The Department of Physical Medicine and Rehabilitation of St. Luke's Hospital operated for the first time in January 2002, in order to provide rehabilitation services to patients hospitalised in our Hospital. These services concern patients who have an impairment of their functional abilities, of traumatic or organizational aetiology.

Services of the Department

The services of the Department of Physical Medicine and Rehabilitation of St. Luke's Hospital are specialised, depending on the problems patients and their relatives have to face.
 

What is Rehabilitation?

Rehabilitation includes the concepts of deficit, incapacity and disability. According to the World Health Organization (WHO) the meaning of the definitions is:

• Impairment. Any loss of psychological, physiological or anatomical structure or function of the body e.g. loss of limb, sensory impairment.
• Disability. Any restriction caused by a deficit that disrupts the patients' ability to carry out an activity within the frameworks that are considered normal e.g. inability to get dressed, to drive, to feed themselves.
• Handicap  . Disadvantage for a particular person caused by a deficit or incapacity that limits or prevents the completion of the normal role of that person.

Philosophy of the people of the Department

The purpose of rehabilitation services is to retrain patients, based on the improvement of their abilities and functionality. The ultimate goal is to reintegrate patients into their social role. 

To whom the Department is addressed

The services of the Department are offered to patients who have suffered damage from neurological, orthopaedic and cardiovascular diseases, such as:

• Cerebrovascular accidents
• Traumatic brain injuries
• Spinal cord injuries
• Polyneuropathies
• Multiple fractures
• Acute myocardial infarctions 

After the treatment of the acute phase of the condition and if there are functional problems, a rehabilitation program is organized, adapted to the needs of each patient.

Medical care in outpatients

Rehabilitation services are also provided to patients visiting the Outpatient Departments of Physical Medicine and Rehabilitation of the Hospital. The Outpatient Department treats patients who do not wish or do not need to be hospitalised in the Hospital. There is a medical evaluation of these patients, their problems and condition and, therefore, a rehabilitation program is organized, without the need for hospitalization. 

Multidisciplinary Rehabilitation Team of St. Luke's Hospital
 

Patients are treated by various therapists of various medical specialties. All together they participate in the organization and implementation of the rehabilitation program and constitute the Rehabilitation Team. The provision of rehabilitation services through the Rehabilitation Team is the only correct way to approach patients with special problems.

The Multidisciplinary Rehabilitation Team St. Luke's Hospital consists of doctors and therapists who either work in the Hospital on a permanent basis, or cooperate with the Hospital as external partners. The coordination of the team is done by the Head Physiatrist who organizes the services and the meetings. The team gathers at regular intervals, in order to inform the therapists about the patient's progress and plan the continuation of the program. The main members of the Multidisciplinary Rehabilitation Team of St. Luke's Hospital are:

• Specialist Doctor of Physical Medicine and Rehabilitation
• Physiotherapists
• Special nurses
• Occupational therapists
• Speech-Language pathologists
• Nurses trained in rehabilitation care
• Manufacturers of orthotic and prosthetic limbs
• Psychologists 
• Dieticians
• Social Workers

The medical specialties that are involved in Rehabilitation services are:

• Vascular surgery
• Cardiology
• Cardiac surgery
• Neurology
• Neurosurgery
• Orthopaedic Surgery
• Pulmonology
• Rheumatology 

Treatment of musculoskeletal pain

The Department of Physical Medicine and Rehabilitation of St. Luke's Hospital also focuses on the treatment of musculoskeletal pain. Just as with rehabilitation services, patients with musculoskeletal pain have the options to visit the Outpatient Department and: 

• Treat the pain immediately.
• Treat the pain with only one day in the Hospital.
  
• Admit the patient to the Hospital and treat the pain during his hospitalisation.

Means of treatment of musculoskeletal pain

The means of treating musculoskeletal pain used in the Department of Physical Medicine and Rehabilitation are: 

• Physiotherapy
• Kinesiotherapy
• Therapeutic exercise
• Acupuncture
• Electro acupuncture
• Biofeedback
• TENS
• Therapeutic infiltrations
• Local anaesthetic infusion
  

Pain treatment methods depend on the needs and problems of each patient.

Specialised Musculoskeletal Physiotherapy - Manual Therapy 

What is Manual Therapy?

Manual Therapy (MT) is a specialisation in the field of Physiotherapy that deals with the treatment of diseases of the neuro-musculoskeletal system.

The treatment is applied with the hands of the specialised physiotherapist (Manual Therapist) and includes gentle manipulations and mobilization of the joints, nerves, muscles, fascia and tendons. In addition to the passive techniques applied, emphasis is placed on the active participation of the patient. Thus, the beneficial properties of active exercise and retraining of motor control are used. 

The aim of treatment is not only to relieve the symptoms, but also to treat the causes.

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To whom Manual Therapy is addressed

Manual Therapy is addressed to:

• People with recent or chronic pain due to injury or dysfunction of the structures of the neuro-musculoskeletal system. 
• People with musculoskeletal pain who have tried methods of classical physiotherapy and did not find a solution to their problem.
• People who complain of symptoms, such as headache, vertigo, stiffness, numbness, tingling, muscle weakness, feeling of instability, etc.

Some examples of conditions treated with Manual Therapy are:

• Cervical headache and vertigo
• Spinal pain syndromes (neck pain, back pain)
• Neck injury after car accidents (whiplash injury)
• Nerve entrapment syndromes (sciatica, cervical brachial syndrome) 
• Shoulder and hip impingement syndrome, tendinopathy, epicondylitis 
• Mild hip and knee osteoarthritis
• Restriction of joint movement or stiffness (frozen shoulder, degeneration of the spine)
• Musculoskeletal disorders of musicians (overuse syndrome, chest exit syndrome)
• Sports injuries (contusions, sprains)

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