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At Richland Hills Rehabilitation & Healthcare, we have been pleased with the results of using the AlterG Anti-Gravity Treadmill. We had one client who presented with a history of COPD and HTN and was greatly limited by pain. As a former athlete, he was eager to participate in rehabilitation, but he struggled due to his comorbidities. The rehab team determined that he would be a great candidate for use of the AlterG.

Intervention

The AlterG allowed us to target strengthening and conditioning in a fall-safe environment. Our client regained mobility and increased range of motion, all while minimizing stress and pain. Although skeptical at first, after his first time on the AlterG, he was ecstatic that he was able to be mobile and have no pain afterward. The therapists were able to monitor his weight-bearing status and easily track his progress.

Added Challenge

Another limitation for our client was that he came to us without shoes. He wears a 16 wide! Staff members of Richland Hills pooled money together and searched for the perfect shoes for him. He loves his new shoes as well as the rehab department, and he will be staying with us as a long-term care resident.

Oftentimes, patients undergo various setbacks on the road to recovery. For instance, one of our patients, a 77-year-old woman with history of post-polio syndrome, had sustained a pathologic hip fracture related to osteoarthritis in January 2014. She underwent a L THA and was sent to a rehab center. A few days later, she developed a marked increase in pain and shortening of her leg. She had significant bruising on her entire leg and up into her back.

Our client was sent back to the hospital, where X-rays revealed the hip socket had dislodged into her pelvis. Over the next month, she changed surgeons and underwent additional surgeries to reconstruct her hip joint, including an impaction bone graft of her left acetabulum. She did not return to the previous rehab facility, but instead chose Sloan’s Lake Rehab.

Despite her history of polio as a child, our client had been fully independent and living alone in a duplex. She was able to walk without a device, drive and lead an active lifestyle as a senior in her community.

Intervention

When our client arrived at Sloan’s Lake, she was non-weight-bearing on her left lower extremity and totally dependent with all of her self-care tasks and mobility. She was limited by severe pain and weakness, and her family was extremely concerned about her care due to the complications she had sustained.

As the patient began her recovery, she slowly improved in all aspects of ADL tasks and mobility. Because she was not able to rely on her stronger left side, she began gaining strength in her weaker right side.

Our client was able to use adaptive equipment to dress, and she improved in her ability to transfer. After several weeks, her surgeon, Dr. Hugate, upgraded our client to 25 percent weight bearing, and she was able to take her first steps in the Alter G. Over time, our client gained confidence in addition to strength. The patient returned home at wheelchair level, and her son was able to take care of her until her next follow-up appointment.

When Dr. Hugate increased our client’s weight-bearing status to 50 percent, she again used the AlterG to walk and gain strength. One of her therapists accompanied her to the follow-up appointment, where she received full weight-bearing status. After tears of joy and hugs all around — six months after her original injury — our client returned to Sloan’s Lake to continue rehab. She was able to gradually work up to 100 percent weight bearing using the AlterG, and she began walking with a walker.

Results

Our client returned home for the last time — after a total of four inpatient admissions and two outpatient stints over the course of eight months — walking with a cane and able to complete all of her basic self-care tasks with modified independence. Her loss of independence was devastating to her, but she was somehow able to keep an amazingly positive attitude throughout her eight-month rehab process.

One of the revelations she had during rehabilitation was discovering that she had been compensating for her post-polio condition since childhood and had developed many strategies to offset her imbalances over several decades. Working with our client to achieve better balance, bilateral integration and strength and provide techniques for her to complete tasks without compensation allowed our client to return home stronger and more capable than she had been in years.

Recently, Rose Villa purchased a mobile kitchen as an additional tool for our facility. Gym space in our building is so limited, we believed that this would be valuable in providing excellent care to our residents. We have been getting high-level patients, and this has great potential in helping our patients to return to the community.

Our occupational therapist Lorena Penulear thought of this mobile kitchen. Our patients love it, as we are able to do IADL acts such as cooking and meal prep. Lorena can move the mobile kitchen to the back patio as well, where patients and family can watch how they perform some ADLs.

Another facility incorporating pet therapy is Willow Bend Nursing & Rehabilitation, which has similar guidelines and training requirements for its therapy dogs. At Willow Bend, pet therapy consists of supervised visitations in rooms, in hallways and in the gym. The goal of this animal-assisted therapy is to improve residents’ social, emotional, physical and cognitive functioning. The handler’s course for AAT must be completed by at least one staff member, who in turn trains additional staff.

Advocates of the program indicate that AAT can be useful for increasing motivation among participants. Therapists who approach patients with a dog may be viewed as less threatening, thereby increasing rapport between patients and therapists.

For many residents, the ability to nurture and care for another living being is what gives them a feeling of purpose. Before they were residents, they may have lived their lives caring for their children, their spouses and their communities. Having to give up their caretaking duties and also rely on someone else to take care of their own needs often leads residents to feel as though they are no longer needed.

Enter the pet therapy program at Cambridge Health & Rehabilitation. Through this program, residents are able to interact with trained therapy dogs that allow them to be caregivers once again. The results are nothing short of magical for residents who may have previously experienced feelings of hopelessness, unhappiness and stress.

By caring for and visiting with therapy dogs, our residents:

• Experience joy and laughter throughout daily life
• Have a greater ability for newcomers to meet new friends
• Are more likely to engage in exercise and activities
• Have an avenue for touch
• Gain feelings of self-confidence, self-esteem and achievement
• Are able to reduce stress
• Have a means to cope with depression and loss
• Are more likely to communicate

Our patients look forward to their visits with therapy dogs as though they are expecting a visit from family. One patient remarked, “This dog reminds me of my dog at home!” while another commented, “I was proud to be able to stand and walk the dog today!” It’s clear that the residents and dogs have a mutually beneficial relationship that fosters feelings of companionship and self-worth.

To be considered for our therapy program, dogs must be gentle, non-aggressive, sociable and adaptable to new environments. As specially trained working animals, these dogs are tested, observed and certified before they are given the green light to work with people.

Although it may be difficult to quantify the benefits of pet therapy with hard scientific facts, we have enough anecdotal evidence to show that the program is a must at Cambridge Health & Rehabilitation. We welcome any inquiries from facilities looking to implement a similar program at their locations.