Patients who have had a stroke, traumatic brain injury, spinal cord, amputation, or other medical event receive therapy from different therapists to help them succeed in their recovery. While most rehabilitation involves physical therapy, occupation therapy, and speech therapy, at MossRehab patients also have access to recreational therapists (RTs) to assist in the patients recovery process. RTs use leisure activities to motivate patients resume their leisure lifestyle and improve their quality of life. A team of four RTs, led by Anne T. Wieland, CTRS, MHA, provides inpatient therapy across the spinal cord, stroke, brain injury, and comprehensive rehab units at MossRehab Elkins Park.
Using games, music, and arts & crafts as therapy, the RTs help improve patient’s mental, physical, social, and cognitive health. A Certified Horticultural Therapist on the team also engages patients in horticultural therapy sessions in MossRehab’s Alice and Herbert Sachs Therapeutic Conservatory to support their rehabilitation goals. The RTs take patients on functional outings to help them acclimate re-entry into the community.
“We conduct group therapy sessions where patients can participate in a ‘fun and functional’ activity including chess, an interactive video game, or a board game that offers a distraction while working on balance, dexterity, mobility, or endurance,” explains Jeffrey McCormack, CTRS, who works with patients who have had a stroke. “While desiring to take breaks in physical therapy, a patient may stand for 20 minutes or more during a PT and RT co-treat session, which can increase the patient’s standing tolerance during a therapy session, which is important in recovery.”
After a patient assessment, RTs choose specific recreational activities that considers patient treatment goals, interests, and physical and cognitive conditions. For example, when working with a woman who had a spinal cord injury that affected her upper extremities, Michael Bane, CTRS, MSR, chose a card game that helped with fine motor skills and range of motion while offering a fun and social activity.
“I chose a card game for therapy because the patient previously enjoyed playing cards with their family prior to their injury. This session offered the patient an opportunity to regain dexterity in her hands,” said Bane. “By moving the card holder a bit away from her, I also could work on her trunk control as she leaned over to reach the card holder. So, in one session, I could work on fine motor skills, core strength, and range of motion.”
Some activities are adapted to accommodate a patient’s physical limitations and past interest. For another patient who enjoyed cycling and became paralyzed due to an ATV accident, Bane helped him get back onto a bike that was modified for his specific needs. “Biking is something that helps this patient to relieve stress and maintain fitness,” Bane remarks. “To make him more comfortable with his new lifestyle while helping him to re-engage in a favorite leisure interest, we gave him access to a modified bicycle adapted to his physical differences and utilized the hospital’s parking lot to practice riding the adapted bike. Before he left inpatient rehab, Bane helped the patient research and purchase a bike for his use at home.”
Integrating Patients into the Community
Since many leisure activities happen in the community, RTs take patients on functional outings to learn how to navigate different settings in the real world with their different abilities. “One of our goals is getting patients into the community so that they get back to everyday activities,” notes McCormack. “I’ll work with a patient to create a list of ten things they want to do and plan outings to the actual place.”
If a patient enjoyed going out for coffee, an RT may accompany them to a local coffee shop for the first time utilizing a wheelchair or while wearing a helmet. In addition to teaching safety awareness in negotiating vehicle transfers, ordering coffee, and taking the beverage to a table, the RT can determine if an individual’s condition affects money management or social cues.
Going on more elaborate outings to the mall or stores, the RT may work with the patient on navigating the environment using a wheelchair or cane. An occupational therapist or physical therapist may also engage in the outing, depending on goals identified for the patient. Family members that attend the outing receive real-time training and a perspective of the responsibility of assisting their loved one when discharged from the hospital.
“Many patients say they would be less likely to leave their home without the benefit of doing an outing, because they would be too nervous to go into the community alone and resume leisure activities,” explains Wieland. McCormack adds, “the outings also benefit family members by giving them the confidence to take out their loved ones into the community after being discharged from MossRehab.”
For individuals who use a wheelchair or are unable to drive, they may need to rely on customized community transportation or paratransit vehicles for transportation. MossRehab RTs help patients practice using wheelchair lifts with the hospital’s adapted vehicles. “We practice using lifts with a wheelchair, so that users are comfortable the first time they go out on their own,” notes McCormack.
Camping
Yearly, MossRehab hosts a week-long camping excursion where persons with physical disabilities can participate in outdoor activities and socialize with friends. MossRehab’s Camp Independence is the a weeklong overnight camping experience, held on the grounds of the Variety Club in Worchester, PA. People who have physical disabilities have the chance to participate in swimming, archery, talent shows, horticultural therapy, and arts & crafts to name just a few fun activities. MossRehab RTs attend the event to help ensure that any adaption needs are met for participants to fully engage.
Camp Independence has been held virtually for the past two years due to COVID-19. The decision to hold Camp Independence in person for Summer 2022 is currently under review.
Anyone with a physical disability over the age of 18 can apply to attend Camp Independence. Click here for information about participation.
Community Resources
Patients also receive community reintroduction education, with discussions focused on what it will be like the first time they go out and how long it takes to get acclimated to their new reality. Additionally, RTs provide resources to support patients after hospital discharge, while connecting them with the Christopher Reeve Foundation, Amputee Coalition, Amputation Abilities Support Group, Philadelphia Corporation for Aging, The MossRehab Driving School, The MossRehab Young Empowerment Stroke Support (YESS) Group, and other community groups.
“We encourage our patients to attend support groups that offer recreational activities like going to dinner, the movies, or the beach that provide an opportunity to get outside the home and meet with people having the same challenges,” McCormack says.
Learn about the range of rehabilitation services offer at MossRehab Elkins Park.