Physical Therapy at WWRC aims to help persons whose lives have been changed by injury or illness that has resulted in movement-related disability or painful conditions. Examples of these conditions include:
Our physical therapists will work with clients to meet the challenge they are facing with an injury or illness. Our goal is to help individuals regain functional independence to return to living life fully at home and in their community. Physical therapists and other rehabilitation team members, including the client's physician, will design a therapy program that focuses on meeting his/her goals for recovery.
The client's physical therapist will evaluate and measure their abilities in areas of strength, flexibility, balance, mobility (walking or using a wheelchair), movement coordination and speed, cardiovascular and respiratory endurance. We also introduce ways to improve the client's fitness and wellness for a long life of good health. We will also look at functional skills and needs for moving around within the home, community to increase the client's potential for living a productive and satisfying life. Your program will also introduce assistive technology devices that may be needed to help the client reach his/her goals. Treatments will aim to improve the client's…
Ability to “Get Around”:
Strength, Flexibility, Skin Care, Pain Management and Fitness:
Ability to Return to Work:
WWRC’s Physical Therapy Department is proud to offer LITE GAIT TM – a partial weight bearing suspension gait training device. This intervention is used to help clients regain a more normal walking pattern after lower extremity paralysis or weakness from a stroke, brain injury, or spinal cord injury. The harness suspension supports as much body weight as needed to allow the legs to move in a walking pattern through your own volitional movement or with a therapist’s manual assistance, without fear of falling. Initially this device is usually used over a treadmill but, as progress is made, it can be used as you walk over ground. Also, as you get stronger and better at walking, the LITE GAIT TM device can be adjusted so that you are taking more of your weight on your legs.
Standing programs are an important therapy option used to either prepare the legs and body for the upright position of walking or to reduce the side effects of not being able to stand. Standing programs allow clients to achieve a standing position through use of a tilt table or standing frame to promote weight bearing through the client’s legs; improve circulation, range of motion and flexibility of the trunk and lower extremities; and to have a positive effect on bowel and bladder function.
Individuals may need help with improving one's ability to balance and not be fearful of falling when performing transfers, sitting without support, standing to perform daily activities, or during walking. WWRC physical therapists instruct clients in many different activities to facilitate improvements in balance that enhance their mobility skills such as bed mobility, transfers, and ambulation.
Justin using the ERGYS® 2 to exercise the paralyzed muscles in his legs. One of the big benefits that he has noticed is that his leg spasticity is much less for up to a day after using the ERGYS® 2.
View a short video clip of Justin pedaling (768 KB)
WWRC’s Physical Therapy Department is pleased to announce that it has both the ERGYS 2 Rehabilitation System (Therapeutic Alliances Inc.) and the RT 300-S (Restorative Therapies Inc.) lower extremity cycle ergometer. Although there are unique differences between the two units, both are computerized functional electrical stimulation units that allow persons with little or no voluntary leg movement to actively pedal a stationary leg bike. Electrodes are placed over specific lower extremity muscle groups and connected to the computer which sends impulses to produce a smooth, coordinated cycling pattern.
Regular participation in an FES cycling program can result in the
following benefits:
• Prevention of muscle atrophy
• Relaxation of muscle spasms
• Improvement of circulation
• Improvement in range of motion
Some published studies also indicate improvements in cardiopulmonary
function, a reduction in the frequency of pressure sores, improvements
in bowel and bladder function, and a decreased incident of urinary tract
infections
For more information on these systems, you may want to look at the manufacturer’s websites: www.musclepower.com (ERGYS2) and www.restorative-therapies.com (RTS) or contact Kate Baxter or Joe Fangman in the Physical Therapy Department at 540-332-7118 or 1-800-345-9972 ext. 7118.
WWRC was also a fortunate recipient of grant funding from the Commonwealth Neurotrauma Initiative in 2006 that enabled us to purchase additional ERGYS 2 bikes and help to set up FES cycling programs at other locations in Virginia. These sites now have active programs and if they are nearer your home, you may contact them for more information.
The Parastep® System is an FDA-approved form of assistive technology that enables some persons with spinal cord injury to stand and walk limited distances. It involves the use of neuromuscular electrical stimulation to deliver low-voltage electrical impulses to excite peripheral nerves causing skeletal muscle contraction. The Parastep® System includes a stimulator that generates sequences of electrical pulses which are sent to targeted peripheral nerves through surface electrodes placed on the skin over muscles and sensory nerves of the lower extremities. The user is in control of the time and intensity of the stimulus application. Through a specially adapted walker, the user pushes buttons on the walker to tell the stimulator to send signals. Stimulation of the hip and knee extensor muscles allows the user to stand. Stimulation of the flexor muscles of one leg at a time allows a user to take steps. This technology usually works best with people with complete injuries between T2 and L1.
For more information contract Kate Baxter or Wendy Ledbetter at 540-332-7118 (1-800-345-9972 X 7118).
WWRC physical therapists will work with individuals to determine what type of leg brace will best help them walk. We can use our evaluation braces or make temporary braces and shoe inserts for them to try before we prescribe a “real” brace that will be made by a certified brace specialist. Once the brace is made, the specialist will work with the client's therapist to make sure that it fits comfortably and works well for them. Their physical therapist will train them in using the brace.
After an injury, muscles often need to learn how to function properly again to be able to use them. There are many ways for physical therapists to retrain muscle function. Functional electrical stimulation, or FES, is one method used that involves using safe forms of electrical stimulation to “excite” the muscles into working. These electric signals can substitute for weak or absent signals between the brain and the muscle. This may allow the brain and muscles to develop new lines of communication. It also can increase the strength in the muscle while the individual works on recovering the ability to control the movement on their own.
Getting from Wheelchair to the Floor and Back
Learning to Roll in a Wheelie Position to Cross Uneven Ground
Building adequate strength in muscles to enable client's to do the activities they desire to do is an important part of what the physical therapist will focus on during their rehabilitation program. WWRC offers a variety of exercise options for persons with a wide range of strength—from very weak as they start exercising on up to challenging them as they get stronger. If a client desires to continue a strength program in their community through a local fitness center, we have equipment that is similar to that available in many communities so that we can help clients feel safe as they return to their community to exercise.
Tight muscles and stiff joints can interfere with one's ability to move easily and comfortably. Following certain injuries such as a stroke, head injury or spinal cord injury, it is very important to develop a good routine for stretching out those muscles and joints that are more likely to get tight and interfere with mobility or activities.
WWRC physical therapists may use certain therapeutic modalities (devices) that will allow for improved comfort during exercise or to reduce pain from an injury or following surgery. Devices that create a deep heating of the muscles and tissues around joints (such as ultrasound or moist hot packs) will help with increasing flexibility and speed up healing after an injury. Certain electrical stimulation devices can assist with healing open wounds. A physical therapist will use these devices in combination with the rest of the client's program activities, such as exercise or mobilization (joint or tissue movement created by the therapist’s hands), to meet their goals.
The WWRC Therapeutic Pool offers the physical therapist another modality for helping clients to regain strength and mobility as part of their medical therapy program. The buoyancy, viscosity, hydrostatic pressure and therapeutic temperature of the WWRC pool make it a vital part of a comprehensive rehabilitation program. Many clients that find it difficult to move on dry land (due to weakness, spasticity and pain) may find it easier to move and begin exercising in the pool. The WWRC pool is available Tuesday through Thursday as part of a medically necessary program. Clients needing continued independent aquatic therapy are referred to community pools (AMC Lifetime Fitness or the local YMCA). The WWRC pool is also used by the recreation department for open swim and SCUBA lessons.
Community outpatients who have completed a course of Physical Therapy and who wish to continue exercising independently using the WWRC Physical Therapy equipment that they used during their therapy program may sign up for the transition program. This program allows clients to transition from formal Physical Therapy, using familiar equipment and exercises, before transitioning to community gyms or fitness centers. Access to this program requires a monthly fee and concurrence with the program guidelines outlined at initiation.
Many people who are overweight or obese find it difficult to participate in sports or activities or to work out on exercise equipment. The purpose of Weigh To Go is to engage in physical activity for 30 minutes or more in a non-threatening setting while having fun! Classes meet 3-5 times per week and incorporate discussions regarding nutrition, meal portions and choices, junk food vs real food and ways to monitor calories, activities and nutrients i.e. on-line computer resources. The majority of the time is spent in movement activities such as walking, relay races, “boot camp” ; games such as kickball, basketball, softball, whacky softball, volleyball, pool volleyball, Frisbee golf, Ultimate Frisbee, dodge ball, marathon bowling, etc. Activities and games are modified to be minimally competitive and inclusive of all skill levels and/or visual/hearing/cognitive/mild physical impairments.
Video of Weigh To Go Class, with play Button
The WWRC Physical Therapy gym is equipped with a wide array of exercise equipment that is accessible from a wheelchair. This includes weight lifting stations as well as exercise “bikes” that are pedaled with the arms.
WWRC Physical and Occupational Therapy staff work together to assist people who need to be fitted with a wheeled mobility device. We have a wide range of manual (push) chairs, power assisted manual wheelchairs, scooters, and power wheelchairs available for trial during the mobility evaluation. Therapists work with clients to determine which type of chair and seating (cushion, back, and accessories) meet their needs by having them try several options to determine which one actually works best.
All wheelchair evaluations include a thorough seating evaluation. Clients may have special concerns with sitting comfortably, having enough support to keep his/her balance, or have problems with skin breakdown (pressure sores). Each client is assigned an experienced seating team to evaluate and address particular issues and recommend appropriate safe equipment with client input. The WWRC team may include physical therapists, occupational therapists, rehab engineers, physicians, and nursing as needed.
WWRC utilizes the Force Sensing Array (FSA) pressure mapping system as an additional tool to assist the wheelchair and seating evaluation process. Pressure mapping is used to address concerns of pressure relief techniques, potential causes of skin breakdown (pressure sores), and postural deformities to determine seating and wheelchair set-up. A very thin mat with pressure sensors inside is laid between the person and their seating, displaying areas of unsafe pressure on a computer monitor. Both the therapist and client view changes to optimize the benefit of the seating technologies and customize them, if necessary for the maximum benefit
Our Durable Medical Equipment staff helps clients understand insurance coverage and payment options for purchasing the recommended technology. If a client chooses to order equipment through WWRC, we schedule the person to be seen by the same therapists when the new device arrives to ensure proper fit and function. Clients leave with their new technology fully trained in its use and educated in maintenance, warranty, and vendor contact information. At times, Rehabilitation Engineering provides custom mounting of components and modifications to the technology.
WWRC is proud to have a computerized pressure mapping system that gives us another tool to help identify the seating system or cushion that will help clients avoid complications of skin breakdown or pressure sores. If someone has had skin pressure problems, we can use a very thin mat laid over their cushion to “see” on the computer screen any areas of unsafe pressure between that person and their cushion. Then we can continue to look at this computer picture as we make changes to how they are positioned or as we try new cushions and seating supports. This helps us to decide what we can do to improve skin protection.
One of WWRC’s claims to fame is the creative and innovative solutions that our teams come up with to help persons with disabilities conquer their daily challenges. When technology needs span many areas of an individual's life, our team works together with them to either find existing technology that will work with or without special modifications. If none exists, fear not …our team of rehabilitation engineers and therapists will custom-design a solution just for that person!
In the first picture , Joey’s team fits him with a special seating system to use with his chair that he drives with head movements. In front of him is mounted a communication device that he programs to speak for him again using head movements to enter his words into the device. He has delivered a sermon at his church using this set-up!
In the next picture , Dawn needed a way to carry her new baby around her home. She uses a power chair and wanted to be able to have her baby with her as she moved about her home in the chair.
If a person is preparing to go back to work after an extended time away from work due to an injury or illness, they may have some concerns about what they can do physically. WWRC offers many vocational evaluation and training programs to assist individuals with disabilities who want to go to work. The Physical Therapy department offers specialized evaluations of a person's physical ability to perform work activities such as lifting, carrying, pushing and pulling. We will also evaluate each person's ability to get into and work in different positions like sitting, standing, kneeling, squatting and stooping. Other areas tested are mobility (walking, climbing stairs and ladders and crawling), balance and fine-motor coordination. Finally, we evaluate the client's endurance to work a full 8-hour day. From this testing, we can make recommendations to help clients regain the strength needed to return to work safely.
The WWRC STAR (Supporting Therapeutic Access to Recreation) Trail is a half-mile accessible fitness and mobility trail traversing the scenic woodlands surrounding the Woodrow Wilson Rehabilitation Center Lake area which was completed and opened to the public in June of 2008. The STAR Trail is being enjoyed with many positive comments by WWRC clients and staff as well as numerous members of the Augusta County community. The STAR Trail features include six outdoor fitness stations, accessible fishing piers and benches. A fully-accessible bathroom facility has been constructed along with accessible parking. Physical therapists use the STAR Trail as a pleasant outdoor alternative for advanced mobility and lifetime fitness training for both clients in wheelchairs and those regaining walking and running skills.
