Tag Archive for: Rehabilitation

Treating Diabetes through Rehabilitation

For many, a healthy diet and regular exercise are self-prescribed ways to feel better. But for people with diabetes, diet and exercise often are medically recommended to help treat the disease.

Diabetes is a disorder where either the body does not produce enough insulin or the cells in the body do not recognize the insulin.

To understand diabetes, you first need to understand the role of insulin in your body. When you eat, your body turns your food into sugar, also called glucose. At that point, the pancreas releases insulin to open the body’s cells to allow the sugar to enter so it can be used for energy.

But with diabetes, the system doesn’t work.

Without insulin, the sugar stays and builds up in the blood. So the body’s cells starve from the lack of glucose. If left untreated, complications can develop with the skin, eyes, kidneys, nerves and heart.

There are different types of diabetes, with the most common form called type 2 or adult onset diabetes. People with this type of diabetes can produce some of their own insulin, but often it’s not enough. Some of the common symptoms of diabetes include:

  • Feeling very thirsty
  • Frequent urination
  • Feeling very hungry even when you’ve eaten
  • Blurry vision
  • Fatigue
  • Slow healing cuts or bruises
  • Tingling, pain or numbness in hands or feet

Treatment for diabetes usually includes diet and exercise – and medicine if sugar levels remain high after lifestyle adjustments. At rehabilitation hospitals, diabetic patients often are provided a medically supervised care plan that includes physical exercise and healthy eating strategies.

Exercise helps control diabetes because it allows glucose to enter the cells without the use of insulin. It also can help lower blood glucose levels and blood pressure. In addition, exercise assists in weight loss and improves balance and energy levels.

A combination of both aerobic exercise and resistance training has the most positive effect on blood glucose levels. Physical therapists can help individualize and supervise exercises that will be the most beneficial to a patient. They monitor the exercise program to ensure safety and progress, while improving and maintaining sugar levels. The exercise plan can be carried out at home after the individual leaves the hospital.

A healthy diet also is integral to managing diabetes. How much and what types of foods are eaten affect the balance of insulin in the body and make a difference in blood glucose levels. Dietitians at rehabilitation hospitals can teach patients about carbohydrates in food, how it affects the glucose levels, and they provide practical strategies for healthy cooking and eating.

Typically through rehabilitation hospitals, patients not only receive treatment, but are educated on how to manage the disease to the best of their ability in their everyday lives. This helps them to live as independently as possible.

The Latest Technology Trends in Rehabilitation

Choosing the right rehabilitation hospital for yourself or a loved one is an important decision. You probably have plenty of questions to ask, as well as a set of criteria that must be met before you make your final choice.

But your decision will be made easier if the hospital you’re considering has kept up with the latest technology. That’s why Ernest Health Systems are a great fit: they have the latest in rehabilitative technology that’s at the foundation of superior patient care. That technology includes LiteGait, Dynavision, and VitalStim Therapy.

LiteGait

LiteGait creates an ideal, safe environment for treating patients with a wide range of impairments, and who are at different functional levels. How does it work? Through its unique harness design, LiteGait eliminates concerns for balance while training coordinated lower extremity movement, while also providing proper posture.  The LiteGait system makes it possible to adjust the weight-bearing load on the weaker side of the body by either increasing or decreasing it. It also allows the technician to assist the patient’s legs and pelvis in helping to achieve proper gait patterns. LiteGait is used in an environment that’s free from falls.

For patients, its benefits are many and include re-learning to walk with proper postures, and also beginning gait training earlier in the rehabilitative process. Moreover, it helps patients experience a sense of accomplishment.

Dynavision

Dynavsion is designed for use in rehabilitation facilities, and is a device that improves patients’ visual and motor skills that have been affected by diseases or injuries. It also allows each patient to have their own personalized rehabilitation program that best suits his or her needs – a feature that separates Dynavision from other physiotherapy devices.

Patients who use Dynavision can improve their peripheral visual awareness, hand-eye-coordination, visual attention and anticipation, as well as visual-motor reaction time. At the same time, it’s providing physicians and physical therapists with the necessary data to evaluate the patient’s gross motor skills, response to visual stimuli, and his or her ability to perform neuro-cognitive tasks.

Dynavision can be used to successfully improve the abilities of patients who may have limitations from a stroke, spinal cord injuries, head injuries, amputations, and orthopedic injuries.

VitalStim Therapy

Dysphagia, or trouble swallowing, is a common condition among stroke and brain injury survivors, and VitalStim Therapy has been proven effective in the treatment of it. VitalStim therapy involves external electrical stimulation that helps re-train the muscles needed to complete the swallowing process. Electrodes are attached to the patient’s neck and a small current is used to stimulate nerves. Over time, this therapy helps to gradually re-train the necessary muscles.

In clinical trials, VitalStim has been shown to be two or three times more effective than traditional stimulation techniques. It’s clearly an important treatment for patients with dysphagia – in which symptoms can range from mild discomfort while swallowing to losing the ability to swallow.

A Day in the Life of a Speech-Language Pathologist

It can be difficult to fully describe the role of a Speech-language Pathologist, as the rehabilitative work they do throughout their days is extremely varied and complex. In order to give our readers a more accurate idea of what an SLP does, we asked one to tell us a little more about her patient work here at an Ernest Health Hospital, as well as walk us through her activities throughout the day.

EH: Can you share with us what a typical day looks like for you?

SLP: I get to work around 7 or 7:30 a.m. to help patients with using their safe swallow strategies during breakfast.

We have a short staff meeting at 8:00 to quickly discuss appointments, discharge plans, medical complications, etc. I treat patients from 8:30 to 12. I personally have more energy in the morning, so I try to see my patients then and save documentation for the afternoon

I document daily/weekly progress notes during lunch and begin therapy again at 1:00. I have 2-3 sessions in the afternoon, and then I need to write daily/weekly notes. Part of my role in the afternoon is to look at the patients we will have in the evening and which therapists will be coming in for the evening shift and get the patients signed out to a therapist accordingly.

Some of the things that I have to think about as I’m evaluating patients is: Are the patients sticking to their diet? Are they ready for advancement? How are they handling the diet?

EH: What does the majority of your work involve at Ernest Health, and how would you describe the majority of the patients you work with?

SLP: I provide individual sessions and group therapy sessions two days a week. The majority of my patients have cognitive impairments that limit their ability to make safe decisions.

Stroke and head injury are the majority of the causes.

EH: What treatments/therapies do you use to work with your patients at Ernest Health?

SLP: For dysphagia (swallowing issues): I use myofascial release therapy and e-stim (electrical stimulation) modalities.

Myofascial release therapy is a treatment for patients with dysphagia that aims to loosen up muscles in the cervical area to allow for more contraction in swallowing.

E-stim modalities are used for neuromuscular re-education, which is a technique used to help the patient contract the muscles used in swallowing to teach the patient what it should feel like. E-stim machines can be used for a variety of purposes, though, and all depends on the settings (pain management, muscle contractions, etc.).

One of our SLP’s main focuses is keeping the patient safe by educating them and family members on things like locking the wheelchair and using the call light for help. In addition to these practices, she also does her best to find fun and fresh ways to help retrain patients to their former levels of functionality. Using music therapy and technology like iPad games, for instance, allows the patient to learn in a way that feels less like work and more like recreation.

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Her empathy for the patients, dedication, and caring personality are shining examples of the qualities that Ernest Health values in its team members.

EH: Why did you choose Speech-Language Pathology as a career?

SLP: I chose to be an SLP because I wanted a career that would make a positive impact on someone’s life.

My first semester in undergrad, I, by chance, saw a class schedule with a class about Communication Disorders.  I decided to take it and knew from the beginning this was what I wanted to do with my life.

EH: What hobbies or interests do you have?

SLP: I teach fitness classes before and/or after work. My alarm usually goes off at 4:30 so I can fit in my hobbies. My husband and I enjoy traveling, skiing, and fly fishing together.

What Aphasia Looks Like, and What to do About it

Last week we learned about a patient who had Aphasia, and what it was like for him and his family. Each patient is different when it comes to rehabilitation, but every patient can benefit from a family member that is aware of their condition. Aphasia Awareness Month is the perfect time to learn more about this condition. When a patient experiences damage to the parts of the brain where language occurs, we call this “aphasia.” Aphasia can cause a person to lose their abilities to process language, be it in expression or comprehension.  Most often, the left side of the brain is the one responsible for aphasia and causes the affected person to encounter difficulties with speech and comprehension.

Many of our aphasia patients are stroke survivors. Although things like brain tumors and traumatic brain injury can also be responsible, stroke is most-often the culprit for the language struggles that we help our patients work through.

Common symptoms of aphasia:

Patients with aphasia often display issues with both comprehension and expression.

When most of the problems lie in the comprehension or reception of language, this is often classified as “Wernicke’s Aphasia.” While a sufferer can sometimes pick up on the melody or cadence of a sentence (determining if it’s a command or question, for example), they might have problems understanding the specific words that are being said. Since a person’s vocabulary is housed in the left side of the brain, understanding of words can sometimes be affected, as well as the concept of stringing words together to form a full thought.

When the issues mostly lie in the survivor’s ability to express themselves, it usually falls under the category of “Broca’s Aphasia.” In this case, the symptoms are more outwardly visible, as the patient struggles greatly with speech and the construction of sentences. Aphasia, in this case, can present itself in a variety of ways. Sometimes a patient will create something that sounds like a sentence, but is comprised of gibberish-like words. Other times, they might be able to get out enough words to get an idea across, but leave out small connecting words like “the” or “and.” When all areas of language are hindered, it is referred to as “global aphasia.”

Support

The range of symptoms that can occur during aphasia is wide and varied, but the factor that stays constant is a need of support. Through the support of family members, friends, and rehabilitative therapists, a person suffering from aphasia has a better chance of getting back on the road to understanding and function.

What can you do?

The word “aphasia” can be intimidating. While it is definitely a serious condition, it is one that can be worked with and, to some degrees, overcome.

Recognize… that aphasia has not affected the patient’s intelligence. It has altered their ability to communicate and understand language, but their personality, memories, and knowledge remains. Remembering that the same person you’ve always known resides behind this communication disorder can be grounding and encouraging.

Take the time… to learn your suffering family member’s struggles and specific communicative needs. After a period of routine, you’ll be able to discern how to understand and communicate with your loved one, bringing a sense of comfort and progress to the both of you.

Create… an environment that is conducive to focus and treatment. When a person has difficulty understanding the simplest of words, even the simplest of distractions can be a deterrent to progress. Eliminate extra sounds and excessive visual stimulations, so that your loved one can focus on the task at hand. Simplifying your questions to yes/no and slowing down your rate of speech can encourage success.

Explore… different methods of therapy. Sometimes drawing, writing, and even the encouragement of socialization can stimulate progress in a stroke survivor’s language. It is important to keep communication with your loved one’s therapist open so that you can learn about techniques that may be specifically helpful to your situation.

We understand that recovery is a process that can take its toll on not only the patient but their support systems as well. To alleviate some of the pressure, we encourage you to seek help from rehabilitative professionals, Speech-language pathologists being an ideal option, to make this process as successful as possible.

 

What to Expect from Rehabilitation

Last week we covered identifying and understanding brain injuries. If you or a loved one you know has had a brain injury or are at risk for a brain injury, knowing what rehabilitation will consist of can be comforting during a stressful time. There are many physical and emotional challenges that can discourage both the patient and the caregiver.

Brain injury is a broad category that refers to any injury to the brain which impairs functioning. The injury may be mild, severe, traumatic, or caused by associated medical problems; however, the goal of rehabilitation is the same – help patients gain the most independent level of functioning possible. Whether the brain was injured during a stroke, a fall, or even an electric shock, the goal of Ernest Health is to get our patients back to a place where they can manage and hopefully flourish in daily life. Rehabilitation therapists form a team, together with the patient and family/caregiver(s), to achieve the best possible outcome.

REHABILITATION AFTER BRAIN INJURY:

Rehabilitation after a brain injury is more likely to involve several types of therapists and practitioners on our staff because of the effect that a brain injury can have on multiple parts of the body. A physical therapist would help the individual regain range of movement and strength, like in the case of a patient who has had a stroke and subsequent paralysis. An occupational therapist caring for the same patient might work with him or her on dressing, eating, and completing household chores. A speech pathologist might work with the patient on swallowing and communication. Still other practitioners such as psychologists and social workers would aid in psychological, emotional, and social assessment and care.

Just as with any type of rehabilitation, a patient’s treatment plan is highly individualized. A patient who has experienced a stroke may need different types and degrees of therapy than a person who was in a car accident. It all depends on the extent and impact of the injury. Likewise, one’s treatment may vary according to life stage, age, and daily needs. This individualization greatly benefits our patients and their families.

However, Brain Injuries are so much more than a series of physical consequences. One of the major impacts that brain injuries have on the quality of life is the way that they affect a person’s emotions and relationships. There are hardships that immediately come to mind – communication problems, mobility limitations, cognitive impairment – but there are also complex social and emotional stressors that impact well-being.

 

Knowing what to expect from brain injuries can be especially useful for the caregiver. Being a caregiver requires constant encouraging and optimism, but that can be wearying. Next week we cover brain injury rehabilitation for the caregiver.

For more information on brain injury, go to www.biausa.gov.