Authors: M. Grüneroválippertová - 1; T. Korbička 2; J. Votava 3; D. Netuka 3; M. Sameš 4; T. Tyll 3; J. Kolombová 1; Z. Nerandžič 1; H. Zimermanová 1; M. Kinkor 1; M. Smrčka 5 Authors‘ workplace: Klinika rehabilitačního lékařství, 3. LF UK a FNKV, Praha 2 SurGal Clinic s. r. o. Brno 1; Klinika anesteziologie, resuscitace a intenzivní medicíny 1. LF UK a ÚVN – VFN, Praha 3; Neurochirurgická klinika Fakulty zdravotnických studií J. E. Purkyně a Masarykovy nemocnice v Ústí nad Labem 4; Neurochirurgická klinika LF MU a FN Brno 5 Published in: Cesk Slov Neurol N 2026; 89(2): 117-122 Category: Original Paper doi: https://doi.org/10.48095/cccsnn2026117
The aim of the projeck is to integrate early neurorehabilitation into the healthcare system for patients with acquired severe brain injury in the Czech Republic.Objectives. Methods: The intensive neurorehabilitation (NINR) pilot project implements phase B1 of the neurorehabilitation phase model, which is defined as the early rehabilitation phase. During this phase, intensive care must be provided if necessary, including the possibility of artificial pulmonary ventilation. Patients indicated for admission to the NINR facility are conditiontransferred from intensive or acute neurosurgical care units, such as traumatic brain injury, inflammatory brain dis ease, brain tumor, cerebral stroke or impaired cerebrospinal fluid production, flow and resorption. Admission is possible within one month of the onset of the condition, according to admission criteria. The maximum duration of care provided to one patient at NINR facility is 12 weeks. If necessary, the length of stay at an NINR facility can be prolonged due to a deferred prognosis; in such cases, an ‚indication seminar` is held with representatives of the health insurance company in attendance, where justification for such a proposal is assessed and further actions are recommended. A stay at the NINR facility will end if there has been no improvement for an uninterrupted period of up to six weeks, or if a Barthel Index value of 30 has been achieved at any time during the stay. Under the NINR program, patients receive up to 12 weeks of 3 to 4 h of intensive therapy per day. Results: The project is currently operating at three locations in the Czech Republic. As of the end of June 2025, early neurorehabilitation as part of the project had been completed in 122 patients, who were admitted on average 18 days after the onset of acute illness. The average hospitalization time at NINR facility was 45.8 days. Upon admission, 53.6% of patients were on mechanical ventilation, compared to 9.7% at discharge. Of those admitted with tracheostomy (79.5%), 29.5% remained upon discharge. A Barthel Index score of 30 or more was achieved by 75 (61.5%) patients at discharge. 38% were able to progress to the next phase of rehabilitation, 30% were transferred to fol lowor longintensive care units, and 11% were released to home care. Conclusion: The project results demonstrate the feasibility of successfully implementing this approach into the healthcare system in the Czech Republic. Following the completion of the project, we hope to extend this care to other facilities.
neurosurgery – early neurorehabilitation – CNS damage – functional therapy
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