Outpatient Rehabilitation Services

Aquatic therapy at Boca Raton Regional Hospital is provided in one-on-one sessions with a physical therapist or physical therapist assistant. The water creates a feeling of weightlessness that makes exercising fun and easy. Our exercise programs focus on strength, stability, and flexibility in shallow water as well as at deeper levels.

Benefits of aquatic therapy:

• Water buoyancy supports the body
• Reduces stress to joints during exercise
• Strengthens and tones muscles
• Promotes maximal range of motion
• Reduces cases of re-injury
• Reduces stress
• Decreases swelling

Aquatic physical therapy can improve and promote:

• Circulation
• Strength and endurance
• Range of motion
• Balance and coordination
• Muscle tone
• Promote lumbar (lower back) strengthening
• Walking and standing

Aquatic physical therapy also:

• Protects joints during exercise
• Reduces stress
• Decreases swelling

What conditions can benefit from aquatic physical therapy?:

• Pregnancy
• Post-mastectomy
• Arthritis
• Athletic injuries
• Chronic pain
• Fibromyalgia
• Joint replacement
• Neck and back pain
• Oorthopedic dysfunctions

Aquatic Facts:

• Only 50% of a person's body weight is supported by their own muscle effort when standing in water at hip level and only 30% is supported when water is at chest level. Only 10% is supported when water is at shoulder level.
• Water can help to control swelling. It exerts four times as much pressure to the limbs and body as an ace bandage.
• Water provides 16 times as much resistance as air, making aquatic therapy ideal for therapeutic exercises. Patients who have weight bearing and balance restrictions can exercise in a virtually weightless environment while experiencing appropriate resistance in all planes of movement.

For information on how to schedule an appointment, and directions please click on the following link: appointment information

Do you suffer from a backache or neck pain? Does your job require heavy lifting, repetitive bending or twisting, sitting or standing for prolonged periods of time? If your answer is yes, you may want to attend The Back and Neck School of Boca Raton Regional Hospital.

Cumulative trauma Injuries are caused by our lifestyles. The way we work, play sleep, hear, handle stress and exercise all play a factor. At the Back and Neck School of Boca Raton Regional Hospital, you can learn how to recognize the factors that contribute to these injuries and how to prevent them from occurring to us, our families, co-coworkers, and employees.

Classes at the Back and Neck School are taught by a licensed physical therapist or physical therapist assistant. The course instructs current patients in the care and prevention of back and neck injuries. This two hour course consists of a lecture, patient practice and demonstration of various lifts and mock situations with individual one on one instruction, a post test, and a question and answer session to address individual needs.

After attending this course, patients will have a basic understanding of back and neck anatomy, common causes of injuries, proper body mechanics for various household chores and work related tasks, and will understand the importance of exercise in stress management.

For information on how to schedule an appointment, please click on the following link: appointment information.

Gloria Drummond Physical Rehabilitation Institute at Boca Raton Regional Hospital offers custom made orthotics.

Patients who present with mal alignment of the foot and or ankle can benefit from custom shoe inserts. The way your foot hits the ground can not only affect your feet, ankles, hips, and back, but virtually every joint in your body. We use a state of the art casting technique that captures the foot in its corrected position by passing weight through the foot as if the patient was walking. This very precise technique called Dynamic Casting obtains a true representation of the foot as it actually functions, in relation to the ground.

Orthotics are covered by many insurance companies and can accommodate just about any shoe. They come in various colors, materials, and lengths providing the highest levels of comfort. We offer a wide variety of additions including magnets, heel lifts, heel pads, and cutouts at no additional charge. An outgrowth policy for children's orthotics is available as well. This makes the orthotics more affordable in the cases of children who are likely to out grow them.

For information on how to schedule an appointment, please click on the following link: appointment information.

There has been a rapid increase in the incidence of cumulative trauma injuries reported in the United States in the past 20 years. Gloria Drummond Physical Rehabilitation Institute at Boca Raton Regional Hospital offers patients the ability to have their work site evaluated. The purpose of this program is to identify specific areas at a patient's job that may be leading to awkward movement patterns or poor body mechanics resulting in cumulative trauma injuries.

A physical therapist or physical therapist assistant evaluates an employee's workstation and work techniques to identify potential risk factors. Immediate modifications and solutions are recommended along with a written report and suggestions for equipment modification, body mechanic changes, stress management and exercises that can be performed in the office setting.

For information on how to schedule an appointment, please click on the following link: appointment information.

Falls and balance dysfunction are two of the greatest problems that can impact aging individuals. One fall is one fall too many. Gloria Drummond Physical Rehabilitation Institute offers a thorough balance intervention program specific to each client's needs. People may develop balance problems rather suddenly. Difficulties can develop after a long hospital stay or when patients have developed muscular weakness from another cause of lengthy immobility. They may find that their balance has been progressively deteriorating over sometime and it is finally threatening their safety and independent mobility.

Balance problems may be the result of tight muscles, muscle weakness, postural problems that offset a person's center of gravity, delayed balance reflexes and reactions, subjective fear of falling, to name a few contributing factors.

One of the most common questions that we hear from clients is “Can I get any better, or how much improvement can be expected?” There is hope! Prognosis is dependent on many factors, including the number of systems involved in the problem and patient compliance with their home program.

Your therapist will explain his or her findings and expectations at the evaluation. The good news is that “yes,” most clients do show significant functional improvement. One of the greatest goals that we can help person achieve is to reduce his or her fear of falling and increase confidence with balance to minimize the risk for falls.

For information on how to schedule an appointment, please click on the following link: appointment information.

The Institute of Shoulder and Joint Rehabilitation was created to enable patients to reach their highest level of recovery from injury, surgery, overuse or degenerative joint problems. Our program focuses on the achievement of proper movement patterns, and is designed to prevent additional problems by fostering good body mechanics for functional activities. Patients are seen by licensed physical therapists who perform comprehensive evaluations and subsequent treatments for various shoulder and joint problems. Our approach to the injured or dysfunctional shoulder includes:

• Manual mobilization to ensure proper movement mechanics
• Early intervention for stabilization of joint
• Individualized exercise programs to address functional problems
• Retraining of work/ recreational activities
• Education of home programs for patients to continue independently, once therapy is completed
• Strengthening program for independent management after discharge from therapy
• Aquatic Therapy , as adjunct therapy to rehabilitation
• Consultation with occupational therapists for associated hand and or elbow problems, as needed
• Consultation with lymphedema therapists, as needed
• Consistent care from teams of two expert therapists treating each patient

Our unique approach to rehabilitation is exemplified by the use of manual mobilization techniques to promote proper function and reduce pain. Our hands-on treatment methods set us apart. We treat a variety of shoulder problems, including post surgical diagnoses and always maintain active communication with referring physicians. We encourage family and patient participation in an upbeat and positive environment.

For information on how to schedule an appointment, please click on the following link: appointment information.

Guided Imagery
Mondays, Noon to 1:00pm, no cost
Guided imagery and meditation is a mind-body intervention that focuses on the imagination and the senses and has been shown to induce the “relaxation response,” which may help diminish anxiety, pain, nausea and fatigue to help enhance the healing process.

Massage Therapy
1/2 hour session - $45, one hour session - $75
Massage therapy is aimed at improving health and well-being by affecting the musculoskeletal, circulatory. lymphatic and nervous system, as well as mental and emotional states.

Nutrition
A healthful diet can help to rebuild your body’s cells, especially if you are receiving chemotherapy or radiation treatment. Nutrition counseling is available by trained clinical staff for all patients. The registered dietician has special training in helping you make healthful food choices.

Tai Chi
Tuesdays and Wednesdays, $10/class or six consecutive classes for $48
Tai chi is held on Tuesdays from 1:00pm to 2:00pm at the Lynn Cancer Institute at the Harvey & Phyllis Sandler Pavilion and on Wednesdays from 5:30pm to 6:30pm at Gloria Drummond Physical Rehabilitation Institute. This is a traditional no impact exercise program suited for individuals of any age who are interested in improving their balance, strength, breathing and posture. Courses are taught by a certified martial arts instructor with over ten years experience

What is Lymphedema?
Lymphedema is swelling of a body part caused by abnormal accumulation of lymph fluid.

Signs and Symptoms

• Swelling
• Feeling of heaviness or pressure
• Pain or discomfort
• Tingling and or numbness
• Difficulty fitting into clothing
• Increased temperature
• Redness
• Chronic infections of the affected area
• Open Wounds

Types of Lymphedema

• Primary lymphedema is caused by a congenital abnormality of the lymph nodes and their connecting vessels. It can appear immediately after birth, during puberty or in mid adulthood. Some primary lymphedemas have familial or hereditary influence and can affect several limbs.
• Secondary lymphedema, the most common type of lymphedema, is caused by an interruption of lymphatic vessel and nodes due to surgery. It may also develop due to non-surgical causes such as radiation therapy, metastatic cancer, severe trauma, infection or venous insufficiency.

Treatment
Lymphedema is treated with a program called Complete Decongestive Physiotherapy (CDP) which has four components:

• Manual Lymph Drainage (MLD) is a gentle manual technique which stimulates lymph flow and redirects edema to healthy lymphatic vessels.
• Compression bandaging composed of low elastic, multi layer, cotton, bandages are applied to the affected limb to increase tissue pressure, to improve efficiency of muscle and joint pumps and to prevent re accumulation of edema.
• Therapeutic Exercisesare performed with compression bandages or compression garments in place. They improve lymphatic circulation as well as muscle strength and tone. Patients are advised about which types of exercise may benefit or aggravate their lymphedema.
• Education about the lymphatic system, causes of lymphedema, edema control techniques, skin care and a home management program contributes to successful treatment. An essential component, education provides patients and their families with the information necessary to promote long term effective results and to improve their quality of life.

Complete Decongestive Physiotherapy (CDP) is available at the Howard and Barbara Farkas Rehabilitation Center and the Gloria Drummond Physical Rehabilitation Institute of Boca Raton Regional Hospital. A team comprised of licensed physical therapist/certified lymphedema therapist and a massage therapist/certified lymphedema therapist offers a comprehensive treatment program one to two hours daily, three to five days a week for two weeks. At the end of the program patients have the necessary skills to manage their lymphedema on their own. Because lymphedema is a chronic condition, patients may need to return to the Gloria Drummond Physical Rehabilitation Institute for re-evaluation and maintenance treatment.

*Please note that all patients may no require the full Complete Decongestive Physiotherapy (CDP) described above. Treatments will be tailored to each patient's need. Consultation for education in prevention of lymphedema is encouraged.

For information on how to schedule an appointment, please click on the following link: appointment information.

Recent scientific research has indicated that Massage Therapy can help reduce pain and relieve stress. This non-invasive form of integrative therapy is used to complement traditional medical care. Massage Therapy is aimed at improving your health and well-being by affecting your musculoskeletal, circulatory, lymphatic and nervous system as well as your mental and emotional states. It also provides symptom relief, among other benefits, to cancer patients undergoing chemotherapy and radiation treatments.

Physiological Benefits of Massage
Massage increases circulation in your skin by stimulating your sensory receptors. It increases the flexibility of your muscles, tendons and ligaments by separating connective tissues. It relaxes your muscles, reducing the sensitivity of myofascial trigger points, releasing metabolic wastes and increasing circulation. Massage can also help heal swelling and pain cause by muscle trauma by improving the flow of blood and oxygen to the injured area.

• Pain or tingling in arms or legs - muscles can become so contracted that they press on nerves to the arms, hands and legs causing pain or tingling. Massage can help alleviate muscle spasms in your shoulders and hips.
• Injuries - massage can help heal injuries such as tendonitis that develop over time, as well as ligament sprains or muscle strains caused by accidents.
• Scarring - certain massage techniques can limit scar formation in new injuries and can reduce, or make more pliable, scar tissue around old injuries.

Benefits to your Skeletal System
Massage benefits your skeletal system by increasing joint mobility, range of motion and flexibility. It can also help restore tone to flaccid muscles and partially compensate for lack of exercise and inactivity.

• Prevention of new injuries - by relieving chronic tension, massage can help prevent injuries that might be caused by stressing unbalanced muscle groups or by favoring or forcing a painful, restricted area.
• Pain or restriction in joints - massage works directly on the joints to improve circulation, stimulate production of natural lubrication and relieve pain from conditions such as osteoarthritis.
• Posture - releasing the restrictions in joints and surrounding fascia, the body is able to return to its natural posture. Massage can also relieve the contracted muscles and pain caused by abnormal spinal curvatures such as scoliosis.

Effects on your Relaxation Response
A soothing massage can help reduce anxiety, muscle tension and stress as well as improve your mood and the quality of your sleep.


Your immune system may be affected by massage due to the increased flow of the lymphatic system, which influences the immune function. Chronic stress can make you more susceptible to infections, slow wound healing and exacerbate certain autoimmune diseases.


Massage stimulates the parasympathetic nervous system, which helps reduce pain and helps muscles relax.

Therapeutic Massage for Cancer Patients
Research studies suggest that cancer patients at all stages can experience benefits with Massage Therapy. Specifically, Massage Therapy may decrease symptoms associated with radiation and chemotherapy, increase the effectiveness of cancer treatments, strengthen the immune system, reduce the need for pain medication and help improve a patient’s overall quality of life.

Other benefits of Massage Therapy that can be seen by cancer patients include:

• Increased Relaxation
• Stimulates Bowl Activity
• Increased Alertness and Mental Clarity
• Improved Blood and Lymph Circulation
• Decreased Anxiety and Depression
• Relief from Muscle Soreness
• Faster Wound Healing and Recovery from Anesthesia

There are a few cautions for cancer patients seeking Massage Therapy. Massage should be avoided completely around the site of a tumor, or where a tumor has recently been removed. Additionally, although Massage Therapy can help lessen the discomfort of chemotherapy and radiation treatments, it is important that patients wait the appropriate amount of time to schedule a massage, as the skin could be irritated or damaged by the cancer treatments. It is best to always consult your physician to determine if you are a good candidate for Massage Therapy.

The Gloria Drummond Physical Rehabilitation Institute offers a comprehensive outpatient intervention program for persons requiring neurological rehabilitation. Physical, Occupational, and Speech Therapists collaborate (as the client's need necessitate) to provide the most comprehensive and individualized approach to promote a client's functional independence. Some clients require only one therapy discipline, others require more. Common diagnoses treated include, but are not limited to, the following:

• Post Stroke
• Multiple Sclerosis
• Parkinson's and Parkinsonism
• Guillain Barre Syndrome
• Hydrocephalus and NPH
• Nerve Damage secondary to injury or virus
• TBI (traumatic brain injury)

One of the most common, and difficult question we hear is, 'How much recovery can I expect?' The amount and speed of recovery of course is entirely individual. Some factors that affect recovery include:

• acuteness of the incident ('did this happen one month ago or ten years ago?')
• the extent of damage to the body system and the number of systems affected
• compliance with therapy, therapy recommendations, and home programs
• ATTITUDE
• Age is not necessarily a factor in recovery!

For those individuals who have impairments related to a neurological condition, one of the greatest ways that therapy can positively affect performance is the use of research-based management that will help them return to the highest possible functional level and improve quality of life. Following an individualized and thorough evaluation, therapy findings and plan on intervention is discussed with the client, family and communicated with the physician.

For information on how to schedule an appointment, please click on the following link: appointment information.

Occupational Therapy at Gloria Drummond Physical Rehabilitation Institute specializes in upper extremity injuries and neurological diagnoses. Occupational Therapists specialize in improving physical abilities and personal independence. The Centers treat:

• Fractures
• Tendon and nerve lacerations
• Carpal Tunnel Syndrome
• Tendonitis
• Arthritis
• Work-related injuries
• Multiple trauma disorders
• Stroke
• Traumatic brain injuries

The occupational therapy department is comprised of therapists who specialize in treating patients with neurological as well as orthopedic disorders. We utilize traditional intervention as well as new, computer-assisted rehabilitative technology. Patients receive care directed at solving problems of daily living and restoring function. Therapists use individually designed programs of activity which enable each patient to achieve his or her highest level of independence.

A diverse team of this area’s top specialists - doctors, nurses, therapists, registered/licensed dietitians, and other medical professionals - consult one another on the best program of care for each individual patient. For more information or to schedule an appointment, please call 561.955.2100.

Gloria Drummond Physical Rehabilitation Institute at Boca Raton Regional Hospital offers patients a unique opportunity to be educated in a personalized exercise program at their home or community gym.

Patients often experience difficulty transitioning from a clinic exercise routine to a personal gym or home exercise program. As a result, patients can fall short in carrying out their home exercise program after physical therapy. Our program provides a safe, effective and convenient means for patients to maintain their new skills and abilities and continue to make progress in their personal goals. Now patients can have a licensed professional therapist come to their home or community gym to guide them in the right direction.

These one-on-one sessions are taught by a physical therapist or assistant and are completely covered by insurance. They are specifically designed to educate patients on proper equipment set-up, body mechanics, safe progression and precautions to meet their individual needs.

For information on how to schedule an appointment, please click on the following link: appointment information.

The services at The Gloria Drummond Physical Rehabilitation Institute include a team approach to a variety of orthopedic diagnoses. We address both surgical and non-surgical problems, with focus on return to activities of daily living. Some of the problems that are treated at our center include:

• Joint replacements
• Back / Neck problems
• ACL reconstruction
• Rotator Cuff tear / Surgery
• Shoulder pain
• Sacroiliac pain
• Tendonitis / Bursitis
• Fractures
• Knee surgery
• Sports related injuries
• Worker's compensation

We have a large physical therapy staff that work closely with not only other disciplines, as needed, but also our referring physicians, to maintain a high level of communication. This ensures the most thorough outcomes for our patients. Our approach is to identify and address problems according to individual needs, not the diagnosis, in order to maximize function for daily tasks.

For information on how to schedule an appointment, please click on the following link: appointment information.

Postural Correction and Osteoporosis Program

• Loss of body height in standing
• Postural changes (protruding tummy, leaning to the side, hunching forwards)
• Back pain for no specific cause
• Loose teeth or loss of teeth
• Fracture, or slow healing fractures
• Transparent skin - often affects people who are on corticosteroid therapy

The lifetime risk of osteoporosis related to fracture is one out of two for women, and one out of four for men. When fractures occur, they are most prevalent in the spine, hip, or wrist. Other common fracture sites include the ribs, pelvis, or any other bone in the body.
'I am taking medication for my bone density - how can exercise help?'

Current anti-resorptive medications act only to slow or stop bone loss - they do not build bone. The exception is Forteo. Exercise, specifically the right kind of exercise, is critical in improving both bone density and significantly reducing the risk for fracture. Performing the wrong type of exercise (knee to chest stretches, reaching to the floor, recumbent bikes) actually increases the risk for compression fractures in the spine.

Goals of the postural correction and osteoporosis program may include the following:

• To increase standing height from 1/2 inch to 4 inches to decrease the risk for compression fractures
• To provide the client with a thorough understanding of the role of diet and medication for improving bone density and reducing bone loss as much as possible
• To make the client more knowledgeable regarding body mechanics to avoid and reduce the risk for fracture and reduce back pain
• To improve postural alignment in midline
• To eliminate problems with swallowing, digestion and/or breathing
• To eliminate the need for a pillow to see over the steering wheel!

The postural correction program focuses on lifestyle education and teaching the client an individualized home exercise program. Sessions may last 30 - 45 minutes and typically extend for a total of six to eight sessions. Results can be seen after one visit!

Useful links:
http://www.norf.org

For information on how to schedule an appointment, please click on the following link: appointment information.

Pack your myths at the door - skeletal health issues are a concern for people of all ages. Osteopenia and osteoposoris affect both men and women of all ages, heights and structures. According to the National Osteoporosis Fundation, 'Osteoporosis and low bone mass are a major public health hazard for about 55% of the U.S population aged 50 and older.' (February 2002)

Most people with low bone density don't even know it. The symptoms may present themselves as back pain or other 'random' signs.

Physical therapy addresses movement disorders caused by injury, illness, surgery, etc. They generally work with problems such as pain, loss of balance, and difficulty walking, standing or sitting. Some of the common conditions treated in our facility include: back injuries, joint replacements, arthritis, strokes, workplace injuries and sports related injuries.

The physical therapy department, utilizing licensed physical therapists and assistants, provides care in a variety of specialties. Therapists, with special training in such areas as musculoskeletal dysfunction, sports medicine, neurological rehabilitation, and manual lymphatic drainage, use the very latest equipment. They also offer monthly educational sessions in back care and injury prevention including: balance, spinal stabilization, posture re-education, and a comprehensive neck and back school.

Occupational therapy addresses issues that limit a person's ability to care for themselves. This includes fine motor skills such as handwriting, cooking, and dressing and bathing. Some common conditions treated in our facility include: stroke, hand surgery or injury, total joint replacement, arthritis, spinal injuries, and work place injuries.

The outpatient rehabilitative staff at the Gloria Drummond Physical Rehabilitation Institute of Boca Raton Regional Hospital understands the importance of physical activity for a healthy lifestyle and is committed to helping you achieve your long term fitness goals. To help you down the road to better health they have established an independent Post Rehabilitation Strengthening Program which allows you to continue your exercise program at the Gloria Drummond Physical Rehabilitation Institute once your formal physical therapy sessions have been completed.

Post Rehabilitation Strengthening Program Highlights:

• A referral from a Florida physician, dated within 30 days, is required to initiate physical therapy services.
• During your formal physical therapy sessions, your therapist will evaluate and design an exercise program that reflects your specific medical needs.
• You will be educated and instructed on the safe use of exercise equipment to meet your goals.
• You will be counseled on the progression of your established program and will be provided a flow sheet to track your progress.
• Once you are discharged from formal therapy sessions and transferred into the strengthening program, you will be at liberty to use the facility from 8 a.m. to 6 p.m. Monday through Friday.
• Unlike most local gyms, there is no membership fee to join the strengthening program. However no third party payer will be billed and you will be personally responsible for the $8 per visit charge. For your convenience, you may pay at each visit or you can be billed on a monthly basis.
• The strengthening program is an independent program. No therapist will be assigned to you during your visits. However, staff is available to answer questions and help if the need arises.
• For consistency and your safety, any changes in your medical status should be reported to your physician or therapist. Transfer into the strengthening program should be completed within one month of your last formal therapy session and you must attend at least one session in a three month period to stay eligible for the program.

Helping patients get back to active living is our goal!

If you think the strengthening program is appropriate for you or you have additional questions do not hesitate to contact us at 561.955.2100.

For information on how to schedule an appointment, please click on the following link: appointment information.

The Gloria Drummond Physical Rehabilitation Institute at Boca Raton Regional Hospital offers comprehensive assessment and treatment of adults with disorders of:

• Articulation
• Language
• Memory
• Cognition
• Voice
• Fluency
• Hearing
• Swallowing

Some common underlying etiologies include:

• Stroke
• Traumatic brain injury (TBI)
• Degenerative neurological diseases such as Parkinson's disease, ALS, Multiple Sclerosis
• Gastrointestinal diseases including GERD, LPR, reflux
  Thyroid disorders
  Cancer
• Paralysis or weakness of the muscles involved in speech, voice, or swallowing as the result of injury, surgery or misuse.

At the initial evaluation, the therapist designs a treatment plan in cooperation with the physician and patient. Our highly skilled staff is trained in the latest evaluation and treatment techniques. Diagnostic and therapeutic services are offered five days per week with early morning or late afternoon appointments available upon request. The needs of our patients and quality of life are always our first priority.

Voice Disorders
In addition to clinical evaluation of voice disorders, objective assessment by Videostroboscope and Sonispeech are available. This comprehensive assessment provides diagnostic information as to the function of the vocal mechanism, and assists the physician in differential diagnosis of the vocal pathology. In addition, it provides the treating therapist the information necessary to delineate the most effective treatment approach. We have recently updated our equipment to Kay Elemetrics digital system that allows us to provide our referring physicians or speech pathologists with photo quality pictures and copies of the examination on CD, or by E-mail. Common symptoms of vocal pathology include:

• Chronic or recurrent hoarseness
• Changes in pitch
• Changes in Loudness
• Feeling that talking is an effort
• Chronic cough
• Hyper or hyponasality
• Excessive tension in the muscles associated with speech or voice
• Changes in the quality of the voice

Common etiologies include:

• Lesions such as vocal nodules, polyps, granuloma, contact ulcers, or cancer
• Edema
• Vocal cord bowing
• Paralysis or paresis of the vocal folds as the result of injury surgery of disease process
• Paradoxical vocal fold dysfunction
• Functional disorders as the result of misuse of the vocal mechanism.

Swallowing Disorders-Dysphagia
Dysphagia (difficulty with swallowing) is a common problem for both the young and the elderly. Often it is a 'silent' problem that goes undiagnosed or misdiagnosed. However, even a mild problem can significantly affect a person's health or lifestyle as eating is involved in most social activities.

Aspiration is the result food or liquid going into the trachea/wind pipe, and passing into the lungs. It may be accompanied by coughing which is the body's protection for the lungs, or it may be 'silent aspiration' where there is no protective cough. Aspiration may result in pneumonia which can be life threatening, especially for the frail elderly or person's with limited mobility, respiratory impairments, or multiple major medical problems.

A comprehensive assessment of swallowing must include BOTH clinical functional assessment and instrumental assessment by Modified Barium Swallow Study (MBS/VEG). Treatment may include a combination of traditional behavioral exercises, dietary management, patient education, and Neuromuscular Electrical Stimulation (NMES).

Common symptoms of a swallowing disorder include:

• Coughing or choking during or after eating or drinking
• Coughing or choking after lying down
• Waking up choking or coughing
• Chronic cough
• Excessive mucous or saliva
• Recurrent pneumonia, bronchitis, or chest congestion
• Exacerbation of symptoms of COPD
• Shortness of breath associated with eating or drinking
• Low grade fever of unknown origin with no other infections in the body
• Sneezing or runny nose during or after eating or drinking

Common etiologies include:

• Paralysis or weakness of muscles of the mouth, throat, and larynx due to stroke, brain injury, neurological diseases, complications of surgery, intubation, or radiation, or trauma
• Generalized weakness in the frail elderly
• Gastrointestinal disorders including GERD/LPR (Reflux)

For information on how to schedule an appointment, please click on the following link: appointment information.

This program specializes in joint replacement rehabilitation of the knee, hip, and shoulder. Our team consists of occupational and or physical therapists who evaluate and treat the individual both preoperatively and/or postoperatively. The objectives of our program emphasizes the following:

Education
We instruct individuals on how to properly manage the affected joint both before and after surgery. We clarify any questions or concerns about the surgical procedure to help the individual understand the role of rehabilitation and what outcome to expect. We educate the patient on pain management, home exercises, joint protection, proper positioning and progression throughout rehabilitation.

Manual Therapy
Our therapists specialize in a hands on approach initially to massage, stretch, and mobilize the joint to decrease pain and increase range of motion. Early manual intervention is essential to reduce scar tissue and promote reduction of pain and swelling. In addition, we also utilize various modalities to assist the healing process.

Therapeutic Exercise
We provide strengthening and range of motion exercise to maximize the mobility and stability of the involved joint. By communicating with you and your doctor we design and customize an exercise program that addresses your individual needs. The therapist will instruct you on exercises at a tolerable level and progress you to ensure an quick return to activity. We utilize state of the art equipment and emphasize correct body mechanics during exercise.

Ambulation
Individuals who have undergone a total knee or hip replacement will be educated on the appropriate assistive device and how to properly walk with it. They will further progress and transition accordingly toward independence. Individual are taught to walk correctly and safely with proper weight bearing through the affected joint.

Activities of Daily Living
Individuals will receive training toward maximizing their potential in daily routine tasks that encompass the affected knee, hip or shoulder joint. Occupational and physical therapists will teach the individual to modify tasks such as dressing, bathing, standing activities at home and any functional tasks the individual desires to return toward.

Our program also addresses those individuals who have had joint replacements and require further rehabilitation, as well as those who have endured a problematic recovery.

For information on how to schedule an appointment, please click on the following link: appointment information.