Defining Rehabilitation

What therapy might look like in a wheelchair

While many believe that therapy must take place in a 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 three hours of therapy a day, five days a week requirement, 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 take place in a wheelchair in their room and focus more heavily on improving cognitive skills, positioning and pain management. We also provide special cushions for those patients who have difficulties sitting upright. The following are examples of what speech, occupational and physical therapies could look like and the technologies available* to treat a higher acuity patient who has difficulty standing.

Speech therapy

• Participate in tasks such as medication organization, balancing a checkbook and identifying safety concerns 
• Participate in activities that increase their ability to pay attention to a task long enough to complete it such as sorting medications into a weekly planner
• Perform oral or swallowing exercises to be able to eat a meal or improve their speech clarity
• Utilize technology such as Parrot Software, Vital Stim, iPad, ReoGo to assist in communication and swallowing
• Patient and family education on how to safely increase their independence with daily tasks such as dressing and bathing
• Improve reading comprehension and writing to increase the patient’s ability to understand how to pay their bills 
• Work on communicating needs and wants in their room 

Occupational therapy

• Sitting up correctly in the best position utilizing the correct devices to prevent pressure on their bottoms, increase tolerance to sitting and interaction with others
• Work on improving strength in core, arms and hands
• Work on eating, brushing teeth and combing hair while sitting upright in the wheelchair 
• Teach how to use equipment like a grabber or tool to help them dress to put on socks.
• Utilize technology such as Dynavision, ReoGo, MOTOmed, Hand Mentor and Bioness to increase participation and improve strength
• Family, staff and patient education and training 
• Practice activities of daily living such as organizing and folding laundry, gardening, cutting vegetables and clipping flowers

Physical therapy

• Practice changing movements in preparation to stand
• Improve ability to maintain sitting position
• Improve the ability to manipulate a wheelchair
• Exercise lower extremities, back and stomach muscles
• Practice transitioning from one surface to another with or without supportive equipment.
• Utilize technology, such as the MOTOmed, Nustep and BioStep to improve their ability to get around
• Family, staff and patient education

*Not all Encompass Health hospitals offer the same technologies