Occupational Therapy: Getting back to the tasks of living

To the uninitiated, physical therapy and occupational therapy may seem to be pretty much the same thing.  So how do you know which one you need after you’ve suffered a health crisis – a fall, perhaps, or a stroke?

Both physical and occupational therapists deal with patients with physical injuries and limitations, but they approach those patients in very different ways.  The difference shows up in how they treat the issues, as well as in what issues those are.

Physical Therapists deal with “the big picture:” the treatment of disease, injury, or deformity by physical methods. They help patients with strength, balance, flexibility – the basics of motion.

Occupational therapists go beyond this. While they, too, deal with the overall issues, they also tend to the finer points of daily life and activities – the “occupation of life,” so to speak. They help clients relearn how to tie their shoes, do up buttons, and manipulate small objects. They can facilitate independence by teaching or re-teaching necessary tasks and skills such as writing, cooking, and even housework.

Both fields focus on the recovery of a functional impairment. The difference may be evident in setting and practice. In the hospital setting, the "occupational functions" that are being recovered include self-care activities such as restoring the ability of the patient to perform bathing, dressing, feeding, etc. Physical therapy will focus on mobility tasks such as getting out of bed, standing, walking etc.

In the outpatient setting, occupational therapists may focus on  "hand therapy,"  as hand injuries are common occupational hazards not only on the job but elsewhere, and on elbow and shoulder therapy.

Clients of occupational therapists may need help in those broader areas that physical therapy covers, as well; some clients of one type of therapist are also clients of the other, as the two go hand in hand in many cases.

Occupational therapy covers much more than physical therapy. Occupational therapists can aid clients in treating developmental and cognitive disorders such as Attention Deficit Disorder (ADD) and learning disabilities; sensory disorders, such as autism; and mental health, including depression, addiction, anxiety and eating disorders.

One of the differences between physical therapists and occupational therapists is the help clients get from an OT with the world around them and the things that affect them in everyday life, not just the limitations caused by their own physical and mental state. An OT can help a client with:

  • Medication management: helping clients keep track of their medications and teaching them about their effects and interactions.
  • Routine and schedules: the OT can help develop an outline for the client to follow, and help them stick to it.
  • Education: an OT can suggest training, groups, and classes tailored to the client’s needs.

Occupational therapy treatments will frequently include manual therapy techniques, stretching, therapeutic exercise, hand strengthening, activities to improve manual dexterity, and caregiver training. Occupational therapists may also recommend appropriate adaptive equipment such as reachers, dressing aids, specialized dishes and utensils, and splints for positioning. Educating patients regarding their condition, accommodations, and proper use of adaptive equipment is an important aspect of occupational therapy. An occupational therapist will also create an individualized home exercise program to encourage a patient’s continued progress.

The PT and OT they will often collaborate to maximize the effectiveness of a session. For example, in a nursing home, the physical therapist may help the patient stand from a wheelchair and maintain standing balance while the occupational therapist assists the patient in hygiene tasks at the sink. At an outpatient clinic, they can work together to help a person resume gardening – the physical therapist would help with walking outdoors on uneven surfaces, using proper body mechanics while lifting and carrying gardening supplies, and practicing squatting; while the occupational therapist would assist with opening packages, using a trowel, and turning on the faucet.

Physical therapy and occupational therapy overlap in some areas, and at times it can be hard to tell which is which. The difference lies in the occupational therapist’s assistance in combining the physical, mental and environmental aspects of the client’s situation to arrive at a plan that will heal as well as re-enable the client to take up the reins in everyday life.  

We at Blue Sky Therapy are ready to assist your therapy – we’re the experts!

Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!

This information is not intended to replace the advice of a doctor. Blue Sky disclaims any liability for the decisions you make based on this information.

Resources:

Holsman Physical Therapy

& Rehabilitation P.C.

Occupational Therapy

Schools Guide

Ortho Hips and Knees- Part 7

The recovery period

In our previous blogs, we’ve talked about the alternatives to hip and knee replacement surgery, and what to expect if you’ve chosen total joint replacement.  In this, our final blog on the subject, we’ll talk about the recovery period. As with the previous columns, our information comes from the American Association of Hip and Knee surgeons; this time, the association’s Dr. Stephen J. Kelly, M.D., answers most frequently asked questions: 

Will I need to stay in the hospital?
On average, patients spend two nights in the hospital following surgery. Some patients may spend as little as one night, others may stay as long as three nights.

What is recovery like in the hospital?

Recovery starts right after surgery. You are helped out of bed on the day of or the day after surgery. A physical therapist will help you to walk, and most patients will have one or two sessions of physical therapy per day. The goal of therapy is to assist with strengthening of the muscles and walking. Therapy will also make sure that you are safe when you go home. That’s important when doing things like dressing, using the bathroom, getting up from a chair, and climbing stairs.

Will I be able to walk after surgery?
Most patients use a walker or crutches after surgery but often will be able to progress rapidly to using a cane. Walking soon after surgery helps you get better. It also helps avoid things like bedsores, pneumonia, and blood clots.

Can I go directly home from the hospital?
Many patients are able to leave the hospital and go directly home after surgery. It is important to identify a family member or friend who will be able to help with common household tasks such as preparing meals and doing dishes. Some patients will require a stay at a specialized care facility such as a nursing home or rehab hospital.

Will I be able climb stairs when I leave the hospital?
In general, patients are able to climb stairs after leaving the hospital; however, it is often initially slow and tiring and most patients are happiest if initially they are able to stay on one floor after returning home from surgery.

Will I need Physical Therapy after surgery?
All patients benefit from specific exercises after surgery. These will be directed by your surgeon and often will involve a physical therapist. Most patients need to do their exercises for a minimum of four to six weeks following surgery.

How much will my joint replacement weigh?
Most weigh between one and two pounds.

Are there any activities I will not be able to participate in after I recover from my joint replacement?
Most patients are advised to avoid running, jumping, or impact sports after surgery, so that your joint replacement may last longer.

Will I be in a lot of pain?

Fear of pain from surgery is one of the biggest reasons why people avoid having a hip or knee replacement. Pain control comes from using several medications that affect both the spinal cord and the brain.  With better pain control, you will have mild to moderate pain. There are also medications that help control nausea if it occurs.

When will I be back to normal?

Most people get better from hip or knee replacement in about six weeks. The time it takes to walk without a cane or drive after surgery is different for everyone. You will need physical therapy after going home. The skin incision or cut will heal in two to three weeks, but the process of healing can take up to a year. Once you are without pain, you will notice an improvement in your ability to walk.

We at Blue Sky Therapy are ready to assist you after knee replacement therapy!

Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!

Resources:

American Association of Hip and Knee Surgeons. Developed by the AAHKS Patient Education Committee. Authors: Craig J. Della Valle, MD, Frank R. DiMaio, MD, Marc W. Hungerford, MD.

Ortho Hips and Knees- Part 6

When total knee replacement is the only option

If alternative methods such as medications, injections, bracing, weight loss or exercise don’t give you relief, you may consider a total knee replacement – a TKR. These are some of the frequently asked questions regarding total knee replacement:

How long does a TKR last?

As with a total hip replacement, you have a 90-95% chance that your joint will last 10 years, and a 80-85% chance that it will last 20 years. With improvements in technology, these numbers may improve.

What types of implants are there?

Here are specific implant design terms:

Gender specific: a modified implant design that accounts for average anatomic differences between men’s and women’s knees.

Rotating platform: a plastic bearing that independently rotates on a metal tray on which it is seated.

Will I need general anesthesia?

Both hip and knee replacements can be performed under regional anesthesia. Choices for regional anesthesia include spinal anesthesia, epidural anesthesia, or one of a variety of peripheral nerve blocks. Data shows that regional anesthesia can reduce complications and improve your recovery experience with less pain, less nausea, and less narcotic medicine required.

What is minimally invasive surgery?

Minimally invasive surgery is a term that describes a combination of reducing the incision length and lessening tissue disruption beneath the incision.

How long will I stay in the hospital?

You will likely stay in the hospital for one to three days, depending on your rehabilitation protocol and how fast you progress with physical therapy.

When can I walk after surgery, and how long before I can shower?

Most people are walking with the assistance of a walker on the day after surgery, and using a cane or nothing at all by 2-3 weeks. If you have been given a standard dressing, you won’t be allowed to shower for 5-7 days.

How long does it take to recover?

It can take up to three months to return to most activities, and likely six months to a  year to fully recover following a TKR.

Will I need physical therapy, and if so, for how long?

Most people who have undergone TKR require outpatient physical therapy following surgery. A skilled therapist can accelerate the rehabilitation as well as make the process more efficient with the use of dedicated machines and therapeutic modalities. Depending on your condition before surgery, physical therapy is beneficial for up to 3 months and rarely longer. The amount of therapy needed depends upon your condition before surgery, motivation, and general health.

In our next blog, we’ll talk about the recovery period.

We at Blue Sky Therapy are ready to assist you after knee replacement therapy!

Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!

Resources:

American Association of Hip and Knee Surgeons. Developed by the AAHKS Patient Education Committee. Authors: Craig J. Della Valle, MD, Frank R. DiMaio, MD, Marc W. Hungerford, MD.

Ortho Hips and Knees- Part 5

Surgical Options for Knee Arthritis

As we’ve pointed out in previous blogs, the first line of treatment for knee pain is nearly always non-surgical, even if the pain is significant.  But if alternative methods such as medications, injections, bracing, weight loss or exercise don’t give you relief, you may consider a total knee replacement – a TKR.

If you are considering such a move, you’re bound to have questions.  Here are some of the most common ones, and the answers as provided by the American Association of Hip and Knee Surgeons.

Arthroscopy

Arthroscopy involves a surgeon making a small incision in your knee and irrigating and removing loose pieces of cartilage. In the arthritic knee, there is a very limited role for an arthroscopy. Results of a “clean out” or a “wash out” are unpredictable at best and should be avoided.

Partial Knee Replacement – The Unicompartmental Knee

A surgeon performing a partial knee replacement, also known as a “uni,” replaces only the part of the knee that is worn out. This can be either the knee cap-femur joint (patello-femoral) or more commonly the femur-shin joint (femoral-tibial). These procedures are appealing because they are generally less invasive, more normal tissue is retained, and recovery is easier. Outcomes of partial knee replacements can be comparable to total knee replacements ten years after surgery.

Total Knee Replacement

Total Knee Replacement (TKR) is the gold standard when conservative treatment for arthritis of your knee has failed. This procedure involves resecting the ends of the bones of the knee and replacing them with a combination of metal and plastic. This is one of the most successful of all surgical procedures: on average, TKR provides 90-95% pain relief and has only a 1 to 2% complication rate. Approximately 90% of replaced knees will be satisfactory twenty years after surgery.

Osteotomy

This procedure, which involves cutting the bone and reorienting the alignment of the knee, has traditionally been reserved for younger patients with malaligned knees who participate in high-demand activities such as sports. Currently, osteotomy has a limited role in the treatment of osteoarthritis of the knee.

Cartilage Procedure

This procedure involves harvesting cartilage cells and transplanting them into the area of disease in your knee. There is very little role for this procedure in an arthritic knee and it has no role to play in the treatment of the advanced arthritic knee.

In our next blog, we’ll discuss total knee replacement in detail.

We at Blue Sky Therapy are ready to assist you!

Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!

Resources:

American Association of Hip and Knee Surgeons. Developed by the AAHKS Patient Education Committee. Authors: Craig J. Della Valle, MD, Frank R. DiMaio, MD, Marc W. Hungerford, MD.

Ortho Hips and Knees- Part 4

When total hip replacement is the only option

As we’ve pointed out in previous blogs, the first line of treatment for hip pain is nearly always non-surgical, even if the pain is significant.  But if alternative methods such as medications, injections, bracing, weight loss or exercise don’t give you relief, you may consider a total hip replacement – a THR.

If you are considering such a move, you’re bound to have questions.  Here are some of the most common ones, and the answers as provided by the American Association of Hip and Knee Surgeons.

How long does a THR last?

A common reply is that total joint replacement lasts 15-20 years. A more accurate way to think about it is through the annual failure rates: most current data suggests that both hip and knee replacements have an annual failure rate between 0.5-1.0%. This means that if you have your total joint replaced today, you have a 90-95% chance that your joint will last 10 years, and a 80-85% that it will last 20 years. These numbers may improve with improvements to technology.

Are all hip replacement implants the same?

As surgeons and manufacturers determine which designs work best, most implants today have become more similar than different. One variable that still remains is the bearing surface – the  ball and liner that attach to the stem and cup that fix to the bone. The ball can be composed of either metal or ceramic, and the liner can be made of plastic, metal, or ceramic.

My surgeon talks about “approach;” what is he talking about?

The way a surgeon gains access to the hip during hip replacement surgery is referred to as an “approach.” There are several types of approaches: the “posterior approach,” which is done from the back of the hip and is the most common; the “anterior approach,” which is performed from the front of the hip, and the lateral approach, which is less popular.

Will I need general anesthesia?

Not necessarily: both hip and knee replacements can be performed under regional anesthesia such as spinal anesthesia, epidural anesthesia, or one of a variety of peripheral nerve blocks. Regional anesthesia has a high preference rate because data shows it can reduce complications and improve your recovery with less pain, less nausea, and less narcotic medicine required.

What is minimally invasive surgery?

Minimally invasive surgery is a combination of reduced incision length and lessened tissue disruption beneath the incision. This includes cutting less muscle and detaching less tendon from bone.

How big will my scar be, and when will it disappear?

This depends on several factors: the size of the patient, the complexity of the surgery, and surgeon preference, to name a few. The scar will heal within a few weeks, but then will remodel and change appearance over the next one to two years.

How long will I stay in the hospital?

You will likely stay in the hospital for one to three days,  depending on your rehabilitation program and how fast you progress with physical therapy. This is highly dependent upon your condition before surgery, your age, and medical problems that can hinder your rehabilitation.

When will I be able to walk after surgery, and when can I shower?

Most people are walking with the aid of a walker on the day after surgery, and using a cane or nothing at all by 2-3 weeks. Most surgeons do not like the wound to be exposed to water for 5-7 days; however, more surgeons are using waterproof dressings that allow patients to shower the day after surgery. You can remove the dressing at 7-10 days after surgery.

How long does it take to recover?

The majority of people who undergo THA are able to participate in a majority of their daily activities by 6 weeks. By 3 months, most people have regained much the endurance and strength lost around the time of surgery, and can participate in daily activities without restriction.

Will I need physical therapy, and if so, for how long?

Initially, you will receive some physical therapy while in the hospital. Depending on your preoperative conditioning and support, you may or may not need additional therapy as an outpatient. Much of the therapy after hip replacement is walking with general stretching and thigh muscle strengthening, which you can do on your own without the assistance of a physical therapist.

We at Blue Sky Therapy are ready to assist you after hip replacement therapy!

Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!

In our next blog, we’ll talk about surgical options for knee arthritis. 

Resources:

American Association of Hip and Knee Surgeons. Developed by the AAHKS Patient Education Committee. Authors: Craig J. Della Valle, MD, Frank R. DiMaio, MD, Marc W. Hungerford, MD.

Ortho Hips and Knees- Part 3

Surgical options for hip arthritis

With people living longer than ever, arthritis of the hip and knee is more common. The American Association of Hip and Knee Surgeons estimates there may be a need for 500,000 hip replacements and 3,000,000 knee replacements each year by the year 2030.

But joint replacement is the last option.  There are treatments and surgical procedures that may relieve the problem without restoring to knee or hip replacement. In this and succeeding blogs, we’ll discuss your options as recommended by the AAHKS.

First, let’s look at hip arthritis. When non-surgical treatments for hip arthritis fail, you and your doctor may consider surgery. There are several surgical options that are useful for treating osteoarthritis in your hip:

Hip arthroscopy is usually an outpatient procedure to repair torn cartilage and to remove extra bone that occurs in the very earliest stages of osteoarthritis. The surgeon uses small incisions around the hip to allow for insertion of a tiny camera called an arthroscope. Arthroscopy is rare in patients over 40 years of age.

Femoral and acetabular osteotomy surgery involves cutting the bone to reorient your hip joint when your hip has structural abnormalities. This is extensive surgery that involves the insertion of plates and screws to hold the bone in place while it heals. It requires several days of inpatient hospitalization, and recovery usually takes six to twelve weeks.

Hip resurfacing is the use of a metal-on-metal device where the hip ball is capped. It usually requires inpatient hospitalization for several days, and recovery usually takes six to twelve weeks. There are few circumstances where it would be required.

Total hip replacement (THR) is considered the “gold standard” for treating your disabling hip pain. Circumstances that may indicate the necessity of THR occur in people of all ages, sexes, and activity levels.

In our next blog, we’ll discuss Total Hip Replacement in detail.

We at Blue Sky Therapy are ready to assist you!

Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!

Resources:

American Association of Hip and Knee Surgeons. Developed by the AAHKS Patient Education Committee. Authors: Craig J. Della Valle, MD, Frank R. DiMaio, MD, Marc W. Hungerford, MD.

 

Ortho Hips and Knees- Part 2

Non-surgical treatment for hip and knee pain

With people living longer than ever, arthritis of the hip and knee is more common. The American Association of Hip and Knee Surgeons estimates there may be a need for 500,000 hip replacements and 3,000,000 knee replacements each year by the year 2030.

But joint replacement is the last option.  There are treatments and surgical procedures that may relieve the problem without restoring to knee or hip replacement. In this and succeeding blogs, we’ll discuss your options as recommended by the AAHKS.

If your doctor is not recommending surgery for your hip or knee joints at this time, there are some other ways to alleviate pain and improve mobility:

There are Medications:

·Simple pain relievers, such as acetaminophen (Tylenol), are available without a prescription and can be effective in reducing pain.

·Non-steroidal, anti-inflammatory medications include other over-the-counter medications such as aspirin, ibuprofen (Motrin or Advil), or naproxen (Aleve) to help reduce pain and swelling in the joint.

·More potent types of pain relievers are prescription-strength, non-steroidal, anti-inflammatory drugs (NSAIDs) that can be prescribed by your doctor.

Or your doctor may recommend Injections:

·Cortisone injections can provide pain relief and reduce inflammation, but aren’t very helpful if the arthritis affects the movement of your joint. The length of time the injection works can vary, and there is a limit to how many your doctor can give you per year.

·Viscosupplementation is a treatment in which hyaluronic acid (HA) is injected into the joint. It can help joints to work properly by acting like a lubricant.  Because of the anatomy around the hip joint, injections into the hip are more complicated and therefore less frequently prescribed.

Your doctor may recommend Weight Loss:

·If, like many people with osteoarthritis, you are overweight, you should know that weight loss can reduce stress on your hip or knee. The physics of the hip and knee joints tell us that you put three to five times your body weight across these joints throughout the day – especially during stair climbing and getting in and out of a chair. Every ten pounds of extra weight that you carry can result in fifty pounds of weight-bearing pressure across your hips and knees! It makes perfect sense that losing weight can result in reduced pain and increased function, particularly in walking.

I hate that word: Exercise!

·But it’s a known fact that an exercise routine can help increase your range of motion and flexibility as it strengthens the muscles in your legs. Simple exercise is often effective in reducing pain and improving function. However, in the case of advanced arthritis (bone-on-bone), exercise can sometimes increase pain in your hip and knee joints. Your physician or a physical therapist will develop an individualized exercise program that meets your needs and lifestyle.

Braces and Splints may help:

·Braces may be especially helpful in knee arthritis.  If the arthritis is centered on one side or the other, a brace can assist with stability and function. Braces are not for everyone, however, and they can be difficult to fit for certain people.

There may be relief from Physical Therapy:

·Because it works to strengthen the muscles around your joint, physical therapy may help absorb some of the shock imparted to the joint. Physical therapy can help to reduce the pain, swelling, and stiffness of osteoarthritis and improve joint function. It can also make it easier for you to walk, bend, kneel, squat, and sit.

And there are alternative therapies:

·Examples of alternative therapies include the use of acupuncture and magnetic pulse therapy. Acupuncture, which uses fine needles to stimulate specific body areas to relieve pain or temporarily numb an area, is used in many parts of the world, and evidence suggests that it can help ease the pain of arthritis. Magnetic pulse therapy is painless; it works by applying a pulsed signal to the knee, which is placed in an electromagnetic field.

Next: Learn about surgical options.

Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!

Resources:

American Association of Hip and Knee Surgeons. Developed by the AAHKS Patient Education Committee. Authors: Craig J. Della Valle, MD, Frank R. DiMaio, MD, Marc W. Hungerford, MD.

Ortho Hips and Knees- Part 1

Questions, questions. Do I need a joint replacement?

If you are starting to experience pain and loss of mobility in your hips or knees, you may be looking at surgery to relieve the condition.  Our next few blogs will answer some questions you may have, describe your options, and focus on recovery.

With people living longer than ever, arthritis of the hip and knee is more common. The American Association of Hip and Knee Surgeons estimates there may be a need for 500,000 hip replacements and 3,000,000 knee replacements each year by the year 2030.

But joint replacement is the last option.  There are treatments and surgical procedures that may relieve the problem without restoring to knee or hip replacement.

Treatment of arthritis starts without surgery. Over-the-counter pain relievers and anti-inflammatory medication may help. Using a cane or avoiding doing things that hurt may give relief as well. At first, you may only have pain or stiffness when walking a long way. As the arthritis gets worse, however, routines like taking short walks, putting on shoes, or dressing may cause pain that can only be treated by surgery.

The good news is that hip and knee replacements are very successful surgeries. It takes time to heal afterwards, but many people return to an active, pain-free life.

Many factors are important to think about when you’re considering surgery: general health, time away from work, family commitments, and the time it will take you to get better afterwards. Perhaps you cannot take care of your home or family, or you can no longer do your job. You’ll likely decide the time is right for surgery when your knee or hip pain prevents you from living comfortably.

But don’t wait too long! People with hip and knee arthritis have disability from two things: pain and “mechanical” symptoms such as locking of the joint. You may suffer from pain, swelling, and stiffness for a while before considering surgery. Or you may decide to see a doctor when the mechanical symptoms get worse, because these symptoms can jeopardize safety at home or at work.

As hip and knee arthritis worsens, the stiffness of the arthritic joints also worsens. This can make the replacement surgery more difficult, resulting in a longer recovery and more physical therapy. Unfortunately, in severe cases joint flexibility may never return to normal. By waiting too long, you may not get the full benefits of your hip and knee replacement surgery.

In the next few blogs, we’ll discuss the various treatments for developing arthritis and the options you can choose from in the event surgery is recommended. Remember this: the first line of treatment is nearly always non-operative. This includes weight loss if appropriate, an exercise regimen, medication, injections, or bracing. If the symptoms persist despite these measures, then you could consider total hip or knee replacement.

Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!

Resources:

American Association of Hip and Knee Surgeons. Developed by the AAHKS Patient Education Committee. Authors: Craig J. Della Valle, MD, Frank R. DiMaio, MD, Marc W. Hungerford, MD.

 

Outcome Measures for Physical Therapy – what are they, and why are they important?

You’ve gone faithfully to your physical therapy appointments, and you can feel the positive effects of your treatment.  Now it’s time to pay the bill.  And because your therapist is required to provide documented proof of your treatment and its outcome to Medicare in order to receive payment, you can rest assured that every “i” will be dotted, and every “t” crossed, in your treatment plan.

Medicare and other payers closely scrutinize claims for all providers, especially in the area of medical necessity for all physical medicine claims. Part of that scrutiny is the requirement, since 2013, that physical therapists report what is called “functional outcomes” on claims they submit for payment. Medicare will use the data received to determine the need for services, the quality of care, and the value of the service received by the beneficiary.

The requirement has shown the importance of using functional outcome measures – actual tests and measures that can be used to grade your overall function.  They are important tools to prove your therapist with a simple and effective way to measure your mobility.

Functional outcome measurement tools may serve many purposes, including but not limited, to:

  •  Aiding in goal setting
  • Helping to provide motivation
  • Guiding treatment
  • Providing a prognosis for your specific condition, and
  • Providing justification for treatment 

Besides these basic tools, your Blue Sky physical therapist may use other measurements to help assess your progress in physical therapy. He or she may measure your strength and range of motion. Balance and posture may be assessed as well. But functional outcome measures are also important to help track your progress in physical therapy.

To be effective, functional outcome measurement tools must meet certain criteria of usefulness in the physical therapy clinic. First, they must be reliable, which means that the results must be consistent with each patient and within groups of patients. They must also be valid. Validity in an outcome measurement test means that it measures exactly what it is intended to measure.

Busy physical therapists want the test to be practical and simple to perform. Outcome measurement tools must also be purposeful -- a test of your balance must reflect your current function related to your balance ability, for example.

There are six measures that physical therapists can use to determine the efficacy of their treatment:

  •  Mobility: walking and moving around
  • Changing and maintaining body position
  • Carrying, moving and handling objects
  • Self care 
  • Other primary functional limitation, and
  • Other subsequent functional limitation.

It is more important than ever before to objectively measure outcomes by specific, standardized measures that are used consistently throughout treatment period.   Repeated use of the same outcome measure at the initial evaluation, each re-evaluation or progress report, and again at discharge allows a provider to clearly demonstrate the medical necessity of the care provided. Outcome measuring can enhance patient communication and help determine the plan of care.

Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!

Pulmonary Rehabilitation

“Like a fish out of water, gasping for air” is how one asthma patient described it.

For the estimated 115 million people living with chronic pulmonary conditions such as emphysema, persistent asthma, COPD or lung cancer, every breath is a battle. Even simple tasks like getting dressed or climbing the stairs can be exhausting.  If they aren’t managed properly, these diseases can lead to repeated trips to the doctor or extended stays in the hospital.

The Blue Sky Pulmonary Program is designed to improve the overall conditions and respiratory status of patients who have one or more pulmonary conditions. By reducing the tendency of these conditions to worsen, we help residents to become more confident in participating in activities that may have once caused them anxiety. In addition, re-hospitalizations may be avoided.

Pulmonary rehabilitation is a program that uses exercise and education to put people with chronic lung conditions back in charge of their breathing.  Patients in this program find that they are less short of breath, less tired and more independent. And to top it off, research has shown that people with chronic lung conditions who exercise just generally feel better! If they are hospitalized, they are usually admitted for a shorter period of time than those who don’t exercise.

While almost everyone can safely engage in exercise, deciding what’s “safe” needs to be individualized. This is where Blue Sky Therapy’s pulmonary rehabilitation specialists can help. We provide one-on-one instruction: our therapists will help you adjust your level of exercise to your own needs, spend extra time educating you about your condition, and give you personalized feedback on performance and progress. The final result: an improved quality of life.

Who benefits from our pulmonary rehabilitation program? Pulmonary rehab patients are suffering from one or more of the following:

  • COPD
  • Persistent asthma
  • Interstitial lung disease
  • Bronchiectasis
  • Pulmonary Fibrosis
  • Obstructive/restrictive lung disease
  • Lung transplant

After having received pulmonary-respiratory services as a hospital inpatient, many will enroll in our pulmonary rehabilitation program upon return to their skilled nursing facility or assisted-living facility. Others are referred from their doctor. The program is designed to help patients increase stamina, decrease breathlessness and reduce the risk of disease progression.

After an initial evaluation, our clinicians will work with the physician to design an individually tailored exercise plan that promotes increased pulmonary efficiency.   Patients are monitored closely by a respiratory therapist as they maintain a specific activity regimen.

Pulmonary rehabilitation is covered by insurance and recognized by Medicare. A physician referral is required.

So … take a deep breath, and know that we are here for you!