Medical rehabilitation involves procedures and services that aims to restore or supplement loss of function arisen from diseases (movement disability, speech problems, decreased heart function, infertility, etc.) or to develop new, compensatory skills.
Depending on the type of the injury or the disease, different rehabilitation techniques are available.
Multiple types of medical rehabilitation services are available, such as:
- musculoskeletal,
- post-trauma,
- postoperative,
- cardiovascular,
- oncological,
- psychiatric,
- respiratory rehabilitation (pulmonary rehabilitation), and
- addictology rehabilitation.
What is rehabilitation good for?
Rehabilitation is necessary for those who have temporarily or permanently lost their abilities to lead their everyday life to the fullest. The purpose of rehabilitation treatment is to restore functioning and to re-integrate patients to their jobs and to society. Rehabilitation is a complex process that aids patients to achieve the best physical and mental condition and social function – but in order to achieve this, their active cooperation is also essential.
When is rehabilitation recommended?
Rehabilitation is recommended in the following cases:
- after traumatic injuries,
- after a heart attack,
- in case of severe diseases,
- if residual symptoms are left after a disease,
- if the patient cannot function in their social role the way they did before: they cannot work or supply their family.
Time is an important factor, since rehabilitation is a long process. One must be patient, and positive attitude and perseverance makes a difference.
The process of rehabilitation
Setting the goal of the rehabilitation is the first step.
Second step is the therapy which has the following phases:
- Immediate rehabilitation: it takes place in the hospital, in the form of inpatient care. Most of the time, it takes several days, while in more severe cases, it might last up to weeks or months.
- Early rehabilitation: after hospital discharge, rehabilitation might be needed at the home of the patient, which usually takes a maximum of several weeks, depending on the patient’s condition.
- Outpatient rehabilitation: when patients can attend rehabilitation facilities. This phase usually lasts 6-12 weeks, or up to 24 weeks in severe cases.
- Inpatient rehabilitation: complex, efficient rehabilitation program which might last for months. Its purpose is to achieve the goals set in the rehabilitation plan. During inpatient rehabilitation, the patient does not only receive medical and nursing care, but also appropriate therapy for their illness. They can be discharged from the facility if they reached to rehabilitation goals, or if it is proven that the aims of the rehabilitation cannot be achieved (in that particular phase of the disease or within the reasonable, set timeframe).
- Maintenance rehabilitation: rehabilitation after long-term illnesses is a slow process. Lifelong rehabilitation might be needed at particular periods in the case of certain cardiovascular, respiratory, oncological musculoskeletal diseases or traumatic injuries.
The main treatment methods of medical rehabilitation
Medical rehabilitation is a harmonized teamwork, during which the disabled individual regains their abilities to lead an independent, active life by developing their physical and mental skills. Treatments include physiotherapy, device-physiotherapy, natural physiotherapy and therapeutic massage, speech therapy, psychology sessions, medical aid supply, sports therapy, thermal water, ergotherapy, dietotherapy.
Below you can find a brief summary of these treatments.
- Physiotherapy:a therapeutic approach using different modalities that include device-physiotherapy, electrotherapy, phototherapy, physiotherapy and therapeutic massage.
- Device-physiotherapy: different musculoskeletal, neurological and circulatory symptoms and pains can be eased by different devices. Although physiotherapy devices are available in professional shops, such treatments can only be prescribed by doctors, since these treatments are not recommended in certain types of pain.
- Electrotherapy: treatment with electrical impulses that directly stimulate muscles. Electrotherapy can be pain-relieving and strengthens the weakened muscles.
- Phototherapy: treatment method applying a specific spectrum of light rays. Light rays are believed to have several favorable biological effects. In phototherapy, generally selective light rays are applied.
- Physiotherapy: it is concerned with the musculoskeletal system. Physiotherapy helps to restore moving ability and muscle strength, its rehabilitation and preserving muscle strength.
- Therapeutic massage: massage performed by a massage therapist or a physiotherapist. It can be applied as an exceptional supplemental therapy before physiotherapy sessions to relax muscles or help regaining muscle tone. It improves circulation, eases the pain and relaxes the muscles.
- Speech therapy: speech education. During the sessions, professional speech and language therapists treat speech, phonation and tongue disorders.
- Sports therapy: it uses the methods of physical education, physiotherapy sessions, sport psychology and conductive pedagogy. It improves patient’s stamina and movements with gradual load, on group sessions.
- Ergotherapy: with special activities, it focuses on reaching the possible, greatest extent of independency in life. It is concerned with the restoring and teaching the activities of daily living.
- Dietotherapy:the personalized, disease-specific dietetherapy is provided by dietitian specialists. During the therapy, due to adequate diet, the patient might heal faster. Another purpose of the therapy is to provide patients the necessary knowledge about a proper and healthy diet, so when they are discharged from the hospital, they can integrate the acquired information in their everyday lives, thereby “threating” themselves with an adequate diet.
- Balneotherapy: the practice of bathing, usually in minerals and other additives, as a therapeutic modality. It is believed to have advantageous effects in certain musculoskeletal diseases.
- Halotherapy and Speleotherapy: the clean, allergen-free air and micro-climate created artificially (halotherapy) or found in the nature (in caves and mines) is believed to aid patients with respiratory diseases (e.g. Cave therapy).
Medical rehabilitation pathways
1.Referral is necessary for the rehabilitation treatment
Rehabilitation treatments are provided only by medical specialists. If the patient requires rehabilitation due to a disease, then the rehabilitation treatment provider physician can be a physician who is a specialist in that field of medicine, or a specialist concerned with the consequences of the disease or a rehabilitation specialist.
2. Outpatient rehabilitation facilities
Outpatient rehabilitation facilities can only be attended with a referral issued by a GP (GP Pediatrician or school physician) or a specialist. Outpatient departments supplement the activities of inpatient rehabilitation departments. Their scope of activities involves outpatient services, health condition check-up prior to inpatient rehabilitation treatments, and the complex, rehabilitation treatment planning. Outpatient rehabilitation well supplements inpatient services, internal medicine and musculoskeletal problems-related exams can also be carried out.
3. Opportunities in rehabilitation treatment
Immediate rehabilitation treatment after hospital discharge (in- or outpatient services)
If during inpatient care, the treating physician considers the need for rehabilitation, the hospital can request the further rehabilitation. The need for rehabilitation treatment must be implied in the hospital discharge document and in this case, the discharge document serves as a referral.
Maintenance rehabilitation treatment after a disease/surgery (in- or outpatient services)
Rehabilitation treatment can be availed only in certain diseases, that makes patients eligible for the rehabilitation. Referral is necessary for the treatment. Referrals can be issued by treating physicians, rehabilitation or physiotherapeutic specialists.
Medical services
These include medical spa and -below the age of 18- group medical swimming sessions. Referral is necessary for the treatments. Referral can be issued by rheumatologists, physiotherapeutic specialists, rehabilitation specialist, orthopedic surgeons or traumatologists (for group medical swimming sessions pediatric surgeons, orthopedic surgeons, rehabilitation specialists or GP Pediatricians can give referrals).
Convalescent hospital care (sanatoriums, inpatient care)
For convalescent hospital (sanatorium) treatment, only specialists concerned with diseases requiring rehabilitation can issue a referral.
How and when can I get treated at a convalescent hospital?
According to the legal regulations:
- after an injury, once within a year,
- in case of conditions resulting from cardiovascular or neurological disorders, within one year after the development of the condition,
- within 3 months after big articular prostheses, or other reconstructive surgeries,
- patients suffering from big articular or multiarticular chronic inflammatory diseases, causing severe disability*, 6 months within worsening of symptoms.
* Severe disability means loss of function in one or more big articulations, in the spine, or – in case of inflammatory diseases- greater than 30% loss of function in small joints.
