How to Help Patient Through Rehabilitation Care Team?

Dance therapy and play therapy is practiced more often with mental health patients than with physically disabled patients. The dance therapist sometimes called movement therapist focuses on rhythmic movement as a physical and psychological medium to:

1- Improve gross motor control.

2- Improve body image and awareness.

3- Classify and describe body movements.

4- Improve group activity and competitiveness.

In the realm of person with disability it is not possible for a single person to guide the whole course of rehabilitation. Due to the diverse symptomatology and the spectrum of diseases which lead to to disability, optimum results can only be obtained when a group of qualified professionals (where available) get together and chart out a comprehensive program for the relevant disability. Each member contributes in his own area of specialization, and functions with empathy, not sympathy.

Medical

There is hardly any area of medical specialization that has no bearing on the course of rehabilitation. The specialists interact with the rehabilitation team on a case basis. The neurologist, for example, would prescribe drugs for epilepsy, the plastic surgeon would prescribe drugs for epilepsy, the plastic surgeon would treat the pressure sore and the rheumatologist would assess the patient with ankylosing Spondylitis.

The Rehabilitation Team

Physiatrist

Physiatrist , also known in some hospitals as the specially of Physical medicine and rehabilitation has developed recently in to a very comprehensive and holistic field. There are very few trained physicians in the field of Physiatry today. The physiatrist is the leader of the rehabilitation team. The functions of the physiatrist are, to clinically assess the patient, arrive at a functional diagnosis and coordinate with other member of the team to chart out a line of management.

The physical medicine specialist or Physiatrist is qualified in the evaluation of disability, prescription of physiotherapy, occupational therapy programs, orthoses and prostheses. He often needs to involve the vocational counsellor, for vocational evaluation. He often needs to involve the vocational counselor for vocational evaluation, counseling, training and job placement, or with the architect to design barrier free environment for the person with disability. During the course of his review, he would need to interact with his peers in other fields like neurology or orthopaedics. On the academic side, he needs to work on improving the specialty and do some original work, and teach other members of his team (or even learn from them) wherever required.

The physiatrist is in best position to guide the patient and his relatives through the challenging course of rehabilitation. He keeps in mind the residual abilities of his patient, matches them with the skills of his team and limits the final disability of the patient.

It is imperative that the physiatrist has the knowledge sufficient enough in each of the paramedical, medical and socio vocational specialties relevant to rehabilitation to be able to provide the best possible course of therapy to the patient. He seen as friend, philosopher and guide to his team members and patients. By nature a physiatrist must be able to bring out the best in his team and listen patiently to individual opinions.

The other members of the medical team bring in their specialized skills for individuals needing them.

Physical Therapist

The physical therapist assists the patient in movement restoration. He is a very important member of the rehabilitation team. He has to perform a through muscle strength evaluation and quantification, spasticity assessment, and measurement of joint range. On the therapeutic side he would have to perform exercise to maintain and increase joint range of motion, train sitting and standing balance, or increase strength, endurance, and coordination for specific muscle groups or the entire body.

During the course of therapy he would have to use various therapy modalities, such as heat and cold, as well as hydrotherapy techniques, electrical stimulation , traction and massage for pain relief. For those confined to home he would visit them and aid in home evaluation to make the environment barrier free and accessible. The use of various mobility aids including the wheelchair and its accessible. The use of various mobility aids including the wheelchair and its maintenance has to be taught to the patient. For those who are not ambulant the physiotherapist does progressive gait training with or without ambulatory aid.

Music Therapist

Who does not love music? Music is one of the finest of the fine arts. Its can transports one to the highest plane of ecstasy.

The intervention of the music therapist may involve instrumental or vocal performance by the person with disability or helping him appreciate music or attend musical events. This goes a long way in helping children or adults with cerebral palsy or other paralytic conditions. Playing an instrument like the keyboard or the violin improves fine motor skills while dancing or exercising to music (creative movement therapy) is a novel way to improve gross motor milestones. Some children with Down syndrome respond naturally to music. Music helps in relaxation, sedation, or control of pain or anxiety, for those who sing, it improves speech through articulation training or melodic intonation.

Creative Movement Therapist

Recreational Therapist : The recreational therapist uses recreational activities to improve social and emotional behavior and promote the development of the patient. The first step is, assessing in detail the patient’s interest, social capability, cognitive and emotional functioning, level of orientation and awareness. His Physical limitation and abilities, resources, perceived barriers in his immediate environment, also will help plan out his recreational activities.

Next, The therapist goes about educating patients in leisure activities, with specialized equipment, adapted sports, and alternatives to existing life styles, acquiring new skill. This is particularly beneficial to kids who would love to have a session of cricket instead of a session with the physical therapist! These recreational activities like tours, adventure trips, picnics, games and dramatics have several benefits. They help to increase attention span, concentration, maintain physical strength, social skill and motivation.