IN-HOSPITAL REHABILITATION

Begin with the end in mind

IN-HOSPITAL REHABILITATION

Begin with the end in mind

Our services

Pre-habilitation

Post-operative Rehabilitation

Critical Care

Pre-habilitation

“Major surgery is like running a marathon – and both require training.”

Prehabilitation is the pre-operative interventional training prescribed to patients in anticipation of a major physiological stressor, such as surgery. It is based on the principle that structured and sustained exercise over a period of weeks leads to improved cardiovascular, respiratory and muscular conditioning. Increased physical activity can improve the functional capacity of a number of organ systems and result in an increased preparedness to withstand that physiological stressor.

In most cases, deteriorating health is ordinarily perceived as a barrier to exercise. As a result, most patients are not “fit for surgery”, thereby increasing their risk of post-operative complications and hospital length of stay. Efforts to improve recovery through rehabilitation are focused on the post-operative period, when instead, the pre-operative period may be a better time to promote lifestyle changes, such as exercise.

Prehabilitation programmes should acknowledge the multi-dimensional aspects of pre-operative preparation to include nutritional, psychological and behavioural interventions, in addition to exercise.

Post-operative Rehabilitation

At NHH Physiotherapists Inc., we assist in the post-operative rehabilitation of orthopaedic, abdominal and cardio-thoracic conditions.

Orthopaedic: For patients undergoing orthopaedic surgery the post-operative physiotherapy protocol that they follow will be critical to the result that they achieve. Our physiotherapists, together with the orthopaedic surgeons, have structured protocols to ensure optimal recovery. These protocols will be adjusted and tailored as necessary, to suit patient specific circumstances. Post-operative physiotherapy occurs in three phases. The early recovery phase, the strength and range of motion phase and lastly the functional restoration phase.

Abdominal Surgery: Upper abdominal surgery (UAS) has the potential to cause post-operative pulmonary complications (PPCs). We follow consensus-based best practice guidelines formulated by Hanekom et al. (2012). Such best practice guidelines recommend that physiotherapists should be using early mobilisation and respiratory intervention to minimise risk of PPCs

Cardio-thoracic Surgery: To prevent or diminish post-operative complications, pre- and postoperative physical therapy treatment is often prescribed to cardio-thoracic surgery patients during the hospital stay. The physical therapy treatment consists of early mobilization, range of motion exercises and breathing exercises

Critical Care

“Begin with the end in mind.”
Critical care is the specialised care of patients whose conditions are life-threatening and who require comprehensive care and constant monitoring, usually in intensive care units (ICUs).

Critically ill patients frequently suffer long-term physical and psychological complications. Prolonged stays in the ICU are also associated with impaired quality of life, functional decline and increased morbidity, mortality, cost of care and length of hospital stay.

Patients therefore require a multidisciplinary team in critical care who are uniquely qualified with skills and expertise to work with the assessment and management of respiratory complications, physical deconditioning, neuromuscular and musculoskeletal conditions.
Physiotherapy treatment as part of a multi-disciplinary approach to care is integral in promoting lung function, reducing the incidence of ventilator-associated pneumonia, facilitating weaning and promoting safe and early discharge from the ICU.

Physiotherapy rehabilitation in ICU: Physiotherapy is an important intervention that prevents and mitigates adverse effects of prolonged bed rest and mechanical ventilation during critical illness. Rehabilitation delivered by the physiotherapist is tailored to patient needs and depends on conscious state, psychological status and physical strength of the patient. It incorporates any active and passive therapy that promotes movement and includes mobilisation. Early progressive physiotherapy, with a focus on mobility and functional tasks, is essential in minimising functional decline.