Category: Rehabilitation & Therapy

By: Dr. Robert Cromley

My approach to patient care is simple: to help you live a long, healthy, and happy life. As a Board-Certified Family Medicine physician, my practice focuses on outpatient management of adults with multiple and complex medical conditions like hypertension, diabetes, and congestive heart failure as well as health promotion, weight loss and smoking cessation.

I am also trained in osteopathic medicine, where I utilize a treatment method called Osteopathic Manipulative Medicine (OMM) to manage patients with musculoskeletal issues.

What is OMM?

OMM is used to treat mechanical pain (muscle, tendon, or bone pain) and a wide range of health issues by applying gentle pressure to manipulate muscles, soft tissue and fascia. This treatment helps to restore your body’s optimal function and reduce pain.

There is a wide variety of treatments that fall under OMM. However, during an OMM treatment with me, patients are generally treated while lying on their back. The techniques we can use in OMM depend on the specific issues a patient is experiencing. Because I see a lot of patients who are older or have complicated pain issues, my approach is usually careful and gentle to avoid causing pain. If at any point in your treatment you feel pain or discomfort, you should let me know.

Everyone responds to OMM differently, but you may feel sore for a day or two after. Some people feel tired after treatment while others feel energized. Regardless of how you’re feeling immediately after, it’s important to drink plenty of water, go for a short walk, and take it easy avoiding rigorous physical activity.

Who can benefit from OMM?

OMM can treat a variety of medical conditions that affect several systems in the body. However, I primarily utilize it to help patients manage musculoskeletal issues.

These include:

Migraines and tension headaches

Neck stiffness

Neck pain

Back pain

Muscle spasms

Sciatica

Ankle sprains

Pelvic pain

Postpartum pain

As well as chronic pain conditions such as fibromyalgia

An estimated 50 million Americans suffer from chronic back pain, and it is one of the leading reasons patients seek medical care. The most common causes of back pain, which are often treatable, include poor posture, excessive weight, poor workstation set up, lack of exercise and limited flexibility.

Many of my patients tell me they would prefer to not take medications for pain when possible. Osteopathic manipulation is one modality which has proven to be effective in helping patients heal with less or no medicine.

By: Jeri Inmon, PT, Manager, Rehabilitation

October is Physical Therapy Month! What do you think of when you think of physical therapy? Do you think of recovering from an injury or surgery? That is probably the first thing that comes to mind for a lot of people. However, Physical Therapy is so much more! At Fisher-Titus, we have many specialty physical therapy services that you may not know about. In honor of Physical Therapy month, learn more about some of these services available to our community. PT Month

Vestibular therapy is a specialized physical therapy program that addresses symptoms of dizziness and/or imbalance. It is tailored to the individual, depending upon the cause of the symptoms, and helps to retrain the systems of the body for optimal equilibrium and balance.

Concussion therapy is a specialized physical therapy program that addresses any of the myriad of concussion symptoms, including but not limited to dizziness, imbalance, headache, and neck pain. While the majority of concussions resolve in a short period of time, this therapy can be beneficial for those with a delayed recovery, promoting return to normal function and sport play.

Cancer rehab is a specialized physical therapy program that combines aerobic conditioning along with large muscle group strengthening exercises to address some of the side effects of cancer treatment or cancer itself. Common reasons for referral are weakness, decreased endurance, fatigue, balance problems, and pain. Each patient is evaluated to get baseline measurements of their exercise tolerance and strength, and a personalized program is designed to optimize their functioning.

Certified Work Capacity Evaluators (CWCEs) perform functional capacity evaluations (FCEs) to determine maximum physical abilities for return to work after an injury or to determine abilities and/or limitations for disability.

Wheelchair assessments Wheelchairs provide alternative mobility and independence for those needing an alternate way of getting around their home and community. Wheelchairs come with countless options and customizable features to provide the user with optimal function. Our physical therapists will team up with an adaptive technology professional to find the right wheelchair for you.

Pelvic floor rehab is geared towards helping men and women with urinary incontinence, bowel incontinence, trouble emptying their bladder, or difficulty making it to the bathroom in time. We use Biofeedback is used to help teach exercises correctly. Education provided on how environmental factors can contribute to your problem.

Sportsmetrics is a jumping program geared towards high school and junior high athletes to help reduce risk of injury while improving sports performance.

Aquatics therapy is the practice of performing physical therapy exercises in the water.

Custom orthotics provide relief of foot pain from a variety of issues such as flat foot, plantar fasciitis, poor foot alignment, arthritis/foot deformity, or mechanical changes due to aging. These are custom made specific to the patient’s needs based on impairment. A custom orthotic can provide improved support, alignment, and pain relief.

The Orthopedic Specialist (OCS) certification was established to provide formal recognition for physical therapists with advanced clinical knowledge, experience, and skills in orthopedic practice and to assist consumers and the health care community in identifying these physical therapists. Orthopedic Clinical Specialization in physical therapy requires knowledge, skill, and experience exceeding that of the physical therapist at entry to the profession and is unique to the orthopedic area of practice. Jen Oakley Swartz is an Orthopedic Certified Specialist at Fisher-Titus.

Geriatric Clinical Specialists (GCS) are designated to those individuals who have successfully become board certified clinical specialists in the areas of geriatrics. At a minimum, therapists who receive this clinical distinction has completed 2,000 hours of direct patient care in the area of geriatrics, and have successfully completed a rigorous written examination. Jason Strong, DPT, PT is a Geriatric Certified Specialist.

If you feel like you could benefit from any of these services, talk to your doctor about a referral and then call the Fisher-Titus Rehabilitation Department at 419-660-2700 to set up an appointment. For more information, visit fishertitus.org/rehabilitation-services.

By: Jeri Inmon, PT, Manager, Rehabilitation

September 20-26 is National Rehabilitation Awareness Week. This week we are proud to celebrate our dedicated rehabilitation professionals at Fisher-Titus and recognize the exceptional care they provide to patients in our community. Our Rehabilitation Team includes specialists with advanced training in Physical Therapy, Occupational Therapy, Speech Therapy, Audiology/Hearing, Pediatric Therapy, Cancer Rehabilitation, and Athletic Training. Therapy is customized for each individual patient and reflects the best evidence-based practices in the rehabilitation field.

One of the programs offered by Fisher-Titus Rehabilitation is the Ready to be Steady fall prevention program and post-fall management program.

Facts about Falls

Falls can be dangerous especially as individuals age. Here are some things to know about the dangers of falls:

• One out of every five falls causes a serious injury such as a broken bone or a head injury
• Over 800,000 patients are hospitalized every year because of a fall injury, most often because of head injury or hip fracture
• Over 300,000 older people are hospitalized every year for hip fractures
• More than 95% of hip fractures are caused by falling, usually by falling sideways
• Falls are the most common cause of traumatic brain injury (TBI)

Who is at risk of falling?

If you are concerned about your fall risk or the fall risk of a loved one, consider these questions:

• Do you feel less steady on your feet than you did one year ago?
• Have you had a fall recently?
• Do you ever lose you balance or feel dizzy?
• Do you have a fear of falling?

If you answered yes to any of these questions, you may be at increased risk of falling and could benefit from the Ready to be Steady program.

Ready to be Steady

Through the Ready to be Steady program, Fisher-Titus Physical and Occupational Therapists collaborate to create individualized programs for preventing falls with their patients.

The Ready to be Steady program focuses on preventing falls by targeting the five components of fall prevention:

• Strength – Strength is very important for the response of your body after a balance disturbance. Testing will identify weakness and, if necessary, exercises will be suggested to improve ankle and leg strength.
• Balance – Normal balance is controlled by a complex combination of visual, muscular, and neurological systems.. Together these systems keep individuals from falling when encountering a sudden loss of balance. Testing and exercise will improve your ability to remain upright during challenging conditions.
• Walking Speed & Step Length – Older adults typically have a slower walking speed. Steps may also be shorter and vary in length. Speed and step length help our bodies maintain balance. Testing and exercise may help you learn how to walk more safely and confidently.
• Environmental Modifications – In some cases, the setup of your home may limit your independence with certain activities such as showering and cooking. Education and instruction on possible changes to your home may improve your ability and safety when attempting these activities. These modifications and knowledge of proper use of equipment will decrease your risk of falls at home.
• General Health – Living a healthy lifestyle, keeping blood sugars and medications at a therapeutic level will help decrease your risk for falls.

During your first Ready to be Steady visit, patients receive an evaluation from a licensed therapist. The evaluation will include:

• Screening of general health, medical and surgical histories, and a review of current medications
• Assessment of your strength, flexibility, balance, and gait
• Completion of a functional outcome assessment
• Customized goals and program

After your evaluation and the development of your personalized fall prevention plan, you will continue to visit Fisher-Titus Rehabilitation for:

• Exercising to improve strength, balance, walking speed, step length, and flexibility
• Establishing exercises to complete at home with little or no equipment
• Practicing everyday activities to ensure you are completing them as safely as possible
• Establishing methods to maximize safety in the home environment

Your therapists may even recommend a home evaluation as part of your fall prevention plan to help determine what fall hazards there may be in your home and what modifications can be made to make your environment safer.

During your final Ready to be Steady session, you will review your home programs with your therapist(s), progress reports will be sent to your primary care provider, and your therapist will address any remaining questions you may have.

How to Enter the Ready to be Steady Program

To begin the Ready to be Steady fall prevention program, you will need a referral from a doctor. Talk to your doctor if you think you might benefit from the program. You can also get more information from the Fisher-Titus Rehabilitation Department by calling (419) 660-2700 or by visiting fishertitus.org/rehab.

About Jeri

Jeri Inmon, PT is Manager of Rehabilitation at Fisher-Titus. The Fisher-Titus Ready to be Steady program is based on well established and researched science. Fisher-Titus Rehabilitation professionals utilize technology and assess individualized needs to develop an objective and personalized program. They are dedicated to helping improve the safety and mobility of their patients as well as increasing their independence with day-to-day activities.

It was a normal Friday for Denny Weisenburger at his Norwalk Concrete Industries job in 2017 when he began to notice a pain in his neck. As the evening wore on, that pain got worse, and he decided to go to the Fisher-Titus Emergency Room the next day.

“They did some imaging on my neck and transferred me to Toledo,” Denny explained. “They found out that I had a staph infection on my spinal cord and would need surgery.”

Denny underwent his first surgery with the surgeon accessing the infection through the back of his neck. Unfortunately, they weren’t able to clear the infection with that procedure, and he had to undergo a second surgery from the front near his throat.

Those surgeries were just the beginning of Denny’s road to recovery. As a result of the infection and the surgeries, he required a trach, ventilator, catheter, tube‐feeding, and more over the next few months. But Denny never gave up or got discouraged.

“I had determination,” Denny explained with a chuckle. “I wasn’t going to go with the big guy up top, and the little guy down below is too darn hot!”

After recovering in the hospital, he spent several weeks at local rehabilitation centers. Denny also remembers being quadriplegic and wheelchair bound for over a year.

Denny was able to return home in early April of 2018 and started physical therapy the following month.

“My care team has been great,” Denny said. “The biggest thing they’ve helped me with is being able to take care of myself.”

Denny has worked hard in therapy to get to where he is today feeling good overall, independent, and able to do some of the things he enjoyed before his illness. With therapy, he’s been able to stop blood pressure medication and lose weight he gained while he was unable to walk.

“Between physical therapy, Anytime Fitness, and my wife who was a nurse for 50‐something years, I get no rest!” Denny joked.

Since starting therapy, Denny went from being in a wheelchair to walking with two canes and now, while at therapy under the supervision of his care team, he is able to walk without a cane. He is even able to mow his five acres of yard.

Denny says his biggest take away is to not give up and keep a positive attitude.

“It’s been a long road back and I’ve still got a ways to go,” Denny said. “But there is a light at the end of the tunnel that gets a little bit bigger every day.”

To learn more about Fisher-Titus Physical Therapy, visit fishertitus.org/physical-therapy-services.