The ABC of neurological rehabilitation

By Verah Mugambi

In a snap, life can change. An injury, surgery, disease, illness, or decline in functioning because of age might make one in need of rehabilitation. This can happen to children and adults; it may affect the ability to even perform routine activities.

Neurological Rehabilitation (rehab) is a doctor-supervised program designed for people with diseases, injuries, or nervous system disorders. Neurological Rehab can often improve function, reduce symptoms, and improve the well-being of the patient.

The World Health Organization’s definition of rehabilitation states: “A set of measures that assist individuals, who experience or are likely to experience disability, to achieve and maintain optimum functioning in interaction with their environments” (WHO, 2011).

At Kenyatta National Hospital, Neurological Rehabilitation is at the Occupational Therapy (OT) department which is located on the ground floor; tower block, Opposite the Blood Transfusion Unit (B.T.U).

The clinic runs on Mondays & Thursdays morning; from 8.00 AM to 1 PM. Initially, it used to be Mondays only but after cases started rising, the department saw the need to schedule the rehab on Thursdays too.

Newsline spoke with Mr. Japheth Asungu, KNH’s Assistant Chief Occupational Therapy department. “Occupational therapy is about promoting health, promoting functions after the injury, disease, etc.,” he explains.

According to Asungu, a Neurological Rehab program is designed to meet your individual needs, depending on your specific problem or disease. Active involvement of the patient and their family is vital to the success of the program.

“The caregivers are very important when it comes to neurological rehabilitation. These are the husband, wife, sister, and friend; the patient’s support system. Remember this is a person whose life has changed and has to relearn everything.

The caregiver initially is always as sick as the patient since they also don’t know how to take care of the patient’s new condition. So, you have to involve them from the start,” Asungu emphasized.

“The goal of neurological rehab is to help you return to the highest level of function and independence possible while improving your overall quality of life — physically, emotionally, and socially.

“Neurological conditions mostly affect the brain, the spinal cord, and the nerves…i.e., stroke. “Stroke is the highest… almost 50% of our neurological patients are suffering from a stroke. Others include a wide range of disorders, such as epilepsy, learning disabilities, neuromuscular disorders, autism, ADD, brain tumors, and cerebral palsy, just to name a few.” He added.

What conditions can benefit from neurological rehab?

Vascular disorders, such as ischemic strokes (caused by blood clots), hemorrhagic strokes (caused by bleeding in the brain), subdural hematoma, and transient ischemic attacks (TIAs), Infections, such as meningitis, encephalitis, polio, and brain abscesses, Trauma, such as brain and spinal cord injury, Structural or neuromuscular disorders, such as Bell palsy, myasthenia gravis, and Guillain-Barre syndrome.

Functional disorders, such as headache, seizure disorder, dizziness, and neuralgia, and Degenerative disorders, such as Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis (ALS), Alzheimer’s disease, and Huntington’s chorea.

“Neurological rehab is a journey, not a one-day hospital visit. We can work with patients for weeks, months, or even years. It’s a journey which requires a willingness from both parties and good support systems”, Asungu continued.

“Neurological rehab is a journey, not a one-day hospital visit. We can work with patients for weeks, months, or even years. It’s a journey which requires a willingness from both parties and good support systems”, said Asungu

“Patients with neurological conditions will present symptoms like, physical challenges, nerve psychosocial, cognitive deficit, visual… when you put all these factors together, you will realize their daily activities are affected. For example, they are not able to feed well or dress well by themselves, and even their leisure activities are affected.

Where do you get the patients?

We have a referral system for our patients we get them from; first Clinic no.17 the neurological clinic on Mondays & Thursdays morning hours only. The team will refer the patient to the outpatient here in O.T. Also, we get referrals from other clinics within our hospitals for patients who present neurological deficits like orthopedics, diabetic clinics, or even self-referrals from other private hospitals.

Why rehab?

Patients must change how they used to do things before the accident/disease and need to relearn/ redefine how to do it. Once a patient suffers a condition, the patient needs to relearn how to do things to live day-to-day living.

Outcomes

“When the patient tells you I wasn’t able to bathe, but I now can, I wasn’t able to lift, speak, and use the phone, etc. that’s when you feel you have done your job right.

“Neurological rehab is not a one-man show, but a multidisciplinary approach to get better results. We work closely with neurologists since they are the ones who make the diagnosis and the referrals, the physiotherapists, orthopedics tech no 46, and also speech therapists”, Asungu concluded.

Brain and spinal injuries can be life-changing. Our team of experts at KNH’s neurological occupational therapists supports the rehabilitation process by helping those affected and their families find their new version of normal.

Eunice Naliaka, a KNH patient: during a Neurological rehab session at O.T department

PHOTO |ELIJAH NG’ANG’A