Are You Ready?  Karen Axelson, M.S., CCC-SLP, Director of Clinical Services

Change means moving forward, and a key component to progress is learning from the past. Consider how you fared over the past year and what therapy looked like for your residents. Many patients had to receive therapy within the confines of their room, and yet insurance companies and the patients themselves still expect the same outcomes as if they had access to the rehab department equipment and space. I challenge you to take a good look at your rehab department.

Take stock of the type and condition of the equipment you have, what you could (or perhaps should) part with, and where you can invest in your residents. Many equipment suppliers have exciting new options when it comes to modalities, incorporating virtual reality, and when considering the need for sturdy yet portable equipment. Imagine how versatile your therapy delivery can be when you have the equipment to help a patient stand or walk that can be easily rolled from the gym to the bedside. If there is a future infection control concern that limits or prohibits the use of the gym space what is your plan? Consider how you have prepared your facility to meet the various ongoing clinical needs of your residents if therapy is restricted to the nursing unit or the resident’s room. Have you set your team and residents up for success?

With competition from home care companies, outpatient locations, and competitor SNFs, how do you stand out to your clients? Do you have the means to rehabilitate them to their prior level of functioning? Here are a few pieces of rehabilitative equipment that we love:

Jintronix is interactive technology intended for rehabilitating seniors in the areas of strength, balance, stability, motor relearning, mobility, and problem-solving. The Jintronix itself looks like a flat TV screen on a rolling stand and has a very small footprint, making it ideal for even the smallest exercise spaces! By incorporating virtual reality, patients stay more engaged in the task and often participate longer. Jintronix allows users of varying abilities to participate (e.g., seated in a wheelchair, standing with a walker/cane), are customizable to provide a “just right” challenge, and can be implemented with individual patients or as part of a therapy group. Best of all, Jintronix has the clinical data to back its effectiveness. 

Another product line that we love is Medline’s NeuroGym. I find their Sit-to-Stand Trainer (STST) particularly impressive because a transfer that could require the assistance of two to three people can be accomplished with the help of one person. There is no heavy lifting in order to strap on a harness before getting the patient up in the equipment like there is with a traditional standing frame. Also, this device is different than a standing frame as it allows for the patient to complete multiple sit-to-stands with the help of a counterweight. Click here to see a brief video of how it works.  One of the rehab locations that I frequent have benefited from the ability to roll their Sit-to-Stand Trainer right onto the elevator and down to the patient’s room to work on transfers.  The whole NeuroGym suite offers compact options that are easily portable within the facility. I had the opportunity to watch a demo on the Bungee Mobility Trainer, and I love the fall safety that it provides the patient and the therapist while allowing the patient room to improve dynamic balance. Like the other equipment in the NeuroGym, the Bungee Mobility Trainer reduces the need for multiple people working with one patient; this item allows for one person to work with a resident on reaching outside of their base of support rather than requiring one person to guard the resident while another person facilitates the reaching tasks. Click here for a sneak peek on how it is used.  The NeuroGym suite improves efficiency, increases patient safety, and quite literally reduces the load on the clinician or restorative aide. 

The third innovative solution I want to mention is The REAL® System which is an immersive virtual reality system consisting of a tablet, headset, and sensors. The REAL System is for seated exercises that can be done in the gym or at the bedside. The virtual reality offers the patient a visual representation of themselves during upper body activities that target range of motion (ROM), core and balance, cognition, and functional uses. Because this VR system is wireless and portable, the clinician can guard or cue the patient as much as needed. 

The items above are excellent pieces of equipment for physical and occupational therapy that will surely provide facilities with a return on investment. I cannot wrap up this article, however, without showing some love to speech therapy. Theradynamics has a mobile flexible endoscopic evaluation of swallowing (FEES) program. FEES imaging essentially allows the SLP to visualize the swallow at the bedside. Over this past year, we have wanted our patients to avoid unnecessary trips to the hospital, and hospitals themselves have had limited availability to complete modified barium swallow studies. Access to mobile FEES has proved tremendously useful in helping our patients with dysphagia receive the testing they needed while never having to leave their room. Many patients have been able to advance from NPO status to safely resume eating/drinking given modifications or compensations deemed successful during imaging; others received important referrals as a result of what was seen on imaging. Our FEES-trained SLPs currently travel to sites across the five boroughs and Westchester County. Please reach out to to help you better serve your patients with dysphagia.

I hope that the resources above help to energize you in your thinking about how we can meet the needs of our patients with innovative solutions. There have been big advances in rehab technology and equipment over the past several years, yet some gyms I have visited have equipment that is 10-20 years old. Investing in our residents facilitates both clinical and operational outcomes. Whether it is a pandemic, a competitor SNF, an unmotivated patient, a patient with a fear of falling, or a patient that requires the extensive physical assistance of multiple people, the equipment solutions above can help you overcome such challenges.  So I ask you, are you ready for the next challenge?