Rehabilitation

What is rehabilitation?

Rehabilitation is the process of helping an individual achieve the highest level of independence and quality of life possible - physically, emotionally, socially, and spiritually. Rehabilitation does not reverse or undo the damage caused by a stroke, but rather helps restore the individual to optimal health, functioning, and well-being. Rehabilitate (from the Latin "habilitas") means "to make able again."

The stroke rehabilitation team:

The stroke rehabilitation team revolves around the patient and family. The team helps set short- and long-term treatment goals for recovery and is made up of many skilled professionals, including the following:

physicians such as a neurologist (a physician who treats conditions of the nervous system such as stroke) and physiatrist (a physician who specializes in physical medicine and rehabilitation)
internists and specialists
rehabilitation nurses
physical therapists
occupational therapists
speech and language pathologists
dietitians
social workers and chaplains
psychologists, neuropsychologists, and psychiatrists
case managers

The stroke rehabilitation program:

The outlook for stroke patients today is more hopeful than ever due to advances in both stroke treatment and rehabilitation. Stroke rehabilitation works best when the patient, family, and rehabilitation staff works together as a team. Family members must learn about impairments and disabilities caused by the stroke and how to help the patient achieve optimal function again.

Rehabilitation medicine is designed to meet each person's specific needs; thus, each program is different. Some general treatment components for stroke rehabilitation programs include the following:

treating the basic disease and preventing complications
treating the disability and improving function
providing adaptive tools and altering the environment
teaching the patient and family and helping them adapt to lifestyle changes

The success of stroke rehabilitation depends on many variables, including the following:

the cause, location, and severity of stroke
the type and degree of any impairments and disabilities from the stroke
the overall health of the patient
family and community support

Areas covered in stroke rehabilitation programs may include the following:

Patient need:	Example:
Self-care skills, including activities of daily living (ADLs)	Feeding, grooming, bathing, dressing, toileting, and sexual functioning
Mobility skills	Walking, transfers, and self-propelling a wheelchair
Communication skills	Speech, writing, and alternative methods of communication
Cognitive skills	Memory, concentration, judgment, problem solving, and organizational skills
Socialization skills	Interacting with others at home and within the community
Vocational training	Work-related skills
Pain management	Medicines and alternative methods of managing pain
Spasticity management	Medication and therapy for altered muscle tone
Psychological testing	Identifying problems and solutions with thinking, behavioral, and emotional issues
Family support	Assistance with adapting to life styles changes, financial concerns, and discharge planning
Education	Patient and family education and training about stroke, medical care, and adaptive techniques

Choosing a rehabilitation facility:

Rehabilitation services are provided in many different settings, including the following:

acute care and rehabilitation hospitals
subacute facilities
long-term care facilities
outpatient rehabilitation facilities
home health agencies

When investigating rehabilitation facilities and services, some general questions to ask include the following:

Does my insurance company have a preferred rehabilitation provider that I must use to qualify for payment of services?
What is the cost and will my insurance company cover all or part of the cost?
What are the admission criteria?
What are the qualifications of the facility? Is the facility accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF)?
Has the facility handled treatment for this type of condition before?
Is therapy scheduled every day? How many hours a day?
What rehabilitation team members are available for treatment?
What type of patient and family education and support is available?
Is there a physician onsite 24 hours a day?
How are emergencies handled?
What type of discharge planning and assistance available?

Also see Ohio State University Medical Center's Checklist for Choosing Rehabilitation Services.

For those who have been impaired by stroke, rehabilitation is a crucial part of recovery. Each patient admitted to the Stroke Rehabilitation Program at Dodd Hall, OSU Medical Center's stroke rehabilitation facility, is evaluated and a treatment plan is developed. Treatment may address self-care skills; bowel and bladder function; nutritional intake and swallowing; mobility and locomotion; speech, language or vision needs; cognitive function; or leisure skills.

While treatment targets specific neurological impairments brought on by stroke, the program provides a structured environment to reinforce physical, cognitive and psychological goals.

And, the success of rehabilitation is measured by functional outcome--how much change and improvement the patient has made.

Because Dodd Hall is part of the OSU Medical Center, a leading academic medical center, research into new ways to treat stroke is performed here. One example is the use of Botox.

Given as an injection in very small amounts directly to a specific muscle or group of muscles, Botox blocks the transmission of nerve impulses to muscles. Essentially, it paralyzes the muscles. Botox helps to relax spastic muscles that are too tight, painful, and not able to contract on their own. For example: an arm or leg that is spastic may cause problems with walking, bending and simple movements such as bringing the arm down the side of the body. When Botox is used, it helps to relieve the disruption of muscle coordination.

Depending on the severity of paralysis, one or two injections may be needed or injections every one to two months indefinitely may be necessary. Many patients find relief with one or two Botox injections and an exercise program, which follows. To learn about the side effects of this drug, consult your doctor.

As a result of inpatient rehabilitation, nearly two-thirds of patients discharged from the stroke rehabilitation program return to a home setting. About half take part in outpatient rehabilitation to continue the progress begun at Dodd Hall.

The OSU stroke rehabilitation team is led by board-certified physician specialists in rehabilitation medicine and coordinated by patient care resource managers that includes: nurses; physical, occupational, speech and recreation therapists; social workers; psychologists; dieticians; and other specialists as needed.

We provide a wide range of inpatient services at Dodd Hall and outpatient services throughout central Ohio to help individuals regain lost skills and learn to compensate for those skills they are unable to recover due to a stroke. Our rehabiliation team provides the most comprehensive and efficient treatment available anywhere.

Dodd Hall consistently ranks among the top ten rehabilitation centers in the country according to U.S. News & World Report's list of "America's Best Hospitals." It offers the most comprehensive and efficient treatment available anywhere.

For information about stroke services, call (614) 293-5123 or (800) 293-5123.