This article explores the differences between the home and high-tech gyms as venues for physical therapy to treat stroke victims.
High-Tech Gyms
During my seven months of occupational therapy in a high-end, high-tech gym in a Rehabilitation Hospital, I observed a number of stroke victims, some old, one just a girl of 20. Many used walkers and wheel chairs. Their therapies focused on improving their walking.
There were machines where the patient sat and pedaled a sort of bike for a time and at a speed selected by the therapists. The treadmills there sported overhead harnesses which support the weight of the patient as he moved his legs. The goal was to gain enough speed and endurance on the treadmill to be able to walk unassisted.
Until a patient was walking independently, the therapist would walk along behind him
holding the heavy strap which was buckled around his waist. Later, as the stroke victim had progressed to walking for a distance, the therapist would follow along with a long-handled, wheeled measuring device to record the distance walked that day.
Some stroke victims exercised in a shallow, heated pool with the therapist right there for support.
Home Therapy
In home therapy, stroke victims do not use machines. The physical therapist teaches the patient to do exercises to improve strength and balance, and to walk every day.
Study by Duke University Researchers
408 stroke survivors who had trouble walking were studied over a period of one year. On the average, they took
1700 steps a day. 10,000 is normal. Some engaged in either home or high-tech therapy. Some started after 2 months of the stroke, some after 6 months. Findings
1. Treadmill exercisers felt dizzy during therapy and had a higher risk and incidence of falling.
2. Fewer patients dropped out of home therapy (3%) compared with (13%) in high-tech therapy.
3. Study shows that high-tech machines are not always better.
Insurance Insurance companies generally allow 20 visits or sessions of high-tech therapy. Such therapy is for three to six months and has been determined not to be sufficient to get patients where they need to be. On the other hand, home therapy visits are generally covered for 36 sessions.
Costs Currently, studies of the costs of these two therapy options are being administered. Costs for home therapy may be lower because no expensive machines are being used, overhead is minimal and just one therapist is involved. At the same time, high-tech rehab gyms use expensive machines and as many as three therapists for each patient in a single session. The message here is that for many stroke victims it takes more than six months for them to make their initial little steps become independent, functional big strides. Somewhere in all of these differences between the two types of therapy there is an answer. Maybe when patients learn the exercises they can do on their own, more will increase and extend their progress beyond the paid sessions covered by insurance.
