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List of All Topics
Rehabilitation
Also called: Rehab
After a serious injury, illness or surgery, you may recover slowly. You may need to regain your strength, relearn skills or find new ways of doing things you did before. This process is rehabilitation.
Rehabilitation often focuses on
- Physical therapy to help your strength, mobility and fitness
- Occupational therapy to help you with your daily activities
- Treatment of pain
Rehabilitation focuses on function. Being able to continue to function is key to maintaining or regaining independence and quality of life, particularly after an illness or injury. Starting rehabilitation early can help you maintain function and increase your chances of returning to your previous level of function as much as possible. In restorative rehabilitation, the goal is to restore a function that you have lost.
It is often funded by Medicare or other payers. Examples include short-term rehabilitation that usually follows a stroke or a hip fracture. In maintenance rehabilitation, the goal is to maintain and strengthen a function. Maintenance rehabilitation is less intense, with physical therapy or occupational therapy continued three times a week as an outpatient. With longer-term therapy, possibly more function can be gained or more functional loss can be prevented.
Who Benefits from Rehabilitation?
When evaluating a disability, your health care provider will focus on understanding how the loss of function developed and progressed over time. Other vital factors in predicting whether function can be regained are how severe the loss of function is, what caused it, and the potential for recovery.
The level of function you had before a disability is an important consideration in the level of function you can expect to regain after rehabilitation. For example, if a healthy older person who walks without a cane falls and fractures a hip, he or she will likely be able to walk again after several months of a rehabilitation program. However, the same goal is not as realistic for someone of the same age who was already having a hard time walking (possibly due to arthritis or bad circulation) before suffering a hip fracture.
If a person has additional medical conditions, such as heart, lung, or joint diseases, his or her participation in an intense rehabilitation program may be limited. However, many people can still improve their ability to exercise gradually even if they have moderate to severe heart and lung disease.
Another important factor in successful rehabilitation is commitment to an ongoing program. Commitment is important not only for the person who has lost some function, but also for family members (or other caregivers) when he or she returns home after the rehabilitation program. What the older adult and his or her family expects and prefers should also be considered, because rehabilitation programs usually require everyone’s participation. Another reason why everyone should be involved in the decision-making process is because many disabilities of older adults are chronic (eg, arthritis, diabetes, hypertension, heart disease). For older adults to be able to best control their chronic diseases, they should understand the disease or injury, feel confident that they understand and can perform the activities needed to manage their disease and prevent new problems, and be able to monitor their disease status as much as possible.
The type of disability and how severe it is, as well as what the person actually needs to do at home as well as what others can do for the person are important considerations in the decision of whether a person can safely return home after rehabilitation. People living at home should, at the very least, be able to move safely from a bed to a chair, and from walking or a wheelchair to the toilet. For people who have difficulty thinking things through or who have problems with vision, 24-hour supervision may be necessary. Often, the critical factor for discharge from a rehabilitation unit is whether 24-hour support is available at home for those who need it.
Common Medical Problems During Rehabilitation
During rehabilitation, potential barriers to regaining or maintaining function are identified and removed. Medical evaluation is often ongoing throughout rehabilitation, so that significant illness and disability can be treated or prevented. Factors that have an important influence on the outcome of rehabilitation include the following:
- the nature and extent of the limitation
- the individual’s motivation and commitment
- adequate daily supervision
- Blood clots Older adults who have had a stroke or suffered a hip fracture are at increased risk of blood clots that are painful and could travel to the lungs (pulmonary embolus). Generally, people are treated with blood thinners during rehabilitation to prevent blood clots from forming.
- Heart disease Most physical therapy programs do not require a high level of physical activity. In fact, it may come as a surprise that occupational therapy puts more stress on the heart and lungs than physical therapy does. This is because exercising the arms increases blood pressure and pulse rate more than exercising the legs. Therapy activities for people with heart disease are generally adjusted, especially if these activities cause chest pain, shortness of breath, light-headedness, or fatigue. Blood pressure and pulse rate are checked often. Sometimes, additional tests are needed to evaluate cardiac risk.
- Joint problems Arthritis that is already present may get worse during rehabilitation. This is because therapy usually involves progressive weight bearing, which can stress the joints. Some people may develop an inflammation or bursitis around the shoulder or hip joints. Some of this is due to the increased physical activity in their rehabilitation program. Treatment is generally the same as for arthritis.
- Lung disease Lung function should be checked again in people who have lung disease or who become short of breath while participating in a physical or occupational therapy program. Sometimes the amount of oxygen in the blood is measured during the therapy sessions. It may be possible to include a lung rehabilitation program within the person’s primary rehabilitation program. Usually, lung rehabilitation programs work on breathing techniques, pacing activities, and learning exercises and relaxation methods to help in activities of daily living.
Information obtained from National Institute of Health