When someone is injured or suffers a serious illness, it may take some time, attention and extra help to regain their independence. They may need help learning to move around again. It may be the ability to speak that’s been damaged. Or they may need to relearn motor skills used to perform basic daily tasks.
For most of us, we probably don’t think much about things like movement, speech, eating and going to the bathroom. After all, we’ve been doing those things since we were kids. But for some, a point will come when those activities can no longer be taken for granted – and that’s where rehabilitation (“rehab”) comes in. There are three main types of rehab therapy that may be used in these situations – physical, occupational and speech.
Rehab is part of a medical field known as Physical Medicine and Rehabilitation (PM&R), or physiatry. Physiatrists treat many different types of medical conditions involving the nervous system, bones, joints, ligaments, tendons, muscles and brain.
Rehab is often part of the treatment for serious illnesses and injuries, including stroke, chronic pain, arthritis, heart attack or severe infection.
Sometimes, there is not a singular event that leads to rehab. As people age, it becomes more difficult to move as well as they used to. Physical therapy can be used proactively in helping older adults maintain their mobility and independence.
Your Rehab Team
Rehab is usually overseen by a PM&R physician. PM&R physicians may also have a subspecialty in:
- Brain Injury Medicine
- Hospice Care
- Palliative Care
- Neuromuscular Medicine
- Pain Medicine
- Pediatric Rehabilitation Medicine
- Spinal Cord Injury Medicine
- Sports Medicine
“PM&R doctors work closely with your other physicians to implement a rehab plan,” explains Dr. Ade Adedokun, a physiatrist based in Fort Worth. “For example, if you’re a stroke patient, we will work with a neurologist and your primary care physician. If you suffered a major sports injury, the treatment plan would involve working with your sports medicine and orthopedic doctors.”
Rehab Therapy Specialists
PM&R doctors work with a team. Specially trained therapists are often called on to work with rehab patients, including:
- Speech language pathologists are trained professionals and communication experts who help patients with their speech. They work with young children, older adults and everyone in between. They work with people who have had a traumatic medical event that affected their speech, such as a stroke.
- Physical therapists are trained experts in helping people regain their ability to move, reduce pain and restore function. Physical therapists are often found in an orthopedic setting, helping patients recover from an injury to a joint. They also work with stroke patients, helping them regain mobility and balance, as well as with people who are recovering from certain surgeries. Privia Medical Group North Texas has physical therapists, as well as speech language pathologists, among its providers.
- Occupational therapists help with daily activities, such as eating, drinking and bathing. They work with children and adults with disabilities who need help to better participate in school and other functions. Occupational therapists also work with people who have suffered stroke or other conditions that have adversely affected cognitive ability and require specialized help to complete certain tasks.
Nurses, dieticians, social workers, psychologists and counselors may also be part of a rehab team. In addition, an effective team also involves family members, who play an important role supporting a loved one’s rehab journey.
Purpose and Benefits of Rehab
The purpose of rehab is to help a patient live as normally as possible following an illness or injury that has compromised their ability to do so.
If an injury or illness has necessitated use of wheelchair, the patient must learn how to transition from the wheelchair to a bed or into a car. If a stroke has affected a patient’s balance, learning to walk without falling is necessary. These are the types of essential skills and functions that rehab can help a patient with.
Rehab provides numerous health benefits, including:
- Improving muscle strength
- Increasing flexibility
- Improving coordination and balance
- Increasing range of motion and movement
In addition to improving quality of life, rehab can help you live and move about safely, reducing your chances of an injury. It can also result in the ability to live more independently and not need as much assistance in day-to-day activities.
Where Does Rehab Take Place?
When someone needs rehab, it is generally best to start it just as soon as the patient is able. That could mean rehab starts in the hospital following a surgery. Depending on how much support and care the patient needs, rehab may continue at an inpatient rehabilitation facility – this allows the patient to undergo rehab while also having access to ongoing medical care. Skilled nursing facilities are also available to serve patients.
After a patient has been discharged from one of these facilities, he or she will continue to rehab at home and go into a health care provider’s office for additional therapy sessions.
Rehab to Help Recovery
There are numerous reasons someone may need rehab. Some of the most common include:
Stroke
A stroke occurs when blood flow to the brain is interrupted and the cells in the affected part of the brain begin to die.
Depending on the severity of the stoke, the patient may lose the ability to complete tasks and activities that we take for granted. Talking, walking, reading, writing and using a hand to lift or hold something can all be negatively affected by a stroke.
Following a stroke, a physiatrist, working with your other physicians, will work to get a stroke patient into physical rehab as soon as possible. Speech, occupational and physical therapy may all be necessary to help a stroke patient recover.
These therapists, working under the physician, will typically assign stroke patients the most challenging rehab programs they can handle, based upon the severity of the stroke, age and overall health.
Joint Problems
An injury to a joint may require rehab. Rehab can help people with an injured joint safely increase their range of motion and strengthen the muscles and tendons that support the joint. As with any injury, a measured and deliberate approach to recovery is essential so the injury is not worsened. Rehab is also an option in cases where severe arthritis has limited the use of the joints.
“Physical rehab is an essential component of recovery from joint replacement surgery,” says Dr. Joseph Milne, an orthopedic surgeon in Fort Worth. “Recovery activity begins almost immediately after the procedure, often on the same day.”
Knee and hip replacement recovery starts with use of a walker or crutches. A physical therapist will provide instructions on a graduated walking program and how to gradually resume more challenging activities, such as climbing stairs.
Pain
Millions of people are affected by chronic pain. Pain management specialists have numerous strategies available to help patients with pain, including physical and occupational therapy.
Physical Therapy for Healthy Aging
Physical therapy is no longer simply a treatment in reaction to an injury or illness. Increasingly, it is seen as a valuable piece of a proactive approach to healthy aging, helping people stay active longer and reducing risks of falls and other injuries. PM&R physicians are skilled in evaluating older patients and prescribing specific therapies that will help improve mobility and strength, yet not be too strenuous or difficult.
As people grow older, they do not move as well as they used to. Someone may be in relatively good health and not suffered a traumatic injury or a stroke, yet still benefit from physical rehab. Aging can bring on stiffness and unsteadiness that can make it more difficult to walk, bend over and lift things. Conditions such as osteoarthritis or being overweight can worsen these concerns.
This is normal and fortunately, physical rehab therapy can help. Even better – Medicare will cover it, as long as the therapy has been ordered by a physician following an in-person visit. Medicare will cover home-health services, as well.
“Your primary care provider may make a determination that outpatient physical therapy is medically necessary, which Medicare Part B will then help pay for,” explains Dr. Lindsay Brooks, an internal medicine physician in Fort Worth. “So, if you find yourself having difficulty moving around or maintaining your balance, make an appointment to see your doctor. We may be able to help get you the therapy you need to maintain your independence.”
Rehab: An Essential Part of Health Care
None of us want to have an injury or illness that requires rehab, but sometimes it is necessary. If you one day find yourself in that situation, rest assured that there are highly-trained and qualified health care professionals ready to help you recover and regain some or all of what you have lost – be it mobility, speech or independence.
And if you have a loved one who will undergo rehab, they will need your help. A strong support network helps increase the odds of a successful rehabilitation.
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
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