Excellence in Action

Focusing on the Remarkable – Providing the TMC Experience through Specialized Interventions

A patient was admitted to our Paola, KS, facility following a left cerebrovascular accident (CVA), with right-sided hemiparesis and expressive aphasia. Prior to experiencing the CVA, the patient lived at home, where he was the father/caregiver for 11 children. He was able to independently care for himself and his family, including all activities of daily living (ADLs) and instrumental ADLs (iADLs), such as home care, medication and money management, grocery shopping, and meal preparation. The deficits following his stroke impacted almost every area of his life: independence with ADLs, functional movement, communication, and even bowel and bladder function. He required assistance from a caregiver for all self-care and communication of daily needs.

Upon admission to our facility, the Rehab team performed neuro-focused evaluations using TMC’s Neuro Connections specialty evaluation and clinical program, creating a plan of care that was tailored to the patient’s unique needs.

The Physical Therapy (PT) and Occupational Therapy (OT) teams, consisting of Mark, PT, Ashita, PTA, Jennifer, OTR, and Lisa, COTA, implemented visual ocular rehabilitation (VOR) for awareness of the right upper extremity, balance, and to prepare the patient for somatosensory and proprioceptive activities. They also implemented use of a mirror, manual treatment techniques, and proprioceptive neuromuscular facilitation (PNF) stretching techniques, in order to impact the patient’s ability to move and function appropriately in the facility. The patient was also trained on use of an assistive device (AD) for mobility.

Jodi, SLP addressed the patient’s speech-language deficits resulting from the CVA through implementation of augmentative and alternative communication devices, including written language, sign language/gestural communication, low-tech communication boards, and trials of higher-tech electronic devices. Use of alternative means of communication allowed the patient to be able to make his wants and needs known to family and staff as he continued to strive to regain verbal speech.

Additionally, this team implemented LSVT BIG movement patterns. LSVT BIG is an intensive, one-on-one treatment that was created to help people living with Parkinson’s Disease and other neurological conditions (including CVA) which addresses walking, balance, and other activities of daily living. Training for LSVT BIG certification involves several hours of focused, specialized training, and an opportunity to become certified through successful completion of an examination. Trainings and certifications such as LSVT BIG give therapists another skillset in addition to what is learned in school and offers their patients opportunities for successful outcomes that are above and beyond some traditional methods. Jennifer, our OTR in Paola, KS, has been LSVT BIG certified for several years, and is an Expert in Neuro Rehab/Parkinson’s Disease on TMC’s Advancing Clinical Excellence (ACE) Team. This expertise allows Jennifer to implement these strategies with her patients, and to lead her team in providing superior care for their patients with neurological issues and conditions.

Through the patient’s strong-willed determination and the skilled interventions led by our therapy team, the patient made steady progress and emotionally celebrated each milestone with our team. He was brought to tears when the fingers on his right hand moved for the first time, the first time he was able to shave one-handed with a manual razor, again the first time he walked with a hemi-walker, and yet again when he wrote a note saying, “Love, Dad” to his kids.

To date, the patient continues to work toward achieving his rehabilitation goals and is now able to perform grooming tasks with only minimal assistance, and he is now on a toileting schedule and is asking to use restroom with only moderate assistance for transfers and clothing management. His ability to feed himself has progressed to modified independence; upper body dressing to minimal assistance; lower body dressing to moderate assistance; and he can transfer (depending on the surface) with moderate to maximum assistance from only 1 person (he required 2 people initially.) He has also been able to walk with a hemi-walker with assistance from 2 helpers for approximately 25 feet.

The high level of expertise of our innovative team in Paola, KS has driven the success of this patient and so many others. Through implementation of TMC’s Neuro Connections specialty program, combined with highly specialized trainings such as LSVT BIG, sought out by our individual therapists our team has been able to help this patient to regain some of the skills which are most meaningful to him. In Paola, KS, we are focusing on the extraordinary, not the ordinary, and we are ALL IN for making a positive difference in the lives of everyone we serve!