Rehabilitation following traumatic brain injury - Return to everyday life

From the acute event to the follow-up treatment, the patient goes through several phases of rehabilitation. Ideally, the patient does not have to change clinics.   
The earlier rehabilitation begins, the better the chance of recovery.
At Schoen Clinic, we therefore start mobilising patients at an early stage. This is done using technical aids and causes strong stimulation of the balance system as well as general activation. 
In order for patients with severe traumatic brain injury to regain consciousness more quickly, an attempt can also be made at therapy with stimulant medication. Further rehabilitation is individually tailored to the disorder and includes physiotherapy, occupational therapy, speech therapy, swallowing therapy and neuropsychological therapy.

Rehabilitation and aftercare

Physiotherapy and robot-assisted therapy

The patients at Schoen Clinic are already mobilised by our therapists during early rehabilitation. This involves moving their arms and legs. Through the passive execution of these natural movements, the brain possibly “remembers” lost abilities and can regenerate itself. The therapists at Schoen Clinic are supported by state-of-the-art robot technology and hardware: for example, paralysed or functionally restricted arms can be trained with special arm robots. This stimulates nerve cells, promotes muscle development and improves coordination. If it is possible for the patient to perform movements with less help, we work on fine motor skills. We have the latest therapy equipment available in our hospitals, such as Hand Tutor, arm robots, Lokomat, exoskeletons and Spacecurl.

Swallowing and speech therapy

Many patients come to our clinic with severe swallowing and breathing disorders. They have to be artificially ventilated and fed. One of the top-most goals at Schoen Clinic is therefore to enable patients to breathe and swallow independently again through special swallowing and speech therapy. 90 per cent of all our neurological rehabilitation patients can breathe independently again when they leave our clinic. 89 per cent of our patients can swallow better again.

Other therapies

Our treatment spectrum also includes many other therapies, such as
  •  Occupational therapy with supply of aids
  • Physical therapies and massages
  • Functional electro stimulation
  • Neuropsychological training
  • Psychological therapy
  • Music therapy
  • Physiotherapy 
  • Speech therapy team
  • Brucker Biofeedback 

Unresponsive wakefulness syndrome (apallic syndrome)

Following a severe traumatic brain injury with an initial coma, some patients develop permanent severely impaired consciousness, called “unresponsive wakefulness syndrome” (formerly: apallic syndrome or persistent vegetative state) or minimally conscious syndrome. 
The cause is a decoupling of largely intact brain stem functions from the damaged cerebrum. Up to 50 per cent of patients regain consciousness over the long term. 
For patients with severely impaired consciousness, intensive rehabilitation measures such as physiotherapy and occupational therapy are necessary to avoid complications. This is important as prolonged bed rest can lead to joint stiffness, osteoporosis, a decrease in heart activity, digestive disorders, susceptibility to infection, and thrombosis. 
Perception is addressed using specific sensory stimuli. Touching, movements, certain smells or even music should animate the patients and initiate contact with the environment. 
We now know that patients with unresponsive wakefulness syndrome are more conscious than we used to think. At Schoen Clinic, consultants, nurses and therapists talk to the patients: they greet the patients when they enter the room, and they inform the patients before they touch them. Our team takes care not to frighten the patients and to touch them only with warm hands.
Short, regular visits by one or two caregivers are also important. Physical contact, a comforting approach, and bringing in familiar objects, pictures or music can have a beneficial effect.