful rehabilitation program, it requires an efficient coordination and teamwork of medical professionals, which includes:
Nursing Attendants and health care workers
Wellness Coach and Psychologists
Cardiac rehabilitation (rehab) is a medically supervised program that helps improve the health and well-being of people who have heart problems. Rehab programs include exercise training, education on the heart and healthy living, and counselling to reduce stress and help you return to an active life.
What is the duration of this program?
As per the requirement of the patient, the program duration can vary from 6 to 8 weeks to lifelong.
What can one achieve through this program?
The goal of this program is to prevent and limit the physiological and psychological effects of cardiac illness and to improve the overall cardiovascular fitness and health of the patient. This is accomplished by developing individualised program which cover exercise, education and lifestyle modification, tailored to the individual needs and abilities of the patients.
Who requires Cardiac Rehabilitation?
People with the following cardiac diseases require cardiac rehabilitation:
·Coronary Artery Bypass Surgery
·Stable Angina Pectoris
·Two Or More Documented Classical Risk Factors For Coronary Heart Disease
·Stable Chronic Heart Failure
·Peripheral Vascular Disease
·Diabetes Mellitus (Type II)
·Valvular Heart Disease
What are the facilities for Cardiac Rehabilitation at SAANS?
SAANS Foundation has a dedicated cardiac rehab facility, complete with exercise equipment, i.e., treadmills, ergocycles, steppers and cross trainers; a gymnasium for pre-class warm-up and resistance training classes; Human Performance Labs for fitness testing; and a dedicated area for patient education.
The cardiac rehabilitation team
Phase I (Initial Phase)
This is an inpatient program. It begins with pre-procedure counselling and continues immediately after coronary artery grafting or stenting and post-angina or myocardial infarction. Its aim is to initiate early mobilisation (out of the bed) to reduce the effects of de-conditioning, along with patient education about heart disease. This is continued with a walking and exercise program at home or till the patient returns back to the hospital for Phase II.
Phase II (Conditioning Phase)
This consists of a comprehensive program to modify the risk factors for heart disease and consists of exercise, stress management, smoking cessation, behaviour modification, nutritional advice and patient education about the risk factors of heart disease. The aerobic exercise program can begin as early as 2 weeks after an uncomplicated infarction, angina and stenting or 4 weeks after a complicated infarction or bypass grafting. This is conducted in the form of group sessions or classes consisting of the three steps of initial stretching exercises, conditioning phase of aerobic training on the treadmill, ergo cycle, stepper or cross trainer (along with strengthening exercises) followed by the cool down phase. One session usually lasts for 60 to 90 minutes. It takes a frequency of 3 to 5 times a week to complete 20 sessions. Initial sessions are conducted with electrocardiographic monitoring. The behaviour management and nutritional component runs along with the exercise program. All sessions are physician monitored and are conducted by trained staff.
Phase III (Maintenance Phase)
This aims at continuing the benefits gained by patients during the second phase. It consists of the continuation of the aerobic exercise program but at a lesser frequency of about 2 to 3 times a week at home/in a gymnasium/at a hospital.
What is Pulmonary Rehabilitation?
Pulmonary Rehabilitation (Rehab) is a medically supervised program that helps to improve the health and well being of people who have pulmonary problems.
Rehab programs include endurance training, chest therapy, education on lung hygiene and healthy living, counseling to reduce stress & trigger factors and smoking cessation thus helping you return to an active and healthy lifestyle.
Who requires Pulmonary Rehabilitation?
People with following diseases require Pulmonary Rehabilitation:
Chronic Obstructive Pulmonary Disease (COPD)
Interstitial lung diseases
Obesity and Breathing Disorders
Combined cardio-pulmonary diseases
SAANS Foundation has a dedicated Pulmonary Rehab facility with separate areas for postural drainage, oxygen therapy and Non Invasive Ventilation, nebulisation and telemetric ECG monitored exercise systems i.e. ergo cycles, stepper and cross trainer; a gymnasium for pre-class warm-up and resistance training classes; Lung function testing labs; and a dedicated area for patient education.
A multi-disciplinary team consisting of
Physiatrists (rehab physician)
Physical and Occupational Therapists
Psychologists and Wellness Coach
As per patient requirement, the program duration can vary from 4-6 weeks to lifelong.
The goal of this program is to prevent and limit the physiological and psychological effects of pulmonary illness and to improve overall cardio-pulmonary status and health. This is accomplished by developing individualized programs of exercise, education and lifestyle modification that are tailored to individual needs and abilities.
Phase I (Initial)
This is an inpatient program which starts at the time of hospitalization. It aims to initiate early mobilization to reduce the effects of de-conditioning. It consists of oxygen therapy, chest wall manipulation, nebulization, postural drainage, breathing exercises and incentive spirometry to improve oxygenation. This is continued with a walking and exercise program at home or till patient return back to the hospital for Phase II.
Phase II (Conditioning Phase)
This consists of a comprehensive program to modify the aggravating factors for lung disease along with endurance training. This consists of chest care, aerobic exercise, stress management, smoking cessation, behavior modification, nutritional advice and patient and family education. The Phase II can begin after stabilization of the early symptoms. This is conducted in the form of group sessions or classes, one session usually last for 60-90 minutes. Frequency is 3-5 times a week to complete a total of about 20 sessions. Initial sessions of aerobic training are conducted with electrocardiographic monitoring. All sessions are physician monitored conducted by trained staff.
Phase III (Maintenance Phase)
This aims to continue the benefits gained by patients during Phase II. It consists of continuation of the aerobic exercise program but at a lesser frequency of 3 times a week at home/in a gymnasium/at a hospital.
What is Musculoskeletal Rehabilitation?
Musculoskeletal Rehabilitation involves maximising your function and potential so that you can return back to the community as soon as possible after any injury.
Who requires Musculoskeletal Rehabilitation?
People with following problems require Musculoskeletal Rehabilitation:
·Acute or chronic musculoskeletal pain
·Post fracture stiffness and reduced function
·Loss of a part of limb
·Repetitive strain injury
·Prolonged bed rest with generalised weakness (deconditioning syndrome)
Complex MSK Management
The Complex MSK Management specialises in treating patients who have significant functional mobility and movement impairments related to the musculoskeletal system such as, arthritis, osteoporosis, de-conditioning syndrome, post-operative complications and diabetes mellitus with associated neurological and cardiac conditions. Patients receive physical and occupational therapy, balance & gait training and education to improve their level of independence in daily living.
Multiple Trauma Management
Multiple Trauma Management provides rehab to people who have sustained multiple fractures and other injuries e.g. in a motor vehicle accident. The admission criteria are two or more active orthopedic medical conditions, multiple injuries / fractures as a result of trauma, physically ready to participate in the entire rehab process with cognitive ability to learn new activities and follow direction. These patients will be managed by a multi-disciplinary team taking care of post trauma stress disorder, pain management, mobility and activities of daily living.
The Sports Rehab provides comprehensive care to people with shoulder joint and rotator cuff injuries, tennis and golfers elbow, hand injuries, anterior cruciate ligament tears, hamstring and ankle sprains who are engaged in outdoor sports like cricket, football, basketball, volleyball, etc. leading to significant pain, strength, movement & mobility impairments. The latest technology available at the centre - multi-joint dynamometer and gait and motion analysis gives significant input in managing these conditions allowing early return to the sporting activities.
Repetitive Strain Injury (RSI) Management
The RSI Management aims to manage patients who present with chief complaints of neck or back pain or any other cumulative trauma disorders due to overuse. Patients will be evaluated by an inter-disciplinary team and comprehensive rehabilitation activities will be provided with pharmacotherapy, electrotherapy, exercise programmes, ergonomic advice, behaviour and relaxation techniques, trigger point injection procedures and education.
Amputation Management caters to the need of upper and lower limb amputation due to traumatic, ischemic, diabetic or other conditions. It offers comprehensive programme beginning with pre-amputation counselling, immediate post-operative pain reduction & temporary prosthesis, permanent prosthesis fitting & training and management of late early & late complications. The programme aims to reintegrate the person back into the society.
As per patient requirement, the programme duration can vary from 2-12 weeks.
Drug addiction is a condition, which is abnormal or pathological and occurs due to excess use of alcohol, drugs, smoking or other such addictive substances. The different effects of addiction are acute drug use, drug-seeking behavior, relapsing vulnerability, slow response to natural stimuli, and last but not the least, low motivation in life.
Drug addiction is regarded as a community disease as it leads to crimes, violence, failure in school, child-abuse, the loss of productivity and domestic violence. That is why it is very important to eradicate this problem from the society; especially the teens should be educated on the same.
Madatya in Ayurveda
In Ayurveda, the problems of drug addiction is dealt under the heading of Madatya, meaning ‘intoxication’. The state of individual occurs due to continuous use of drug, alcohol, tobacco or any substance of high intoxication. Madatya is relative to the third and fourth stage in the addiction process i.e., drug dependence and drug abuse. Madatya kills the will to live a happy and healthy life because it is a total opposite of ‘ojas’, which means a source of energy. Madatya and wellness can’t go hand-in-hand in a body.
Addiction and doshas
The Ayurvedic states that the doshas are aggravated by the overdose of drugs into one’s body. They are Vata (Air), Kapha (Water), Pitta (Fire) or a combination of all three doshas termed as Tridosha.
Treatments in Ayurveda
In Madatya, Ayurveda balances the aggravated doshas. It first detects the doshas, and then treats them. Ayurveda uses herbal remedies to treat the symptoms, discards the toxins (ama) collected in the body and motivates and regenerates cells and tissues. There is a phase in the de-addiction process where the patient becomes confused because their intelligence level drops due to drug abuse. Ayurveda treats this problem with the use of herbs like Yashtimadhu (Glycyrrhizaglabra), Brahmi (Bacopamonnieri), Shankhpushpi (Convolvulus pluricaulis) and Guduchi (Tinosporacordifolia).
In Ayurveda, treatment of Sattva Guna, meaning the quality of goodness, is done to promote mental health. The patients are made to follow strict healthy practices like consumption of natural vegetarian food, practice Yoga, and meditation and follow a daily routine of less anxiety and stress. Activities like wearing neat and clean clothes, walking and spending time in natural flowery ambiance with good friends, listening to good music and all other forms of natural relaxants and entertainment are also a part of treatment. These will boost the soul and mind of the patients and make them grateful to God for their lives.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Seeing someone who used to do all their activities on their own turn to someone who needs help even with small things like going to the bathroom can be very difficult.
The lungs are vital organs in that they are essential to supply oxygen to the entire body. If the various organs do not receive adequate oxygen, their function can be impaired. Therefore, lung function needs to be maintained. Lung function can be impaired by chronic conditions like COPD and bronchiectasis. In both these, the overall ability of the lungs to take in adequate oxygen is reduced. Therefore, the lungs need to be rehabilitated so that they can improve their ability to function better. These exercises are aimed at the following:
It has been proven beyond doubt that in addition to medications, physiotherapy plays a vital role in improving lung function over a period of time. Depending on the actual condition of the patient, a physiotherapy program is drawn up. Initially, the therapist will guide the patient and/or the caretaker with the various exercises. Over a period of time, the caretaker and the patient can do these on their own. The intent of these common exercises is to improve breathing efficiency, clear mucus, and improve overall lung function.
It has been proven beyond doubt that with no side effects (unlike medications), physiotherapy improves the overall quality of life in people with COPD.
LATE FUNCTIONAL PHASE
The late functional phase is characterized by a full range of motion, no effusion, and improved muscle strength and flexibility.Advanced closed chain exercises are added at this stage. The pro fitter continues Proprioceptive and balances training.
Stair master and versa climber are utilized to build muscular strength and endurance as well as aerobic conditioning.Quadriceps and hip musculature stretching are added as increased emphasis being placed on flexibility at this stage.
Isokinetic exercises include the progression to velocity spectrum training(60 to 400 degrees/sec), depending on the needs of the individual patient.Running is initiated when quadriceps strength approaches 80 percent.
At first, an underwater treadmill system is used since the buoyancy of the water decreases the amount of force is significantly less during retro running versus forward running. Retro running has also been found to increase quadriceps strength at slow Isokinetic speeds. when running forward the patient is encouraged to maintain a controlled sprint rather than a jog.
By staying on the ball of the foot, vertical or compressive loading is decreased.Before allowing the patient to return to sports activity, the therapist needs to do more than achieve normal range of motion and muscle strength.
The components of the patient’s sport or activity should be incorporated into the rehabilitation program as well. For example, basketball players need to jump and land. Therefore jumping activities should be included in their program.
More importantly, they should be taught how to land to protect their knees.
Golfers rely on a great deal of tibial rotation throughout the swing, their program, therefore, should include an assessment of their swing and a modification made if necessary. Agility drills in the form of figure eights, carioca, and cutting manoeuvres are included here as they replicate components of most team and racquet sports.
Prior to discharge from rehabilitation and the full return to sports activity, a series of tests must be satisfactory: