- level and type of amputation
- type and degree of any resulting impairments and disabilities
- overall health of the patient
- family support
The goal of rehabilitation after an amputation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life - physically, emotionally, and socially. In order to help reach these goals, amputation rehabilitation programs may include the following:
- treatments to help improve wound healing and stump care
- activities to help improve motor skills, restore activities of daily living (ADLs), and help the patient reach maximum independence
- exercises that promote muscle strength, endurance, and control
- fitting and use of artificial limbs (prostheses)
- pain management for both post-operative and phantom pain (a sensation of pain that occurs below the level of the amputation)
- emotional support to help during the grieving period and with readjustment to a new body image
- use of assistive devices
- nutritional counseling to promote healing and health
- vocational counseling
- adapting the home environment for ease of function, safety, accessibility, and mobility
- patient and family education
The brain injured individual's medical issues can be complex. They can involve issues related to cognitive (thinking) skills, attention, judgment, impulsivity, visual changes, decreased balance, behavior issues, and movement disorders to include tremors and spasticity. Family involvement is also emphasized, because traumatic brain injury effects the whole family system as well as that patient's ability to return to work, and social events.
The goal of rehabilitation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life - physically, emotionally, and socially. In order to help reach these goals, programs may include the following:
- assistance with activities of daily living (ADLs) such as eating, dressing, bathing, toileting, handwriting, cooking, and basic housekeeping
- speech therapy to help patients with speaking, reading, writing, or swallowing
- stress, anxiety and depression management
- bladder and bowel retraining
- activities to improve mobility (movement), muscle control, gait (walking), and balance
- exercise programs to improve movement, prevent or decrease weakness caused by lack of use, manage spasticity and pain, and maintain range of motion
- social and behavioral skills retraining
- nutritional counseling
- involvement in community support groups
- activities to improve cognitive impairments, such as problems with concentration, attention, memory, and poor judgment
- help with obtaining assistive devices that promote independence
- patient and family education and counseling
- safety and independence measures and home care needs
- pain management
- vocational counseling
- managing pain.
- improving bowel and bladder function.
- improving nutritional status.
- improving physical conditioning, endurance, and exercise performance.
- improving social, cognitive, emotional, and vocational status.
- reducing hospitalizations.
In order to help reach these goals, cancer rehabilitation programs may include the following:
- using medications and pain management techniques to reduce pain
- exercise programs to help build strength and endurance
- patient and family education and counseling
- activities to improve mobility (movement) and decrease sleep problems
- assistance with activities of daily living (ADLs) such as eating, dressing, bathing, toileting, handwriting, cooking, and basic housekeeping
- smoking cessation
- stress, anxiety, and depression management
- nutritional counseling
- management of chronic illness or complications due to cancer treatments
- vocational counseling
- decreasing cardiac symptoms and complications.
- encouraging independence through self-management.
- reducing hospitalizations.
- stabilizing or reversing atherosclerosis (plaque buildup in the blood vessels).
- improving social, emotional, and vocational status.
In order to help reach these goals, cardiac rehabilitation programs may include the following:
- medication management to help reduce cardiac symptoms, complications, and hospitalizations
- exercise programs to help build fitness and improve endurance
- methods to improve independence and activities of daily living (ADLs)
- patient and family education and counseling
- smoking cessation
- nutritional counseling
- stress management and emotional support
- vocational counseling
The test involves measuring the conduction along the nerve in various parts of the extremities. Generally, a test may take anywhere from 30 minutes to several hours depending on the degree of difficulty. A typical study lasts approximately one hour. Electrodiagnostic studies begin with a focused history and detailed physical examination. The initial component involves small electrical stimulations that assist with a measuring how fast signals travel along a nerve. The second part involves placing small pins into different muscles in the back, arms, or legs to assess the affect of the nerve on the muscle itself. Physicians complete all tests.
Individuals discharged from the inpatient rehabilitation program are seen for follow-up visits to evaluate continued progress made with physical and/or occupational therapy. The goals are for independence in activities of daily living and to maximize the mobility potential on an individual basis. When the maximum home health goals have been met and further needs are present, the individual will be referred for outpatient therapy for continued rehabilitation.
The goal for individuals discharged to an extended care facility for short term stay is for progression to home health in their home and outpatient therapy if needed. Mobility goals are always established with maximum safety as a goal. The progression is wheelchair, walker, quad cane, straight cane, and independent ambulation. Referring physicians are provided reports of individuals progress and consulted promptly should a new medical situation arise.
- medical management of chronic pain, including medication management
- heat and cold treatments to reduce the stiffness and pain, especially with joint disorders such as arthritis
- physical and occupational therapy interventions such as massage and whirlpool treatments
- exercise to reduce spasticity, joint contractures, joint inflammations, spinal alignment problems, or muscle atrophy (weakening and shrinking) to prevent further problems
- local electrical stimulation involving application(s) of brief pulses of electricity to nerve endings under the skin to provide pain relief in some chronic pain patients
- nerve blocks and regional anesthesia
- emotional and psychological support for pain, which may include the following:
- psychotherapy and group therapy
- stress management
- relaxation training
- meditation
- hypnosis
- biofeedback
- behavior modification
- assertiveness training
The philosophy common to all of these varied psychological approaches is the belief that patients can do something on their own to control their pain, including changing attitudes, feelings, or behaviors associated with pain, or understanding how unconscious forces and past events have contributed to pain.
- patient and family education and counseling
- alternative medicine and therapy treatments, as appropriate
Surgery may also be considered for chronic pain. Surgery can bring release from pain, but may also destroy other sensations as well, or become the source of new pain. Relief is not necessarily permanent, and pain may return. There are a variety of operations to relieve pain. Consult your physician for more information.
- assistance with activities of daily living (ADLs) such as eating, dressing, bathing, toileting, handwriting, cooking, and basic housekeeping
- speech therapy to help patients with speaking, reading, writing, or swallowing
- stress, anxiety and depression management
- bladder and bowel retraining
- activities to improve mobility (movement), muscle control, gait (walking), and balance
- exercise programs to improve movement, prevent or decrease weakness caused by lack of use, manage spasticity and pain, and maintain range of motion
- social and behavioral skills retraining
- nutritional counseling
- involvement in community support groups
- activities to improve cognitive impairments, such as problems with concentration, attention, memory, and poor judgment
- help with obtaining assistive devices that promote independence
- patient and family education and counseling
- safety and independence measures and home care needs
- pain management
- vocational counseling
The goal of stroke rehabilitation is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life - physically, emotionally, and socially. In order to help reach these goals, neurological rehabilitation programs may include the following:
- assistance with activities of daily living (ADLs) such as eating, dressing, bathing, toileting, handwriting, cooking, and basic housekeeping
- speech therapy to help patients with speaking, reading, writing, or swallowing
- stress, anxiety and depression management
- bladder and bowel retraining
- activities to improve mobility (movement), muscle control, gait (walking), and balance
- exercise programs to improve movement, prevent or decrease weakness caused by lack of use, manage spasticity and pain, and maintain range of motion
- social and behavioral skills retraining
- nutritional counseling
- involvement in community support groups
- activities to improve cognitive impairments, such as problems with concentration, attention, memory, and poor judgment
- help with obtaining assistive devices that promote independence
- patient and family education and counseling
- safety and independence measures and home care needs
- pain management
- vocational counseling