Dr PATRICK MIDDLETON, Physical Medicine and Rehabilitation, France
For several months now, health and social news have shown the harmful effects of chronic diseases in the complications of viral attacks. Frail people— especially the elderly—are often more vulnerable because of their lack of physical activity. Huber 360® Evolution has been used daily for years by independent physiotherapists and centres specialising in the prevention and rehabilitation of elderly and frail patients.
Here’s the response from Dr Middleton, doctor in Physical Medicine and Rehabilitation at the Les-Grands-Chênes Clinic in Bordeaux (33) and the Sports Clinic in Mérignac (33).
“If we are interested in acute post-phase management, the ‘heaviest’ patients will face 2 types of sequelae: those related to COVID-19 and those related to prolonged immobilisation in intensive care unit. Their infectious state and their possible contagiousness will also be a question for caregivers and family members. It is foreseeable that rehabilitating these patients will take many weeks or even months. This will require setting up care channels including functional rehabilitation centres and independent practitioners.
The transition to a rehabilitation centre seems essential for a multidisciplinary care. This requires the implementation of preventive measures to protect the various stakeholders and other patients in order to offer care tailored to each patient. An initial assessment and an individualised therapeutic plan must be put in place. The initial assessment must be as complete as possible. In addition to a basic biological assessment, it is necessary to decide on the significance of respiratory insufficiency, cardiovascular repercussions, orthopaedic and neurological disorders (related to the disease or prolonged immobilisation in intensive care unit (ICU) and the psychological state of the patient.”
“ The patient’s previous activities and future aspirations should also be considered. On this latter point, some testimonies show that the workplace would no longer be a priority. “Surviving” patients are more likely to refocus on values such as family and leisure, which is understandable. Difficulties in concentration and memory impairment that make resuming intellectual activity difficult are also important to bear in mind.
A neuropsychological assessment or consulting with a psychiatrist may be suggested, with followup. The orthopaedic assessment for joint ankylosis, musculotendon retractions and muscle deficiency is supplemented by a neurological assessment that may find neuropathies (related to COVID-19) or in relation to compressions at the point of support on the ICU beds. As for the treatment, it requires the intervention at least of a physiotherapist, an occupational therapist, or a sports coach specialised in Adapted Physical Activity and a nutritionist for patients who previously had comorbidities, such as being overweight or diabetic.
Rehabilitation should also take into account the significant frailty and fatigue of patients. Multiple short sessions should be recommended. Patients will not be able to undergo respiratory rehabilitation, joint mobilization, muscle strengthening, exercise, psychological support and management of cognitive disorders in a short period of time. We will have to be as efficient as possible.
WHY DO THE HUBER 360® EVOLUTION’S FEATURES MAKE IT AN IDEAL MEDICAL DEVICE FOR REHABILITATION?
“This is why it makes sense to work on this motorised balance platform, which has developed programs for joint mobilisation, muscle strengthening and balance work. It is an overall workout that is not very demanding from the cardiorespiratory point of view. It is done while standing or sitting using a stool adapted specifically for the device. During this exercise, there is essentially an eccentric or static muscular load that is not very energy-intensive, so it will be well tolerated by the patient.
There are FIVE levels of increasing difficulty in the existing programs. Each patient can have their own specific program and complete it on their own once they have been educated by their therapist. In 10 to 30 minutes, depending on their abilities, the patient can get a benefit from gentle mobilisation, muscle strengthening and proprioception without putting excessive load on their cardiorespiratory system (with visualisation and recording of the heart rate during exercise). The difficulty increases once an initial level is achieved.
This work commences after A FULL 15-MINUTE assessment of the patient’s stability, restricted mobility, strength and coordination, among other possibilities. Recording information about their progress will make it possible to assess changes in a patient’s physical condition.
Before each session, the handles, railings and touch screen will be cleaned with disinfecting wipes. This innovative rehabilitation will be possible once the strict patient lockdown measures are lifted. Later, patients will continue their rehabilitation with the network of independent physiotherapists and rehabilitation centers equipped with a HUBER 360® Evolution.”
Legal notice – Cookies © LPG SYSTEMS 2023
