Rehab: getting back to independence

By Toni Derr Wilcox

Please do try this at home - sit down and cross your arms with your hands resting on your elbows. Now stand up and sit down; repeat for one minute. How many repetitions were you able to do?

According to Physical Therapist Randy Herme, who also manages Bigfork Valley's Rehabilitative Services, standing from a seated position is one of our most common daily activities. Not being able to stand up unassisted can deprive someone recovering from illness or injury of the ability to live independently.

The tools to maintain independence, and take a proactive approach to their own physical well being, are just what the staff of Rehab Services and new Fitness Center want for everyone in the community. With new and improved space, equipment and programs, the opportunities to get and stay fit at Bigfork Valley are better than ever.

Although every patient has a completely individualized rehab program developed in consultation with their primary care physician, Herme describes the usual goals following knee replacement surgery. "The surgeon notifies us of a patient's knee replacement and guides the post-surgery protocol. We'll start that day with what is called a continuous passive motion device. It moves the knee for you. Over the following two days the patient will get up, stand and start moving. On day three Melissa Nelson, our Occupational Therapist, gets involved with adaptive equipment and strategies to take home. These help with things like bathing as well as donning and doffing clothes. The emphasis is on building capabilities for self care and endurance."

Depending on age and overall health, a patient who receives a total knee replacement can expect to be on the way home about four days after surgery.

"That's where the real challenge is for any therapist, and any patient," says Herme. "Patients must take control of the program and manage their condition at home." When asked to explain how the therapist fits into the self care equation Herme explains, "About 30 percent of the people we see are able to do their prescribed rehab sessions then work the rest of the way back to full functioning on their own. We help the other 70 percent make and maintain a commitment to a program. Therapy can be hard work, and the therapist is there to help guide patients through the obstacles."

After many months of anticipation, that guidance is now being provided in the brand new Rehabilitative Services facility, near the specialty clinics and right next door to the newly opened Fitness Center. With about four times the space they used to work in, Herme and Nelson, along with physical therapists Chuck Gibbel and Roberta Votava, find themselves appreciating the location. "It makes the teamwork we were already doing with physicians easier," says Herme, "but the biggest benefit is having room to move around equipment and set things up permanently that used to have to be moved before or after each use." With new treatment rooms, patient privacy is enhanced too.

Fitness Center

"Winter exercise doesn't have to be all about the treadmill," claims Meyers. "I encourage people to keep all options open. They can take a great walk in the woods at home. However, one advantage of coming to the Fitness Center is that when you're here, there are no excuses, you can only work out."

She adds, "Once you're in the door, I gotcha!"

Meyers' enthusiasm will soon extend from individual workouts to group activities. Step aerobics, core strengthening, abdominal and back classes are starting. "We've had a tremendous response, particularly with the 40-70 year old group," notes Meyers. "To me, the best thing about the Center is that people say they feel good after being here. One person told me she was finally able to sleep through the night after starting regular workouts."

So how did you do with the sit-stand activity? Ten to thirteen repetitions are what physical therapists look for to insure that people have the necessary strength and range of motion. "Our biggest opportunity here at Bigfork Valley," Randy Herme says, "is that we can use this great facility and our expertise with assessments, and help keep the community healthy by teaching people to take care of themselves."