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Wheelchair and Seating Evaluations: Who Would Benefit and What to Expect

Man in WheelchairWe’re halfway through National Occupational Therapy Month! We wanted to take today to highlight a lesser-known service provided here at Elite Integrated Therapy Centers – Wheelchair and Seating Evaluations. Our Occupational Therapists are able to help determine if a wheelchair or scooter is right for you!

So… Who Would Benefit From a Wheelchair and Seating Evaluation?

Anyone who already has or is in need of a scooter, power, or manual wheelchair is eligible for a Wheelchair and Seating Evaluation. If you would like to be more independent, our Occupational Therapists would love to help determine the best fit for you and your lifestyle. We work closely with your primary care physician throughout this process, although you do not need a referral to come see us! When you first schedule your appointment, we verify your insurance and let you know your benefits ahead of time – no surprises!

Insurance Requirements to Obtain a Wheelchair

Each insurance is different, but most power and manual chairs are covered by insurance after following copay and deductible policies. Currently, insurance companies only require that the therapist documents how the wheelchair is going to be used inside the home. First, insurance requires the patient to have a face-to-face appointment with their physician to document that a wheelchair or scooter is medically-necessary. Then, you can schedule your appointment with us so one of our Occupational Therapists can perform the evaluation. Next, we fax the results to your physician. Finally, your physician will have a face-to-face visit with you in the office and he or she will submit the necessary paperwork to order your chair and/or parts!

WHAT does the Wheelchair and Seating Evaluation Include?

Our Occupational Therapists complete an in-depth, one-hour evaluation to determine what type of mobility device, either a manual wheelchair, power wheelchair, or scooter, is most appropriate. We assess balance, posture, strength, and range of motion of upper and lower extremities. A local Assistive Technology Provider will also be present for the evaluation to assist with taking measurements and choosing the optimal chair, seat cushion, and backrest. The Assistive Technology Provider works for the company that provides the chair or various parts.

Scooter vs. Power Wheelchair vs. Manual Wheelchair

A scooter is a power device that you would normally see or use in a grocery store. They have 3 or 4 wheels, giving them a larger turning radius, and also making it harder to get in and out of rooms. Scooters are difficult to use inside the home. Scooters allow you to use both of your upper extremities rather than just one hand.

Similarly, a power wheelchair provides more seating options and is controlled by a joystick. The power wheelchair has a smaller turning radius which makes it able to turn tight corners, which makes it easier to use in the home.  For those with poor trunk control and difficulty with transfers and walking, a power chair would be a better option.

Lastly, a manual wheelchair allows you to propel yourself and can be fitted specifically to you. These lightweight chairs are great for individuals who have good upper body function and the necessary strength to propel themselves around the home.

Back and Seat Cushions on a Wheelchair

Once you determine which device is best for you, the final step is to address backrests and seat cushions. Backrests on chairs can provide you with better stability if you have poor trunk control.  Depending on the condition of your spine, you may require a specialty backrest.  There are also specialty seat cushions that provide pressure-relief for individuals who are at high risk for pressure sores. If you have poor trunk control, then seat cushions that provide support and stability are also an option. These cushions can be used in both manual and power wheelchairs.

Maybe you’re considering a wheelchair or scooter to help you be more independent and have more mobility. Maybe you already have a chair and need it to be adjusted/repaired. Either way, contact us today! We would love to talk with you and get you set up with an appointment. We are passionate about helping you live your life to the fullest!

 

OT and Custom Splints: Keeping It Straight!

April is National Occupational Therapy Month! To kick it off, we wanted to dive into one of the most adaptable aspects of occupational therapy-splinting! A splint is a device worn on an affected area and can be used to immobilize, mobilize, restrict, support, or protect a body part.

What is OT, you ask?

Occupational Therapy is a rehabilitation discipline focused on maximizing one’s independence performing meaningful tasks. That means that we can treat you for problems you have when performing daily activities, work duties, or even leisurely pursuits and make these tasks easier for you. Yeah, it’s a pretty big deal.

What can OTs treat?

In our clinics, we see many different types of complaints including, but not limited to pain and weakness in any joint or area of the arm and shoulder, fractures of any part of the arm, rotator cuff injuries, shoulder pain with scapular dysfunction, nerve injuries/palsies, and many more. OTs can even conduct driver assessments and wheelchair evaluations. We also go beyond physical treatment and can help enable people with cognitive impairments including cerebral palsy, traumatic brain injury, spinal cord injury, Parkinson’s Disease, Alzheimer’s Disease, and the list goes on. For a full list of everything our OTs can treat, check out our diagnoses list!

How do OTs treat?

Our treatments usually involve a combination of exercise, activity practice, activity modification, and massage/manual therapy. Each session will be adjusted to meet your specific needs that day to ensure that you are getting the most out of every appointment. Also, you will have an individualized home exercise program to continue your progress when you are not in the clinic. And of course, our treatments are interactive and fun!

Splints

You have probably seen splints in stores such as CVS and Walgreens. However, they often don’t do the job quite right and that’s where custom splinting comes in! Our occupational therapists are trained to make a variety of finger, hand, wrist, and elbow splints that are customized for each condition and individual. The process is relatively simple and can be done during your first visit with a prescription. Most people find our custom splints more comfortable than those bought at a store. And even better, our custom splints are covered by most insurances!

Common diagnoses that our therapists make splints for include:

  •         Carpal tunnel syndrome
  •         Wrist sprain
  •         Wrist clicking
  •         Carpal instability
  •         Thumb arthritis
  •         Trigger finger
  •         Mallet finger
  •         Tennis elbow
  •         All types of fractures

We will fully assess your condition and needs to determine the best splint and adjust it for your unique needs!

The Splinting Process

The process of making a splint is surprisingly quick and easy! First, our therapists will perform a full assessment of your condition and what you need to do. Then, we will design a paper pattern for the splint sketching around your arm and try it on to ensure it meets your unique needs. Next, we will heat a special thermoplastic in warm water to make it soft. After cutting the material to match the pattern, we reheat it to a moldable, but comfortable, temperature. We will then apply the warm material to the affected area and ensure proper fit and position while the splint cools and firms (most people really enjoy how warm this feels!) Finally, we will fine-tune the splint to maximize comfort and add Velcro straps. Most splints only take 15-20 minutes to make!

 

OT making custom splint

Jon, OTR/L, making a custom splint in our clinic.

 

If you have any problems with a finger, hand, wrist, or elbow, then you should call in and ask to speak with one of our Occupational Therapists. We can discuss your specific condition, give immediate advice, and tell you if therapy, including a custom splint, is right for you. Often, we can see you in the clinic within 1-2 business days!

 

You Asked, We Answered!

Last month in our e-mail newsletter and on our social media platforms, we invited you to “Ask the Experts” and we’re excited to address your questions about physical therapy! Make sure to sign up for our monthly newsletter to stay up-to-date on all of the latest PT happenings, contests, and announcements here at Elite!

 

Q: What is Physical Therapy?

A: Physical Therapy is the treatment to improve mobility, relieve pain, restore physical function, and address disease or deformity.

 

Q: What can Physical Therapy treat?

A: The better question is… what can’t physical therapy treat? We can treat a wide variety of diagnoses. While PT is most commonly thought of for either back pain or sports injuries, some lesser known diagnoses can include headaches, vertigo, and TMJD/lockjaw. Click here for the full list of diagnoses we treat here at Elite!

 

Q: Do I need a referral from my doctor?

A: In most cases, no. In the state of South Carolina under “Direct Access” laws, you can be seen by a Physical Therapist for 30 days before a physician’s script is needed. But we like to get ahead by looping in your Primary Care Physician from the get-go. That way, if we need to see you past 30 days, we already have their consent to move forward!

 

Q: What if I’ve been referred to another facility?

A: As a patient, you have a choice in where you would like to attend therapy. If you want to come see us, let your physician know!

 

Q: How much does Physical Therapy cost?

A: This depends on your insurance coverage. While we accept all private and commercial insurances, we verify insurance benefits ahead of time to let you know what your financial responsibility is prior to your first appointment.

 

Q: Do I need to wait until the pain goes down to come in for treatment?

A: No! In fact, seeing a therapist in the midst of pain will help us better assess the situation and take action appropriately. Moreover, the sooner you are seen and treated, the faster and more effective your recovery will be.

FACT: Studies show that patients seen by a physical therapist within 2 weeks of onset of pain or injury have a 93% success rate.

 

Q: Can I continue working out while attending physical therapy?

A: This will all depend on what you’re being seen for and what you’re looking to do in your workout. Often, your physical therapist can make recommendations on exercises and cater your treatments to your individual goals. If maintaining an active lifestyle during physical therapy happens to be one, your physical therapist can assist you in coming up with a plan that won’t disrupt your PT progress!

 

Q: Should I get an MRI or X-ray first?

A: Your therapist can still evaluate you and see what’s going on. If they see a further underlying problem, your clinician can work with your doctor to determine if radiology would be appropriate.

 

Q: Does physical therapy hurt?

A: While the “No Pain, No Gain” mantra is often associated with physical activity, it’s not always the case with physical therapy. Depending on your diagnoses and advised treatment plan, you may deal with soreness or slight discomfort due to reactivating your muscles and joints. While this is to be expected, pain levels are monitored by your therapist throughout the course of treatment to ensure you’re not overworking your body. Keeping the lines of communication open between you and your therapist in regards to how your body is reacting will allow the therapist to better manage your treatment plan.

 

Were we able to answer your physical therapy questions? If not, shoot us a message and we’ll help you out!

In addition to Physical Therapy, we also offer Occupational Therapy, PT Home Visits, Massage Therapy, and Fitness & Wellness. Check out a full list of our services here.

Safe Squats: Proper Form and Common Mistakes

Buckling Knees

Proper squat form is one of the most popular topics with the popularity of weight lifting. One common mistake when squatting is knee valgus. Knee valgus is when your knees move inward towards midline during functional movements. This usually occurs when your hip adductors (the muscles on the inside of your thighs) overpower your hip abductors (the muscles on the outside of your thighs). Over time, not correcting this mistake could lead to injuries. To correct knee valgus, start with a resistance band above the knees to help give you a tactile cue of pressing out against the band as you are squatting. Your knees should align with the second to third toe during the movement pattern.  Having the band guide your knees outward will help you activate your abductors and lead to better knee alignment in your squats.

Brace Your Core

One of the most important components of a squat is making sure you have properly activated your core. By engaging the core, the spine is braced not allowing for flexion or extension during the movement. Your low back should not round or have an excessive arch. Your hips should flex during a squat without movement at the lumbar spine. Start with unloaded squats to master your pattern. Use a wand or broom stick pressed against your back to see how much your back moves during your squat. The goal is to maintain the same contact and distance with the broom stick throughout the full movement.

Watch Your Neck!

Be mindful of your head and neck position during your squats. Do not lead with the crown of your head! You should not be looking up and have excessive extension through your neck. This is a common mistake that often goes unnoticed. You want to have neutral neck position and keep your eyesight gazing about six to eight feet in front of you. Imagine a dowel running from ear to ear. Do a chin tuck about that axis and maintain that position without moving your head or neck throughout the squat.

Knees Over Toes

A common myth about squatting is “Don’t let your knees go past your toes!” This is a great cue for some people, but remember, everyone’s structure is different. Center mass of load, femur length, shin length, and foot length all play a roll in knee positioning during squatting. If you have long legs and small feet, it would be hard to find a squat position where your knees don’t go over your toes. Hip and knee flexion should happen at a 1:1 ratio during the squatting motion. In short, your knees and hips should both be moving equally and together. The thought is that if we ban our knees going over our toes, then we have reduced the torque on our knees. However, that torque is then translated to the hip joint. Fry, Smith, and Schilling reported in the Journal of Strength and Conditioning Research that when blocking the knees, we reduce torque by 22% at the knee joint, but increase torque at the hips by 1,070%. We have also changed the angle of the hip joint which increases the moment arm and puts more stress on the lumbar spine. Therefore, the stress you save your knees is multiplied and wreaks havoc on other parts of your body like your hips and back! In summary, sometimes the knees should not track over the toes, but sometimes they should. This cue is not a “one size fits all” cue. An individual’s structure and the type of movement performed dictate knee positioning. There is a place for both methods in training and rehabilitation.

Schedule an appointment at one of our 12 locations throughout the Greenville, Anderson, Spartanburg, Belton, Boiling Springs, Fort Mill, Powdersville, Seneca and Simpsonville, SC areas.

 

New Year, Best You

New Year, Best You

It’s 2019! With the new year comes new motivation to set and crush your resolutions. One of the most popular resolutions year after year is to get in shape. But did you know almost 80% of people give up on their resolutions by the second week in February? Luckily, Elite’s Wellness Coordinators are here with tools to help keep you on track all throughout 2019!

Goal Setting

The best way to make sure you don’t get lost in the frenzy of the new year is to set realistic goals. Setting smaller goals along your way will help you stay motivated and prevent you from getting burnt out. When setting these goals remember to stay “SMART”!

Specific: Your goal should be well-defined and easy to understand.

  • Instead of: “I will be healthy in the New Year”
  • Try: “I will lose weight in the New Year”

Here, you go from a vague and all-encompassing goal to one that focuses on a specific aspect of being healthy.

Measurable: Continuing with our example of losing weight, that is still not enough. We must be able to measure and track progress. To make your goals measurable, try assigning numbers to make sure you can track your progress!

  • Instead of: “I will be more active in the New Year”
  • Try: “I will jog 3 days a week for 30 minutes each”

Attainable: You must have a realistic target goal in mind. It’s great to know how much weight you want to lose overall, but keep in mind that healthy weight loss usually means losing between 1-2 lbs. per week. So be careful here! It’s great to be ambitious, but don’t get extreme. On the other hand, don’t make the goal so easily attainable that you’re not challenging yourself!

  • Instead of: “I will lose 25 lbs. this month”
  • Try: “I will lose 5 lbs. this month”

Relevant: Align your goals with where you are in life. Make sure you are setting goals that are important to you. For example, don’t set a goal to cut out fast food if you don’t eat it regularly. However, recognizing and eliminating an unhealthy habit, such as drinking multiple caffeinated beverages in a day, is more relevant to your daily life.

  • Instead of: “I will cut out fast food”
  • Try: “I will cut out Diet Coke”

Time-bound: Set a deadline. Having a known end-point can help motivate you to get started.

  • Instead of: “I will lose 20 lbs.”
  • Try: “I will lose 20 lbs. by my birthday”

Now that we understand how to properly set goals, let’s talk about how to successfully plan for exercise.

Planning for Exercise

In the fitness and wellness world, when talking about exercise program we refer to FITTE.

Frequency: If you are just starting out or refocusing, then it is important to determine how often you plan to exercise. Buy a calendar solely for your workout schedule and stick to it! Nothing is more satisfying then checking off a completed workout.

Intensity: Check your goals and decide how hard you need to work. If you are just starting out, don’t overdo it. You’ll be able to build intensity over time. If you are already on a regimen, then maybe it’s time to switch it up and challenge yourself with a higher intensity.

Time: How much time each day are you willing to dedicate to exercise? Again, for beginners you should start slow and build tolerance. Knowing your limits and respecting them will help prevent you from burning out and throwing in the towel on your resolution.

Type: Now it’s time to determine what types of exercise you would like to partake in. There is no shortage of types to choose from: weightlifting, bodyweight training, walking, swimming, running, dancing, etc.! Remember to vary your exercises to avoid overuse injuries and keep yourself interested in your fitness journey.

Enjoyable: Most importantly, we come to enjoyable. Make sure to choose exercises that you like. If you enjoy your workout, then you are more likely to stick to the new plan!

Now that you have these goal setting tools in your toolbox you’re on your way to having a great new year and being the best version of yourself! Don’t be afraid to ask for help – we’re here for you! You can always stop by one of our offices and chat with one of our Wellness Coordinators about how to further your goals.