By Susan Hecht, R.N.
Video games, for many years that I can remember, have been geared to the younger generation with parents complaining, “Those video games are no good,” and “My kids sit in front of the television all day on those games.” The older generation often describes video systems as, “Too complicated!” “They’re for kids” or “They’re no good for you.”
But the new Nintendo Wii system is playing a big part in rehabilitation for stroke, brain injury and other patients with decrease in balance, coordination or functional mobility.
Wii requires the player to perform the movements of the game as opposed to pushing buttons on a controller. Saint Francis Hospital’s Comprehensive Integrated Inpatient Rehabilitation Program has implemented the Wii system.
I personally have played the game. It is unbelievable, great for exercise, coordination, balance, eye-hand coordination and motor skills. Here’s how it helps a patient:
It is much more fun than the traditional therapies and exercise programs. It assists in getting patients to communicate and participate in group activities. It helps gain coordination and balance. The games simulate activities such as; tennis, golf, bowling, racing, Ninja games and many more. Keep in mind different games may be helpful to different patients depending on their diagnosis. The games resemble movements of activities of daily living, such as sweeping, washing windows or sometimes even the sport itself. The Ninja games help patients with eye-hand coordination and to even improve scanning visual fields.
Keep in mind that the Wii system is just a tool used by the patients with staff monitoring and does not replace the individual therapy designed upon admission. Here’s some feedback from patients who have used the system: “It was great, the golf is very realistic, and I am a big golfer. It was very helpful” and “The bowling was good for me; it showed me my weaknesses and what I need to work on.”
Saint Francis Hospital Inpatient Rehab continues to research innovative ways to improve the quality of life and increase independence to all our patients throughout their rehabilitation stay.
Friday, February 22, 2008
Monday, February 18, 2008
Muscle Loss Part of Aging Process
By Joanne Chaconis, RD
Chief Clinical Dietician
I recently read an article that caught my eye because it applies to an age group that I find myself a member 44 -55 years. It addressed a condition called sarcopenia. This means a degree of muscle loss (suddenly gray hairs don’t seem so bad!). But even though skeletal muscle starts to decline in this age group, there are ways to lessen the impact.
1.) Less muscle, less bone. It seems that osteoporosis and sarcopenia are interrelated. If you lose muscle, you lose bone because muscle helps prevent bone loss. Therefore, weight-bearing exercises are recommended.
2.) Muscle helps to control blood sugar. As muscle mass decreases, it alters the body’s ability to keep blood sugars stable. That means your risk of developing type 2 diabetes increases.
3.) Ensure adequate protein intake. Research is finding that a low protein intake contributes to muscle loss. About 50 grams of protein is recommended daily. High quality protein sources are lean meats, fish, low fat dairy, and eggs. Non-animal sources to consider are dried beans, legumes, lentils, and tofu.
4.) Stay active. Activity helps to increase and maintain muscle strength. Studies show that people in their 70s, 80s, and even 90s benefit from safe strength training.
So, adopting these principles to make some changes, or continuing with an already health lifestyle, can help as the aging process marches on.
Chief Clinical Dietician
I recently read an article that caught my eye because it applies to an age group that I find myself a member 44 -55 years. It addressed a condition called sarcopenia. This means a degree of muscle loss (suddenly gray hairs don’t seem so bad!). But even though skeletal muscle starts to decline in this age group, there are ways to lessen the impact.
1.) Less muscle, less bone. It seems that osteoporosis and sarcopenia are interrelated. If you lose muscle, you lose bone because muscle helps prevent bone loss. Therefore, weight-bearing exercises are recommended.
2.) Muscle helps to control blood sugar. As muscle mass decreases, it alters the body’s ability to keep blood sugars stable. That means your risk of developing type 2 diabetes increases.
3.) Ensure adequate protein intake. Research is finding that a low protein intake contributes to muscle loss. About 50 grams of protein is recommended daily. High quality protein sources are lean meats, fish, low fat dairy, and eggs. Non-animal sources to consider are dried beans, legumes, lentils, and tofu.
4.) Stay active. Activity helps to increase and maintain muscle strength. Studies show that people in their 70s, 80s, and even 90s benefit from safe strength training.
So, adopting these principles to make some changes, or continuing with an already health lifestyle, can help as the aging process marches on.
Thursday, February 14, 2008
Physical Therapy Services At Home
By Dana Pavelock, Dir., Home Care Operations
In today’s ever changing world, combined with significant aging trends, shorter hospital and skilled nursing facility stays, the demand for physical therapy is ever increasing. In fact, state and national averages along with Saint Francis Hospital Certified Home Health Services statistics reflect that 68 percent to 73 percent of all patients receive in-home care physical therapy services. In-home physical therapy is ideal for many patients and has been an option available in the health care field for many years. I’ll attempt to provide some education as to what types of services at home Physical Therapists perform, determining what patients may qualify for In-Home Therapy and how to access services and choose the right provider.
The starting point with most home care services, including Physical Therapy, generally begins with obtaining an order from your treating physician or contacting a home care agency and presenting your circumstances to an intake worker that will help you navigate the system. Those recovering from any type of musculoskeletal problems, suffering from neurological conditions like Cerebral Vascular disease (stroke), Multiple Sclerosis (MS), Parkinson’s disease or recovering from orthopedic surgery like knee or hip replacement, are very commonly served by arranging physical therapy at home.
Most agencies will consult with the physician and obtain a script for an assessment to be completed. One of the primary criteria to receive in-home rehabilitative therapy is the patient must be considered “homebound,” requiring assistance to get in or out of the house due to some muscle weakness, decreased balance or endurance, and difficulty walking due to some musculoskeletal or neurological deficits. Patient evaluation may include measurement of range of motion, strength, balance, safety awareness, and level of assistance required in determining intervention outcomes.
A home safety evaluation will review various safety hazards such as loose rugs/carpeting, evaluate the home environment for needed modifications to make living space more accessible with assistive devices and durable medical equipment such as raised toilet seats, tub/shower chairs, transfer and lift devices, walkers or wheelchairs, grab bars and personal emergency response systems. The evaluation will incorporate procedures and techniques in determining one’s ability to perform at his or her optimal level: Based on one’s prior, versus current, level of functioning, physical therapy intervention is valuable in achieving improvement in future quality of life.
Once an assessment is completed a physical therapist will create a comprehensive plan of care in collaboration with your treating physician and other caregivers with the end goal helping achieve your highest functional mobility if not to bring you back to your prior level of functioning before your illness. Physical therapy services focus on therapeutic exercise programs, activity training like transfers and bed mobility, neuromuscular re-education to work on balance and muscle strengthening, gait training and pain management. Safety training is of primary concern to make sure that during your recovery period secondary complications from falling will be avoided. Generally, Medicare long term or private insurance will also authorize a Home Health Aide, oriented by the treating therapist, to assist the patient with their therapeutic exercise program.
Special thanks to Phil Ricafort, Physical Therapy Supervisor with Saint Francis Hospital Certified Home Health Services, (845-483-5550), an expert in the field, who contributed to this information. According to Ricafort, one of the most important actions one should take in choosing an agency is to review credentialing, insuring the agency is certified by the state Department of Health and Joint Commission accredited. Another important factor is to review quality outcome measures of the agency you are considering to obtain services from that can be accessed by visiting http://www.medicare.gov/.
In today’s ever changing world, combined with significant aging trends, shorter hospital and skilled nursing facility stays, the demand for physical therapy is ever increasing. In fact, state and national averages along with Saint Francis Hospital Certified Home Health Services statistics reflect that 68 percent to 73 percent of all patients receive in-home care physical therapy services. In-home physical therapy is ideal for many patients and has been an option available in the health care field for many years. I’ll attempt to provide some education as to what types of services at home Physical Therapists perform, determining what patients may qualify for In-Home Therapy and how to access services and choose the right provider.
The starting point with most home care services, including Physical Therapy, generally begins with obtaining an order from your treating physician or contacting a home care agency and presenting your circumstances to an intake worker that will help you navigate the system. Those recovering from any type of musculoskeletal problems, suffering from neurological conditions like Cerebral Vascular disease (stroke), Multiple Sclerosis (MS), Parkinson’s disease or recovering from orthopedic surgery like knee or hip replacement, are very commonly served by arranging physical therapy at home.
Most agencies will consult with the physician and obtain a script for an assessment to be completed. One of the primary criteria to receive in-home rehabilitative therapy is the patient must be considered “homebound,” requiring assistance to get in or out of the house due to some muscle weakness, decreased balance or endurance, and difficulty walking due to some musculoskeletal or neurological deficits. Patient evaluation may include measurement of range of motion, strength, balance, safety awareness, and level of assistance required in determining intervention outcomes.
A home safety evaluation will review various safety hazards such as loose rugs/carpeting, evaluate the home environment for needed modifications to make living space more accessible with assistive devices and durable medical equipment such as raised toilet seats, tub/shower chairs, transfer and lift devices, walkers or wheelchairs, grab bars and personal emergency response systems. The evaluation will incorporate procedures and techniques in determining one’s ability to perform at his or her optimal level: Based on one’s prior, versus current, level of functioning, physical therapy intervention is valuable in achieving improvement in future quality of life.
Once an assessment is completed a physical therapist will create a comprehensive plan of care in collaboration with your treating physician and other caregivers with the end goal helping achieve your highest functional mobility if not to bring you back to your prior level of functioning before your illness. Physical therapy services focus on therapeutic exercise programs, activity training like transfers and bed mobility, neuromuscular re-education to work on balance and muscle strengthening, gait training and pain management. Safety training is of primary concern to make sure that during your recovery period secondary complications from falling will be avoided. Generally, Medicare long term or private insurance will also authorize a Home Health Aide, oriented by the treating therapist, to assist the patient with their therapeutic exercise program.
Special thanks to Phil Ricafort, Physical Therapy Supervisor with Saint Francis Hospital Certified Home Health Services, (845-483-5550), an expert in the field, who contributed to this information. According to Ricafort, one of the most important actions one should take in choosing an agency is to review credentialing, insuring the agency is certified by the state Department of Health and Joint Commission accredited. Another important factor is to review quality outcome measures of the agency you are considering to obtain services from that can be accessed by visiting http://www.medicare.gov/.
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