When persons are discharged back to their homes following an acute inpatient rehab stay, celebration can quickly give way to bewilderment. Even after months or years of functional improvement, they may be stunned by the difficulty of common household tasks. Worse still, some may experience a profound sense of isolation, as they discover that participating in social events has become considerably more difficult.

MossRehab understands that being discharged, while certainly a significant milestone in a person’s recovery, is ultimately just another step in their journey. That’s why we conduct several post-discharge telephone surveys of our former inpatients to ensure they are experiencing a satisfactory recovery—both physically and emotionally.

For many years, our follow-up surveys asked patients questions about the durability of the outcomes they achieved—for example, the degree to which disability was hampering their return to daily activities and if they had had any additional hospitalizations. Data were collected and reviewed, yet it was difficult to use the data in a meaningful way.  In 2007, members of the Advisory Board of MossRehab suggested an idea for improving the survey process. After soliciting feedback from several stakeholders, including persons with physical disabilities and a panel of former MossRehab patients, the survey was revised and piloted using  specific questions focusing on quality of life issues. Among the questions added were:

What do you think would help you participate in more activities?
Are you interested in information about support groups?
Are you interested in volunteering at MossRehab?
Are you interested in information about adapted sports, wheelchair sports, or other activities?

The results of the new survey showed our patients had a strong desire to reconnect with community resources and with MossRehab. At 48 hours post-discharge, all 101 patients who were surveyed requested information on outpatient services and were referred. At three months post-discharge this number had dwindled some, but more patients asked to volunteer for MossRehab, wanted to join our support groups, or requested information about sports groups, adapted fishing groups and our scuba driving program.

Patient Demand Spurs New Programs

This increase in demand, coupled with MossRehab’s reputation for superior patient outcomes, spurred our therapists to initiate three new outpatient programs in 2008 that allowed patients to continue their recoveries in supportive, social environments. Collectively called the Lifelong Living Programs, these programs are funded entirely through grants from the Albert Einstein society, an internal foundation that operates within Albert Einstein Healthcare Network.

“As we discovered from our revamped post-discharge survey, many former inpatients wanted to reconnect with MossRehab—for the purpose of both continuing physical rehabilitation and for establishing a social connection with other person with disabilities and our therapists,” said Julie Hensler-Cullen, RN, director of education and quality. “The Lifelong Living Programs are the latest addition to our growing repertoire of innovative outpatient programs that help them accomplish just that. They provide the physical benefits of outpatient rehab under the direction of a trained therapists, while simultaneously emphasizing social interaction.”

Enhance Through Dance

This programs uses social dance as a means to develop core stabilization, posture, balance and coordination. Created by MossRehab physical therapist Kathleen Myers, DPT, the eight-week course teaches such dances as basic swing, foxtrot, cha-cha, rhumba, or merengue. “It’s great exercise, and it’s a social activity, helping patients connect with others facing similar challenges. People with limitations can dance in this group without feeling self-conscious,” said Myers.

Instructors provide a model of normal movement both visually and kinesthetically.  Physical therapy principles are emphasized throughout the instruction, with feedback given by the physical therapist instructor. The target populations are ambulatory individuals, age 18 years or older, with impairments related to orthopedic or neurological diagnoses. These individuals have completed a course of outpatient physical therapy, and have been instructed to continue regular exercise in order to maintain gains made in therapy and promote further recovery.

Fitness for Life

This exercise program is designed for spinal cord injury patients—both paraplegics and tetraplegics (C5 and below)—who have finished therapy but still have lifelong fitness needs. Exercises are designed to address problems associated with long-term manual wheelchair use. Key goals are the reduction of shoulder pain, and increase of flexibility, strength and cardiovascular endurance. Members use the VitaGlide machine to strengthen their scapular muscles and reduce shoulder pain.

“In addition to the benefits of exercise, our members love the opportunity to socialize with other persons with spinal cord injury in their community,” said Alison Bell OTR/L, the MossRehab occupational therapist who founded Fitness for Life. “Members are also invited to attend an inpatient spinal cord injury support group that precedes the exercise program. There they act as peer mentors for our inpatients, which gives them the opportunity to be altruistic and help others in the same situation.”

Survivors: In the Pink

This exercise class for breast cancer survivors combines step aerobics, resistive training and stretching, all geared to address common deficits following breast cancer treatment. Survivors: In the Pink, conducted under the direction of a physical therapist, is meant to serve as a stepping-stone for breast cancer survivors, providing education and empowerment to initiate or resume independent, unsupervised exercise. Participants are provided with handouts that contain pictures and a written description of each exercise performed in order to aid performance with proper technique. Every participant wears a heart rate monitor throughout each session in order to ensure that the participant is working within his or her safe physiological limit.

“Many of our members said other cancer support groups had left them feeling emotionally drained,” said founder Tricia Crane, DPT, a MossRehab physical therapist. “By combining the social aspect of a support group with a physical outlet like  exercise, we aim to provide them with the best of both worlds.”