Download Rehabilitation Services document

OT
Rehabilitation
Therapy
PT
Function
SW
Settings
SLP
The capabilities and expertise of
rehabilitation professionals overlap and
complement each other, with the ultimate
goal of restoring and enhancing patients’
function in their environment
AT
Acute Care (Inpatient) - All 3 Disciplines make recommendations for discharge planning based
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upon patient’s current functional status
PT assesses patient’s ability to walk, climb stairs, and transfer in and out of bed/ chair safely
OT assesses Activities of Daily Living (ADLs) such as bathing, dressing, grooming, toileting
SLP assesses patient’s speech and swallowing to ensure effective communication and safe
swallowing
Inpatient Rehab - Focuses on improving patient’s mobility and ADL performance to the point that
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they can return safely to their pre-morbid living environment
Typical patients need less acuity of nursing and medical care, with their mobility deficits being the
main thing keeping them out of their homes
Patient participates in 3 hours of combined PT, OT, and Speech Therapy (if needed) daily
Work on transfers, gait and stairs with assistive device, ADLs, speaking or communicating if
speech is impaired, and safe feeding to facilitate their safe return home
Outpatient Orthopedic (Adult)
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Treat musculoskeletal and neurological conditions to reduce pain and maximize function
Spine care (low back and neck pain) typically comprises about half of business
Also treat sprains/ strains, surgical, and chronic conditions that cause pain in muscles and joints
Pediatric (Birth – 21; sometimes older if clinical expertise still needed)
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Treat a wide variety of physical and cognitive developmental delays and disabilities
Measure, cast or fabricate splints and orthoses to promote mobility/ function
Treat conditions that affect child’s ability to communicate and interact effectively with others
Train eating and drinking strategies for kids with either physical impairments or sensory aversions
Sensory Integration therapy for attention, hypo- or hyper-activity, eating, bathing and dressing
Other Settings for Rehabilitation Services
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Extended Care Facility (ECF): Nursing Home or Skilled Nursing Facility (SNF)
Home Health
Pediatric: First Steps (Home-based Early Intervention), School System
Industrial (Employer-based in factories, manufacturing facilities, or medical clinics)
Rehabilitation Services: Therapy Discipline Overview
Physical Therapy (PT)
apta.org
PT encompasses the treatment of musculoskeletal and neurological gross motor impairments to reduce
pain and maximize function in all areas of life
 PTs observe and assess how their patients move, then teach and demonstrate safe, efficient and
biomechanically sound movement patterns to reduce the chances of re-injury or aggravation of
chronic conditions
 Evaluate and train mobility to ensure safe and efficient transfers and ambulation in the home and
community, with any needed assistive devices
 Prescribe appropriate exercise dosage to promote strength, range of motion, flexibility, balance
and functional endurance with tasks in and around the home, workplace, community or sport
environment
 PTs perform a wide variety of manual therapeutic mobilization techniques on soft tissue and
joints using their hands or tools/ instruments to reduce swelling, inflammation, adhesions, joint
contracture, and increased muscle tone
 The over-arching goal of Physical Therapy is to reduce pain, restore function and guide
return to work, sport, or leisure activity in a measured, graded fashion
Education
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Physical Therapist (PT): 4 years of Undergraduate followed by 3 years of Graduate School.
Results in Doctor of Physical Therapy (DPT). National Board Exam taken prior to licensing in
state(s) you will practice.
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Physical Therapy Assistant (PTA): 2-year Associate’s Degree
Specialty Areas
Beyond “traditional” exercise therapy for musculoskeletal pain, neurological disorders and return to
sports/ activity, physical therapists treat:
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Pediatrics
Lymphedema
Wound care
Women’s Health:
pelvic pain and dysfunction
Vertigo/ Vestibular dysfunction/
post-concussive disorder
Cardiovascular and Pulmonary
dysfunction
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TMJ
Occupational Medicine
Various Headache
Classifications
Chronic Pain
Bell’s Palsy
Clinical Electrophysiology
(perform EMG/ NCV studies)
Rehabilitation Services: Therapy Discipline Overview
Occupational Therapy (OT)
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aota.org
Occupational Therapy enables people of all ages to “Live Life to its Fullest” by helping them
promote health, prevent injury, or live better with an existing injury, illness, or disability
OT centers around facilitating function in activities that occupy their time
 Hence the term ‘Occupational Therapy’
Common categories, or Activities of Daily Living (ADLs), that occupy one’s time include:
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Basic ADLs: Foundational needs that must be met to remain healthy
o Bathing and showering, Personal Hygiene and Grooming, Dressing, Eating/ Feeding,
Toileting
Instrumental ADLs: Higher level, daily tasks performed throughout the day
o Meal preparation and cleanup, Home establishment and maintenance, Taking
medications as prescribed, Managing money, Shopping for groceries or clothing,
Transportation within the community, Using telephone or other form of communication,
Work, Education, Leisure/ Social Activities, Using technology to assist any of the above
Therapists break down the complex movement patterns or thought processes used during the
various activities into their component parts
Analyze how patients perform any tasks that the patient reports or the OT observes them having
difficulty with, and offer tips and insight on how to simplify them or make them more efficient
Fabricate, vend or order specialized adaptive devices to make difficult tasks easier
OT evaluation and treatment techniques are supported by data, informed by clinical experience,
and driven by “best practices” that have been developed and proven over time
Care plans, treatment strategies and modifications are customized for each individual to resolve
problems, improve function, and support everyday living activities. The goal is to maximize each
patient’s potential given their abilities and impairments
Education
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Occupational Therapist: 4 years of Undergraduate followed by 2-3 years of Graduate School.
Results in Master of Science. National Board Exam taken prior to licensing in state(s) you will
practice. Degree is OTR/L (Occupational Therapist, Registered/ Licensed)
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Certified Occupational Therapist Assistant (COTA): 2-year Associate’s degree
Areas of specialty include:
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Certified hand therapy (CHT)
Pediatrics (Inpatient, Neonatology, First Steps Early Intervention, Outpatient, School System)
Community Mobility (Driving Assessments for Senior Citizens or those with Physical Impairment)
Home Modification to promote Independent Living
Gerontology
Feeding, swallowing, and eating (for issues related to sensory processing impairment)
Low vision therapy
Vestibular Therapy
Mental Health
Lymphedema Management
Rehabilitation Services: Therapy Discipline Overview
Speech Therapy (SLP- Speech Language Pathology)
asha.org
Speech-Language pathologists (SLPs) evaluate and treat speech, language, cognition, communication,
and swallowing disorders in individuals of all ages, from infants to the elderly
Adult: Post-Stroke, Dementia, Parkinsons, Traumatic Brain Injury (TBI), Concussion, Head & Neck Cancer
Pediatric: Premature birth, Speech delays, Stuttering, Cerebral Palsy, Autism, Cleft Lip and Palate, ADHD
Speaking/ Communicating Deficits and Treatment
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Voice- dysfunction of vocal apparatus or breath support when talking; causes voice to weak/quiet
Dysarthria- difficulty making speech sounds; caused by cranio-facial muscle weakness/ paralysis
Apraxia- muscles are strong and work properly, but ‘programming’ from brain to oral musculature
is compromised (so sound sequencing doesn’t work right)
Aphasia- a disorder that results from damage to the parts of the brain that contain language,
causing problems with any or all of the following: speaking, listening, reading, and writing
Verbalization- Production of words (Strategy: reduce speaking rate)
Vocalization- Production of sounds (Strategy: over-articulation of sounds/ words)
Augmentative and Alternative Communication: Using other strategies or technologies besides
speaking to communicate with others, if speaking is difficult or not possible
Organizing Thought Processes
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Memory Deficits- Long-term or ‘Working’ (short-term) memory
Focused Sustained Attention- staying ‘on-task’ until it is completed, especially with other distractions
nearby (multi-tasking)
Swallowing
Normal swallowing is needed for safe, effective eating and drinking to ensure adequate hydration
and nutrition can be consumed without risk of aspiration, which can cause pneumonia
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Dysphagia- Difficulty swallowing due to issues with getting the muscles of the mouth, throat, and
esophagus working together normally
Aspiration- Swallowed food or drink goes down the trachea into the lungs instead of down the esophagus
and into the stomach
Suck-Swallow-Breath Reflex- can be impaired in infants, causing difficulty with nursing/ feeding
Speech therapists perform 2 kinds of studies to diagnose swallowing disorders:
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Bedside Swallow Studies- SLPs monitor patients for signs/ symptoms of aspiration while eating regular
food/ drinks
Modified Barium (aka Videofluoroscopic) Swallow Studies- Patients eat foods of varying consistency/
thickness mixed with a small amount of barium to determine if they are going down to the stomach or going
into the lungs when they are swallowed
Treatment Based upon Swallow Study Results:
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SLPs recommend specific food thicknesses/ textures (thin, nectar, honey, pudding, pureed)
based on the test results to ensure safe swallowing and reduce risk of aspiration
Education
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Entry level practice requires a Master’s Degree which typically consists of 4 years of
undergraduate, followed by 2-3 years of graduate classroom and clinic instruction as well as
School-based and Medical-based Externships followed by a 9 month Clinical Fellowship
Rehabilitation Services: Therapy Discipline Overview
Athletic Training
nata.org
The services provided by ATs comprise prevention, emergency care, clinical diagnosis, therapeutic intervention
and rehabilitation of injuries and medical conditions. ATs work under the direction of physicians, as prescribed
by state licensure statutes (information provided from www.nata.org)
ATs improve patient functional and physical outcomes for Athletes of all ages
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Teams and clubs at both public and private secondary schools (Middle School and High School)
Community sports leagues, clubs and sport facilities (both Youth and Adult)
College and university athletes
Professional and Olympic sports
ATs perform a variety of roles
 Provide Immediate and acute care of injury and illness, especially in emergencies on the court, playing
field or sideline
 Perform treatment, rehabilitation and reconditioning of injured athletes to facilitate effective return to
sport as quickly and safely as possible
 Provide evidence-based practice and health promotion to educate athletes, coaches and families with
prevention measures to ensure highest quality of care
Many athletic trainers work outside of athletic settings; providing care to people of all ages
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Doctor’s offices as physician extenders (similar to nurses, physician assistants, physical therapists
and other professional clinical personnel)
Outpatient clinics with specialties in sports medicine, cardiac rehab, medical fitness, wellness and PT
Occupational health in manufacturing
Police and fire departments and academies
City municipal departments
Branches of the military
Education
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Can practice with an undergraduate or graduate degree (70 percent of ATs have a master’s degree)
47 states require ATs to hold the Board of Certification credential of “Athletic Trainer, Certified” (ATC)
Rehabilitation Services: Therapy Discipline Overview
Social Work
socialworkers.org
Social work is a profession devoted to helping people function the best they can in their environment.
The phrase "in their environment" points to a distinguishing characteristic of social work—one that sets it
apart from other helping professions. Social workers help clients deal not only with how they feel about a
situation but also with what they can do about it.
Social workers are needed in hospitals, clinics, and other medical and health care settings to facilitate
medical and emotional treatment of patients with acute, chronic and long term illnesses.
Social workers:
 Assess their patients’ needs
 Act as advocates for their patients
 Educate patients and their families
 Connect patients and their families to essential resources within the community
 Protect vulnerable patients and ensure that their best interests are observed
 Help patients and their families cope with the personal and emotional difficulties related to their
illness
In Rehabilitation Services, the social worker collaborates with all of the therapy disciplines as well as the
medical staff, school, mental health professionals, insurance providers, and federal, state and local
agencies to coordinate care. The social worker can also be helpful in sensitizing other healthcare
providers to the social and emotional aspects of illness.
Education
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Entry level practice typically requires a Master’s Degree (MSW), which consists of 4 years of
undergraduate, followed by 2 years of graduate classroom and clinical instruction.
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Licensed by state(s) they practice in after passing state exam and completing clinical supervision
hours
Rehabilitation Services: Therapy Discipline Overview