By Cindy Kenyon, Grace Cottage PT, and Melinda Roy, Grace Cottage OT
Grace Cottage Hospital offers several specialized inpatient therapies that help patients recover from a neurological issue such as a stroke or other brain injury, spinal injuries, surgical procedures, Parkinsonism, multiple sclerosis, or post-polio syndrome. Would this help someone you know? We’d like to explain some of these therapies to help you decide.
The first therapy we would like to tell you about is called “Neurodevelopmental Treatment,” or NDT for short. Using NDT, Grace Cottage’s physical, occupational, and speech therapists help patients recover their ability to move their bodies when neurological functions have been compromised.
NDT is a hands-on treatment approach using guided (or facilitated) movements to enhance the neurological messages from receptors in the skin, muscles, joints, balance centers, and the whole sensory system, to stimulate the brain toward normal movement. During treatment sessions, repeated experience in guided or facilitated movement ensures that a particular pattern is more readily accessible for motor performance.
The scope of problems that neuro-rehab can address is as wide as the number of physical tasks that a person performs during a typical 24-hour period. One simple example is the task of brushing your teeth. Most of us don’t have to think too hard to brush our teeth, but it actually requires a complicated series of movements, as well as good vision and cognition. Fine motor skills are needed to move your fingers effectively to take the cap off the toothpaste tube. You also need a certain amount of strength to grip the brush in your hand and to raise it to your mouth. You have to be able to steer properly and coordinate movements to effectively complete this task.
Another more recent neuro-rehab technique is called “Constraint Induced Therapy” (CIT). An example of CIT is putting the stronger arm in a sling to encourage the brain to use the weaker side. Research using functional MRI testing demonstrates that the injured neurons in the brain are more able to rejuvenate, a condition called “neuroplasticity.” The increased motor stimulation leads to a greater recovery of motor function with more normal movement patterns after a stroke.
Sometimes, the care team determines that a patient with weakness on one side of the body, perhaps due to a stroke, is overly dependent on the stronger side, rather than challenging the weaker side to get stronger. In this case, the therapists may decide to rearrange the patient’s room so that everyone, including doctors, nurses, therapists, food service, housekeeping, and even visitors will approach the patient from the weaker side.
Grace Cottage also treats many patients with Parkinson’s disease. With these patients, the key treatment word is “BIG.” People living with Parkinsonism often move differently, with gestures and actions that tend to become smaller and slower over time. Exercises termed “BIG” are ones that work to increase range of motion and push patients to use all of their muscles, from head to toe. These intensive “BIG” therapy exercises can help to improve flexibility, increase step length and walking speed, strengthen core muscles, and improve balance. Recent studies have shown that physical, occupational, and speech therapies can also reduce depression and anxiety for patients with Parkinsonism, contributing to a higher quality of life.
One other exciting development in the field of neuro-rehab is the use of Tai Chi. The slow, deliberate movement patterns of Tai Chi challenge the patient’s nervous system to improve strength, control, coordination, and balance. Research proves that Tai Chi reduces fall risk in the elderly. In addition to utilizing Tai Chi in the inpatient setting, Grace Cottage also offers Tai Chi classes for the public in its Community Wellness Center.
NDT, CIT, BIG, and Tai Chi therapies are advanced professional skills that require additional coursework. Grace Cottage therapists have been trained in these skills and use them regularly, in addition to other therapeutic techniques.
Grace Cottage Family Health & Hospital has 19 inpatient beds, so the rehabilitation therapy staff has more time for personalized care. Therapists provide up to three hours of therapy each day for our inpatients, usually two sessions of physical therapy and two sessions of occupational therapy each day, plus speech therapy if needed. Our rehab sessions are always patient-goal-oriented (never in a group), so patients continually receive the one-to-one therapeutic care that helps them recover to their fullest potential.
At Grace Cottage, the whole staff is intimately involved in a patient’s therapy. Twice a week, physicians, nursing staff, rehabilitation therapists, and other staff meet to discuss the plan of care for each inpatient and to strategize ways to help promote greater healing. Social workers, discharge planners, and members of the Community Health Team also attend these meetings so that they can help with planning for a patient’s eventual move to home or another facility. Family members and caregivers are also included in these decisions.
To find out more about these services at Grace Cottage, please call 802-365-3637.
Cynthia Kenyon, PT, graduated Cum Laude from University of Connecticut in 1981 with a Bachelor’s of Science degree in physical therapy. She joined the Grace Cottage staff in 2008.
Melinda Roy, M.S. OTR/L, earned her Masters of Science in Occupational Therapy at Springfield College. She joined the Grace Cottage staff in 2015.