EARLY REHABILITATION SIG REPORT IN ABU DHABI H. Binder K. Diserens D. Boering

MISSION STATEMENT Early rehabilitation should start immediately after acute neurological events: stroke, brain or spinal cord injury and acute inflammation or global hypoxia all of which often represent a „big bang“ for the patient and his/her relatives. It is an open question if curative neurology and rehabilitation should be performed in parallell, overlapping or in succession in this early phase. Early rehabilitation builds upon a competent working knowledge network at best linking applied neuroscience and pathophysiology, considering the impact of underlying precipitating acute neurologic events and interrelated functions of other organ systems. It demands therefore a broad medical knowledge and special skills from all professionals comprising an ideal early rehabilitation team.

AIMS 1.To promote an integrated approach to specific topics of early rehabilitation 2.To offer a networking and communication platform for special early rehab issues 3.To promote development of research and scientific meetings 4.To offer teaching courses in early rehab, from introductory to advanced, in order to foster best practice in early rehabilitation worldwide

1.PROMOTION OF INTEGRATED APPROACH The ER- SIG focuses on fundamental questions like: Promoting broad acceptance of starting early rehabilitation during ICU treatment Promoting broad acceptance of starting early rehabilitation during ICU treatment Defining clinical standards and interfaces to provide best practice ER Defining clinical standards and interfaces to provide best practice ER Define quality criteria (structure, processes, competencies) Define quality criteria (structure, processes, competencies) Define assessments for a thorough tracking of recovery Define assessments for a thorough tracking of recovery Provide adaption/evaluation of actual rehabilitation approaches to/in early rehabilitation (robotics, virtual reality) Provide adaption/evaluation of actual rehabilitation approaches to/in early rehabilitation (robotics, virtual reality) Consider infectiological aspects of early rehabilitation/management of multiresistant bacteria colonisation Consider infectiological aspects of early rehabilitation/management of multiresistant bacteria colonisation Refine knowledge on special aspects: DOC, TBI, stroke, CIP Refine knowledge on special aspects: DOC, TBI, stroke, CIP Liaise with colleagues in palliative care Liaise with colleagues in palliative care by implementing task forces/ editor boards to these issues  web

2. OFFERING A NETWORKING AND COMMUNICATION PLATFORM Networking within the WFNR: Early rehabilitation is the very early beginning of clinical work in any neurological patient; therefore it interferes and overlaps in content with ALL WFNR SIGs, which are kindly therefore asked to give us inputs. Especially Mild and severe BI SIG Mild and severe BI SIG Stroke rehab. SIG Stroke rehab. SIG Dysphagia SIG Dysphagia SIG Autonomic rehab. SIG Autonomic rehab. SIG Cognitive and neuropsychologic rehab SIGs Cognitive and neuropsychologic rehab SIGs Communication SIG Communication SIG Ethics SIG Ethics SIG (SIG on palliative care ???) (SIG on palliative care ???)

2. We plan networking with other international organizations: World Federation of Neurosurgery: World Federation of Neurosurgery: Committee of Neuromodulation Committee of Neuromodulation Committee of Neurorehab. and Reconstruction Neurosurgery Committee of Neurorehab. and Reconstruction Neurosurgery World Federation of Societies of Intensive and Critical Care World Federation of Societies of Intensive and Critical Care Scientific Panel for Neurocritical Care of the European Academy of Neurology (EAN) Scientific Panel for Neurocritical Care of the European Academy of Neurology (EAN) International Brain Injury Association (IBIA) International Brain Injury Association (IBIA) Special Coma Science Groups (e.g. the Liege group) Special Coma Science Groups (e.g. the Liege group) 2.OFFERING A NETWORKING AND COMMUNICATION PLATFORM CONT.

3.PROMOTING DEVELOPMENT OF RESEARCH AND SCIENTIFIC MEETINGS Past activities: ECNR Bucharest 2013: two sessions a. Diminished states of consciousness Nomenclature and Assessment of Diminished States of Consciousness /Dana Boering (Germany) Nomenclature and Assessment of Diminished States of Consciousness /Dana Boering (Germany) Severe disorders in consciousness: diagnosis with fMRI /Franz Gerstenbrand (Austria) Severe disorders in consciousness: diagnosis with fMRI /Franz Gerstenbrand (Austria) b. Early rehabilitation Early Mobilisation out of bed after acute neurological lesion in intensive and intermediate care: options and confines /Karin Diserens (Switzerland) Early Mobilisation out of bed after acute neurological lesion in intensive and intermediate care: options and confines /Karin Diserens (Switzerland) What is the impact of acute treatment on repair/restoration of brain and spinal cord /Heinrich Binder (Austria) What is the impact of acute treatment on repair/restoration of brain and spinal cord /Heinrich Binder (Austria)

WFNR Istanbul 2014: two sessions State of the art in early rehabilitation Early rehabilitation after stroke: time is brain-and that goes for rehabilitation too/Karin Diserens ( Switzerland) Early rehabilitation after stroke: time is brain-and that goes for rehabilitation too/Karin Diserens ( Switzerland) Early rehabilitation of brain injury: between urgency and limitation/ Dana Boering ( Germany) Early rehabilitation of brain injury: between urgency and limitation/ Dana Boering ( Germany) Early rehabilitation a balancing act regarding organization and performance/Heinrich Binder (Austria) Early rehabilitation a balancing act regarding organization and performance/Heinrich Binder (Austria) Workshop: Assessments in patients with disorders of consciousness/ Dana Boering ( Germany)

RESEARCH COLLABORATION OF MEMBERS Development of a qualitative measurement tool of dysphagia during the acute phase in patients with tracheostomy ( SIG Dysphagia- SIG ER Kay Coombs- Karin Diserens) Development of a qualitative measurement tool of dysphagia during the acute phase in patients with tracheostomy ( SIG Dysphagia- SIG ER Kay Coombs- Karin Diserens) Trial on outcome prediction of DOC patients using a new motor behavioral tool (Collaboration Coma Science Group S Laureys- Ac. Neurorehabilitation Germany V Hömberg- Switzerland K Diserens) Trial on outcome prediction of DOC patients using a new motor behavioral tool (Collaboration Coma Science Group S Laureys- Ac. Neurorehabilitation Germany V Hömberg- Switzerland K Diserens) Book contribution: Neurorehabilitative interventions in the acute stage of disease ( H Binder 2014) Book contribution: Neurorehabilitative interventions in the acute stage of disease ( H Binder 2014)

FUTURE ACTIVITIES Concerning organization: Enlargement of the SIG-council (chairman, vice-chairman) by an editorial committee consisting of a number of members to be defined selecting and prioritizing the 10 most relevant publications of recent times every 6 months an editorial committee consisting of a number of members to be defined selecting and prioritizing the 10 most relevant publications of recent times every 6 months a scout group consisting of „stringers“ from all interested members of any SIG, which refer to the editorial committee about potentially interesting publications or developments a scout group consisting of „stringers“ from all interested members of any SIG, which refer to the editorial committee about potentially interesting publications or developments Time scale: July/August 2015, Chairman. Prof. Binder Time scale: July/August 2015, Chairman. Prof. Binder..

Concerning knowledge management: Continuous communication line via a periodic updated newspaper containing a short summary of relevant recent publications including links. This could be also done via WFNR –Homepage. via a periodic updated newspaper containing a short summary of relevant recent publications including links. This could be also done via WFNR –Homepage. January 2016 could be on the cards for first publication provided agreement of WFNR January 2016 could be on the cards for first publication provided agreement of WFNR Regular input to WFNR newsletters Regular input to WFNR newsletters FUTURE ACTIVITIES

4. OFFERING TEACHING COURSES IN EARLY REHABILITATION Possible forms: Congress workshops and seminars Congress workshops and seminars Summer schools Summer schools Web summaries of our task forces Web summaries of our task forces Flying faculty activities Flying faculty activities