Going Beyond the Plateau in Physical Rehabilitation

Going Beyond the Plateau
I turned on a news program on Sunday. There have been meetings in Washington DC lately,
talking about health care. Of particular interest on this program, were the frail elderly and people of all ages with chronic disabling conditions. Survivors of stroke, spinal cord, and traumatic brain injury, MS Parkinson's to name but a few, too many to mention here. Medicare studies find, these populations are having multiple hospitalizations; sometimes in less than 30 days of release.

I can see where this is cause for some concern. I am fully on board with the need to examine the way we treat, or DON'T treat chronic catastrophic populations. Some of the members on this panel discussion asked, how this might be remedied. Suggestions included utilizing community based programs to address the whole person and identify what else may be contributing to this pattern. A large part of this problem, I believe, can be traced to a lack of access to physical therapy, Occupational therapy, and Rehabilitation services. This would evaluate what conditions are present, and what would be the specific activities that would support the goals and potential of each of these individuals. This level of N.D.T (Nero Developmental Technique) trained P.T.’s (Physical Therapist) is very important to identifying and replacing long held bad habits, and recognizing potential, which is crucial to intervene and correct this revolving door issue.

Telling people in this population to "just exercise" is not a solution. In order to begin an exercise program for those in this group, requires a P.T. evaluation to assure the exercise will be correct to the individual. No “one size fits all”.

The repeat admission to the hospital by these groups and how to fix this problem is a part of what the Challenge Centers mission is. I am glad to hear of this interest from Washington DC. I do have to wonder where these interests were 25 years ago when Challenge Center was getting its start in El Cajon, CA in an old post office building. We have taken steps to intervene in this one area of missed opportunity. Physical Therapy and its logical follow up “Chronic physical activity” is how we focus on a reduction of avoidable acute hospital admits. We create our approach around these chronic catastrophic children through seniors. These Groups have been identified in Medicare studies as the highest repeat users of emergency and acute medical services. Our aftermarket approach is to see who we are able to help and how far they are able to progress. Most of our clients are able to advance, and regain some lost ability, So, we have the opportunity to see what happens, if these chronic catastrophic former patients continue in maintenance - rehabilitation program, beyond the “plateau”.

I have always wondered why we American Media will cancel rehabilitation for chronic/catastrophic populations, because of a plateau they have reached. It is true, people do reach a plateau in their recovery, this is where being “patient” is a virtue, but to stop rehabilitation and quit is no solution to anything. If that’s how we are to treat this “plateau”, we can expect to see these individuals return to acute care repeatedly , until we address the root cause.

Challenge Center does offer that follow up to short term acute physical therapy and the result is turning these repeat hospital admissions, into active exercisers, not reoccurring acute care patients.
CHALLENGE CENTER is run by licensed Physical Therapists. We do not bill insurance because we are not willing to compromise the recovery of chronic catastrophic children, adults, and seniors because they are not able to keep pace with some one’s idea of how fast we expect the progress should be. Fitness is a lifelong commitment and can be of great benefit when taken at our own pace.

Bill Bodry Challenge Center August 2012