Defining Rehabilitation

Therapy at the bedside

While many believe that therapy must take place in a therapy gym, that’s not always the case, especially with patients who have suffered a severe stroke or other debilitating injury or illness that has left them with little mobility and complex medical needs.

You may think these patients can’t withstand the required three hours of therapy a day, five days a week, but think again. Therapy comes in a variety of forms and levels, and those three hours can be spread out in short increments throughout the day—and it doesn’t have to occur in a gym.

For these patients, therapy could start at the bedside and focus more heavily on cognitive skills, positioning and pain management. The following are examples of what speech, occupational and physical therapies could look like and some of the technologies available to treat a higher acuity patient who has difficulty standing.

Speech therapy

• Treatment focus can be on orientation to their environment such as how to use their remote, call light or communication boards
• Practice visual scanning to improve participation in eating and grooming activities
• Practice communicating needs and wants such as the need for a drink of water or the need to go to the bathroom
• Practice oral exercises to improve swallow 
• Assistive technology could include iPads, VitalStim and augmentative communication devices  
• Family and staff education

Occupational therapy

• Positioning to prevent bed sores
• Practice movements for going from lying down to sitting up
• Participate in activities of daily living training such as washing hands and face, brushing teeth, bathing and eating
• Stretching limbs to keep them moving and pain free
• Technology could include electrical stimulation to exercise muscles and decrease pain
• Utilize pain management strategies like heat, cold, massage and others to increase the patient’s ability to participate
• Create and apply braces to prevent deformity
• Family and staff education on how to care for skin and move the patient

Physical therapy

• Pain management
• Moving limbs
• Work on going from lying to sitting up in bed and from sitting to lying
• Practice keeping joints and muscles flexible
• Exercising lower legs to improve strength
• Technology could include the E-Stim for pain management and to keep the patient’s muscles from shrinking
• Patient and family education

*Not all Encompass Health hospitals offer the same technologies