Nursing vs PT

Part of the constant battle between nurses and therapists.

Benefits of Home Physical Therapy

There are many settings that physical therapists practice their craft.  Schools, hospitals, private outpatient clinics, nursing homes, and private homes are some of these settings.  The most common setting for a patient that is unable to commute to an outpatient clinic or for patients that are homebound is home care physical therapy.  New trend in physical therapy such as the clinic is brought to the patient is now a common practice. Some models are being used. One model is that some physical therapists have a mobile clinic in the form of an RV.  Equipments such as treatment tables, exercise equipments and the typical modalities you would find in a PT outpatient clinic can be found in the RV. A second model which is cheaper would be a physical therapist coming to the patient’s home with a portable treatment table and other hand-held physical therapy modalities such as ultrasound machine, ES, TENS, walking aids and more.

What are the benefits of treating patients in their homes?

• Patients will not miss any treatment sessions thereby improving compliance.
• Evaluation of patients by physical therapist in their REAL natural environment.
• More time efficient since patients don’t have to travel to the clinic
• Patient’s privacy with their family
• Elimination of disruptions such as other clients/patients being treated, etc.
• Physical therapist can have a quality time with the patient as it is a one on one treatment session.
• Allows effective treatment sessions and reduces the risk of injury
• Your whole family is present to support you throughout the treatment session
• Can eliminate complications of driving or riding a car or a public vehicle and the hassle of going to an outpatient physical therapy clinic after a surgery.

Why is home physical therapy right for you?

You must consider some few questions if the home physical therapy is right for you. 

Are you comfortable with a stranger in your home? 

The first few minutes in a therapy session is the adjustment period.  After the physical therapist has introduced him and the treatment approach, you may now be comfortable with him since you are divulging personal information regarding your medical history.

Can you concentrate without any distractions in your home?

Just enough space for the therapy session is required by the physical therapist.  They just need to set up the treatment table and may require an outlet for modalities.  Therapists are trained to be creative in such a way to take advantage of a small area to achieve the required room for exercise.  In addition, most equipments and modalities required for therapy is light and portable.  Thus requires just a little space.

In my experience, patients prefer home therapy because it is more comfortable, more convenient, and promote patient compliance.  They can also take advantage of not going to travel anymore.  It is typical for the patients who undergo home physical therapy to have their therapy sessions scheduled in the morning before going to work or late in the evening after office or working hours.

What about insurance coverage?

Your insurance coverage is dependent on your physical therapist.  Some therapists are connected with Medicare and other commercial plans while others are out of network. It is important to communicate with the therapist prior to the first visit to find out how your treatment sessions will be covered.

Not all patients are candidates for home therapy program.  Physiatrists and physical therapists may advice outpatient care.  However, if you are enjoying your home therapy program you can ask your physiatrist and physical therapist so that they can provide adjustments in your treatment program.

Physical Therapy can Help with Common Upper Extremity Problems following Breast Cancer Surgery

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Upper extremity pain and stiffness is common following surgery for breast cancer. According to McCredie et al, 7 out of 8 who have surgery for breast cancer experience some type of ongoing problem with shoulder/arm function, with most women presenting with more than one symptom. The prevalance of stiffness 6 months following surgery is greater than 40%; 60% have pain in the axilla or chest wall, and 25 to 50% experience weakness. (Kilbreath et al) These problems may not be resolved up to 2 years after surgery.

As a result of these postoperative problems, women may experience a reduced quality of life. Women may experience long term difficulties with everyday activities including: driving, dressing, washing their hair, and sleeping on the involved side. (Maunsell et al, Collins et al) For many women, the 'cure' produces other problems.

Physical therapists with specialized training in breast cancer rehabilitation are the ideal health care providers to address these musculoskeletal problems and help you achieve a pain free and fully functional lifestyle. Physical therapy intervention may address musculoskeletal problems regardless of how long ago your surgery may have been.

Physical therapy interventions aiming to decrease pain and improve function for those who have had breast cancer surgery may include:

• Exercises including an individualized stretching and strengthening program


• Manual therapy to improve the extensibility of tissue affected from surgery


• Scar mobilization to decrease pain, improve mobility and range of motion


• Aerobic exercise program to combat fatique and improve endurance


• Patient education


• Home program
  

At Fauquier Health Outpatient Rehabilitation Services, our cancer rehabilitation team, currently consisting of two physical therapists with specialized training, can provide these physical therapy interventions to patients with breast cancer.

If you have any questions for our cancer rehabilitation team, please call us at 540-316-2680 or click on the button below to submit an email inquiry.

References:

Collins LG, Nash R, Round T, Newman B. Perceptions of upper-body problems during recovery from breast cancer treatment. Support Care Cancer: 2004: 12: 106-13.

Kilbreath S, Refshauge K, Beith J, MiJoung L. Resistance and stretching shoulder exercises early following axillary surgery for breast cancer. Rehabilitation Oncology: 2006: 24:9-13.

Maunsell E, Birsson J, Deschenes L. Arm problems and psychological distress after surgery for breast cancer. Can J Surg. 1993:36:315-320.

McCredie MRE, Dite GS, Porter L, et al. Prevalence of self-reported arm morbidity following treatment for breast cancer in the Australian Breast Cancer Family Study. Breast. 2001:50:292-311.