During the war, the issue of rehabilitation and restoration of health became relevant again - unfortunately, not only patients of a respectable age are forced to seek help, but also very young guys who lost their health at the front...
The main difference between modern rehabilitation centers and ordinary hospitals is in the approaches and methods of working with patients. The rating agency "ElitExpert" visited the "Nasha Turbota" physical rehabilitation center, located in Kryzhanivka near Odesa, and talked with the medical director of the institution - Oleksiy Yuriyovych Yablonskyi.
— Oleksiy Yuriyovych, please tell us about your experience in physical rehabilitation
— I have been engaged in physical rehabilitation for over twenty years. He started, like almost everyone at that time, as a paramedic-masseur, then received a higher education. Constant training, practice and internship in the best rehabilitation clinics of Ukraine and Europe created me as a specialist. Physical rehabilitation improves over time and requires constant training of medical personnel. Our team is all my students who, together with me, attend various educational seminars, congresses and workshops, because the improvement of rehabilitation methods never stops. Today, we have formed a professional multidisciplinary team that clearly knows what to do and how to do it. We love our work and are responsible for the result.
— Please tell us about your Physical Rehabilitation Center. What makes it special?
Our center employs 12 rehabilitation specialists, physical therapists and three doctors: a neurologist, a general practitioner and a doctor of physical rehabilitation medicine. We use the latest computer and audio-visual technologies to work with patients, which allow us to interactively perform various exercises to restore physical functions. In addition, we have a full-fledged swimming pool, where classes are also held with patients of various conditions.
In general, centers of this kind require special furniture, medical equipment and specialists - we have all of this. In addition, thanks to the location of our center in the private sector and near the sea, where there are very few cars and outsiders, our patients can freely attend classes on the street and walk accompanied by medical personnel.
— What capacity is your Center designed for?
— For 35 patients. For us, their comfort and convenience are of primary importance. The facility is two-story, equipped with an elevator. We order all furniture according to our models, taking into account the needs of patients. In each building, we have the right set of furniture for classes, so that patients with severe complications are not forced to move excessively.
We work individually with each patient depending on his medical indications and, of course, take into account his wishes. The patient's family members can also always come and visit their relative for a while, which psychologically helps the patients a lot.
— What are the food conditions in your center and in which wards do the patients live?
— We have a full-fledged kitchen, where very tasty and healthy meals are prepared every day, including dietary food, taking into account the medical indications of each patient. Our chefs prepare various pickles, compotes and jams for the winter, because, firstly, it is tastier than from the store, and secondly, we guarantee the quality of the products. And perhaps our most important philosophy of catering is that food for patients, in addition to its usefulness, should be tastier than homemade.
As for the wards, each building of our center has different wards. By the way, when families of patients want to provide their loved ones with comfortable conditions of stay, they believe that a single-bed ward is the best. But this is a stereotype and it is not always correct.
A person needs social contacts, communication, especially when there are problems with speech. And when there are several patients in the ward and one of them makes certain progress in rehabilitation, the others see it and are inspired, their self-confidence increases. And normal communication helps. Because in classes you communicate with rehabilitators; during medical procedures - with the medical staff, and while you rest or watch TV, you can talk to your neighbor. It is also a training of mental and cognitive functions, articulation and speech. This is very important for a person as a social being - we need to be in contact with others.
— What diseases and problems do people come to you with?
— First, these are the consequences of severe neurological diseases, such as stroke, brain oncology, Parkinson's disease, multiple sclerosis, and the consequences of craniocerebral trauma. These are different types of encephalitis and the consequences of polytrauma.
Even today, unfortunately, mine-explosive injuries and amputations are still very relevant - here we first apply various methods for the correct formation of the stump, and only then teach patients how to use the prosthesis, put it on, take it off and walk on it.
A large layer of work is carried out with patients with spinal cord injuries due to spinal cord injury, when the ability to move the lower limbs is lost or when neither arms nor legs move at all. The patient must be taught to transfer from the bed to the cart, to use it, to overcome obstacles when moving.
We also deal with patients after joint replacement and after heart attack, stenting or shunting. Another group of patients is those who suffered from lung diseases. So, for example, when there was a covid pandemic, we had a lot of patients with severe consequences of this disease, whom we successfully rehabilitated and returned to their usual lives.
— Tell us about your team of specialists and recovery techniques...
— A large percentage of patients come to us after a stroke. To restore a person after a stroke, specialized specialists are needed, which are not always available in ordinary hospitals. For example, our speech and language therapist works to restore swallowing, communication skills, speech and articulation. An occupational therapist retrains post-stroke patients to dress, use the toilet independently, go to the store, and generally engage in household and social activities. Our physical therapists work with patients who have no control of movement, no physical strength, no ability to walk or stand. Nurses and orderlies deal with the daily needs of patients and hygienic procedures — the most difficult, but necessary, part of the work rests on their shoulders.
— What recovery methods do you use and how do you differ from ordinary hospitals?
We use only those recovery methods that have proven their effectiveness and are included in modern clinical guidelines.
In addition, we work according to our own methods and features, which are not always the same as in hospitals. They work there according to the international classification of diseases, and for us the biopsychosocial model is more important - the international classification of functioning.
Our large team does their hard work every day - we know what to do, know how to do it and love it, we work with quality, responsibility and taking into account the needs of patients and their families.
— What happens when a patient gets to your center?
— Any patient first undergoes a thorough examination. As a rule, a person comes to us already with a discharge epicrisis from the hospital, where all tests, conditions, diseases, interventions and treatment are prescribed. If there is a need for additional analyzes or studies, we can conduct them in our center.
Even if a person's condition requires a computer tomography or MRI, an ambulance arrives, takes the patient and conducts the necessary examinations. We have worked out everything for a long time, and this model has proven itself effectively.
We evaluate a person according to the biopsychosocial model of the international classification of body functioning. After all the research, our specialists develop an individualized rehabilitation plan and implement it.
— By the way, when should you start physical rehabilitation? For example, after a stroke?
— After a stroke, the first three months are a "golden time" for recovery opportunities. If this time is lost, further recovery is more difficult and much slower.
After six months, the body almost does not recover. And often people spend this time on incompetent specialists or unscrupulous centers, trying to save money, and then the time for recovery, to one degree or another, is lost.
It is in the first three months that neuroplasticity works best, the ability of cells to recover, parts of the brain to take over lost functions. Up to a year, rehabilitation is still taking place, and then you can only improve functions, but not restore them.
— How do you determine the load limits for patients?
— For each patient, we determine his maximum load limits. During classes, he works at 70-80% of these limits. For example, regular physical therapy is 200 steps, our class is 2000 steps. This makes it possible to achieve such progress in a week, which is achieved in 3-4 weeks with ordinary physical therapy. And this has a positive effect on the improvement of all functions.
— What should patients do when they return home?
— For those patients who are already going home from us, we prescribe a detailed plan of independent exercises: what exercises to do, how long, how far you can walk, at what speed, how to increase the load.
A separate issue is family assistance. We prescribe what the family should help with and what not. We also provide videos of classes for a more accurate understanding of the correctness of exercises and remotely monitor and advise patients.
— What is the age limit for rehabilitation in your center?
Our patients are not limited by age. There is simply no upper limit - we have had patients at the age of 95 who successfully recovered.
Of course, age makes certain corrections, there are not so many physical forces, and the ability of the body to recover is not the same as that of a young person. But in such cases, we change the approaches to therapy and the ultimate goals.
Separately, I will dwell on the issue of short visits to our center by patients who have been using a wheelchair for many years or are "recumbent". When they come to us for re-examination, they often realize that they greatly underestimated themselves. We show them wider possibilities, even in the conditions in which they live, and they leave with a completely different attitude, with new goals for the future.
— What are the minimum and maximum terms of rehabilitation?
— As practice has shown, the minimum period of stay in the center to obtain the initial results of rehabilitation is at least two weeks. But this is mostly an exception to the rules, because it must be taken into account that during this period there is also adaptation to the conditions of stay, the team and the tasks of rehabilitation. The maximum time depends on the patient's condition and can last quite a long period of time — from several months to a year, depending on the complexity of the rehabilitation.
— What is the cost of rehabilitation at your center?
— Our model and philosophy – rehabilitation should be comfortable and high-quality. Therefore, the cost of our services is based on the "all-inclusive" principle, which allows the center's specialists to work efficiently, and the patient's family not to worry about food, hygiene needs or other details. The cost of services includes everything, except for individually prescribed medical drugs. There are several service packages that differ in the number of rehabilitation classes and interventions, from the minimum "Care" package, which costs UAH 1700 per day of stay, to the "Optimal" service package for UAH 3200, which is recommended for patients with stable hemodynamic parameters (blood pressure, heart rate ) and is the gold standard in terms of the number of classes, which ensures maximum efficiency in the provision of rehabilitation care after strokes, brain injuries and other diseases. More detailed information on rehabilitation services and their cost, which can be read by anyone, is available on our website and social networks.
— Can services be changed based on a doctor's recommendation?
Based on the recommendation of the doctor and physical therapist, the range and intensity of the services provided may change or be supplemented. If necessary and according to the indications, one procedure can be replaced by another - this is physical therapy, hydrokinesitherapy, ergotherapy, speech therapy, electrical stimulation or mechanotherapy, and in the absence of medical contraindications, patients can additionally be prescribed massage.
In general, we believe that every patient deserves an individual approach and high-quality medical care, so we invite everyone who needs it to the "Nasha Turbota" physical rehabilitation center. And our specialists will help you return to an active and healthy life.
Olena Ovchinnikova communicated
Contacts of the Physical Rehabilitation Center "NASHA TURBOTA"
Website: https://nashazabota.com.ua/
Phone: +380 (96) 891 80 55, +380 (99) 518 64 78
Address: Odesa region, Kryzhanivka
Social networks:
https://www.facebook.com/nasha.zabota.od
https://www.instagram.com/center_nasha.zabota/
