Clinical visits - areas of interest and facilities

Hospital Lucas Andreas

During the clinical visit staff will explain the cardiac rehabilitation programme, with the cooperation of the psychologist and cardiologist. There will be a visit to the cardiology department, the Coronary Care Unit, catheterisation room and physiotherapy department.

Patients requiring cardiac rehabilitation according to the Dutch Heart Foundation and the KNGF guidelines are offered a multidisciplinary cardiac rehabilitation programme.

The programme consists of three phases for the patient.

• Phase 1: Inpatient period-doctors, nurses and physiotherapists responsible for the care and guidance of patients.
• Phase 2: Outpatient cardiac rehabilitation phase.
• Phase 3: Post outpatient phase-continue healthy lifestyle.

Besides this programme patients with heart failure are offered a heart failure programme. The physical training is updated and guidance is more focused on dealing with a chronic condition.

Reade, centrum voor revalidatie en reumatologie

Delegates will hear about cardiac rehabilitation in the Netherlands, according to the guidelines from the KNGF and the Dutch Heart Association, and how it is translated into practice by the Reade rehabilitation centre of Amsterdam. The physiotherapists will then explore how the role of the physiotherapist, especially in cardiac rehabilitation, becomes more and more a coaching role which requires special interviewing skills of the physiotherapist. The team will explain the philosophy of motivational interviewing supported by a few easy exercises which will demonstrate its effect.

Academic Medical Centre, University of Amsterdam

The clinical visit will include a short tour around the rehabilitation department with emphasis on the hand therapy units. Staff will then visually illustrate the treatment path of a patient with hand pathology: from surgery to achieving rehabilitation goals.

The hand surgeon, rehabilitation physician, physical and occupational therapist, and if needed a social worker or psychologist, are all part of the multidisciplinary hand therapy team. The various roles and tasks of these specialists in hand rehabilitation and the evaluation techniques and therapy modalities used will be highlighted in this visit.

Reade, centrum voor revalidatie en reumatologie

The rehabilitation team will introduce delegates to the falls programme run for those with non-congenital brain injuries. They will give an overview of the diagnostic group, the contents of the prevention and training programme and provide a patient demonstration. There will also be time for questions and discussion with the physiotherapists.

Hospital Lucas Andreas

During the clinical visit staff will explain the multidisciplinary programme offered to patients with Parkinson’s Disease. The multidisciplinary team’s main aim is to screen the patients and then decide on the most appropriate and complete treatment plan. Patients are screened following the KNGF guidelines. Staff are able to refer patients to a physiotherapist in their own area who is part of the ParkinsonNet, a multidisciplinary support network, working throughout the Netherlands and set up for patients with Parkinson’s Disease.

During the visit staff will go into more detail about their working practice, how the KNGF guidelines evolved and how, with the help of videos and patient information, the network of physiotherapists works on a daily basis.

Academic Medical Centre, University of Amsterdam

The AMC neurology rehabilitation team is specialised in the rehabilitation treatment of people with neurological disorders, especially motor neurone disease, stroke and post polio syndrome.

For this clinical visit the neurology rehabilitation team will provide a tour of the rehabilitation department, including a presentation on the rehabilitation treatment of motor neurone disease and post polio syndrome by the multidisciplinary team. Staff will also explain how the movement laboratory plays a role in the treatment of post polio patients.

The neurology rehabilitation team consists of physiotherapy, occupational therapy, speech therapy, social work, psychology and a physician assistant. The team works under overall control of a medical rehabilitation doctor.

The team offers clinical rehabilitation treatment on the neurology and neurosurgery wards as well as in the rehabilitation department.

PACA - Paramedisch Advies Centrum Aalsmeer (physiotherapy practice)

During this clinical visit delegates will learn about the fitness testing protocol run at this private practice that is used with older patients taking beta-blockers.

Functional fitness is critical and it is important for older adults to have adequate strength, flexibility and endurance to accomplish everyday tasks. Assessing these components of fitness can detect weaknesses which can be treated before causing serious functional limitations. A special group of older adults are patients using beta-blockers which means that heart rate can't be used as a parameter for training intensity in this specific patient group. Cardiopulmonary diagnostics seems to be necessary in this patient group to determine the correct power levels for training.

The test protocol used in this practice for this patient group results in accurate knowledge about the power levels and heart rate at the anaerobic threshold. The results are used for an individual training programme.

The visit will include a demonstration of the test protocol and a discussion about the test results and the training programme.

Physiotherapy Practice Dekker, Amstelveen

During this clinical visit delegates will learn about the fitness training protocol run at this private practice that is used with older patients taking beta-blockers.

Functional fitness is critical and it is important for older adults to have adequate strength, flexibility and endurance to accomplish everyday tasks. Assessing these components of fitness can detect weaknesses which can be treated before causing serious functional limitations. A special group of older adults are patients using beta-blockers which means that heart rate can't be used as a parameter for training intensity in this specific patient group. Cardiopulmonary diagnostics seems to be necessary in this patient group to determine the correct power levels for training.

The test protocol for this patient group, used in another private practice, results in accurate knowledge about the power levels and heart rate at the anaerobic threshold. Results are used for an individual training programme.

The visit will include a demonstration of the training protocol and a discussion about the test results and training programme.

Schuitemaker Physiotherapy and Manual Therapy practice, Amsterdam

This visit will take delegates to a private practice that is part of the Shoulder Network Amsterdam. This network aims to optimise treatment for patients with shoulder disorders. During the visit delegates will be given a clinical demonstration of both assessment and treatment by one of the tutors from courses run in the Netherlands and Germany. There will be plenty of opportunity to ask questions about the network and treatment approaches.

Hogeschool van Amsterdam

Physiotherapy qualifying education is provided at the Hogeschool van Amsterdam where an international programme is taught in English, as well as a programme for Dutch students. A busy out-patients clinic is run on-site and here students gain clinical experience in a range of conditions, but mainly musculoskeletal. Staff from the university physiotherapy department will introduce delegates to the way in which the outpatients department is run at the university for use by students, staff and local residents, as well as the way in which clinical education is provided on site.

Academic Medical Centre, University of Amsterdam

The Academic Medical Centre offers both polyclinics and residential treatment for children. Specialisations cover:

• Developmental delays
• Cerebral palsy, especially spasticity of the arm
• Prematurity
• Neuromuscular disorders
• Congenital construction disturbance of the arm and hand
• Effects of cancer in children
• Spina bifida

The children’s team at the university will give a presentation in which the multidisciplinary assessments and interventions for a few of the issues in paediatric rehabilitation will be explained. A short tour around the polyclinic will be part of the clinical visit.

Nieuw Groenendaal

Staff at Nieuw Groenendaal in Heemstede look forward to showing WPT2011 delegates how a small private practice can grow into a well-known business.

Nieuw Groenendaal is a business in physiotherapy and fitness related care. In a luxurious environment patients and clients work on their physical fitness, and receive - where indicated - psychological support. The team consists of physiotherapists (all specialisations included), fitness trainers, group lecturers, psychologists and an osteopath. The staff make use of the various professions present on site on a daily basis.

The business continuously searches for new markets. In recent years, for example, they have gained expertise in providing training to (recovering) cancer patients and exercise therapy to (former) heart patients. They cooperate closely with local hospitals on behalf of these groups. Several of the physiotherapists also work in hospitals.  Agreements on quick access to occupational health physiotherapy in order to prevent (potential) absence through illness have been made with many regional and national businesses with offices in the area. The occupational health physiotherapist gives companies advice on work and health issues and on useful tools to keep staff employable in the long term and increase their productivity.