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Surgery for tetraplegic hands: Surgical techniques aimed at improving the function of tetraplegic patients’ hands. |
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Surgery for spasticity/neuro-orthopaedics: Spasticity involves a series of complications (articular limitations, hip dislocations, deviations in body alignment, etc.) unresponsive to conservative treatments. However, accurate surgery carried out by experts does have good results. |
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Intrathecal baclofen infusion by an implantable pump: A technique used at Institut Guttmann since 1987 to treat severe spasticity. |
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The use of botulinum toxin to treat focal spasticity: Intramuscular treatment with botulinum toxin for functional improvements, easier patient’s daily care, pain treatment, better orthesis feel, etc. |
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Intensive walking rehabilitation therapy: Intensive physical and functional training using electro-mechanical systems and partial suspension of body weight. Institut Guttmann has innovative technological systems such as Gait-Training ® or Lokomat®, the most modern in the world. They strengthen muscles around the injury, train patients to stand and re-educate them to walk. These techniques are used for patients with spinal injury, acquired brain injury or other disabling neurological diseases. |
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Comprehensive treatment of neuropathic bladder: Evaluation, diagnosis and specialized medical and surgical treatment of urinary complications resulting from a spinal injury or other pathologies having neurological effects on the urogenital system. |
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Use of neurostimulation/neuromodulation techniques to treat urinary incontinence: Sacral Anterior Root Stimulation (SARS), developed by Dr. Brindley from Great Britain, has been used at Institut Guttmann since 1990. This technique implants an electrostimulator at the sacral roots. It helps some patients with spinal injury to properly toilet, to improve neuropathic bowel function and, in men, to keep erection. |
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Functional electrical stimulation: This programme began in 1991 for easier standing and walking using external electrical stimulators. The system can be used on a specific kind of spinal injury or other diseases. |
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Postpolio syndrome: Comprehensive care for patients with consequences of poliomyelitis, whether they have this syndrome or not. It includes evaluation, monitoring and treating both postpolio syndrome and complications derived from years of disability, in particular, musculoskeletal disabilities common in these patients. |
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The study and treatment of dysphagia: The aim is to evaluate, diagnose and treat deglutition disorders from a neurological disorder affecting the function of anatomical and physiological structures involved in swallowing. The use of a fluoroscope allows for an accurate diagnosis of the deglutition disorder and for therapeutic assessment assuring successful dysphagia rehabilitation. |
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Functional evaluation and treatment of neurogenic bowel: Bowel disorders caused by a spinal injury or other pathologies are evaluated, diagnosed and treated using specific diagnostic techniques such as anorectal manometry, bowel training and comforting procedures for the incontinent, soiling and persistently constipated patient, etc. |
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Chronic neuropathic pain medicine: Chronic pain is evaluated, treated and monitored using an interdisciplinary model including rehabilitation and drug treatment. In addition, invasive techniques are used for acute neuropathic pain. This treatment also deals with psychological aspects, both individually and group-wide, to learn how to better deal with symptoms and to improve quality of life. |
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Comprehensive rehabilitation for children at out-of-school time: This offers comprehensive and specialized rehabilitation for children with a significant physical neurological disability (head injuries, infantile cerebral palsy, traumatic spinal injury, myelomeningocele, progressive diseases, etc.) to achieve their highest possible level of independence, depending on their neurological lesion. Rehabilitation is given at a time fitting children’s schooling so that they can make the most of their schooling. This also eases their mainstreaming and promotes their successful community reintegration. |
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Specialized care for pressure ulcers: Pressure ulcers - or sores - are one of the most standard complications after spinal injury. This programme includes prevention, risk evaluation, and conservative treatment or repair by reconstructive surgery when suitable. Surgery is given by experts in a very conservative way for an open therapeutic window in case of an eventual relapse. |
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Caring for disabled people’s sexuality: Counselling on and rehabilitating from sexual dysfunctions from a neurological disability such as erectile dysfunction, libido disorders, orgasm disorder, etc. This includes marital counselling and therapy when necessary. |
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Assisted reproduction: Treatment for anejaculation, sperm collection by vibrostimulation and/or electroejaculation. Sperm bank and assisted reproduction techniques. |
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Gynecological care for women with a neurological disorder: Prevention and treatment of gynaecological disorders, family planning, pregnancy and birth monitoring. |
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Rehabilitation of higher functions: Aimed at optimizing recovery of the higher functions affected by acquired brain damage. In addition, rehabilitation provides alternative strategies to compensate for cognitive (memory, attention, perception, language, etc.) and behavioural consequences (emotional lability and behaviour disorders, executive functions, etc.) and to improve these people’s functional independence and quality of life as much as possible. Rehabilitation of higher functions also includes neuropsychological treatment and family support and counselling. |
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Evaluation and treatment of communication pathologies: Communication disorders are very frequent after brain damage and may involve language or speech. Such cases take a complete evaluation and a diagnostic assessment for customized treatment programmes, using the most suitable systems for functional communication. This treatment includes re-education techniques, alternative methods and strategies for communication promotion. |
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Transcranial magnetic stimulation: This innovative technique involves the study and modulation of cortical excitability to guide plasticity. It has been proven efficient in various pathological speech and pain processes, and in drug-unresponsive, persistent depression. |
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Psychological counselling and treatment: Evaluating, counselling on and dealing with psychological aspects related to facing and adapting to a disease or disability in its initial phases and to any eventual complications. It includes post-traumatic stress disorders prevention and treatment, relaxation techniques for anxiety control, individual and/or family therapy and treatment of other adaptation or psycho-pathological disorders that affect well-being and quality of life. |
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Comprehensive care of people with neurodegenerative diseases: Evaluating, treating and periodic monitoring of people affected by these diseases, prevention and treatment of complications, neuropsychological care and monitoring. |
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Personal independence and environment control: Using computers and learning to use other technical aids and orthopaedic devices for maximum independence and quality of life possible for people with a severe disability. |
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Periodic comprehensive evaluation: This is an evaluation which all people with a spinal injury, severe acquired brain injury or any other severe neurological disability should take. It allows for early detection of diseases that, due to the characteristics of the neurological injury, may otherwise pass unnoticed until advanced phases. Advanced phases of disease could involve long hospital treatments and even risk the patient's life. Therefore, this is a preventive measure aimed at reducing the incidence of complications in people with spinal injury and/or acute brain injury. At the same time, its goal is to give them the highest possible level of independence and to improve their quality of life and community reintegration. Evaluation includes medical, functional, psychological/neuropsychological and social aspects and those related to health education and risk prevention. It takes one morning. |
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Specialized neurorehabilitation evaluation: This is a multidisciplinary evaluation of patients with a severe physical neurological disability in a sub-acute or chronic phase. This means that patients have undergone medical rehabilitation in another hospital during the acute phase of the process and, for various reasons, ask for an expert’s second opinion at Institut Guttmann. This second opinion involves functional evaluation and consequences forecast. The study includes:
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An accurate physical and neurological examination to determine deficiencies (physical and neuropsychological - cognitive, behaviour and language or speech disorders) and possible complications. |
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A functional evaluation to determine secondary disabilities. |
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A psychological examination to detect inborn disorders or possible dysfunctions interfering with mainstreaming or carrying the risk of getting ill. |
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A social study to try to establish the disadvantages caused by physical, intellectual and behavioural consequences. |
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Complementary examinations (blood and urine tests, X-rays, urinary examinations, etc.). |
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This evaluation requires five days of hospitalization. It enables doctors to evaluate which aspects may benefit from treatment, to rule out complications and to counsel the patient and his/her family on future needs, as well as to train them in the use of preventive measures to avoid the most standard complications. |
