The Pulse

The use of outcome measures has become the standard of care to objectively assess changes in function, quantify clinical observations, enhance interdisciplinary communication, and examine intervention effectiveness at the patient and practice levels. Inconsistent use of outcome measures remains an issue due to difficulty identifying the most suitable measures based on patient diagnosis, acuity of condition, or practice setting.

Patient Information: Male, Age 57

Diagnosis: Cognitive Communication Deficit / Chronic Obstructive Pulmonary Disease /
Chronic Heart Failure

History: This gentleman was admitted to a skilled nursing facility and referred to speech therapy for decreased cognitive function and failure to thrive following bilateral above knee amputations. Previously, the gentleman lived at home.

It is estimated that over 30 million individuals (9.4%) in the US population has diabetes, while more than one in four do not know they have the disease. A staggering 84.1 million adults have pre-diabetes and, of these individuals, 9 out of 10 are unaware of the condition. Diabetes affects multiple parts of the body and causes many complications such as heart disease, stroke, kidney dysfunction, diabetic neuropathy, orthopedic problems, gum disease, and eye disease. Managing blood glucose levels, a healthy lifestyle and physical activity can help prevent these complications.¹

Patient Information: Male, Age 71

Diagnosis: Stroke / Left Hemiparesis

History: This gentleman suffered a stroke causing hemiparesis (muscle weakness) to his left leg and arm. After spending a week and a half in the ICU and an additional three weeks in inpatient rehabilitation, he received six weeks of outpatient therapy. Prior to his stroke, this gentleman was independent with all mobility and worked full-time running a heavy equipment corporation.

Cerebral vascular accident (CVA), or stroke, affects 795,000 individuals each year and is the fifth leading cause of death in the United States, killing 140,000. Approximately 87% of all strokes are the ischemic-type. Additionally, it is the leading cause of serious long-term disability. Individuals who suffer stroke often have communication challenges, dysphagia, pain, edema, depression, limitations in mobility, and impaired functional ability.^1,2

Patient Information: Male, Age 94

Diagnosis: Chronic Kidney Disease / Generalized Weakness

History: Following hospitalization related to chronic kidney disease, this gentleman, a long-term skilled nursing facility resident, was referred to occupational therapy to address severely decreased range of motion (ROM) in his right hand which limited his ability to feed himself. Prior to the hospitalization, he was able to feed himself independently.

Stroke is a common diagnosis in rehabilitation and resultant visual field disorders can be a significant barrier to a successful rehabilitation program.

Patient Information: Male, Age 67

Diagnosis: Stroke

History: This gentleman was referred to a skilled nursing facility for rehabilitation services after hospitalization due to a second stroke which resulted in lower extremity weakness and decreased balance. Prior to this stroke, he lived at home with his wife and walked with a hemi-walker.

In the early phase of rehab, a therapist may elect to challenge a patient with one task at a time. However, most functional activities in everyday life occur with two or more tasks performed at once. Individuals with neurologic disorders, advanced age, muscle weakness, or cardiopulmonary compromise commonly have deficits in their ability to perform motor and cognitive dual-tasks. Dual-task (DT) training is defined as working on one task while simultaneously working on additional tasks (cognitive or motor). DT training has been shown to offer the following therapeutic benefits:

Patient Information: Male, Age 39

Diagnosis: Guillain-Barré Syndrome / Quadriplegia

History: This gentleman was hospitalized for an extended period of time due to onset of Guillain-Barré syndrome requiring mechanical ventilation. After hospitalization, he was referred to a skilled nursing facility for rehabilitation due to significant limitations in muscle strength, activity tolerance, balance and coordination with an inability to perform daily living tasks independently. His goal was to be able to watch his kids play community sports. Prior to this hospitalization, he was independent with all activities, lived on his own, and worked as a truck driver.