Introduction

The goal of the neurological rehabilitation and functional re-education sector is to provide care to patients with deficiencies of neurological origins, both acquired or congenital. (Cerebrovascular accident –cranial trauma– paraplegia or quadriplegia – Multiple Sclerosis – Brain Tumor – Muscular Disease – Cerebral Palsy – …).

The combination of multiple deficiencies in a handicap shows the necessity of the intervention of different therapists and care providers with specific skills: the team should be supervised by a medical practitioner specialized in physiotherapy and rehabilitation medicine.

Care for children with neuro-motor deficiencies are provided by collaborating hospital teams and neighboring care structures: they include the evaluation of motor and cognitive disorders and an optimized management of functional disorders related to the initial lesion, to dysmorphogenesis and to learning disorders.

The goal of the re-education programs developed by the neurological sector is first to evaluate the deficiencies affecting the different functions and then suggest aimed therapeutical activities adapted to the patient’s evolution and social-family environment: the aim of our care is to rehabilitate the patient within an optimized private-professional environment.

Physical Medicine and Rehabilitation

The medical staff of the neurological rehabilitation center is as follows:

  • Dr. Thierry DEBUGNE
  • Dr. Frédéric CHANTRAINE
  • Dr. Elisabeth KOLANOWSKI
  • Dr. José PEREIRA
  • Dr. Samuel SALAZAR

At the medical level, the activities of the neurological rehabilitation center include:

  • External Consultations, Consultations and Management of Physical Medicine and Rehabilitation
  • Functional explorations:

Functional explorations:

  • Electrophysiologic examinations: electromyography (EMG) – evoked potentials among other things…,
  • Neurodynamic examinations,
  • Quantified Movement (and posture) Analysis (QMA):

Movement disorders are often complex. Incertitudes concerning diagnosis must be cleared to give more accurate therapeutic indications. The QMA allows a simultaneous recording of three-dimensional movement trajectories, involved forces (force platforms) and muscular activities (dynamic multi thread electromyography) leading to a better approach of motor disorders affecting posture, balance, locomotion, spatial exploration and prehension.

Postural examination makes it possible to verify the proper functioning of the sensory inputs and their medullary integration and by the higher centers in the stabilization and orientation of the patient.

  • Spasticity Assessment and Treatment of spasticity (ETS) and Dystonia,
  • Motor groups with local anaesthetics and neurolytic agents(botulinum toxin – phenol – alcohol).

Those cares last over weeks, sometimes months, and must be integrated into a concept of continuous care. They require close cooperation between upstream hospital and medical structures as well as downstream long-stay institutions, professional environment, home care services and families.

Important and frequent urinary and sexual consequences of neurological pathologies and their repercussions on patients’ lives led to the creation of a special unit, the Udepp.

The goal of this sexological evaluation and neuro-urological follow-up service is to analyze the neuro-sexual and bladder-sphincter dysfunctions and to offer a therapeutic project taking these elements into account in the treatment of the handicap and into a mid- long-term follow-up: comparative evaluations – medicinal adjustments – new technical help – education of patients and their relatives.

Care Services

The care services are composed of 3 hospitalization units, therapeutic apartments and policlinic care services.

Specialized for treatments of neurological pathologies like cerebral vascular accidents, cranial trauma, medullary trauma…

  • 12 rooms with 2 beds each,
  • 6 rooms with 1 bed each.

Specialized for early treatments of neurological pathologies like comas in a vegetative awaken state, cerebral vascular accidents , traumatic brain injury, medullary trauma…

  • 12 rooms with 1 bed each, including 4 isolation rooms (infectious diseases) and one secured monitored room.

The rehabilitation care approach includes the assessment of the needs and capacities of the patient, the identification of the means to be implemented to allow an optimal gain of autonomy as well as the accompaniment of care in order to reach the personalized goals of the patient and his entourage, declined from the medical goals.

An accompanying nurse welcomes and follows the hospitalized patient according to his needs throughout his stay. She is also involved in the preparation of his leave in collaboration with the various health professionals.

This function makes it possible to provide the patient and those around him with a referent health professional who is constantly interconnected with the care units.

Comfort benefits for the hospitalized patient

  • a patient facilitator offers occupational activities to brighten the patients’ daily lives,
  • a hairdressing service is available to patients every thursday,
  • the hospitalization service has two graduated medical pedicures; their intervention may be requested for aesthetic or medical reasons.,
  • laundry service is provided when needed.

The rehabilitation care approach includes the assessment of the needs and capacities of the patient, the identification of the means to be implemented to allow an optimal gain of autonomy as well as the accompaniment of care in order to reach the personalized goals of the patient and his entourage, declined from the medical goals.

An accompanying nurse welcomes and follows the hospitalized patient according to his needs throughout his stay. She is also involved in the preparation of his leave in collaboration with the various health professionals.

This function makes it possible to provide the patient and those around him with a referent health professional who is constantly interconnected with the care units.

Comfort benefits for the hospitalized patient

  • a patient facilitator offers occupational activities to brighten the patients’ daily lives,
  • a hairdressing service is available to patients every thursday,
  • the hospitalization service has two graduated medical pedicures; their intervention may be requested for aesthetic or medical reasons.,
  • laundry service is provided when needed.

The healthcare policlinic, specialized in the care of ambulatory patients for their different needs of health care, is made up of nurses and auxiliary nurses specialized in rehabilitation who provide different types of care:

  • acts of daily life care: hygiene and dressing in the case of hydrotherapy, meals, mobilization, elimination, etc,
  • technical care: dressings, surveys, monitoring of parameters, drug management, isolation management, biological samples, etc,
  • emergency management,
  • achievement of appropriate lessons for the patient and / or the entourage,
  • relay between the patient, the entourage, home care networks, etc.

Specialized in the transport of patients in rehabilitation, the agents provide the internal transport of hospitalized and ambulatory patients.

Physiotherapie

Neurological physiotherapy is for patients with a pathology or trauma of the central nervous system (CNS). It aims to limit the consequences of CNS lesions. It is an integral part of the multi-disciplinary and interdisciplinary team of reeducation and rehabilitation.

The missions of neurological physiotherapy are:

  • to assess deficits and incapacities due to CNS lesions,
  • to participate in the development and revision of the treatment plan, which is individual to each patient,
  • to limit the consequences due to the CNS impact by rehabilitation or rehabilitative measures to reduce the impact in a bio-socio-professional context.
  • passive and active mobilization, as well as muscle building,
  • the maintenance or even the gain of joint and muscle amplitude by stretching and / or postures,
  • neuromotor rehabilitation,
  • rehabilitation of balance,
  • reeducation / rehabilitation to walk ,
  • physical therapy (hot and / or cold therapy, electrotherapy, etc.),
  • hydrotherapy,
  • robot assisted therapy (Lokomat),
  • participation in creating splints and orthosis, including functional electrical stimulation (FES).

The team also participates in clinical research projects, is represented in various learned societies and is involved in training future health professionals.

Respiratory physiotherapy is an additional tool in the patient’s management arsenal. It aims to:

  1. Prevent bronchial congestion
  2. Fight against bronchial congestion

For this, respiratory physiotherapy uses:

  • techniques that promote lung capacity recruitment,
  • manual bronchial clearance techniques,
  • instrumental bronchial clearance techniques such as Mechanical In-Exsufflation (MI-E -> Cough Assit ®) or intrapulmonary percussive ventilation (IPV -> Percussionnaire®),
  • the establishment of aerosol therapy in close collaboration with the care units under the guise of a medical prescription.

Physiotherapy in pelvic perineal rehabilitation is for patients with:

  • vesico-sphincteric and / or ano-rectal dysfunctions of neurological or traumatic origin,
  • pelvic pain,
  • sexological disorders.

This type of care can also be offered in pediatric cases through specially trained therapists.

Following a medical consultation with our specialized doctors and thanks to a platform allowing the evaluation of the perineal sphere as a whole, the patient receives a prescription of care consistent and adapted to his disability.

Assessments:

The assessments performed include standardized and validated assessments such as specific assessments like muscle and sensory testing of the perineal sphere.

Methods used:

  • analytical and global strengthening of the pelvic floor,
  • proprioception,
  • physiotherapy: electrotherapy, biofeedback technique, etc,
  • abdominal reinforcement with appropriate techniques: Abdo MG technique, hypopressive abdominal technique (De Gasquet, Caufriez, etc.).

Psychomotricity

The specificity of psychomotricity is to consider the pathology of a patient both on physical and psychicological levels, to consider the patient’s case entirely, with its possibilities and difficulties and to pay specific attention to the psycho-physical manifestations of the pathology.

The psycho-motor examination, through a number of exercises adapted to the age and pathology of the patient, allows:

• the evaluation of difficulties as well as possibilities by placing them within the evolution of the pathology,
• to assess the relationship between the patients and their environment.

The psycho-motor examination can give an estimation of the overall physical activities and expressions based on:

• coordination,
• balance,
• muscle tone,
• knowledge and consciousness of the body. The body schema (= the body image ),
• space and time structuring, laterality,
• graphical gesture,
• the relation between the patient and its environment and unusual situations.

The psycho-motor therapist has to deal with diverse manifestations of the pathologies: perinatal, postnatal, neurological, sensory, psychosomatic, geriatric, psychiatric pathologies.

These different manifestations can be seen as:

• visual motor disorders,
• practical disorders,
• tone-emotional disorders,
• knowledge and consciousness of the body, body scheme and body image disorders,
• space-time orientation disorders,
• behavioral disorders,
• personality disorders.

Re-education can be provided through relaxation, gesture education, body or art expression with rhythmical activities, games, balance and coordination exercices using diverse means like water for example.

Gymnastics and Hydrotherapy Therapies

Adapted physical activity therapies (A.P.A.) and hydrotherapy are an integral part of the patient’s care of the Rehazenter.

A medical prescription always justifies this care. Patients are supervised by six therapists in Adapted Physical Activities, as well as by two swim instructors. The entire team works in close collaboration with the other services (physiotherapy, occupational therapy, medical team, etc.).

The goal of these therapies is to integrate physical activities into the functional treatment of the patient. The care provided in A.P.A. can be collective or individual, based on an individual assessment. It consists in adapting all physical activities to the different pathologies of the patients and according to their personal and therapeutic goals (didactic adaptations, logistic, modifications of the regulations, etc.). The goal of this care is also a decentralization of the focus on the lesion, integrating it at the corporal level by more global activities. The peculiarity of pool therapies is to be able to start early an active and secure mobilization.
The proposed physical activities will allow the patient to assert himself and flourish. These group activities will allow him to find or develop a certain socialization through various interactions with others and, thus, some notions of helping each other and cohesion. This care will allow some patients to give them back an interest in an active life. For others, the interest will be in the resumption of a sport of competition whatever the level of the patient is.

The Gymnastics and Hydrotherapy Unit participates in the supervision of trainees in adapted physical activities of different international universities.

In collaboration with other professions we participate in groups.

  • Prevention of falls
  • AMR (Aktivitätstest zur Mobilität im Rollstuhl =activity asessment for mobility with the wheelchair) for wheelchair patients
  • Rehareck (cardio-vascular training, functional reinforcement and hydrotherapy)

Occupational therapy

The person may have difficulties performing most of his or her daily activities such as dressing, feeding, personal hygiene, transfers, traveling, housekeeping, recreation, work, driving, etc., the occupational therapist’s preferred areas of action.

The goal of occupational therapy is to maintain, restore and enable human activities in a secure, autonomous and efficient manner. It prevents, reduces or eliminates situations of disability taking into account the lifestyle of people and their environment.

At the Rehazenter, the occupational therapist intervenes in the reeducation more precisely “Do it better” and in the rehabilitation “Do it with” with the establishment of means of compensation, all under medical prescription.

The management of the patient is done in a multi-disciplinary and interdisciplinary team whose main goal is to put the patient at the center of the process of revalidation. He remains the main actor of his therapy to rebuild a life project, accompanied throughout its care by all medical and paramedical workers.

The neurological management of occupational therapy is spread over two rooms.

One of the strengths of the Rehazenter remains the great diversity of means available to patients.

The occupational therapy department within the Rehazenter re-educates patients by offering an analytic rehabilitation after an evaluation and assessment phase. This work is articulated around the activity proposed to the patient and the different motor, sensory, psychological and socio-cultural requirements that compose it. The service has more specific complementary means to qualitatively support the patient in his care path.

Orthotics

The occupational therapy department has an orthotic workshop located in the orthopedic rehabilitation sector of the upper limb. Specialized occupational therapists perform static and dynamic tailor-made orthoses for the upper limbs for internal or external patients.

Orthotics have the following therapeutic goals:

  • to fight against painful phenomena,
  • to rest or immobilize one or more joints,
  • to recover or prevent a deficiency of joint mobility,
  • to correct or limit a deformation,
  • to promote cutaneous scarring,
  • to replace the function,
  • to allow an early mobilization protected under orthosis.

The realization of these devices is accompanied by an information sheet and explanations on the goals of the orthosis, as well as the instructions for the wearing and a maintenance advice.

Further follow-up to adapt or repair the orthosis is also provided by the occupational therapy service.

Technical support

Depending on the severity of the motor impairment, the person may have to move in a wheelchair. The occupational therapist will determine the required characteristics of the wheelchair and will teach the person how to use it , move it and do the transfer. Environmental control systems as well as technical aids that will facilitate the implementation of certain activities such as dressing, meal preparation, recreation can be implemented, the purpose being to find compensation to facilitate and to overcome the deficiencies of the person.

Virtual Rehabilitation

A l’heure actuelle, la rééducation virtuelle prend une part importante. Des outils tels que l’Arméo, rééducation globale spécifique du membre supérieur et l’E-link plus ciblé en distal, sont utilisés au Centre de Rééducation Fonctionnelle et de Réadaptation.

Rehabilitation of cognitive functions

At present, virtual rehabilitation plays an important role. Tools such as Arméo, specific upper limb reeducation and more targeted E-link distal, are used at the Center for Functional Reeducation and Rehabilitation.

Sensory rehabilitation of peripheral neuropathic pain

LSensory rehabilitation is a therapeutical approach that aims to reduce peripheral neuropathic pain. It uses the neuroplasticity of the nervous system to treat disorders of skin sensitivity and their painful complications.
The occupational therapist performs a somesthetic evaluation to map the painful skin area and the injured nerve(s).

He then determines, with the patient, the multi-day exercises of a few minutes to perform to reduce neuropathic pain and allow the person to reappropriate normal skin sensitivity.

With three professional occupational therapists trained and graduated in this technique, the Rehazenter is the only center to offer this innovative rehabilitation technique all around Luxembourg with convincing results.

Prevention of falls

It is a closed group for a specific duration, facilitated by therapists from occupational therapy and adapted physical activity.

The work of this group is organized around the problem of the fall: determining risk factors, providing advice and recommendations, practical exercises related to the functions of equilibration and everyday life.

This group also aims to reduce the fear of falling and regaining pleasure in physical activity.

Group Handling wheelchairs

In collaboration with therapists in Adapted Physical Activities, the group is aimed at patients who have to use a manual wheelchair on a daily and autonomous basis. With a balance sheet and specific material. they allow them to effectively learn the techniques of wheelchair use indoors and outdoors.

SNOEZELEN

It is an approach that values relaxation and sensory stimulation.
The two main objectives are to allow the person to relax and to be stimulated through his senses.

Occupational therapists are required to make visits to the patient’s home or workplace. Their action will be to advise and advocate specific adjustments to promote access and lift disability situations.
Real life situations are also carried out as part of everyday life activities, related to the person such as transfers, dressing, food or the preparation of meals in a therapeutic kitchen, etc., and also related to the environment such as public transport or other places through specific assessments, such as the multiple wandering test or the Daily Life Activity profile. Other activities in the context of rehabilitation can be proposed such as woodworking in our wood workshop.

Ergokit

The Ergokit is a specific assessment tool of the functional capacities of the person within the case of a vocational orientation or reorientation. It consists of a complete physical assessment of the person and, if necessary, an evaluation of his workstation. This report takes into account the feelings and the patient’s participation throughout the process.

This assessment, over a period of 4 to 8 hours for the patient, is done in the context of internal care at Rehazenter or so, following a targeted medical consultation.

CLECAR

Since 1999, the National Center for Functional Reeducationand Rehabilitation has developed a unit for learning and resuming driving.

Focusing on people’s life concerns, it seemed obvious to meet this need for recovering or learning to drive.

The CLECAR, Luxembourg Cell of Evaluation to Conduct Automobile Rehabilitation, in collaboration with other professions present at the Center such as doctors, orthoptist, psychologist, social worker allows a recovery or an apprenticeship of driving.

The Occupational Therapy department is equipped with a quarter of a car to evaluate the transfer capacity, a driving simulator with driving aids and a suitable driving school vehicle. The occupational therapist will have to evaluate the functional abilities of the person before advising on technical aids to driving. The person can thus regain full autonomy in his movements, whether private or professional.

The occupational therapist will ensure that the person can resume daily activities as satisfactorily as possible, despite any limitations that may persist.

Psychology

At Rehazenter, psychologists dedicate their missions to improving the quality of life of patients. Indeed, whether people with brain damage or pathologies of the musculoskeletal system, their ability to cope with daily life activities and participation in society are undermined, with important suffering.

The role of the psychologist in rehabilitation focuses on several levels:

  • Diagnosis: by allowing an understanding of the extent of emotional, cognitive and behavioral difficulties. This is done using an oriented evaluation, making the inventory of the difficulties but also available resources to develop a rehabilitation project.
  • The development of the rehabilitation project is done in partnership with the multi-disciplinary and interdisciplinary team under the responsibility of the doctor. It will be revised regularly according to the evolution of the patient and may have several different goals: recovery of the concerned or missing function, compensation for what is lacking depending on the preserved skills, the development of the environment to provide and make life easier with deficits.
  • The rehabilitation work of the cognitive, behavioral and affective skills of the patient with brain lesions.
  • The management of pain, with the learning of techniques such as self-hypnosis for example.
  • The accompaniment of relatives and families in the apprehension of difference and disability.
  • Awareness of the deficits and the means of psychological adaptation to live with the change (s).

The main role of the psychologist is therefore to accompany the person in these changes while including the context of the rehabilitation, by considering the opinions of the therapists and the care team, the emotional capacities and the resources of the patient as well as his project of life. Also, the link between the Rehazenter and the outside of the hospital structure is a primordial mission which aims at a family reintegration, a social then professional or school reintegration with a certain quality (Case Management).

At Rehazenter, psychologists are all specialized in neuropsychology and are also trained and recognized in psychotherapy. According to the person and the needs, a psychotherapeutic follow-up of different type can be proposed to the patients (Systemic therapy, briefing hypnotherapy, EMDR / Traumatherapy, etc.).

Beyond these global missions, psychologists orient themselves according to their interests in specific teams of skills. Some specialize in the treatment of pain, sexual dysfunction, dizziness and instabilities (LINK GROUP WEBSITE), behavioural disorder, or in the monitoring of children with the team of teachers (LINK SCHOOL SITE OF THE SICK CHILD), and accompanying families.

The service is also in contact with external partners for specific assessments, such as the assessment of the ability to drive (LINK CLECAR), for vocational rehabilitation (LINK PROJECT COSP-HR), motivated cognitive assessments ( help with diagnosis, advice of care, etc.).

The team of psychologists at the Rehazenter also remains committed to the supervision of trainees, to the involvement in research programs or in teaching (LIEN CORDE).

Orthoptics

This discipline finds its roots in Greek ortho (right) and opsie (eye, vision).

Orthoptics is a paramedical profession whose purpose is to detect, reeducate or rehabilitate disorders of visual function.

The majority of patients referred for an orthoptic assessment at the Rehazenter have or have had brain damage such as stroke, traumatic brain damage, or neurological disease. The visual deficit then depends on the location of the damage (oculomotor palsy, visual field damage, neurovisual disorders, etc.).

The care can also be part of the problems of postural disorders, balance disorders or vertigo.

Finally, one of the missions of our service is the participation in assessments of patient’s driving aptitudes.

Speech Therapies

Speech-language pathology is the assessment and management of oral and written language disorders, communication, speech, articulation, , oral-lingual-facial muscles and swallowing.

Within the Center, the speech-language pathologist’s intervention is aimed primarily at patients with neurological involvement such as stroke, head trauma or neurological disease.

On the recommendation of the rehabilitation doctor, the speech therapist carries out a report from which will result goals and a therapeutic plan on which the care of the patient will be based . Speech-language therapy will then be integrated into the multi-disciplinary and interi-disciplinary care of the patient, respecting individual needs, the main goal being independence and quality of life on a daily basis.

In a rehabilitation approach, the speech-language pathologist will assist the patient to maintain their abilities as long as possible.

Sessions are mainly individual but can also be organized in groups or be computer-assisted.

Speech therapy also includes the accompaniment of the close entourage (counseling, teaching, follow-up).

Social Assistance

Rehazenter Social Service Unit

Social factors influence populations’ health. Illness can increase psycho-social-financial issues, change statutes and destroy lives. Social issues can also lead to a worsening of the pathologies.
Modern hospital procedures are more and more characterized by a multidisciplinary functioning where social services become more and more important.

As the Rehazenter has an goal of excellence, its social services take care of all hospitalized patients from the very beginning of their stay and of ambulatory patients who ask for social aid.

The social procedures must be set in motion as early as possible, as soon as the patient is hospitalized in order to reduce the length of the stay to the minimum for social reasons .

The social workers have a goal to help those who cannot face life’s difficulties. Social workers help these patients to use their resources and benefit from aids provided by society.

  • Analyze short, medium and long term needs.
  • Promote the autonomy of patients.
  • Help the patients with their return back home or their reinsertion into a social, scholar or professional environment depending on the patient’s (and his relatives’) needs and expectations.
  • Réinsérer socialement, familialement, culturellement, scolairement ou professionnellement avec recomposition du lien social.
  • Orienter et conseiller dans les actes de la vie en société
  • Aider dans la démarche de recherche d’une structure de logement adapté.
  • Préparer avec ou sans le patient et / ou famille le retour en week-end, passage en ambulatoire et à la sortie définitive.
  • Informer, orienter, accompagner le patient et / ou la famille dans la résolution de problèmes sociaux, professionnels et administratifs liés à la prise en charge.
  • The implementation of actions (with or without the patients and/or their relatives) leading to the cooperation with external services (health care, accident insurance, home care services, neighboring social workers,…).
  • Elaboration of a project with the patients and their social and family environment.
  • Keeping acquired rights: help with adapted administrative procedures (request for dependence insurance, disablement pension, parking access card,…).
  • Home medical visits, assistance from the social service and/or the employer for accommodations.
  • Briefings during the re-education process allow the team to determine future goals.
  • Family reunions with the patients’ relatives serve as selective but regular evaluations of the progress made through re-education and the level of achievement for future goals.
  • Meetings with the different multidisciplinary groups, like e.g. chronic lower back pain, favor a better approach of the treatments.

Nutrition and Dietetics

Dietitians are food specialists. They are health professionals with a preventive as well as a curative mission. They ensure the quality and healthiness of the patients’ food depending on their health, lifestyle and age.

Dietitians are part of the medical / paramedical team and are supervised by doctors.

In a rehabilitation center such as ours, the dietetics associated with the rehabilitation is essential.

Indeed, unbalanced diet can have dramatic consequences in terms of mortality, morbidity, increasing the duration and costs of hospitalization not to mention the impact on the quality of life.

Dietetics is associated to curative or preventive treatments for numerous pathologies like diabetes, obesity, nephropathies, digestive pathologies and more.

The job of dietitians in a functional re-education and rehabilitation center is being done on several levels:

  • They give food advice to patients and to their relatives depending on their needs.
  • They work within the multidisciplinary medical team (doctors, nurses, auxiliary nurses, speechtherapists, pharmacists,…) to ensure a followed-up diet for the patients.
  • The work with the catering services to adapt the meals to the different pathologies (textures, allergies, intolerances…).
  • They make sure the patients and their relatives know enough about dietetics when the patients return home or when they enter a specialized medical institution…
  • They make sure the chef and the caterers offer balanced menus and that the menus match the different diets of the patients.
  • They control dishes made for patients and their acceptability.
  • They ensure that hygiene rules are respected.
  • The work with the head caterer for foodstuff purchase.

Dietitians make sure the skills of both the medical staff and the diet caterer (who controls the training of the kitchen staff) are up to date.

He also creates groups of patients (ex: chronic low back pain patients…)

  • They evaluate the patients food habits and adapt their nutrition according to their age and condition (following medical prescription).
  • They give food advice to the patients and their relatives depending on their needs.
  • They elaborate personalized documents like food plans, food equivalences and any other document to answer the patients’ demands.
  • They work with the multidisciplinary medical team (doctors, nurses, auxiliary nurses, speech therapists, pharmacists,…) to ensure a followed-up diet for the patients.
  • They closely work together with the hygienist concerning the food hygiene (therapeutical kitchen, central kitchen, satellite kitchen…)

UdEPP

The goals of this service are to:

  1. Evaluate dysfunctions. Of the bladder and the spincters.
  2. Offer medical or even surgical treatments as part of the overall handicap and the multidisciplinary treatment.
  3. Provide education to the patients and their relatives (for example: intermittent auto and hetero polls).
  4. Provide a follow-up and regular treatment and technical help adaptations, depending on the evolution of the pathologies and on technical progress.
  5. Perform neuro-sexologic evaluations and offer therapies adapted to the patient’s medical condition and needs (treatment for erection and ejaculation dysfunctions).

The Udepp team is composed of two medical practitioners specialized in physical medicine with a specific neuro-urology and urodynamic training and a re-education nurse.

This team has two urodynamic chains coupled with electrophysiological exploration, a portable ultrasound scanner to make non-invasive measurements of postvoiding residuals. It also has at its disposal a radiology unit to visualize the entire bladder-sphincter system (Regressive Uretro-Cystography per-Mictional-Ulstrasound) and a whole batch of didactic tools that are necessary to educate patients.

You can find the SENUFS on the ground floor of the Rehazenter, in the Functional Unit.

Requests for an appointment have to be addressed to the following telephone number : (+352) 2698 4106/4107.

CLECAR

Since 1999, the National Center for Functional Reeducation and Rehabilitation has developed a unit for learning and resuming driving. Focusing on people’s life concerns, it seemed obvious to meet this need for recovery or learning to drive.

The CLECAR, Luxembourg Cell of Evaluation to Conduct Automobile Rehabilitation, in collaboration with other professions present at the Center such as doctors, orthoptist, psychologist, social worker allows a recovery or an apprenticeship of driving.

The Occupational Therapy department is equipped with a quarter of a car to evaluate the transfer capacity, a driving simulator with driving aids and a suitable driving school vehicle. The occupational therapist will have to evaluate the functional abilities of the person before advising on technical aids to driving. The person can thus regain full autonomy in his movements, whether private or professional.

The occupational therapist will ensure that the person can resume daily activities as satisfactorily as possible, despite any limitations that may persist.

Group Pain Management

Rehabilitative care is frequently accompanied by painful phenomena. A survey of patients in the Rehazenter revealed a prevalence of about 78%.
Their prevention therefore remains a fundamental first step: mobilization techniques, progressive loading, the application of local physical treatments in physiotherapy, balneotherapy techniques and a medicinal aid often allow to reduce their intensity and to continue   the rehabilitation program.

If necessary, it is also possible to use inhalation of gas comprising an equimolecular mixture of oxygen and nitrous oxide (MEOPA), with antalgic, relaxing and anxiolytic properties: its interest lies in its ease of use and in its rapid action and the limited duration of inhalation.

Hypnosis techniques can also be applied. Two certified psychologists of this approach intervene with patients at the request of doctors of the Rehazenter..

The coordination of the management of pain remains ensured by the medical practitioner of physical medicine and rehabilitation.

If acute pain remains a relatively simple event, the chronization of painful phenomena becomes much more complex to analyze. Pain is no longer simply sensory information about the condition of the body: it contains many emotional and affective characteristics that will at least partly determine behavioral responses.

Its management requires a different, so called bio-psycho-social approach, which will take into account the different components of pain. To carry out this process, it will be necessary to rely on a multidisciplinary and interdisciplinary team, oriented towards a coherent aim which is fixed at the beginning of the treatment. This cohesion between the patient’s goal and those presented by the team remains a priority and is essential for the therapeutical success.

It will include an initial evaluation that will try to better understand the painful mechanisms and guide the content of treatment, possibly focusing on a particular discipline. All professions are likely to intervene to participate in the achievement of theses goals: doctor, physiotherapist, psychologist, occupational therapist, social worker, sport instructors, nurse.

An individual and / or group treatment, a pooling of observations and results during multi- and interdisciplinary summaries and a redefinition of new goals will constitute the structure for these specific treatments. The establishment of the program and its coordination remain under the responsibility of the medical practitioner in physical medicine and rehabilitation: it may, if necessary, use other medical practitioners, such as the medical practitioner in anesthesia-reanimation.

Groupe of Action Pain (G.A.D) is composed of representatives of various professions working with patients treated at the Rehazenter: medical practitioners specialized in physical medicine and rehabilitation, psychologist, physiotherapist, occupational therapist, nurse, social worker, caregiver, swin instructor, etc.

The missions of Groupe Action Pain are oriented towards both patients and employees within the Rehazenter: this multi-disciplinary and interdisciplinary group must promote the following points:
1. Encourage the permanent evaluation of pain phenomena before any therapeutic approach.
2. Raise awareness of the importance of taking into account psychological and environmental factors.
3. Encourage patients to express their pain.
4. Promote a multi-disciplinary and interdisciplinary approach.
5. Participate in continuing education about algology, etc.
6. Participate actively in the management of pain in this institution..
7. Establish the position of Referent Pain within the institution.
8. Continue the development of the Chronic Pain Consultation.
9. Promote inter-hospital exchanges in the field of algology.
10. Promote the place of the Rehazenter in a national network of algology.

Any care must begin with a consultation with the referring physician: the files are then discussed in a multi-disciplinary and interdisciplinary staff, and a decision of treatment is offered to the patient.

For further information, contact the secretariat at the following number::
2698-4107 / 4108.