Rehabilitative Therapy

Patients with many kinds of injuries or illnesses resulting in functional impairment may benefit from home health services.

More specifically individual diagnostic-related groups most likely to need home health rehabilitative services are:

• stroke
• chronic obstructive pulmonary disease
• heart failure
• major joint procedures
• hip/femur procedures

Other common diagnoses or problems indicating home rehabilitative services may include but are not limited to:

• falls and balance problems

• multiple sclerosis

• cancer

• spinal cord injuries

• weakness and debility

• osteoporosis

• osteoarthritis

• spinal compression fractures

• rheumatoid arthritis

• various long bone or joint fractures

• amputations and prosthetic training

• decreased function following surgery or acute

• pain management

• hospitalization

• cardiac conditions

• difficulty for caregiver to provide safe confident care

• parkinsonism

• paraplegia or quadraplegial
  

A typical initial physical therapy visit

A referral for home health services is generated through the patient's physician. If necessitated by the patient's medical condition a nurse will be the admitting professional and will be the case manager, who coordinates all services provided. If nursing is not indicated, the physical therapist wiill admit the patient to home health and coordinate all services provided. Both will communicate closely with the referring physician regarding plan of treatment and progress.

The initial physical therapy visit may include:

• providing information for communication and emergency procedures

• signing of consent to treat forms
  
• assessing home safety and making recomendations
  
• evaluating patient function and dysfunction to determine baseline abilities by utilizing various tests and assessment tools
  
• identifying problem areas
  
• setting individualized goals and planning treatment between the patient, P.T., and caregiver (taking into consideration the patien's prior level of function)
  
• establishing treatment frequency and duration in order to achieve goals
  
• treating the identified problems to initiate progress toward goals
  
• instructing/supervising the patient and/or caregiver with a home exercise program

Subsequent physical therapy visits will focus on teaching and providing treatment techniques to help the patient and/or caregiver achieve the established functional goals and to reach a higher level of independence or self sufficiency.

Some of the treatment techniques utilized may include:

• walking/balance training and testing to improve gait pattern and safety

• therapeutic exercise and strengthening such as: PNF (Proprioceptive Neuromuscular Reeducation),

• NDT (NeuroDevelopmental Treatment), Feldenkrais, and other manual techniques

• pain management such as: TENS (Transcutaneous Electrical Nerve Stimulation) , MFR (Myofascial Release)

• exercise/stretching, joint and soft tissue mobilization, modalities (heat, cold, ultrasound)

• posture training

• ordering of equipment and progressing with appropriate assistive devices

• teaching wellness, prevention and safety

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