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Orthotic Clinic

An orthotic, or brace, is an externally worn device that is designed to either support or assist a weakened or paralyzed trunk, joint or extremity. For short-term use, an off-the-shelf brace may be suitable. In many cases, however, to ensure proper fit and function, a brace must be custom-made to match a client’s specific needs.

Clients may benefit from a leg orthotic to assist with positioning, transfers, standing or walking.  A WWRC physical therapist works with clients to determine the most appropriate type of leg brace to meet their goals. Physical therapists use evaluation braces or make temporary braces and shoe inserts for clients to try before prescribing a brace that is made by a certified brace specialist (orthotist). At that time, the physical therapist will refer you to the bi-monthly Orthotic Clinic to meet with a physician and orthotists to prescribe the recommended brace.

Once the brace is made, the orthotist works with the client and physical therapist to make sure that it fits comfortably and works well. Physical therapists train clients in using braces for proper positioning, transferring, standing and walking to the best of their ability in a safe manner.

Prosthetic Clinic

Limb loss through trauma, disease or congenital absence is often treated by providing a prosthetic device (artificial limb) to substitute for the lost limb.

WWRC offers a monthly Prosthetic Clinic. The clinic team typically works with individuals who have already been using a prosthesis for some time and may be referred for a new device.  Most persons undergoing amputations begin working with a prosthetist affiliated with their hospital soon after surgery and may require new devices over time. During a Prosthetic Clinic, clients are evaluated by a physician and licensed prosthetists to determine what prosthetic changes or replacement devices are needed. The prosthetist makes and fits the device as prescribed by the physician. If needed, the physician will refer the client to Physical Therapy for prosthetic gait training or Occupational Therapy for training with an upper extremity device.


Funding

WWRC’s Durable Medical Equipment (DME) staff work with you to review insurance and any other funding resources that will cover the costs of any recommended orthotic or prosthetic device.

Contact Information

Email: Admissions (AdmissionsInfo@wwrc.virginia.gov)
Phone: 800-345-9922, Ext. 7948 or 540-332-7948 | TTY 800-811-7893

Gait and Balance Training

Safe Gait 360o Balance & Mobility Trainer ™ is an over-ground dynamic body weight support (BWS) and fall prevention system located along the length of the PT gym. WWRC PT staff is using this technology to safely challenge our clients who have difficulty with gait or balance while removing risk for falls during these activities.

This device is used to provide a safe means of treating gait and balance impairments in individuals after injury or illness. The design incorporates a constant fall arrest feature that allows physical therapists to work with patients up to 350# of various abilities to practice intensive gait and balance activities without the fear of falling. By altering the amount of body-weight support the complexity of the gait, balance or transfer task can be adjusted. This flexibility will allow clients of differing abilities to practice walking, perform balance tasks, sit-to-stand and floor-to-stand maneuvers, or stairs in a safe and controlled environment. They can also safely experience balance losses to develop the skill to correct their position to avoid falls.

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Contact Information

Email: mailto:PhysicalTherapyInfo@wwrc.virginia.gov?subject=WWRC%20Web%20Site%20Inquiry">Physical Therapy (PhysicalTherapyInfo@wwrc.virginia.gov) | Phone: 800-345-9972, Ext. 7118 or 540-332-7118 | TTY 800-811-7893

Safe Gait 360

Functional Neuromuscular Stimulation

Functional Neuromuscular Stimulation (FNS) is a rehabilitation strategy that applies low-level electrical current to the nerves that control muscles to stimulate functional movements. "Functional" refers to the restoration of useful movements, like standing, stepping, pedaling for exercise, reaching or grasping.

Physical therapists use FNS to facilitate activation and strengthening of paralyzed or weakened muscles following spinal cord injury, stroke, and brain injury. This tool is used along with other therapy interventions to increase functional muscle activity.

Functional Neuromuscular Stimulation Services

  • Portable FNS units used for individual muscle group strengthening
  • ERGYS 2 Rehabilitation System (Therapeutic Alliances Inc.) lower extremity cycling ergometers
  • RT 300-S (Restorative Therapies, Inc.) lower extremity cycling ergometer
  • RT 300-S (Restorative Therapies, Inc) lower and upper extremity cycling ergometer
  • ParaStep® Walking System
  • Regional Lower Extremity Cycling Clinics—Commonwealth Neurotrauma Initiative Grant funding sponsored equipment and training for four clinics in Virginia to offer FNS lower extremity cycling.  Clinic contact information is listed below.

Regional Lower Extremity Cycling Clinic Contact Information

  • Sentara Hilltop Therapy Center - Virginia Beach, VA | Phone:  757-333-7000
  • Advanced Physical Therapy and Rehabilitation - Vienna, VA | Phone:  703-749-0223
  • Medical College of Virginia - Richmond, VA | Phone:  804-828-2941
  • Carillion Rehab Hospital - Roanoke, VA | Phone:  540-853-0636

Functional Neuromuscular Stimulation Cycle Ergometry

WWRC has both the ERGYS 2 and the RT 300-S lower extremity cycle ergometers. These computerized FNS units allow clients with little or no voluntary leg movement to actively pedal a stationary leg bike. WWRC also has the RT 300-S leg and arm cycle which enables therapists to stimulate shoulder and arm muscles for similar benefits. Regular participation in an FNS cycling program can result in the following benefits:

  • Prevention of muscle atrophy
  • Relaxation of muscle spasms
  • Improvement of circulation
  • Improvement in range of motion
  • Improvement in cardiopulmonary function
  • Reduction in pressure sore frequency
  • Improvements in bowel and bladder function
  • Decreased incidence of urinary tract infections

Functional Neuromuscular Stimulation Gait

The Parastep® System is a form of FNS that enables some persons with spinal cord injury to stand and walk limited distances. Through a specially adapted walker, the user pushes buttons on the walker to tell the stimulator to send signals to electrodes placed over the muscles of the hip and knee muscles to assist the user in coming to a standing position and in taking steps. This technology usually works best with people with complete spinal cord injuries between T2 and L1.

Contact Information

Email:Physical Therapy (PhysicalTherapyInfo@wwrc.virginia.gov) | Phone: 800-345-9972, Ext. 7118 or 540-332-7118 | TTY 800-811-7893

Physical Work Performance Evaluation

Individuals preparing to go back to work after an extended time away from work due to an injury or illness may have some concerns about their abilities to perform the job safely and effectively. The Physical Therapy Department offers the Physical Work Performance Evaluation (PWPE), a specialized evaluation of a person's physical ability to perform work activities.

Physical Therapists evaluate each client’s

  • dynamic strength (lifting, carrying, pushing, pulling),
  • ability to get into and work in different positions (sitting, standing, kneeling, squatting and stooping),
  • mobility (walking, climbing stairs and ladders, and crawling),
  • balance,
  • dexterity,
  • fine-motor coordination, and
  • endurance to work a full eight hour day

Evaluation results allow physical therapists to make recommendations to help clients regain the strength needed to return to work safely. Job-specific testing and comparison of a client’s current physical abilities to the demands of the job are reported in an easy-to-read report which can be used to review return to work guidelines with the employer. For persons exploring new or alternative work settings after an injury or illness, this evaluation can provide guidelines for vocational evaluation or training pursuits.

Physical Work Performance Evaluation (PWPE) Criteria

  • WWRC’s physical medicine physician is available for pre-PWPE screening if the client does not have a physician’s order for the PWPE.
  • If a pre-PWPE screening is completed by the WWRC physician, a one-hour break is scheduled in between the physician’s appointment and the PWPE.
  • Client’s blood pressure must be below 150/100.
  • Client’s heart rate must be below 100.
  • If a client has current work restrictions from a physician, please provide this information when referring. WWRC will attempt to contact that client’s physician prior to the evaluation for clearance to test without restrictions.
  • Client should wear comfortable non-slip shoes and loose clothing suitable for physical activity.
  • Client should make plans to eat lunch prior to the PWPE.
  • Client should follow all usual medication routines.
  • PWPE typically lasts three to four hours.

Contact Information

Email: mailto:PhysicalTherapyInfo@wwrc.virginia.gov?subject=WWRC%20Web%20Site%20Inquiry">Physical Therapy (PhysicalTherapyInfo@wwrc.virginia.gov)

Phone: 800-345-9972, Ext. 7118 or 540-332-7118 | TTY 800-811-7893


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