Neurological rehabilitation is a long process that requires dedication from the patient and his or her family as well as a comfortable and positive environment in which to heal. In this regard, the spa town of Valens is a truly serene place that helps patients to recover. We talk to the head of the department of neurology and neurorehabilitation at the rehabilitation center in Valens, Dr. Serafin Beer, about advances in this field and the new joint rehabilitation program at Kliniken Valens and Grand Resort Bad Ragaz.
– How much of the rehabilitation program is a matter of daily routine – exercise, rest, passive recovery – and how much is down to the active work of a neurologist?
– Neurorehabilitation is based on learning processes and the reorganisation of brain networks. In everyday life, we are continuously analyzing and solving new problems or challenging situations, which requires similar learning abilities and the plasticity of our brain. Luckily, our brain shows the same plasticity when it is injured by trauma or disease. This process can only be initiated and maintained by active training. An enriched environment (as one ordinary meets in one’s daily routine) is known to enhance this restorative process, improving functional abilities, self-efficacy, participatory abilities, and quality of life. Therefore, normal daily activities are an important part of neurorehabilitation.
– What kinds of patients can benefit most from neurological rehabilitation programs? What conditions do you mostly treat?
– Patients admitted to our neurorehabilitation center are suffering from acute health problems (such as stroke, traumatic brain injuries, meningitis/ encephalitis, or inflammatory diseases of the peripheral nervous system) or from chronic disabling diseases (such as multiple sclerosis, or Parkinson’s disease). All these patients benefit from individualised, multidisciplinary rehab programmes which should be started soon after the acute phase and conducted in an intensive manner: both the timing and the intensity of training are crucial for a successful recovery. At our neurological department, we treat all age groups from the age of 16, with patients having an average age of about 50.
– It is known that rehabilitation after a stroke is a particularly long and painstaking process. Can you describe your method of working with such patients?
– Stroke patients are the largest group at our rehab center. Due to close cooperation with regional stroke units and centers, we are able to start our rehabilitation treatment very soon after an acute event, which is important, as mentioned before, for recovery. After admission, patients are examined neurologically and assessed in terms of all disciplines (physical therapy, occupational therapy, nursing care, speech therapy, neuropsychological therapy, and others as needed) to define – together with the patient and his or her relatives – sound, relevant and realistic goals and to set up an appropriate treatment regimen aimed at reaching this goal. During their rehabilitation residence, patients are regularly re-assessed with respect to improvements and on-going problems, and treatment programmes are adapted if needed. Before discharge, clear recommendations are made about the need for further outpatient treatment and support at home.
– How important is the patient’s psychological comfort in terms of their environment? Is there any scientific research to prove that the results actually depend on it?
– Psychological aspects are important issues in the rehabilitation and recovery process. Negative psychological influences (such as depression, motivational problems, etc) are known factors that lead to a deterioration in outcome. Distinguished locations and facilities, and an enjoyable atmosphere, on the other hand, promote welfare and motivation, which are very important elements in successful rehabilitation. In this respect, we are very pleased with the new collaboration of the Kliniken Valens rehab center and the Grand Resort Bad Ragaz in running the Clinic Bad Ragaz together, which incorporates all aspects of highly specialized rehabilitation as supported by the Kliniken Valens and the highest quality of accommodation and services as provided by the Grand Resort Bad Ragaz.
– What are the most recent advances in neurological rehabilitation? Can you tell the readers about new techniques, equipment, and programs?
– Since the 1990s, interest and research in neurological rehabilitation is growing. One important issue was to better understand the underlying mechanisms of recovery due to a stroke or other disorders of the central nervous system and brain plasticity. Another important achievement was the standardizing of sound and evidence-based proceedings in neurological rehabilitation. Finally, the introduction of computerbased and robotic-assisted treatment like virtual reality in a rehabilitation context will probably increase the efficacy of neurological rehabilitation in the future.
– Can you describe some of the biggest success stories in Kliniken Valens in the past months?
– As we treat a very large number of patients every year (over a thousand at our neurological department in Valens), there are many cases we could mention as big successes. Many patients arrive in a pitiful condition but show astonishing improvements during their stay, which doubtlessly wouldn’t be possible without intensive specialized rehabilitation. Therefore, every patient who is able to resume his or her life with the highest possible levels of independence and quality of life is a story of success. One difference that arguably distinguishes us from other rehab centers is the high intensity of our therapies, the high-level qualification of our collaborators, and – especially – the enormous commitment and engagement of our staff in their work for our patients.
Dr. Serafin Beer
After graduating as an MD at the University of Berne (CH), and postgraduate training in neurology, Dr. Beer was appointed in 1995 as a consultant neurologist and later on as a senior consultant and deputy to the head of the department of neurology and neurorehabilitation at the Rehabcenter in Valens (CH). During these 25 years, his team, in close cooperation with renowned international experts in neurorehabilitation, has continuously developed and refined comprehensive, evidence-based programs for outpatient and inpatient treatment of people with neurological disorders (such as strokes, Parkinson’s disease, multiple sclerosis, traumatic brain injury, etc) along with continuing his research and teaching in this field.
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