• Our Services
    • Our Services
    • Therapy Tools
  • Our Team
  • About Us
    • About Us
    • Partners & Board
    • NeuroHope News
    • Media Coverage
    • Videos
  • Success Stories
  • FOUNDER’S STORY
  • Contact Us
  • Donate
  • Menu Menu
  • Home
  • Our Services
    • Therapy Tools
  • Our Team
  • About Us
    • Partners & Board
    • NeuroHope News
    • Media Coverage
    • Videos
  • Success Stories
  • FOUNDER’S STORY
  • Events
    • 6TH ANNUAL SWING “FORE” HOPE GOLF SCRAMBLE PRESENTED BY VALEO FINANCIAL
  • Contact
  • Donate

4 Ways Outpatient Physical Therapy Must Change

March 22, 2014/in General Blog Posts/by Chris Leeuw

The average stay at a rehabilitation hospital after a spinal cord injury is 37 days.

Much of that time revolves around a grueling 3-4 hour per day routine of physical and occupational therapy that is integral to the recovery process, as messages from the brain attempt to re-communicate with the body.  Unfortunately, when patients are discharged, therapy comes to a swift and premature halt.  The injured move home and graduate to outpatient care.  This “graduation” means therapy visits are slashed.  Depending on insurance coverage, time is limited to two or three hours per week, which are then capped at a small total annually.

It’s clear to both patients and clinicians that the limited number of outpatient visits, (and the incredibly high costs of those visits) are a huge problem for the injured.  Therapists spend hours each day documenting progress that begs insurance for more time.

That’s a different topic, for a different day.

What’s not as clear, and what took me three years visiting clinics around the country to understand, is that the approach of outpatient therapy at many facilities needs to change at a fundamental level.  

1.  Shift focus from traditional therapy to activity-based therapy

It’s time for neurologic rehab to move beyond “traditional” physical therapy that focuses on compensatory techniques (methods that show patients how to compensate for what they’ve lost by using what they have).  The underlying goal of traditional therapy is to teach patients how to adapt to their injury, so they can move on with their lives as soon as possible. LT Treadmill fn

Traditional therapy certainly has its value.  There is tremendous importance in learning how to adapt to injury, and find ways to gain back independence.

But, a new paradigm of neuro recovery is gaining traction at some of the elite rehab facilities around the country.  It’s a shift toward activity-based therapy that focuses on strengthening the weaker muscles and nerve connections through intense functional exercise.  This may include a number of different techniques: weight bearing, assisted treadmill and cycling, or aqua therapy – anything to help promote activity both below and above the injury level.

This more recent approach is based on research indicating that the nervous system has, to a certain extent, the ability to “re-train” itself through neuroplasticity.  Which, simply put, is the idea that the central nervous system is not completely irrepairable.  Neurons that relay information through the spinal cord try hard to repair and re-organize themselves after injury.  Activity, and a blend of therapy, exercise, and repetition can help promote this.

Rehab facilities like Shepherd Center's Beyond Therapy, Craig Hospital’s PEAK Center, Magee Rehab, and others are already focusing on activity-based therapy.  More facilities need to follow suit.

 2.  Develop wellness programs at the facility for patient off-days

Access, repetition, and more access. 

That, above all else is what needs to change most about outpatient therapy. vitaglidejpg fn

I’ve lost count of the number of physical and occupational therapists I’ve met and worked with since my spinal cord injury.  I’ve never met one who disagrees with the mantra of access and repetition. They fight a constant battle for more outpatient visits and more time to work with patients. 

A combination outpatient clinic / wellness center makes too much sense not be more common.

Two physical therapy visits per week are not enough rehab for spinal cord injury.  Increasing that time through exercise programs with aides and trainers on off days or after therapy visits can make up for it.

Patients should be able to come to the facility and use what they have learned from their therapists to continue their rehab.  They should have access to the tools, and assistance from aides to develop a workout plan on par with their “official” outpatient visit.  This access can provide the injured more rehab, AND can ensure the limited time they have with a therapist is better spent.   

A therapist knows how to properly support and guide a subluxed shoulder through PNF patterns or serratus presses.  A therapist can pinpoint irregular gait patterns and suggest how to fix it.  A therapist’s time is best used for that.  Save time on an armbike, recumbent bike, or time practicing fine motor skills for when the “official” therapy is over.  Aides or personal trainers can help with that, and supervise routines the therapist may prescribe.

Neuroworx and Frazier Rehab focus on a similar style of rehab and wellness.  Their model needs to be replicated.

 3. Blend methods of technology and exercise

Lokomat 1 fn There is no singular “magic” method of physical therapy for patients with neurologic injury.  Robotic therapy may be very beneficial to one person; old fashioned assisted exercise with a therapist may be the best course of treatment for another person.  Neurologic recovery is far more complex than rehabbing a torn ACL or rotator cuff that has a standard protocol of care and expectation of results.

So, having access to the latest and greatest technological resources like robotics, a body-weight supported treadmill system, or electrical stimulation is fantastic, but any of these methods alone is not enough.  Just like an outpatient visit simply to perform squats is not enough.

“Should we work on hip-flexors today?”  isn’t going to cut it.  Just like harnessing someone up in a Lokomat twice a week isn’t going to cut it.

It takes a comprehensive approach.  A treatment plan that includes time spent using cutting edge equipment, and 1-on-1 exercise with experienced therapists. 

For many outpatient clinics it is often one or the other. 

4.  Create a gym-like atmosphere, not a doctor’s office

The best and most effective physical therapy sessions are WORKOUTS.  They are intense and rigorous routines that get the heart pumping and muscles stretched and fatigued.  Regardless of the injury level, the wheelchair-bound must get out of their chairs and moving, not just for the sake of recovery, but for overall physical and mental health as well.

Therapists need to take a page out of a personal trainer’s playbook and combine their expertise with fitness and exercise routines.

This goes for the atmosphere in the clinic as well. The injured spend a great deal of time in doctor’s offices.  Outpatient therapy should not seem like another doctor visit, sitting in a waiting room until a therapist comes to work on a few isolated muscle movements.  Patients need time to loosen up on a machine like a Nu-Step, or an armbike, and get stretched by an aide before therapy begins.  Muscles affected by paralysis need time to iron out spasticity and prep themselves for use.  Warming up is important for an able-bodied person before a workout, and much more so for people with paralysis.

So, turn on music, open the area, and create a community.  Turn physical therapy into a gym environment, not a doctor’s office.

I’ve seen this approach first-hand at Neuroworx, NextStep Fitness, Project Walk, Journey Forward, Courage Kenny, and more.

Throughout my recovery I’ve been fortunate enough to experience the practices at some of the most forward-thinking facilities in the country.  Every year, when my insurance refreshes and I return to the more traditional programs in Indiana, I see the void, but I also see the potential. 

Many of the resources are present.  All that is missing is the catalyst for change.

For a rehab facility to truly consider itself a beacon in neurologic care, it’s not a question of if it evolves a standard of care – it’s a question of when.

 

 

 

 

 

 

 

Share this entry
  • Share on Facebook
  • Share on Twitter
  • Share on Twitter
  • Share on WhatsApp
  • Share on Pinterest
  • Share on LinkedIn
  • Share on Tumblr
  • Share on Vk
  • Share on Reddit
  • Share by Mail
https://www.neurohopewellness.org/wp-content/uploads/2014/03/1-on-1-matt-fn.jpg 386 620 Chris Leeuw /wp-content/uploads/2022/07/NeuroHope_Color.svg Chris Leeuw2014-03-22 10:51:282015-09-16 17:31:534 Ways Outpatient Physical Therapy Must Change

Archive

Categories

  • Annoucements (32)
  • General Blog Posts (74)
  • Homepage (19)
  • Media (14)
  • News (14)
  • Personal (1)
  • Success Story (15)

Facebook

Instagram

neurohope

View

Dec 7

Open
Staff Spotlight Video: We’re shining the spotlight on Megan Lashley, MS, a Neurorecovery Exercise Specialist at NeuroHope. Megan is an American College of Sports Medicine (ACSM) certified Exercise Physiologist, whose passion for neurologic recovery began when she was a sophomore in college after completing shadowing hours at NeuroHope. Less than a year later, she returned to NeuroHope as an intern, where she once again fell in love with NeuroHope’s mission. After graduation, Megan went on to earn a Master’s degree in Exercise Science from the University of Indianapolis, and she joined NeuroHope full-time in 2020.

Megan aspires to travel to all of the national parks within the US, while also spending time in all 50 states, following in her grandparents footsteps. She also enjoys reading, hiking, and spending time with her family, friends, and her dog.

In this video, Megan discusses how NeuroHope is unique in that long-term, affordable care is available for everybody. She explains how there is a continuum of care at NeuroHope that addresses a spectrum of needs and goals at every stage of recovery. Megan shares how much she enjoys building relationships with NeuroHope clients and being part of this special team. Check out Megan’s video here…

#neurohope #spinalcordinjuryrecovery #neurofit #affordablerehab #hope #neurorecoverycenter #nonprofit #healthcare #inspiring #beinspired #adaptivefitness  #spinalcordinjury

neurohope

View

Dec 2

Open
It’s a Patient Party! Celebrating our amazing people and kicking off the holiday season with the best folks we know! 

#happyholidays #tistheseason #neurohope

neurohope

View

Nov 29

Open
The healthcare system is complex, especially for people recovering from neurological conditions like spinal cord injury, brain injury, and stroke. The cost of care is high and the time spent in insurance-covered rehabilitation is short. Our mission revolves around providing services for the people that fall through the cracks of healthcare. This is why we are here.

We smashed our $5,000 #GivingTuesday goal and raised $12,000 to support our programs for people recovering from paralysis. 

Thank you for supporting NeuroHope!

#givingtuesday #neurohope #affordablerehab #spinalcordinjury #neurorecovery #affordablehealthcare

neurohope

View

Nov 28

Open
♥️ It's GIVING TUESDAY! We would love your support as we strive for $5,000 today for a new medical record system! 

The largest giving day of the year. We appreciate your support and belief in what we do - and we hope you will consider supporting NeuroHope today!
 
Donation link is in our bio!
Follow along our IG Stories for patient videos today!

-The NeuroHope Team

#givingtuesday #neurohope #affordablerehab #spinalcordinjury #neurorecovery #affordablehealthcare

neurohope

View

Nov 27

Open
ONLY 1️⃣ MORE DAY ‘TIL GIVING TUESDAY!

Tomorrow is GIVING TUESDAY – the largest fundraising day of the year!
Please help us reach a $5,000 goal for a new medical record system!
 
We will share the donation link TOMORROW MORNING!
 
In the meantime, the last program highlight in our three day email series is below, featuring the monthly wellness and adaptive fitness programs at NeuroHope. 

Monthly Wellness Program:
 NeuroHope provides an affordable “next step” in care for people recovering from paralysis. 
 
Physical therapy, occupational therapy, and personal training (guided rehabilitative exercise) are the core programs we provide, but NeuroHope also recognizes that recovery is about more than “therapy”.  Our monthly wellness program, called the “Path to Independence” (PTI) program, is an important part of our model of care, with more than 40 of our 120 active patients enrolled!
 
The PTI program is led by Wellness Coordinator Mel Spencer.  Mel earned her Master’s degree in Exercise Science and uses her knowledge to develop exercise plans for clients for open and supervised gym access at our adaptive fitness center.  With assistance from our amazing therapy techs Caroline Kavanaugh, Ryan Bardellini, and student interns, Mel also leads daily group cardio and adaptive strength training classes.

Our wellness program has grown to feature much more than physical fitness. 
 
The caregiver support group “Warrior Wednesdays”, and community group “First
Friday with Friends” led by PTA Lydia Miner and patient Jenny Rosebrock and caregiver Mary Meredith meets each month,  and we look forward to adding nutrition and mental health programs in the coming year!
 
Together, we have created a community that has evolved into a critical resource for the spinal cord injury, brain injury, and stroke community in central Indiana. 
 
Our growth through the years has been possible thanks to supporters LIKE YOU!

Thank you and stay tuned for TOMORROW!
-The NeuroHope Team

#givingtuesday #neurohope #affordablerehab #spinalcordinjury #adaptivefitness #affordablehealthcare #guidedexercise #personaltraining

neurohope

View

Nov 26

Open
2️⃣ DAYS ‘TIL GIVING TUESDAY!! 

We are TWO DAYS away from the nation's biggest fundraising day: GIVING TUESDAY!  On Tuesday morning, we will share a donation link and ask for YOUR HELP to smash our $5,000 goal for the day to fund a new medical record system for the clinic, so don't miss it! No matter the donation amount, every dollar is a difference-making impact. 
 
Each day until then, we're highlighting the three programs at NeuroHope (Physical / Occupational Therapy, Guided Exercise, Monthly Wellness) that make our comprehensive program so unique.

Guided Rehabilitative Exercise:
 It takes months, sometimes years to recover from neurologic injury - much more time than insurance-based therapy allows.  NeuroHope understands that recovery goes beyond therapy.  Our unique model of care features a Guided Exercise (GE) team of kinesiologists and personal trainers that specialize in rehabilitative exercise and work with our physical and occupational therapists to provide patients a critical "next step" in care.
 
The GE Team is led by Director Bart Richwalski (MS, CSPS), Neurorecovery Exercise Specialists Barry Moore, Megan Lashley, Steven Bowser, Marshall Sparenberg, and Exercise Specialist Hamilton Spidle. 

NeuroHope is special because of our comprehensive model that ensures affordable, longer-term access to therapy and fitness programs are available for people living with paralysis.
 
We have helped more than 500 people on their road to recovery - thanks to supporters LIKE YOU!

Thank You and stay tuned!
-The NeuroHope Team

#givingtuesday #neurohope #affordablerehab #spinalcordinjury #adaptivefitness #affordablehealthcare #guidedexercise #personaltraining

neurohope

View

Nov 25

Open
3️⃣ DAYS ‘TIL GIVING TUESDAY!!!

The largest fundraising day of the year is THREE DAYS AWAY! Each day until then, we're highlighting the three programs at NeuroHope (Physical / Occupational Therapy, Guided Exercise, Monthly Wellness) that make our comprehensive program so unique.

As the holiday season kicks off with BLACK FRIDAY and CYBER MONDAY, don't forget about GIVING TUESDAY!

On Tuesday morning, we'll email a donation link, and ask for YOUR HELP to smash our $5,000 goal for the day to fund a new medical record system for the clinic - so don't miss it!
 
Physical and Occupational Therapy:
Patients recovering from neurologic injury are discharged from the hospital in a matter of weeks.  Unfortunately, their long rehabilitative journey has just begun.

Extended care programs at NeuroHope begin with the Physical and Occupational therapists that guide treatment plans and tailor their care to maximize neurologic recovery for patients when they leave the hospital.
 
Our therapy team is led by Director Elliot Cohee (PT, DPT, NCS), physical therapists Brittanie Helgeson and Ali Peters, PTA Lydia Miner, and Occupational therapists Elizabeth Mahay and Krista Kaufman. 

Our amazing therapy team works with our Guided Exercise team (kinesiologists) to ensure a high standard of rehabilitative exercise continues following their clinical discharge.
 
NeuroHope is special because of our comprehensive model that ensures affordable, longer-term access to therapy and fitness programs are available for people living with paralysis.
 
Our growth through the years has been possible thanks to supporters LIKE YOU!

Happy Holiday season, and stay tuned!
-The NeuroHope Team

#givingtuesday #neurohope #affordablerehab #spinalcordinjury #adaptivefitness #affordablehealthcare #physicaltherapy #occupationaltherapy

neurohope

View

Nov 23

Open
It has been the largest year of growth at NeuroHope! We added staff, brought high-tech therapy tools to our clinic, started a new research project to track the health of our patients, and most importantly - helped more than 200 families receive extended care in their fight against paralysis. 

We are eternally grateful for the donors, sponsors, and community partners that make what we do possible.

On behalf of our entire team: THANK YOU and HAPPY THANKSGIVING!!!!

#neurohope #neurorecovery #affordablerehab #thankyou #thankful #grateful

neurohope

View

Nov 20

Open
PT Brittanie working with Mike on the @hocomamedical Lokomat.  Robotic gait training after #spinalcordinjury.  Keep pushing Mike!

neurohope

View

Nov 16

Open
Staff Spotlight Video: We’re shining the spotlight on our (newly promoted - YAY Barry) Lead Neurorecovery Exercise Specialist, Barry Moore!

A native of Ireland, Barry came to the United States after college and earned a Master’s degree in Kinesiology from Indiana University (IUPUI). While in school, he found a passion for helping people with disabilities by working with children with physical and/or intellectual disabilities. Prior to joining NeuroHope as a staff member, Barry served as an intern and helped develop the clinic’s comprehensive “Path to Independence” Wellness program.

Barry is a Certified Inclusive Fitness Trainer through ACSM and has been trained in locomotor training, neuromuscular electrical stimulation and various other neurologic recovery techniques. Barry loves exploring the United States, playing golf and Gaelic football and has recently started taking yoga classes.

In this video, Barry expresses how our client’s opinions matter and their goals matter. Barry explains how NeuroHope has given their client’s the framework to build their own community. He shares how NeuroHope clients support each other and work together. Barry’s role is to guide NeuroHope clients through recovery and give them the skills to utilize in everyday life. Check out Barry’s video here…

#neurohope #spinalcordinjuryrecovery #neurofit #affordablerehab #hope #neurorecoverycenter #nonprofit #healthcare #inspiring #beinspired #adaptivefitness  #spinalcordinjury

neurohope

View

Nov 14

Open
NeuroHope is hiring therapy techs in part-time or full-time roles! Our tech role is an ideal position to get hands-on experience in a Neuro rehab setting and is perfect for anybody interested in PT/OT or adaptive fitness/exercise. PT/OT students are encouraged to apply! 

Interested candidates can contact us here: https://www.neurohopewellness.org/contact/

#nowhiring #indynowhiring #therapytech #neurohopeteam

neurohope

View

Nov 13

Open
🎉 Big congratulations to NeuroHope team members Barry Moore and Hamilton Spidle! Barry has been promoted to our Lead Neurorecovery Exercise Specialist and Hamilton has been promoted to Exercise Specialist. We are so proud of them both! 

#neurohope #spinalcordinjuryrecovery #neurofit #affordablerehab #hope #neurorecoverycenter #nonprofit #healthcare #inspiring #beinspired #adaptivefitness  #spinalcordinjury

neurohope

View

Nov 9

Open
The temperature is dropping in Indy, but the energy is always high at NeuroHope! Our clients are on fire and there’s lots of great things happening here today! Mel is pushing the Neuro-Fit crew hard, Bart is helping Mitchell rock out on the Lokomat, and our PT team is having a blast training with Bill! The fun never stops at NeuroHope! 

#neurohope #spinalcordinjuryrecovery #neurofit #affordablerehab #hope #neurorecoverycenter #nonprofit #healthcare #inspiring #beinspired #adaptivefitness  #spinalcordinjury

neurohope

View

Nov 5

Open
When a drunk driver struck her vehicle in 2020, @laura.burdick10 ‘s life changed in the “Blink of Eye “. As a fitness, nutrition, and wellness expert and a managing yogi at @thehotroomyoga, Laura’s personal identity revolved around physical activity.  After a paralyzing spinal cord and traumatic brain injury she wasn’t sure where life would take her.

Recovery from paralyzing injuries goes well beyond physical rehabilitation, or the ability to move.  In many ways, the mental and emotional journey is even more difficult.  Laura’s message to the audience at the “Inspiration Gala” for @vigo_county_ymca YMCA 
last night , was that no matter the struggle we go through in life,  it can be overcome by finding your purpose. 
 
Laura has found hers, bringing her knowledge and passion for healthy living to a new audience of wheelchair users and people living with paralysis, and by telling her story to continue to inspire everyone she meets to live their best life.

We are honored to know Laura and be a part of her journey!

neurohope

View

Nov 2

Open
Staff Highlight Video! Spotlight on Physical Therapist Assistant (PTA), Lydia Miner!

Lydia received her Exercise Science Bachelor’s degree and Physical Therapist Assistant Associate’s degree concurrently from the University of Indianapolis. During her education she became an ACSM Certified Personal Trainer, earned a minor in Psychology and completed a Healthy Diploma concentration. In her final year of school she had the opportunity to intern at NeuroHope and discovered her passion for helping those with neurological conditions. In 2020 she joined the NeuroHope team full-time as a PTA.

In this spotlight video, Lydia describes how she tries to individualize her client’s treatment plan by focusing on their goals and making sessions fun and engaging. She also touches on the unique bond that NeuroHope clients have with one another and how the NeuroHope community always cheers each other on. Check out Lydia’s video here…

#spinalcordinjuryrecovery #neurofit #affordablerehab #neurorecoverycenter #nonprofit #healthcare #indy #neurohope #hope #inspiring #beinspired #adaptivefitness #spinalcordinjury #physicaltherapistassistant

neurohope

View

Oct 31

Open
🔥 We decided to spice things up at NeuroHope and dress as condiments today! After-all, the secret to our special sauce is this AMAZING team! 

👻 Happy Halloween friends! 🎃

#happyhalloween #sauce #saucey #hotsauce #neurohope #spinalcordinjuryrecovery #neurofit #affordablerehab #hope #neurorecoverycenter #nonprofit #healthcare #inspiring #beinspired #adaptivefitness  #spinalcordinjury

neurohope

View

Oct 26

Open
We are thrilled to announce a two-year grant from the Indiana Spinal Cord and Brain Injury Fund that will track the health and hospital re-admittance rates of NeuroHope patients. 

People living with paralysis must overcome much more than the ability to move. Pressure sores, urinary tract infections, muscle contractures, and other complications from inactivity send 30% of patients to the hospital at least once per year, and cost the healthcare system thousands of dollars every time. 

On November 1, we begin work with the University of Indianapolis to monitor how often NeuroHope patients  are afflicted with or hospitalized with these conditions, compared to the national average of people with neurologic injury.

Providing an atmosphere of access for the programs patients need to stay healthy remains a core principle of what we do.  This grant will help tell the story of the lives we change, and will strengthen our mission to revamp the standard of care in Indiana and beyond!

#neurohope #uindy #ctsi #spinalcordinjuryresearch #spinalcordinjuryrecovery #neurofit #affordablerehab #hope #neurorecoverycenter #nonprofit #healthcare #inspiring #beinspired #adaptivefitness  #spinalcordinjury

neurohope

View

Oct 24

Open
Our Multi-Fit circuit training team is READY TO GO! Let’s goooooo! Let’s get after those goals! 

#multifit #neurohope #circuittraining #goals #letsgo #strengthtraining #adaptivefitness #wellness #strength #community #fitness #resistance

neurohope

View

Oct 22

Open
Two great days at @u2fp annual conference gathering researchers, clinicians, patients, and advocates together to share developments in the search for a cure for #spinalcordinjury and continual improvement of quality of life after injury.

As momentum for a cure progresses, there must also be a system in place for adequate clinical delivery (access to care). 

This is why NeuroHope is here.
.
#neurorecovery #carecast #spinalcordinjuryrecovery #sci #neuro #neuroscience 

#affordablerehab #neurorecoverycenter #spinalcordinjury #unite2fight

neurohope

View

Oct 12

Open
Client Spotlight Video! Today we’re shining the spotlight on NeuroHope client Michael “Mike” Whiteside! 

In this video Mike discusses his spinal cord injury that occurred in 2021 and his road to recovery at NeuroHope. He explains how the staff at NeuroHope met him where he was at mentally and wanted to know how he was doing emotionally. 

He touches on how his military background has shaped him to be a very structured person and how the NeuroHope team helped him create a structured plan of action for his paralysis recovery. Mike shares that there is hope and NeuroHope has given him confirmation that he has a future and it does not stop here.

Check out Mike’s inspiring video here…

#spinalcordinjuryrecovery #neurofit #affordablerehab #neurorecoverycenter #nonprofit #healthcare #indy #neurohope #hope #inspiring #beinspired #adaptivefitness #spinalcordinjury

neurohope

View

Oct 10

Open
Nothing can stop these goal getters! We love watching our hard-working clients crushing their goals! 

#cantstopwontstop #goals #neurorehab #neurorecovery #affordablerehab #physicaltherapy
Load More

6002 Sunnyside Rd.
Indianapolis, IN 46236

Located In The Concrete
Building Attached To The US
Lumber Warehouse

Contact Us

Phone: 317-525-8386

Fax: 844-556-4672

Open Monday – Friday

9AM – 5PM

Donate Now

NeuroHope is a 501(c)3 non-profit that provides long-term physical rehabilitation and wellness following neurologic injury.   TIN: 46-1842276

Your contribution keeps our extended care services strong.  Thank You!

© Copyright NeuroHope 2023

Privacy Policy

One Summer Sunday: A Sister’s Perspective
Scroll to top