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Rehabilitation experts are therapy specialists

June 27, 2005|by Dr. Mark Yacyk

Whether a person is preparing for a total hip replacement, going for aquatic therapy, assisting his or her child with dyslexia or recovering from a stroke in the hospital, chances are he will encounter a rehabilitation professional.

Occupational therapists, physical therapists and speech pathologists are some of the rehabilitation professionals patients might encounter when dealing with an illness. Typically, the relationship extends beyond the time the patient leaves the hospital.

So, who are these persistent rehabilitation experts?

Physical therapists strive to improve gross (large) motor skills, enabling a person to better walk, work or even play a sport. They are experts in anatomy and kinesiology (the study of movement). Occupational therapists focus on improving daily activities such as bathing and dressing. They work with patients' physical, cognitive and behavioral capabilities to assist a person in becoming as functionally independent as possible. Speech pathologists address cognitive, communication and oral motor deficits such as swallowing or speaking.

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Where these professionals work is as varied as the services they can provide. The goal in a hospital is to stabilize a patient's medical condition using medication, surgery and other procedures. A patient's length of stay depends on the severity of the illness or injury. Discharge occurs when a patient's medical needs can be addressed in a less acute setting such as home or a skilled nursing facility. Therapies might be ordered while the patient is in the hospital to evaluate a patient's functional level, initiate rehabilitation and make appropriate discharge recommendations for transition to an appropriate level of care.

Inpatient rehabilitation offers a continuation of hospital services, such as 24-hour nursing care, with a focus on intensive rehabilitation. Patients receive a minimum of three hours of therapy per day from at least two disciplines. Washington County Hospital also offers specialized rehabilitation programs for patients with traumatic brain and spine injuries.

Occasionally after a hospitalization, a patient will be too sick or weak to return home or to transition to an inpatient rehabilitation facility. These patients will be referred to a skilled nursing facility, where a they might receive any or all of the three disciplines for as little as 90 minutes a week to three hours a day. The length of stay is generally longer at such a facility than at an inpatient rehab program.

Patients functioning well enough to go home may receive home-health-care therapy. Patients qualify for home-health-care therapy when they are essentially homebound but are well enough to function in their homes with or without family members providing assistance. A therapist will use the home environment to help patients achieve their maximum level of independence.

In an outpatient setting, therapies might become more specialized. A patient may receive vestibular (balance) retraining from a physical therapist. An occupational therapist might work exclusively with a patient's hands and fingers. A young child with a learning disorder might work solely with a speech therapist to achieve greater learning function in a school setting.

All therapies are offered under the care of a physician and generally can only be received with a doctor's orders. There are some exceptions. Physical therapists or occupational therapists might complete an ergonomic evaluation of trauma disorders such as carpal tunnel syndrome. A new Pennsylvania law allows occupational therapists to accept orders from optometrists to address a patient's visual deficits.

Today's health-care setting is technologically advanced and fast-paced. Americans routinely experience the best health care in the world. And physical therapists, occupational therapists and speech pathologists facilitate their trip on the road to recovery.

Dr. Mark Yacyk is a physiatrist with Washington County Health Systems.

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