A cerebral attack is a serious form of stroke that leaves patients under the supervision of surgeons and physicians for months. However, when there is a will, there is a way. It is possible for patients to revert to their former independent lives with the support of a holistic and patient-centric stroke rehabilitation program.
Stroke rehabilitation after suffering a cerebral attack involves the following categories:
• Speech and swallow therapy – This therapy helps regain smooth operation of language, chewing, and swallowing, which become sedated after a cerebral attack. This rehabilitation entails language therapy, voice training, fluency development training, swallowing examination, therapy and training.
• Cognitive behavior therapy – This is conducted to reinstate proper behavioural techniques that are distorted post stroke. This therapy deals with cognitive disorders, communication disorders, psychological evaluation and treatment.
• Occupational therapy – This is a rehabilitation process that helps improve motor skills and hand-eye coordination through occupational activities. The activities that are conducted by therapist are supported by functional electrical stimulation, robotic technology, wireless technology, and virtual reality.
• Physiotherapy– This is a rehabilitation process that is conducted in the form of phases of physical exercises that help regain strength, mobility, and independent balance. Physiotherapy entails motor-skill exercises, mobility training, constraint-induced therapy, and range-of-motion therapy.
All these above methods of rehabilitation after a cerebral attack or a major stroke, enable recovering patients to gradually develop their mental confidence that further helps gain back confidence to live a healthy life and be as much independent as possible.
At ApoKOS rehabilitation hospital, senior doctors and expert therapists strive to provide the best therapeutic care for a speedy recovery and regained independence. Our comprehensive goal-oriented treatment ensures a smooth journey towards an improved and more independent lifestyle.

Developmental delay is a situation in which toddlers do not attain the desirable level of physical and mental development, as per their age. Holistic development among children might get delayed due to certain medical conditions or unknown reasons. Children, whose health development gets stalled, may be treated through rehabilitation processes so that they can catch up with the others of their age and gain confidence to move on with their regular activities.

Categories of Developmental Delays among Children:

– Speech Delay

– Eating and Swallowing Disorders

– Developmental disorders: Orthopaedic Conditions, Neurological Conditions, Movement Disorders

There are some developmental delays that are mild and some that are more serious. However, all of these categories can be treated through effective communication with the patients and their parents, along with following the correct processes in rehabilitation.

Rehabilitation Processes for Treating Children with Developmental Delays:

• Speech and Language Therapy: This therapy treats children facing difficulty in speaking, communicating ideas, understanding concepts, and putting words together to form sentences. The specific health areas that this therapeutic process deals with are autism, birth defects, cognitive delays, excessive drooling, swallowing disorders, weak oral muscles, hearing impairments, and effects of traumatic brain injuries. Therapy includes speech training, reading and writing exercises, and food intake lessons. Children who get involved in rehabilitative care before five years of age achieve better results, although getting enrolled at any age provides positive results.
• Physical Therapy: This is aimed at improving the child’s strength and mobility through regular exercises using specially designed equipments. Physical therapy is effective in treating congenital defects, movement impairment, and sports-related injuries that halt normal biological development.
• Occupational Therapy: This therapy is aimed at training children to attain basic competence. Expert therapists counsel the child to measure their level of development. A therapeutic programme is processed after the initial assessment, to meet the requirements of the patient. This therapy helps children gradually develop their essential motor skills to exercise sensory actions. Training processes include writing, easy self-feeding and self-grooming, and practising hand-eye coordination.

Follow-up visits to the therapists on a regular basis are vital to maintain a steady pace of progress in the rehabilitation programme. Progress reports are then sent to the paediatrician for further review of the patient’s condition, on which the next stages of treatment are decided.

Rehabilitation programmes consisting of exercises and counselling, which are carried out timely, have positive effects on the physical and mental health conditions of growing children.

At ApoKos, we believe in a humane touch along with professional medical therapies that are conducted to help patients regain their former independent selves. The personal and family-like care provided to patients at our rehabilitation centre, is an integral part of our programme that aims to achieve the best results for the patients and their family members. ApoKos believes in nurturing lives and helping every person live with dignity and as much independence as possible.

Here is a touching story of Mr. Binode Goswami, who suffered a massive life altering stroke. With the strong support of his wife and the services of ApoKos, today he is able to live almost like his days prior to the illness. Let us take you through the wonderful narrative provided by Mrs. Goswami, to help you understand our mission at ApoKos.

“Once in a while, we are given a special gift– a gift that has meaning, a gift that cares, and a gift that truly impacts one’s life. APOKOS Rehabilitation Hospital has been that gift to us.

A massive brain stroke in September 2016 reduced my husband to a faint shadow of his former self. His justify side was totally paralysed making him almost completely immobile. He lost his speech and all his fine motor skills leaving him with little scope for communication. He was unable to swallow anything—solids or liquids, and continuous bouts of coughing often resulted in shortness of breath and increasing dependence on assisted oxygen. Physically, mentally and emotionally his condition was extremely fragile. We soon realised that the facilities in the hospital in Guwahati where he was undergoing treatment were inadequate to deal with the situation. After many frantic enquiries we eventually zeroed down on APOKOS and that is where we brought him in an air ambulance at the end of November.

From the moment I set foot at APOKOS, I knew intuitively that I had come to the right place. Two months of my husband’s stay as an inpatient and then as an outpatient have proved me right. Now he is able to walk with support and carry out his daily activities with minimal help.

The hospital has a comprehensive, advanced and holistic rehab programme in place. In this age of micro specialisations where the treatment of a patient by different doctors often runs parallel, it was very reassuring to find that APOKOS has a sensitive and multidisciplinary approach towards its patients and that everyone involved–the doctors, the therapists, the nurses and the administrative staff — all collaboratively worked as a team.

In any hospital, the environment is an integral part of the healing process. The expertise of the professionals, combined with their genuine warmth and cheerful attitude has made our experience a very positive one. I would recommend APOKOS to anyone who requires rehab care.”

Priyam Goswami

Guwahati, Assam.

Patients ranging from pediatrics to geriatrics sometimes require speech and swallow therapy owing to an injury or ailment suffered or a pre-existing condition. Typically, patients with speech and swallow therapy have difficulty in effective communication and nutrition intake, which can hinder their life further. Therefore, every comprehensive post-acute care rehabilitation program should incorporate effective speech and swallow therapy if the patient exhibits such deficit.

Two categories of speech and swallow therapy –

Adult speech and swallowing therapy: This is usually conducted in cases of stroke, traumatic brain injury, nerologic disorders, tumors, gastroesophageal reflux disease (GERD), srtictures, and diverticula.

Paediatric speech and swallowing therapy: This is conducted in the most common speech issues, which are articulation and language disorders, and some swallowing issues like reflux, food aversions, tongue thrust, and dysphagia.

What does speech and swallow therapy entail?

The level of deficiencies vary from one patient to another. A thorough assessment of the patient’s condition is thus essential before a prognosis can be arrived at, which will cater to their requirements.  A speech and swallowing rehab plan involves the following therapies:

• Speech production improvement
• Computer aided speech therapy
• Language therapy
• Training for fluency development
• Voice improvement
• Swallowing therapy

Who should undergo speech and swallow therapy?

A wide range of conditions and mishaps can leave a patient with weaker speech muscles and speech production structures such as larynx, rendering it difficult for them to articulate, produce speech or swallow. Patients who typically need speech and swallow therapies are:

• Traumatic brain injury patients
• Stroke patients
• Patients with old age-related speech and swallow difficulties
• Parkinson’s Disease patients
• Children with developmental delays
• Children with shuttering or other voice disorders
• Children with eating-related oral motor issues
• Patients with strictures and diverticula

A speech and swallow therapist is a highly trained medical expert who can run a thorough evaluation of the patient’s condition and arrive at the best possible treatment plan aimed at meeting the patient’s goals.  Speech and swallow therapy can return to a patient skills which were once very basic and vital for them, putting them on the path of recovery and normalcy.

Total knee replacement is a surgical method of restoring the functional aspect of the joints. The surgery, which involves replacing the knee joints with metal balls, reduces long-term pain in the knees that occur due to depreciation in bone health during old age. In order to regain physical balance and independence after total knee replacement, periodic orthopaedic rehabilitative care is necessary. This is the predominant type of rehabilitation programme that helps patients  after total knee replacement recover and regain independence.

Orthopaedic rehabilitation programme is conducted by an interdisciplinary team, through a multidisciplinary treatment approach that involves occupational therapy. The interdisciplinary team consists of expert therapists who assess the patients’ mobility, physical ability, motor control, medical status, and psychological determination.

Physical Therapy: This is a set of pain relieving therapeutic processes that involve moving the limbs gently in order to release pressure from the centre of the joint towards its surrounding areas. Such movement results in balancing out the pain and gradually helping in regaining mobility. Mild massage is also provided to the patients to relax their skeletal-muscular system and ease its function. It involves physical toning of the muscles, which in turn relax the bones lying beneath them.

Postural Re-orientation: Due to loss of balance, therapies are conducted to help patients gradually sit and stand, maintaining a straight body posture. This form of balance training triggers mental and physical coordination, which helps patients regain postural independence.

Functional Re-orientation: After spending days in an immobile position, patients are counselled and taught to walk slowly, initially with the help of external support and later without it. Patients gradually re-learn the regular activities that they used to perform previously.

After these procedures are systematically followed and completed, a follow-up care is conducted to ensure successful results of the programme. This entails periodic check-up of the patients, counselling, exercising, and making them practise the regular activities that they were taught again, during the rehabilitative care process.

Orthopaedic rehabilitative care is important to treat patients who are gradually recovering, after undergoing a total knee replacement. Regular therapeutic procedures that involve exercises, natural medication, physical training, and intense sessions of counselling, bring patients back to their former selves by helping them regain physical balance and independence.

Going through rehabilitation procedures at an old age can be difficult for patients due to both physical and mental weakness. A well balanced and healthy diet is extremely necessary for development and regeneration of the cells in the body, so that rehabilitation has a positive effect on the system. Every form of rehabilitation entails a long term procedure that involves different types of exercises, counselling, and intake of healthy food along with regular medicines. Every elderly person going through a rehabilitation procedure must follow a proper diet chart in order to maintain proficient health conditions ever after the procedure is completed. Here are a few tips to help you build a diet chart with accordance to your health requirements during and after rehabilitation procedures.

1. Food Rich in Minerals – Minerals like calcium, iron, potassium, and zinc restore the body’s energy levels and ensure proper functioning of the brain. Calcium has a special property of keeping the bone health and density intact. Foods rich in minerals must be consumed on a daily basis, so that health problems related to old age can be kept at bay. Such foods include bananas, milk, yoghurt, watermelons, apples, beans, lentils, Bengal gram, whole grains, and green leafy vegetables. Regular consumption of these mineral-rich foods enable the body to function in a holistic manner, thereby gradually beginning to regain strength to become as independent as possible.
2. Food Rich in Vitamins – Vitamins are essential sources of nutrients for the body. Foods that are particularly rich in vitamins A, B, C, and D are required for the body to retain its essential nutrients. Consuming a healthy diet of fresh fruits and vegetables is recommended throughout and after the rehabilitation procedure. Such foods include broccoli, carrots, apples, mangoes, spinach, almonds, bell peppers, peas, and citrus fruits. A regular intake of these foods ensure a boost in overall health conditions.
3. Food Rich in Omega 3 Fatty Acids – Omega 3 is a vital source of healthy fats that act as the core catalyst that supports the functions of the heart. With age, it is necessary to deteriorate in terms of health. Hence it is important to keep the heart functioning at a steady pace. Heart problems can take a heavy toll on the patients’ lives. Undergoing rehabilitation procedures require a lot of emotional challenge too, which can affect the heart. To maintain a healthy heart, foods like eggs, fish oils, soya, spinach, cauliflower, tuna, walnuts, and pumpkin seeds, must be eaten, as they help retain proper functioning of the heart.
4. Food to Boost Eyesight – Depreciation of eyesight is an extremely common phenomenon in old age. With the loss of eyesight, patients lose most of their independence. But rehabilitation is all about attempting to regain independence as much as possible. Hence, during the process of rehabilitation, it is important to take essential steps to help remain independent. Foods like carrots, spinach, green peppers, broccoli, corn, garlic, fish, which boost eyesight and are excellent for optic health, must be consumed routinely.
5. Food to Boost Brain Cells – With increase in age, the brain cells gradually cease to reinstate and rejuvenate regularly. At times there is also a decay in the grey cells, which leads to major diseases that negatively affect the whole body. It is vital to regularly nourish the body with foods that replenish the essential cells of the brain. Such foods include almonds, walnuts, eggs, berries, fish, cabbage, spinach, and pumpkin seeds. Daily doses of these rich nutritious foods help the brain to maintain its natural health, making old age easier to handle.

Health problems are bound to arise during old age. Many a time, old age problems can be handled effectively through rehabilitation procedures. In order to go through any kind of rehabilitation process, it is necessary for the patients to maintain an overall healthy condition. Both the body and the mind should be fit and prepared for a lengthy therapeutic challenge ahead. By consuming healthy foods that cater to the bodily requirements of patients, it is easier to undergo rehabilitation procedures that help regain as much independence as possible.

Alzheimer’s disease is a common and intense mental degeneration that mostly occurs among the elderly. This disease causes a person to lose track of regular life affairs and forget everything that was once held in high esteem. Recent incidents, acquaintances, and visited places often escape the mind. A person suffering from Alzheimer’s disease even fails to recognise close connections like family and friends. A comprehensive and holistic rehabilitation procedure helps the patient cope with regular life in terms of performing activities that are to a certain extent independent of others. Rehabilitation in Alzheimer’s disease differs from one person to another, based on the symptoms during extreme cases. However, there are specific guidelines that are followed throughout the general course of rehabilitation for such patients.

Physical Exercises and Activities: Patients are treated by therapists on a regular basis, who train them to carry out easy physical exercises so that their bodies regain the energy that is lost due to daily mental fatigue. Exercises and physical therapies rejuvenate the body’s central nervous, skeletal, and muscular system, thereby attempting to cease further depreciation of the brain cells.

Similar and Rewarding Activities: Therapists make the patients carry out certain important activities on a regular basis so that they gradually develop a habit of conducting daily chores for their survival. Such activities are set against specific rewards for the patients. Setting a bar in the form of rewards, encourages the patients to regularly carry out the duties allotted to them. In this way, therapists get patients to carry out their regular tasks easily, without having to remember everything because the gifts provide enough encouragement to do the same.

Regular Socialisation, yet in Confinement: Patients suffering from Alzheimer’s disease are supposed to be kept in confinement for their own safety because rapid loss of memory makes them wander around, trying to recall and relocate everything. However, it is vital for them to engage in regular socialisation. Speaking to  family members, friends, and the doctors, encourages the patients to utilise their minds, gradually causing the brain cells to work. Positive and relaxing conversations often trigger old memories. Apart from these, it is always good to spend time with special people because the moment one feels loved, positive development within the body begins to take place!

Teaching the Basics Again, and Practising Regularly: Therapists are allotted the task of teaching a set of similar activities and words to the patients everyday. Learning and practising the same tasks everyday over and over again makes the brain accept the mechanics of everyday life. In this way, the patients are encouraged to do their own tasks and keep themselves active. Even mechanical tasks require some mental effort, which enables the patients to activate their brain cells.

Independence and Personal Space for Patients: Although patients are kept in confinement while undergoing rehabilitation processes, it is vital to provide them with personal space so that they can carry out regular activities on their own, thereby learning how to manage every day independently. Carrying out small tasks on their own makes the patients think about the stages of every activity, thereby enabling the engagement of the mind.

Physical and Mental Games: Rehabilitation therapies for Alzheimer’s patients involve engaging them in games that require both the mind and body. Coordination of the mind and the body enables a holistic therapeutic approach and thereby increases the chances of a gradual journey towards independence as much as possible.

Alzheimer’s disease is one in which patients  can be provided the best possible care by means of effective therapeutic rehabilitation procedures, even for a lifetime. Providing the patients with intense care and a loving environment plays an important role in enabling them to live their lives as independently as possible.

A sudden trauma, a strike or jolt to the head, can damage the brain in what we call a Traumatic Brain Injury. A TBI can be as mild as a concussion and as severe as a coma with later proving fatal in many instances.  Traumatic brain injuries can be broadly classified into three kinds based on the level of brain trauma sustained and symptoms experienced by the patient.

Three kinds of TBI based on severity

Mild, with concussions falling under this category, the patient may or may not lose consciousness for a few seconds or minutes. The symptoms suffered could include a headache, dizziness and vision problems.

Moderate, in which the patient can experience prolonged lethargy.

Severe, in which the patient often slips into the coma state. Severe TBI can result in fatality as well.

Preventing TBI
TBI affects the youth and the elderly the most because of their increased risk of falls and sustaining mishaps. Most instances of TBI are preventable by observing caution. While falls are the leading cause of TBI they are closely followed by road traffic accidents as the next cause.

Obey road traffic rules- Obeying traffic rules can bring down the instances of road traffic accidents and ergo instances of TBI.

Wear seat belt – Seat belts can keep you safe in case your motor vehicle meets with an accident.

Wear helmets – If you are a two-wheeler rider, ensure you wear a helmet as it can save your life and also decrease the severity of head injury sustained in the event of a road traffic accident. If you are someone who engages in sports such as cricket or polo, wear appropriate head protection gear while playing.

Never drive under the influence – Refrain from operating your vehicle when you are under the influence of alcohol or drugs ensuring your own and other’s safety.

Preventing Falls

Fall cases in older adults can be prevented by adapting safety measures around their living space.

• Fit handrails in bathrooms.
• Install handrails on both sides of staircases.
• Install brighter lights at the home.
• Ensure the floor and stairs are clutter free.

TBI is one of the leading causes of mortality and disabilities in India. But most cases of TBI are preventable. Even in its treatment, the first 48 hours after the injury is crucial. The patient’s

Autism Spectrum Disorders are neurological conditions which affect the brain and its ability to function. Children stricken with Autism Spectrum Disorders may experience restricted motor movements, issues with speech and communication and focus. Children with autism can also run into developmental issues, learning difficulties along with restricted social skills.

There exists no ‘cure’ as such for ASD and also their exact causes remain elusive. But a comprehensive and dedicated rehabilitation program can help children with ASD lead a more functional and productive life.

Tailoring Treatment

Each individual exhibits a different pronounced symptom making it difficult to come up with a one-size-fits-all rehabilitation plan for ASD. But there of course exists some basic principles on which the rehabilitation for children with ASD rests on.  A comprehensive rehabilitation program will include speech and language therapy, occupational therapy, educational support, plus a number of other interventions to help children and parents.

The rehabilitation plan targets child’s –

1. Communication skills – With speech and language therapy
2. Motor functions – With Occupational and physical therapy
3. Social interaction skills – With counselling and simulated scenarios

Caring about the carers

Along with providing rehabilitative care to the child, another important aspect of the intervention is supporting the caretakers of the child, as it can be quite a draining task, both physically and emotionally.  Also a well informed caretaker can bring about extraordinary improvements in the child’s condition with the right kind of approach. To enable this, the intervention also makes provision for caretaker education and counselling.

Finding the right intervention for a child with ASD can be challenging sometimes, but a comprehensive rehabilitation program should be able to overcome this challenge through a thorough initial assessment of the child’s condition. The initial assessment can function as a base for building a custom and effective prognosis for the child. A successful rehabilitation program can enable a child with ASD to develop individualized coping mechanisms. This in turn can propel them to lead a life that is comparable in terms of quality to that of any regular child.