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MEDICAL EXPERTISE IN FOUR AREAS. THE VERY BEST PHYSICIANS IN THE CARDIOLOGICAL, INTERNAL-ONCOLOGICAL, MUSCULOSKELETAL AND PNEUMOLOGICAL FIELDS.

SPECIALISTS IN VARIOUS AREAS WORK HAND IN HAND AND USE ULTRAMODERN TECHNOLOGY.

Qualified, full-time specialists from the fields of internal medicine, cardiology, rheumatology, physical medicine and rehabilitation, pneumology and nephrology are on hand to provide comprehensive medical care for patients.

If necessary, consultants from the fields of psychiatry, radiology, oncology, endocrinology, urology and dermatology are called in. The medical-technical infrastructure boasts the high standards of a modern rehabilitation clinic.

People who have had surgery or a severe cardiovascular disease cannot accurately judge their physical strength and level of fitness. Cardiovascular rehabilitation increases patients’ stamina in a controlled environment, which in turn boosts their confidence. This is particularly true for patients with several existing illnesses that require interdisciplinary medical care.

Rehabilitation is an important part of the healthcare system that can be carried out in inpatient and outpatient settings. Yet rehabilitation measures are very different from the medical care typically provided in hospitals or by family doctors.

Muscle development training in inpatient and outpatient rehabilitation
Cardiovascular rehabilitation focuses on improving the patient’s prognosis. In other words, it aims to help the patient live a longer life and enjoy the best possible quality of life. Cardiovascular patients are treated using medication while they are in hospital. This should be followed by targeted cardiovascular training to rebuild the patient’s strength and stamina. Training takes place in either an inpatient or outpatient setting. Cardiologists precisely define which exercises should be completed, as well as the rate at which the intensity should be gradually increased.

An essential part of rehab: controlled increases in exercise intensity
Specially qualified physiotherapists and sports therapists help patients complete training sessions using modern gym equipment, which are designed to build up their stamina. The training programme for inpatient rehabilitation also includes individual or group therapies, often featuring cardio-specific stretching exercises, carefully controlled strength exercises and endurance training. Patients also complete physiotherapy exercises and receive psychological support if required.

Supplementary courses for long-term recovery
Seminars about illness-related topics such as quitting smoking, nutrition and stress management can be incorporated into the recovery process during inpatient and outpatient rehabilitation. Patients are taught how to deal calmly with stressful situations in everyday life. These seminars are complemented by lectures and discussions that further familiarise patients with ways to implement lifestyle changes and embrace exercise.

 

An overview of the three types of rehabilitation:

Early rehabilitation
Early rehabilitation is specially tailored to the particular needs of patients who are severely impaired by illness and not yet medically stable, which means they require more intensive monitoring and medical care. The therapeutic measures are adjusted to suit the patient’s limited physical strength and fitness level and are often carried out in private sessions in the patient’s room. In general, intensive early rehabilitation is followed by an inpatient rehabilitation programme that builds on the prior training and is adapted to suit the patient’s individual abilities.

Outpatient rehabilitation
An operation or severe heart disease inevitably leads to feelings of uncertainty. This in turn often causes patients to be overly cautious in relation to movement and exercise, which is the opposite of what they should be doing. It is essential for the heart muscle to be strengthened through a series of strictly controlled exercises. Outpatient rehabilitation is an ideal way to achieve this and it also enables patients to continue living at home instead of staying at a clinic. Outpatient services also include individual consultations and courses about how to quit smoking or change your eating habits. Outpatient rehabilitation is a viable option if the disease or functional disorder is less severe, or if the patient has already completed an inpatient rehabilitation programme.

Inpatient rehabilitation
Inpatient rehabilitation is recommended for patients who have suffered a heart attack, had an operation on their heart or major blood vessels, or if they have multiple risk factors and so on. The criteria for inpatient rehabilitation include the severity of the disease or functional disorder, the required intensity of the therapy and the degree of medical care and support required by the patient. Inpatient rehabilitation also reduces patients’ exposure to factors that could cause stress and the rehabilitation clinic’s pleasant atmosphere, hotel-style services and catering further aids the recovery process.

Diseases affecting the musculoskeletal system often also involve pain and limited mobility. Consequently, the main aims of musculoskeletal rehabilitation are to alleviate pain and restore the patient’s original level of mobility and quality of life.

As people get older, their bones, joints, spine and soft tissue become increasingly worn and damaged. Given that internal diseases such as diabetes and heart problems also increase with age, musculoskeletal rehabilitation often involves the treatment of multiple ailments. If several clinical pictures emerge at the same time, or if a person has undergone major musculoskeletal surgery, surgeons and attending doctors usually recommend an inpatient rehabilitation programme. However, if it is not necessary for the patient to stay at the hospital or clinic, they may be prescribed outpatient rehabilitation in the form of physiotherapy. This is often the case with acute, inflammatory and degenerative diseases if the patient is sufficiently mobile and independent.

Multiple therapeutic aims
Patients arrive in rehab with a diagnosis from their surgeon, specialist or family doctor, which is often accompanied by a list of therapeutic requirements. A comprehensive health assessment is conducted at the very beginning of the programme. Doctors, nurses, physiotherapists, occupational therapists and nutritional therapists consult with the patient and carry out examinations to determine their existing health problems. Based on these results, the team creates an individual therapeutic plan and prescribes an appropriate amount of pain relieving medication. They also determine whether the patient requires any medical aids, orthopaedic equipment, social services or psychological support.

Increased strength and stamina
In addition to measures for alleviating pain, musculoskeletal rehabilitation typically focuses on physiotherapy and occupational therapy. Patients who recently underwent surgery also receive the necessary nursing care. Every day patients undergo several active and/or passive treatments, individually or as part of a group. Elderly patients in particular are advised to switch to a protein-rich diet, as this supports muscle development. All the specialists involved in the rehab programme encourage patients to be as active as possible, because this increases their confidence in their own physical abilities.

 

An overview of the three types of rehabilitation:

Outpatient rehabilitation
People who are still largely able to live independently can complete their rehabilitation as outpatients. Outpatient programmes focus on active therapies such as physiotherapy, occupational therapy and medical training therapy. If these measures do not generate sufficient success, inpatient musculoskeletal rehabilitation provides another option for achieving the desired results.

Inpatient rehabilitation
Inpatient rehabilitation is advisable if pain or limited independence make outpatient care impossible. This type of rehab involves active forms of therapy such as physiotherapy, occupational therapy and medical training therapy, as well as medical care and support. Before the patient is discharged, the necessary follow-up care is discussed with their family or a home care provider, as is the possibility of extending the treatment in an outpatient setting. If necessary, issues related to social services will also be clarified. The patient’s family doctor and/or attending specialist receive a comprehensive final report.

Interdisciplinary outpatient rehabilitation
Interdisciplinary outpatient rehabilitation is based on the services provided during inpatient rehabilitation, however the patient stays at home rather than at the hospital. For this type of musculoskeletal rehabilitation, health insurance companies will only cover the costs if there is a reasonable expectation that the patient’s condition will improve.

After a fight with cancer, everything is different. That is why oncological rehabilitation involves a variety of interdisciplinary measures that enable patients to regain as much of their independence as possible, despite their disease and the debilitating cancer therapies.

The attending surgeon or oncologist will consider ordering rehabilitation if a patient has severe functional limitations and/or strong reactions to chemotherapy or radiotherapy. Inpatient rehabilitation may also be prescribed if a patient is malnourished, or if they cannot be provided with sufficient medical care at home. If a patient is being fed artificially, has a newly created stoma, a wound healing disorder or drainage tubes for removing wound secretion, these are all additional reasons for opting for inpatient rehabilitation.

Interdisciplinary expertise
While patients are undergoing rehab, regular discussions and examinations are carried out to monitor their physical and psychological situation. A team of medical specialists and consultants, psychiatrists, psychologists and specialised nurses will identify any changes and implement the necessary measures. Beyond this, a wide range of therapies – from exercise and nutrition therapy to art, music and occupational therapy – are also used to boost the patient’s well-being and ensure the best possible recovery. An appropriate atmosphere, hotel-style services and excellent catering also support patient well-being during the rehabilitation process.

Patient discharge organised well in advance
Oncological rehabilitation clinics organise each patient’s departure well in advance and in consultation with the patient’s family. Medical professionals determine what kind of resources the family has to provide care at home and what resources are available from external oncological care providers. They also arrange check-up appointments with the surgeon and oncologist. Recommendations regarding nutrition and exercise are discussed with the patients before they leave the clinic and they are also given information to take home.

 

An overview of the three types of rehabilitation:

Post-operative oncological rehabilitation
After a patient has had a tumour surgically removed, the surgeon meets with them to discuss the possibility of inpatient rehabilitation. An inpatient stay is mainly necessary if the patient has to be fed via a tube or has a recently created stoma. However, inpatient rehabilitation may also be required if drainage tubes are still being used to remove wound secretion or the patient’s wounds are not healing properly.

The rehab programme focuses primarily on functional disorders affecting the body, but also takes into consideration psychological changes and mental anguish. Depending on the infrastructure and the medical and nursing expertise available at the rehabilitation clinic, patients can be transferred to rehab at a very early stage in their recovery process.

General oncological rehabilitation
Cancer and chemotherapy and/or radiotherapy treatments often have a profound physical, psychological and social impact. Oncological rehab can address these issues before they start or develop further. Targeted oncological rehabilitation can take place any time after a patient has been diagnosed with cancer. It is prescribed by the attending oncologist in consultation with the patient. The aim is to improve the patient’s quality of life and make it easier for them to re-integrate into everyday life and return to work.

Outpatient oncological rehabilitation
In Switzerland there are more than 317,000 people living with cancer. 60,000 were diagnosed between two and five years ago. These people still require follow-up care and check-ups. Outpatient rehabilitation can be used to provide these services, as long as the patient no longer needs to be in hospital or in care, yet still requires the assistance of a variety of medical specialists.

After spending time in hospital for treatment or surgery, patients with acute or chronic lung disease usually have pulmonary rehabilitation. This part of their treatment is important for improving their physical fitness and quality of life. Rehabilitation helps patients maintain their ability to independently carry out everyday tasks and stay socially active and, if applicable, return to work.

Patients with chronic lung diseases are particularly prone to infections and are at a greater risk of becoming less active and physically impaired. Therefore, they can benefit greatly from targeted pulmonary training that is designed to increase fitness and stamina. This particularly true in relation to the following lung diseases: chronic obstructive pulmonary disease (COPD), pulmonary emphysema, asthma, pulmonary fibrosis and pulmonary hypertension, as well as severe lung infections or lung operations.

Personalised treatment increases quality of life
The treatment concept behind pulmonary rehabilitation typically involves personalised individual and group therapies. These are provided by physiotherapists and are carried out under close medical supervision. Breathing therapies help to increase patients’ lung capacity, improve their breathing technique and strengthen their respiratory muscles. Other therapy sessions include instructions on how to effectively clear phlegm from the lungs and how to adopt positions that make it easier to breath. This is accompanied by gait training, callisthenics, exercise machines (e.g. cycling or rowing) and medical training therapy on selected devices to promote the development of strength and cardiovascular fitness.

Training can be aided by the use of inhalation treatments such as the administration of oxygen. Manual therapies, massage and heat treatments can also provide pain relief and help patients relax. The patients are actively involved in the creation of their personalised treatment plans. This collaborative process helps patients learn what actions they can take to aid their recovery or better manage their disease.

Complementary treatments
Pulmonary rehabilitation is designed to activate and promote each patient’s individual capabilities, so that they can regain maximum independence and be as active as possible in their everyday lives. Consultations and seminars provide patients with important information about their disease and teach them how to use inhalation and breathing therapy devices. Patients also learn how to continue their rehabilitation exercises at home.

Patients suffering from lung disease also receive nutritional advice, as their condition means they often have increased energy requirements. To reduce their exposure to pulmonary risk factors, patients may also receive advice on how to quit smoking and possibly also medication to help them quit.

The chronic impairment caused by lung disease often places significant stress on a person’s everyday life. For this reason, patients are also given access to psychiatric support, psychological counselling and pastoral care.

Depending on the patient’s age, it may also be necessary to re-evaluate their employment options. This is where social counselling can help: counsellors can help patients to clarify what kind of individual support they need in order to rejoin the workforce.

 

An overview of the two types of rehabilitation:

Outpatient pulmonary rehabilitation
Outpatient pulmonary rehabilitation is designed for patients who would like to continue carrying out targeted lung training exercises after their stay in hospital or at a rehabilitation clinic. Patients can only do outpatient rehabilitation if they are sufficiently fit and there is an easily accessible, specialised rehabilitation clinic near where they live.

This form of rehabilitation typically starts with a medical assessment. Once accepted into an outpatient programme, patients usually have two therapeutic sessions per week. The sessions are designed to continue improving their breathing technique and level of fitness, so that they can manage their everyday lives as independently as possible. All of these measures help to improve the patient’s quality of life.

Inpatient pulmonary rehabilitation
Inpatient pulmonary rehabilitation is primarily recommended for patients who continue to be significantly impaired by their disease after they have left hospital. In addition to medical supervision by a doctor, the patients have daily physiotherapy and ergotherapy sessions that are tailored to their limited fitness and strength levels.

They also receive extensive training regarding the use of inhalation devices and other aids, as well as how best to manage their disease. The training sessions also include information about how to quit smoking and avoid infections. The patients are encouraged to integrate what they have learned into their everyday routines. On request, their family can also be informed about the treatment process and actively involved. The aim of an inpatient stay at a rehabilitation clinic is to enable the patient to breathe freely and resume their normal lives to the greatest extent possible.

More about Medical expertise

IHR KONTAKT

Portrait von Klinik Schloss Mammern
Dr. med. Annemarie Fleisch Marx

Chief Physician
FMH Specialist for Internal Medicine, Rheumatology, Physical Medicine and Rehabilitation

IHR KONTAKT

Portrait von Klinik Schloss Mammern
Dr. med. Ruth Fleisch-Silvestri

Chief Physician
FMH Specialist for Internal Medicine and Psychosocial Medicine SAPPM