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PubMedDate not supplied

Psychological assessment during cardiac rehabilitation.

BACKGROUND: Depression and anxiety are common after myocardial infarction (MI) and cardiac surgery and may adversely affect outcome. A comprehensive cardiac rehabilitation service needs to include psychological input as well as education and exercise training. To address this issue the Bromley Hospitals NHS Trust (BHT) cardiac rehabilitation nursing team introduced the Hospital Anxiety and Depression Scale (HADS) into its cardiac rehabilitation service. Over a 21-week period, 130 patients attending a cardiac rehabilitation nursing assessment completed a HADS. CONCLUSION: Audit of the HADS scores revealed that post-MI patients waiting longer than six months for cardiac rehabilitation had the highest levels of 'significant' anxiety (HADS score >10). Results suggest that timely entry into a cardiac rehabilitation programme helps to reduce the HADS scores of post-MI patients. The HADS was shown to be an effective tool for assessing the psychological wellbeing of patients attending cardiac rehabilitation. It enables those with significant anxiety and/or depression to be identified and offered further assessment by a cognitive behavioural therapist.

Anxiety Disorders↗
PubMedDate not supplied

The effects of daily pulmonary rehabilitation program at home on childhood asthma.

OBJECTIVE: the aim of this study is to investigate the efficacy of pulmonary rehabilitation program in children with asthma. PATIENTS AND METHOD: twenty eight children with mild persistent or moderate asthma were included into a double blind, randomised study. Sixteen children (9 girls, 7 boys) with the mean age of 10.8 +/- 2.3 were assigned to receive pulmonary rehabilitation program with their parents for 30 days (group I). Control group included 12 children (6 girls, 6 boys ) with the mean age of 10.2 +/- 2.4 (group II). Symptom and medication scores quality of life index and pulmonary function tests were evaluated in rehabilitation and control group in the beginning of the study and after the one month period. RESULTS: the groups did not differ on all parameters before the study (p > 0. 05). Statistically significant decrease were found in symptom and medication scores in rehabilitation group (p < 0.05) and quality of life index was increased significantly in the same group (p < 0.05). Pulmonary function measures also significantly improved including vital capacity, forced vital capacity, FEV1, PEF and FEF25-75 in the rehabilitation group (p < 0.05). The best improvement were seen in FEF25-75 (10.09% increase) and PEF (7.81% increase) values. In control group no statistically significant differences were found in all parameters. CONCLUSION: in this study it was shown that daily pulmonary rehabilitation at home could improve quality of life and pulmonary functions. So pulmonary rehabilitation should be placed as a component of management in childhood asthma.

Anti-Asthmatic Agents↗
PubMed2000

[Cognitive prerequisites of geriatric rehabilitation].

Rehabilitation aims at the restoration of maximal independence and autonomy after functional loss due to illness or accident. In old age losses of independence in daily life and autonomy are accounted for up to 60% by personal deficits in cognitive abilities. Functional losses in cognitive abilities represent a higher risk of having an accident or becoming ill. Cognitive performance proves to be predictive for success of rehabilitation, independent of functional state. Using the example of a fracture of the femur it can be shown that sensory and cognitive deficits increase the risk of accidents and that executive abilities co-influence long-term results. Strokes are more frequent if cognitive deficits have existed before and the resulting damages are stronger. Long-term results generally depend on complex abilities like everyday competence, reasoning and memory. Experiences with patients with dementia undergoing a memory training show that learning strategies are rarely generalized. Therefore in rehabilitation specific disorders, as for example cortical or subcortical patterns, have to be treated by different rehabilitation methods in the sense of differential rehabilitation. For this an early neuro-psychological assessment of the geriatric rehabilitation patient is needed. The cognitive-psychological findings only scarcely and insufficiently enter diagnostics and therapy. The diverse cognitive disorders have to be taken in account more frequently in education and differential rehabilitation methods have to be developed for geriatric patients with cognitive deficits.

Activities of Daily Living↗
PubMed2000

Outcome analysis of individualized vestibular rehabilitation protocols.

OBJECTIVE: To determine the outcome of vestibular rehabilitation protocols in subjects with peripheral vestibular disorders compared with normal and abnormal control subjects. STUDY DESIGN: Prospective study using repeated measure, matched control design. Subjects were solicited consecutively according to these criteria: vestibular disorder subjects who had abnormal results of computerized dynamic posturography (CDP) sensory organization tests (SOTs) 5 and 6 and underwent rehabilitation; vestibular disorder subjects who had abnormal results of SOTs 5 and 6 and did not undergo rehabilitation; and normal subjects (normal SOTs). SETTING: Tertiary neurotology clinic. SUBJECTS: Men and women over age 18 with chronic vestibular disorders and chief complaints of unsteadiness, imbalance, and/or motion intolerance, and normal subjects. INTERVENTIONS: Pre- and post-rehabilitation assessment included CDP, vestibular disability, and activities of daily living questionnaires. Individualized rehabilitation plans were designed and implemented to address the subject's specific complaints and functional deficits. Supervised sessions were held at weekly intervals, and self-administered programs were devised for daily home use. MAIN OUTCOME MEASURES: CDP composite and SOT scores, number of falls on CDP, and self-assessment questionnaire results. RESULTS: Subjects who underwent rehabilitation (Group A) showed statistically significant improvements in SOTs, overall composite score, and reduction in falls compared with abnormal (Group B) control groups. Group A's performances after rehabilitation were not significantly different from those of normal subjects (Group C) in SOTs 3 through 6, and close to normal on SOTs 1 and 2. Subjects in Group A also reported statistically significant symptomatic improvement. CONCLUSIONS: Outcome measures of vestibular protocol physical therapy confirmed objective and subjective improvement in subjects with chronic peripheral vestibular disorders. These findings support results reported by other investigators.

Activities of Daily Living↗
PubMed2001

[Early results of an ambulatory rehabilitation program for medically treated Leriche grade II arterial disease of the lower limb].

OBJECTIVE: We assess the impact of an ambulatory rehabilitation program in patients with Leriche grade II arterial disease. PATIENT AND METHODS: One hundred nineteen patients with Leriche grade II arterial disease of the lower limbs treated medically were included in a totally ambulatory specifically designed vascular rehabilitation program. There were 91 men and 28 women, mean age 64 years. All the patients participated in a two-phase rehabilitation program with clinical and hemodynamic surveillance for 20 weeks. The first phase involved progressive rehabilitation for 8 weeks followed by a maintenance program for 12 weeks. Performance was assessed with the maximum analytic test (MAT) that reproduced the indicated rehabilitation movement to onset of cramps and with walking distance on flat ground under standard conditions using a treadmill. RESULTS: All patients completed the entire program and non required surgical revascularization. Systolic pressure index at the ankle remained stable at 0.62 for the 20 weeks. At 8 weeks, the patients had improved their baseline MAT 2.22-fold and their walking distance by 1.87-fold. At 20 weeks, these factors were 2.74 for MAT and 2.49 for walking distance. Ninety-one percent of the patients evaluated their baseline walking distance at less than 500 m (mean 210.3 m). At the end of the rehabilitation program, 44% considered their walking distance was between 500 and 1 000 meters. The presence of associated diseases did not hinder implementation of the program. DISCUSSION: Studies evaluating the effect of 6-month regimens of vasoactive agents have generally reported a 1.50-fold improvement. Our outpatient rehabilitation program using treadmill exercises appeared to be more effective, less costly, less demanding for the patients and applicable to a larger number of patients.

Arterial Occlusive Diseases↗
PubMed1975

[Rehabilitation of patients with acute uncomplicated myocardial infarct according to 3 1/2-week program].

The study was conducted in 220 patients with uncomplicated localized primary myocardial infarction, aged 30 to 65 years, rehabilitated according to the 3 1/2-week programme. The control group was composed of 110 patients rehabilitated according to the 5-week programme. At the hospital stage of rehabilitation it has been established that the contractile activity of the myocardium is the same in both groups of patients and is characterized by hypodynamia. On this basis it was concluded that further physical rehabilitation of these patients should be conducted at a moderate pace with an obligatory control of exercise tolerance. The dynamic observation 1--2 years after myocardial infarction has demonstrated that the physical capacity for work is higher among the patients rehabilitated according to the 3 1/2-week programme, than among the control group patients. The 3 1/2-week rehabilitation does not increase the number of complications, either in the acute period of the disease, or 1--2 years after it. This permits to recommend the 3 1/2-week rehabilitation programme for the patients with acute uncomplicated primary infarction.

Adult↗
PubMed2001

Proprietary rehabilitation: Challenges and opportunities in the new millennium.

Proprietary rehabilitation has developed into a distinct professional sector with procedures, practices, and philosophy that differ from those in the public rehabilitation program. As the new millennium commences, proprietary rehabilitation will face a variety of challenges and opportunities that could affect the future of this sector of the rehabilitation profession. Among these issues are changes in occupational information upon which many proprietary rehabilitation practices are based; increased opportunities for early intervention and establishment of disability management programs within industry; adjustment to the movement to a managed health care system; and the necessity to demonstrate fiscal efficacy of rehabilitation services to workers with compensable injuries. This article discusses these issues and suggests some ways in which those involved in proprietary rehabilitation can properly position themselves to address and benefit from these challenges and opportunities.

Journal Article↗
PubMedDate not supplied

[Results of long-term rehabilitation in the treatment of patellofemoral syndrome: retrospective study about 63 patients].

INTRODUCTION: Rehabilitation plays a primordial role in the treatment of the patellofemoral syndrome. We wanted to seek in a sample of population suffering from this problem, the factors favoring the occurrence of this syndrome, the rehabilitation result and the continuation of exercises. PATIENTS AND METHODS: Prospective descriptive study on the rehabilitated patients in a questionnaire form divided in two parts. The first one seeks the information of the patient's file: demographical, social and professional data, risk factors, clinical assessment and imaging, medical treatment, immediate rehabilitation results. The second part seeks the long-term effect of rehabilitation, the perseverance to exercises and the resumption of professional and sports activities. RESULTS: 78 patients, feminine prevalence 59%; average age: 32.7 years (between 12 and 60 years). Occurrence favoring factors found: intensive sports 47.4%, profession presenting a risk 14%, traumatism 24.5%, hypermobility 30,7%. ETIOLOGY: patellar instability 18/78, dysplasia 2, chondromalacia 14, femoropatellar osteoarthritis 4, non-marked 40. Previous treatment AINS: 45%, efficient in third of cases ; previous physical therapy 9/78 (50% failure). The evaluated results of short-term rehabilitation according to Ficat criteria, regardless of etiology, were satisfying (good or very good) in 77% of cases. Very good: 20.5 %; good: 56.5%; acceptable: 19.2% and bad 3.8%. At long term on 63 patients with an average recession of 18 months (6 months to 3 years) we had very good results: 22.2 %, good: 55.5%, acceptable 20.6% and bad 1.7%. Average duration of carry on of exercises: 4 months. CONCLUSION: The functional rehabilitation has confirmed its efficiency in the treatment of young patients suffering from patellofemoral syndrome. The education, the life hygiene, the preparation to sports as well as carry on of exercises prevent recurrences.

Adolescent↗
PubMed2004

[Is it possible to improve social functioning of schizophrenia with cognitive rehabilitation?].

Social dysfunction of schizophrenia is observed in many domains including social skills, ability to conduct tasks, attention/durability, volition/motivation, stability of social life, and insight of dysfunction. These dysfunctions have been found to relate to non-social cognitive functioning to some extent. Social skills may have a strong relationship with social cognition. The intervention technique of cognitive functioning of schizophrenia, known as cognitive rehabilitation or cognitive remediation, has its main target as non-social cognition. Cognitive behavior therapy focuses on the contents of the cognitive process, while cognitive rehabilitation focuses on the cognitive process (information process) or thinking skills. Which cognitive functioning should be targeted was revealed as were theoretical models of cognitive rehabilitation, and various intervention techniques and their usefulness. It has been found that some elements of cognitive functioning, such as executive functioning, could be improved in experimental settings in efficacy studies. However, comprehensive rehabilitation including cognitive rehabilitation should be used in order to relieve social dysfunctioning or psychiatric symptoms. Some experts insisted that an individualized program with several steps, along with cognitive abilities, is required to enhance usefulness and effectiveness. Other experts said more complex cognitive functioning profoundly associated with social life should be targeted, rather than elementary cognitive functioning. The conclusions of meta-analyses of randomized controlled trails were not consistent until now, because inclusion criteria of meta-analysis was different. Finally, it was discussed how the theory and techniques of cognitive rehabilitation should be implemented in traditional rehabilitation.

Cognition↗
PubMed2005

Relationship between tunnel widening and different rehabilitation procedures after anterior cruciate ligament reconstruction with quadrupled hamstring tendons.

BACKGROUND: It has been demonstrated that bone tunnel widening could appear after knee anterior cruciate ligament (ACL) reconstruction, especially for those patients whose ruptured ACL were reconstructed with semitendinosus and gracilis tendons. Many factors can influence the extent of tunnel widening. Few studies have investigated the relationship between bone tunnel widening and rehabilitation procedures. This research was carried out to find the rehabilitation procedures' influence on the tibial bone tunnel widening after ACL reconstruction. METHODS: Sixty-five cases, whose ACL reconstructions were done using quadrupled semitendinosus and gracilis tendons, were divided into two groups. Group A had 33 cases, 19 men, 14 women, averaged (31.2 +/- 12.4) years old, only ACL reconstruction was done using Paessler's technique, and aggressive rehabilitation procedure was used for function recovery post operation. Group B had 32 cases, 20 men, 12 women, averaged (30.3 +/- 10.3) years old. Except for ACL reconstruction, every patient in group B accepted meniscus repair using re-fixation methods or cartilage repair using microfracture technique, conservative rehabilitation procedure was used post operation. Six months post operation, standard posterior-anterior radiographic plates were taken for each case, CorelDRAW 8.0 software was used to digitize all X-ray plates and measure the upper, middle and lower parts of the tibial tunnel. Magnification effect of X-ray plates was taken out after measurement. RESULTS: Six months after ACL reconstruction the tibial tunnel widening of the upper, middle and lower parts on both the posterior-anterior and lateral X-ray plates in Group A with aggressive rehabilitation procedure was much more serious than in Group B with conservative rehabilitation. KT-1000 knee stability measurement and clinical manifestation showed no difference between the two groups. CONCLUSIONS: Rehabilitation procedure after ACL reconstruction is one of the reasons for tunnel widening. It not only can directly influence the function recovery of ACL reconstructed knee, but also perhaps indirectly influence the function recovery and long-term clinical result of the operated knee by influencing the tunnel widening.

Adult↗
PubMed2004

Functional rehabilitation of low back disorders.

Musculoskeletal disorders of which low back pain (LBP) accounts for more than 50% are now the most common cause of chronic incapacity in industrialized countries. The traditional approach in looking for the reason (etiology) for musculoskeletal disorders is to search structural failures but, in most cases, it is difficult to find an explicit reason for back pain. Many scientists now consider spine disorders as multifactorial, bio-psycho-social problems. Pain has clear effects on motor control. Therefore, LBP can also induce changes in neuromuscular control and motor performance, i.e., causing various functional deficits. Another feature, which deserves special consideration with reference to back problems, concerns the numerous psychological factors, which are involved in mediating the relationships between physical impairment, pain and disability. The new scientific knowledge on functional deficits is increasingly being transferred to clinical applications, where the aim is to reverse them with physical rehabilitation. As a result of the recognition of the behavioral (psychological) problems with LBP, psychological, behavioral and educational interventions are commonly combined with the physical rehabilitation for LBP also. Basically, functional rehabilitation includes systematic quantification of both the physical function and psychological factors, which drive the therapeutic process. The exercises used in the functional rehabilitation usually revolve around the treatment of the spine as a functional unit. Thus many programs for functional rehabilitation use rehabilitation equipment (iso-inertial/isokinetic) by properly trained physiotherapists. However, some centers use regular fitness equipment or aerobics-type exercises. Furthermore, some relaxation and ergonomic exercises are typically proposed, and psychological support provided along the treatment. There exists both an outpatient and an inpatient functional rehabilitation approach. They are described in the paper together with the first results obtained in Italy with the outpatient approach.

Journal Article↗
PubMed2004

Stroke rehabilitation pathways and procedures in Italy.

AIM: Rehabilitation pathways and procedures after first stroke vary widely. We wanted to determine in what ways first stroke rehabilitation in Italian rehabilitation centers are similar and in line with the Italian Ministry of Health guidelines and international reports. METHODS: Data from the study, Cerebral Ictus and Rehabilitation: Clinical Indicators and Outcomes, of the Italian Cooperative Research (ICR(2)), on 997 inpatients in 18 rehabilitation centers were analyzed and the rehabilitation procedures were compared. To do this, we compared the variables: onset admission interval, length of stay, intensity of treatment and discharge destination. Statistical analyses were performed using the Kruskal-Wallis test, the post hoc Mann-Whitney U test and the chi squared test. RESULTS: Major differences among the centers were found for onset of admission, length of stay, intensity of treatment and discharge destination, whereas the clinical characteristics and the functional outcomes of the study population were similar. CONCLUSIONS: Our results emphasize the importance of better integration between the acute treatment phase and the rehabilitation teams in reducing the onset admission interval of first acute stroke patients. To define optimal intensity of treatment and length of stay, randomized multicenter studies will be needed.

Journal Article↗
PubMed2005

Barriers to participation in a phase II cardiac rehabilitation programme.

OBJECTIVES: To identify barriers to participation in a phase II cardiac rehabilitation programme and measures that may enhance participation. DESIGN: Prospective study. SETTING: Regional hospital, Hong Kong. PATIENTS: Cardiac patients recruited for a phase I cardiac rehabilitation programme from July 2002 to January 2003. MAIN OUTCOME MEASURES: Reasons for not participating in a phase II cardiac rehabilitation programme. RESULTS: Of the 193 patients recruited for a phase I cardiac rehabilitation programme, 152 (79%) patients, with a mean age of 70.3 years (standard deviation, 11.9 years), did not proceed to phase II programme. Eleven (7%) deaths occurred before commencement of phase II and 74 (49%) patients were considered physically unfit. Reasons for the latter included fractures, pain, or degenerative changes in the lower limbs (24%), and co-morbidities such as cerebrovascular accident (19%), chronic renal failure (11%), congestive heart failure (9%), and unstable angina (8%). Phase II rehabilitation was postponed until after completion of scheduled cardiac interventions in 13% of patients. Failure of physicians to arrange the pre-phase II exercise stress test as per protocol was reported in 7% of patients. Other reasons were reported: work or time conflicts (16%), non-compliance with cardiac treatment (5%), financial constraints (4%), self-exercise (3%), fear after exercise stress testing (3%), and patients returning to their original cardiologists for treatment (3%). CONCLUSIONS: A significant (79%) proportion of patients did not proceed to a phase II cardiac rehabilitation programme for a variety of reasons. These included physical unfitness, work or time conflicts, and need to attend scheduled cardiac interventions. Further studies are required to determine how to overcome obstacles to cardiac rehabilitation.

Adult↗
PubMed1992

[Early rehabilitation of coma patients on the neurosurgical intensive care station. On the philosophy and practice of interdisciplinary cooperation].

The concept of early rehabilitation is an important task of humanity for neurosurgical intensive care patients emerging from coma. In Germany only little experience in this field has been reported, although the concept of early rehabilitation is well known in the other western European countries and the USA. In connection with the author's teaching activities at the pedagogical and psychological departments of the University of Oldenburg, an interdisciplinary concept of communicative "cooperative dialogues" was established for early rehabilitation, beginning in the earliest phases of coma at the neurosurgical intensive care unit. Although the results could not be evaluated statistically yet, the clinical course and outcome of emergence from primary or postoperative coma have improved rapidly by single patients, based on mobilization of neuronal plasticity and self-organized processes. Because of a significant lack of possibilities of early rehabilitation in the northwestern part of Germany, especially for young head injured adults, our efforts will continue. The philosophy and practice of early rehabilitation propose a new interpretation of neurosurgical patients emerging from coma, i.e. a dynamic process of a "second human creation". Early rehabilitation is an important task for the neurosurgically working doctor. Also for the neurosurgical profession the concept of early rehabilitation has to be integrated interdisciplinary to medical teaching at university level as soon as possible.

Activities of Daily Living↗
PubMed2005

[Does the method of treatment in patients with an acute myocardial infarction influence the results of an early cardiac rehabilitation?].

UNLABELLED: Does the method of treatment in patients with an acute myocardial infarction influence the results of an early cardiac rehabilitation? Post-myocardial infarction recovery depends on various complimentary factors. The aim of this study was to evaluate whether the type of reperfusion in an acute myocardial infarction (MI) - primary angioplasty (PCI) or fibrinolysis - influence the recovery period and the final result of an early cardiac rehabilitation. METHODS: Retrospective analysis of case histories of 60 patients undergoing reperfusion procedures for an acute myocardial infarction was performed 30 pts (mean age 56 (9) were treated with fibrinolysis (group I) and 30 pts (mean age 53 (7) with PCI (group II). All the patients underwent cardiac rehabilitation in postMI period according to Rudnicki's model A and B. ECG exercise test was performed before start of rehabilitation and at the end. RESULTS: In both groups a significant prolongation of exercise test duration (0.89 and 1.13 min, p<0.005) as well as an increase in exercise capacity (0.86 and 0.96 METS, p<0.005) were observed. Both exercise duration time as well as maximum workload achieved did not differ among two groups at the beginning and at the end of cardiac rehabilitation. Independently on the reperfusion strategy used no significant differences were noted between two groups in the setting of all studied parameters. CONCLUSIONS: Early cardiac stationary rehabilitation in postMI patients leads to a significant improvement in physical capacity expressed as an increase in exercise ECG test duration and workload achieved. The method of reperfusion, if successful, does not influence the final result of rehabilitation.

Adult↗
PubMed1993

Athletic trainers' attitudes and judgments of injured athletes' rehabilitation adherence.

Certified athletic trainers (ATCs) in District 2 (n=187) of the National Athletic Trainers' Association (NATA) were asked to complete a questionnaire that assessed the attitudes and judgments of ATCs concerning numerous factors presumed to influence sport injury rehabilitation. Gender and experience differences in ATCs' attitudes and judgments about rehabilitation adherence were examined. Successful and unsuccessful adherence strategies also were reported. The questionnaire consisted of 60 statements that were categorized into seven scales: athletic trainer's influence, environmental influences, athlete's personality, pain tolerance, selfmotivation, goals and incentives, and significant others. There were no significant differences for either gender or experience of ATCs on any of the seven scales. An analysis of questionnaire item responses revealed the following as factors ATCs deemed important to injury rehabilitation: a) good rapport and communication between the ATC and the injured athlete, b) explanation of the injury and rehabilitation regimen, c) convenience and accessibility of the rehabilitation facility, d) rehabilitation sessions planned around the athletes' busy schedules, e) athletes' beliefs that the program is worth pursuing, f) personal supervision and regular monitoring, g) need for injured athletes to see immediate results, and h) support from significant others. ATCs reported education, goal setting, encouragement, monitoring progress, and support systems as successful strategies. Threats and rehabilitation without monitoring were reported as unsuccessful strategies.

Journal Article↗
PubMedDate not supplied

Rehabilitation services in Papua New Guinea.

It is now accepted that in developing countries community-based rehabilitation (CBR) is the most effective way to meet the needs of the disabled. The proportion of the population of Papua New Guinea (PNG) having access to CBR is not known. The purpose of this project was to clarify the extent of rehabilitation services in PNG. It was hoped that by establishing the extent of services, communication and cooperation between them would increase, leading to more efficient and effective use of the limited resources (human and otherwise) available for rehabilitation in PNG. A questionnaire was sent to all known existing rehabilitation services, all provincial health departments, provincial hospitals and church health services. A 47% response rate was achieved. Results showed that most provinces have some form of rehabilitation available but rehabilitation is not spread equally throughout PNG. Most of the services are based in the urban centres and the rural population is badly served except in the Highlands Region and the Sepik provinces, which appear to be more comprehensively served by CBR. The services that do exist are hampered by lack of human and material resources and difficulty accessing clients due to transport difficulties. There needs to be a greater movement of rehabilitation into the community with government backing. The greatest effort is being made by Callan Services for Disabled Persons based in Wewak with its group of Special Education Resource Centres that also carry out CBR. CBR would appear to be an appropriate way to address the needs of the disabled PNG population, but in order to be successful it requires greater backing and more trained personnel.

Community Health Planning↗
PubMed1979

[Rehabilitation in oncology].

Successful rehabilitation can only be carried out by the precise teamwork of doctors, nurses and therapeutic personnel whereby, especially in cancer patients, importance of psycho-somatic aspects are emphasized. Under all circumstances, rehabilitation must immediately follow acute therapy. Especially, the rehabilitation of cancer patients convince them, that they are not lost. It is desirable that rehabilitation of cancer patients should increase, preferably in specialized oncology rehabilitation centers - similar to the cardiological or rheumatic rehabilitation centers. The main purpose of general rehabilitation in oncology should be the somatic and psychological revitalization of the patient under the motto: Don't merely prolong life, add worthwhile living for each life.

Acupuncture Therapy↗