By Karen Pechman, M.D.
Director, Physical Medicine and Rehabilitation
When people hear the term “orthopedics,” many assume it involves surgery such as shoulder, knee and hip replacement procedures. While those are certainly part of orthopedics, the practice itself encompasses the entire skeletal system and the associated muscles, joints and ligaments. Patients with orthopedic issues resulting from surgery, illness or trauma may be referred to physical rehabilitation specialists to help them recover.
Some orthopedic diagnoses like sprains, muscle strains and even some fractures may be helped by outpatient physical therapy. Others like joint replacements, amputations, multiple traumas and more severe breaks and fractures may require more intensive therapy to promote recovery. For the latter, an inpatient acute rehabilitation stay would be more appropriate.
In an acute rehabilitation hospital, like Burke, the patient is expected to make significant functional gains and medical improvement within a reasonable time frame. Those who are admitted to this type of orthopedic rehabilitation program are typically discharged from the hospital in eight to 11 days.
During their inpatient stay, orthopedic patients will work with an interdisciplinary medical team comprising physiatrists (physicians who specialize in physical medicine), physical therapists and occupational therapists, as wells as nurses and case managers. Patients receive a minimum of three hours of therapy per day, up to six days a week, in both one-to-one and group settings. The clinical team, with the input of the patient and family/caregivers, designs and implements the treatment program. Each patient’s goals are unique and so should their rehabilitation.
The physical therapists will help patients regain function, motion and strength to the affected area through muscle strengthening exercises, endurance training, flexibility exercises, balance training and functional mobility training. This includes getting in and out of bed; transferring to and from a wheelchair, bed; and walking up and down stairs.
The occupational therapists will assist in managing or overcoming limitations that affect daily tasks such as dressing/undressing, work-related and leisure activities. The therapists provide orthopedic patients the tools they need to make the transition from hospital to home as smooth as possible. They teach them how to do familiar tasks such as bathing, feeding, getting around the home and community in a new way that is tailored to the patient’s function and ability.
The physiatrist monitors the overall orthopedic rehabilitation program, treatment process and outcome.
Complementary therapy programs may also be included such as recreation therapy, nutrition counseling and orthotic services, as needed.
To read other blog posts by Dr. Pechman and the rest of Burke's doctors, visit Burke's Rehab Insights blog.