Postural Restoration: Treating the Unique Asymmetry of the Human Body

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James Anderson is a physical therapist for Horizon Home Health & Hospice, and he brings to us a wealth of knowledge and experience in postural restoration. In his former practice at ProActive Physical Therapy in Burley, Idaho, one of the first clinics in the country to be designated a Postural Restoration Certified Center, James attained clinical exceUomo ai raggi x camminata scheletrollence in the nonsurgical treatment of back, hip, knee, shoulder and neck pain. Through a combination of extensive continuing education and collaborative research, James has become an authority on postural restoration and now teaches national courses for the Postural Restoration Institute®.

Over the years, James has provided course instruction and consultation to thousands of physicians, physical therapists, athletic trainers and strength and conditioning professionals nationwide. His expertise with biomechanics has led to invitations to serve as a sports performance consultant for a wide variety of collegiate and professional athletic organizations. These include regular consultation with athletes, trainers, and strength and conditioning professionals in the PGA, MLB, NFL, MLS, WNBA, UFC and several NCAA Division I men’s and women’s collegiate athletic programs. James’ passion for educating students, clinicians and other medical professionals has led to appointments as clinical instructor for several graduate programs and guest lecturer for a wide variety of local, regional and national events.

James received his Master’s Degree in Physical Therapy from the University of Nebraska Medical Center in Omaha in 1998. He completed his undergraduate studies at the University of Nevada Las Vegas, where he majored in kinesiology. He has been a faculty member for the Postural Restoration Institute for the past eight years.

James was a member of the first class to earn the designation of Postural Restoration Certified (PRC) as a result of advanced training, extraordinary interest and devotion to the science of postural adaptations, asymmetrical patterns, and the influence of polyarticular chains of muscles on the human body as defined by the Postural Restoration Institute®. We are pleased to welcome James to the Ensign family!

A Word on Postural Restoration

Postural restoration recognizes the unique asymmetry of the human body, whose intricate neurological, respiratory, circulatory, muscular and ocular systems differ on each side of the body. It is these differences, in fact, that work to balance the body — for instance, the torso is balanced with a liver on the right and a heart on the left.

Through exercise programs, therapists such as James who are trained in postural restoration are able to identify and correct imbalances that may result from the dominant overuse of one side of the body and the resultant system overuse on the other. These therapists also understand how the two hemispheres of the brain affect the balance of the body and incorporate reciprocal function to balance muscle activity around the sacrum (pelvis), the sternum (thorax) and the sphenoid (middle of the head).

To learn more about postural restoration, please visit http://www.posturalrestoration.com/.

Willow Bend Therapy Team is Committed to Excellence!

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We Are Going Good to Great!

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“We Are All in This Together”

Our Willow Bend Rehab team is, in my opinion, the best of the best. Currently on full-time staff, we have seven in the PT department, six in the OT department, two in the ST department, one Floor Tech/Wellness Tech, 1.5 Administrative Techs/Wellness and one Home Health and Outpatient Coordinator. We all work together for the benefit of our patients.

Current Services/Programs:

The Willow Bend Rehabilitation department provides a variety of unique services that are made available to our patients. Current services provided include outpatient, home health, skilled therapy, rapid recovery, long-term care (LTC) and wellness services.

The wellness program was designed for several purposes to keep our LTC residents at their most optimal level, to reduce falls, to have declines of our LTC noted more quickly, and to provide customer service by enhancing our patients’ rehabilitation experience.

  • Phase 1: Wellness Classes, meeting twice a week to work on improving functional mobility skills such as gardening, playing cards, Wii games, etc. It is usually attended by our Rapid Recovery patients.
  • Phase 2: Contracture management. After receiving training for our therapists, the Wellness techs oversee the application of all devices by training CNA floor staff and monitoring applications daily under the supervision of our licensed therapists.
  • Phase 3: Walking program used for our LTC residents and our rapid recovery residents. After receiving training from the PT, the techs are able to walk with residents one time, five times a week.

Our outpatient services are offered to patients who may have completed their episode of care at the facility but are still in need of skilled therapy services as well as community referrals. This program works to continue the plan of care set up while the patient was at WBNR in an effort to maintain the patient’s current level of function while always striving to meet the patient’s highest potential for success.

We have worked diligently to implement our Home Health program. We started from scratch by signing contracts to developing protocols for treatment and billing purposes. The goal is to provide a continuum of care from the moment a patient admits to WB skilled services, to home health, to outpatient. We signed one contract in July 2013 and recently signed another in September 2013, allowing us to utilize two different vendors in an effort to reach as many community members as possible.

Upcoming Services:

We strive to meet the needs of each and every one of our patients. There are several upcoming programs that are being developed in an effort to reach patient-specific populations. The first upcoming service is the outpatient balance program, which will consist of evaluating core stability; the vestibular system; sensation; and developing a patient-specific treatment program to address balance exercises and activities designed to increase muscle strength, improve sitting and standing balance, and improve overall functional mobility in order to enhance each patient’s quality of life and reduce his or her risk for falls.

A second upcoming program is the Cardiac Wellness program, which will consist of continuous assessment of the patient’s vitals throughout each therapy session, as well as specific exercises that focus on improving endurance and activity tolerance in order for the patient to achieve his or her prior level of function. A standardized test by OT/PT will be administered weekly. Education on cardiac precautions, nutrition and energy conservation will be provided.

What Sets Us Apart?

There are several factors that set us apart from others, including the extensive list of unique programs and services provided to patients at this facility as well as in their own homes. We have a team of compassionate and skilled therapists with a combined 160 years of experience. Our program officers help develop and implement new protocols that range from staff spirit to compliance with documentation. Together, we can accomplish anything! “We Are All In This Together!”

By Anna Boone, DOR, and Kelsey Hendrix, PTA Student, Willow Bend Nursing and Rehabilitation, Mesquite, TX

Something Awesome in Victoria

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IMG_2171-LaVillaLaVilla Rehabilitation & Healthcare in Victoria, TX had a very nice graduation ceremony for their students today. The ceremony culminated a 4-week on-the-job training program that was partnered by LaVilla, the Texas Department of Rehabilitative Services and Victoria High School. The training consisted of DRS requirements and incorporating LaVilla workplace training skills.

The Mayor, local TV station, and newspaper attended. It was very cool to see. The students spent a day in Rehab and got t-shirts as prizes for answering questions about Rehab. These guys are really going out of their way to connect with their community and embrace what Ensign is all about.

LaVilla Rehabilitation & Healthcare Center’s Building Communities Program

This program was a partnership between La Villa Rehabilitation, Texas Department of Rehabilitative Services and The Victoria High School that began on October 15, 2013. The program consisted of four weeks of on the job training focusing on DRS requirements and incorporating La Villa workplace training skills:

  • Transportation training
  • Socially appropriate behavior skills
  • Daily living skills
  • Communication skills
  • Grooming
  • Problem solving
  • Goal setting
  • Time management
  • Self concept and self motivation skills training
  • Work traits and work ethics
    • Conflict resolution
    • Disability awareness
    • Financial Management

Areas of training included:

  • Application and interview process
  • Scenarios of work ethics and socially appropriate behavior along with conflict resolution Infection control and hand washing
  • Safety issues
  • Confidentiality, resident rights and customer service Areas of daily living and activities
  • Dining room preparation and meals, cleaning and stocking shelves Housekeeping and laundry duties, changing linens, delivering clothes
  • Personal care assistant duties such as making beds, serving refreshments, assisting residents Therapy services

Program Sponsors:

La Villa Rehabilitation – Mary Jane Arredondo, Administrator

Texas Department of Assistive and Rehabilitative Services – Liz Maresh, Transition Counselor and Larry Green, Amazi ng Grace Consultant & Trainer

Katherine Ray, VAC Teacher for Victoria ISD

Program Supporters:

Victoria West High School -Randi Stanley, Life Skills Teacher Linda Brasfield, Teacher’s Aide

Mary Beahm, Amazing Grace Trainer

La Villa Staff: Amber Elliott (Social Worker), Cynthia Stanley (Director of Nursing), Ruthie Nuells (Dietary Manager), Salvador Rodriguez (Maintenance), Lolly Lamas (Housekeeping Supervisor), Marise Dudley (Director of Rehab), Caryl Todd (Activity Director), Jamie Puente (Assistant Director of Nursing), Lori Jochen (Human Resources) Dietary Department, Nursing Department, Therapy Department, Housekeeping & Laundry

Utilizing Two Different Approaches to Treat Patients Following a Stroke

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I am an OTR curXiorently working at Alta Vista Rehabilitation and Healthcare in Brownsville, Texas. I began working as a new OT at an inpatient hospital, where I was first introduced to Neuro Integrative Functional Rehabilitation and Habilitation (Neuro-IFRAH) techniques. Neuro-IFRAH courses cover the treatment and management of adults with hemiplegia from a stroke or a brain injury. I was given the opportunity to attend a certification course for Neuro-IFRAH in 2009. Since then, I’ve been utilizing their techniques to treat stroke patients in the inpatient and skilled nursing home setting. Neuro-IFRAH provides the therapist with numerous strategies, ideas and techniques that can be applied and utilized to treat the patient’s functional limitations following a stroke.

I decided to continue to expand my knowledge within the neuro spectrum. I attended a certification course in NDT this year. The NDT clinical practice approach is the inclusion of precise therapeutic handling, which includes both facilitation and inhibition as key intervention to achieve independent function. During this course, we were introduced to the importance of utilizing meaningful and functional task goals with the precise therapeutic handling to facilitate normal movement into functional movement patterns.

NTD is a good course in which the instructors recommend all therapists to engage patients in functional tasks to facilitate normal movement while utilizing precise handling to promote greater results. I attempted to utilize what I learned in NDT with my patients in the skilled nursing home; however, I found myself struggling. Most patients I treat at the nursing home are involved, and trying to engage them in a functional task is a challenge due to the severity of their deficits and reduced cognition. While I was in the NDT class, I experienced good results with the outpatient clientele versus my clientele at the skilled nursing home. Although I did acquire new techniques to put in my toolbox while taking part in this course, these techniques are not effective in the setting where I currently work.

As an OTR, I have utilized the techniques I learned with Neuro-IFRAH more frequently than with NTD in my practice. I was taught techniques/exercises to build up trunk control, scooting, scapula mobilization, exercises to facilitate/inhibit tone, alignment of the pelvis, and pre-gait to gait. I also learned to build simple cost-effective equipment such as a hand paddle to facilitate finger extension, large PVC pipe to utilize with the UE, and how to utilize a bed sheet to transfer or to maintain a patient in standing, among other techniques to restore function. Most importantly, these techniques can be utilized in any setting. I have no regrets about my investing time and money in this course.

After being exposed to two different approaches to treat and manage adults with hemiplegia from a stroke, I have been more in favor of utilizing Neuro-IFRAH techniques. In my years of practice, I have seen great results within this frame of practice at the inpatient and skilled nursing home setting. Please keep in mind, this is my humble opinion of my experience with these two different approaches. As therapists, we need to continue to build and expand our knowledge. Therefore, whatever class or training as clinicians we decide to explore, ultimately, we learn new tools to utilize in our practice to continue to provide excellent therapy and care to our patients.

By Xiomara V. Arevalo, OTR, Alta Vista Rehabilitation & Healthcare, Brownsville, TX