A physical therapist also provides rehabilitation to aide in maximum recovery from a stroke.  They often coordinate therapy with other health care providers, which may include an occupational therapist, speech therapist, nursing, and the physician.

PTs coordinate the rehabilitation program for cardiovascular and pulmonary problems.  Patients with Chronic Obstructive Pulmonary Disease (COPD) may have difficulty performing daily activities because their lungs are unable to provide enough oxygen to the muscles.  A physical therapist instructs the patient in an exercise program to maximize the strength and oxygen supply the lungs provide.  PTs also assist with rehabilitation while recovering from Coronary Artery Bypass surgery (CABG) to regain independence.

PTs can work with a broad scope of patients, which range from newborns to the geriatric population.  They work in many different settings, including hospitals, outpatient clinics, home health, nursing homes, and schools.  Physical therapy is not solely focused on patients recovering, but is also directed at injury prevention and loss of movement.  One of the most commonly addressed areas is elderly fall prevention.

More than one third of adults 65 and older fall each year in the United States.  Among older adults, falls are the leading cause of injury deaths.  They are also the most common cause of nonfatal injuries and hospital admission for trauma.  There are many risk factors for falling, of which the cumulative effect will increase the risk.  Some of the risk factors are: muscle weakness, prior history of falls, balance deficits, use of an assistive devices (e.g. a cane or walker), vision problems, neurological problems (e.g. neuropathy associated with diabetes), depression, cognitive impairment, and heart or lung problems.

The best approach to intervention to reduce the risk of falls is with physical activity.  An exercise program should consist of exercises to improve muscle strength and endurance.  The program should be completed regularly, include dynamic balance activities, and can be performed in a clinic or at home.

A balance exercise program should concentrate on leg strengthening, especially the ankle, as well as stomach and back muscles.  Balance retraining begins by controlling the body within a base of support. When performing balance exercises, they should be performed with either both feet on the ground or only one foot on the ground.  Many factors provide input for balance control, such as vision, inner ear, sensation, joint position awareness, and cognitive processes. 

Tips to prevent falls:

1. Always light the surroundings at night, when getting out of bed.  By having the room dimly lit, visual cues are decreased, which can effect balance.  Also, wear glasses at night when getting out of bed.
2. Keep clutter, including throw rugs, out of the walkways.   
3. Raise the height of chair with blocks or cushions to make rising easier.
4.  Attach handrails on the stairs.
5. Consider using a cane, especially when outside on gravel, grass, or dirt.
6. If dizziness occurs when first rising from either the bed or a seated position, then remain seated and perform ankle pumps up and down.  Once the dizziness subsides, then rise again. 
7. Wear shoes that fit and do not slide off easily.
8. Install grab bars in the bathroom and use a non-slip pad in the bottom of the tub or shower.
9. Consider purchasing a bath bench or shower chair if it is difficult to stand in the shower or get down in the tub.  Also using a hand-held shower attachment makes bathing easier.
10. When it is difficult rising from the toilet, consider using a bed-side commode over the toilet to raise the height of the toilet or install a taller toilet.

To assist with developing a balance or fall prevention program, contact a physical therapist. 

For more information, please contact Pam Mitchell, PT at Covenant Home Health Care Services 304-757-9333.  Offices are located in Scott Depot, West Virginia and Proctorville, Ohio.