There are many reasons why someone might need physical therapy, and people can come up with just as many reasons for not following through with physical therapy.
The good news is that in-home caregivers can be an important part of helping a loved one with physical therapy and seeing the many possible benefits of both therapy and hospital discharge services.
“Caregivers can be extremely important in terms of the ultimate outcome of physical therapy,” said Alice Bell, PT, DPT, GCS, a spokesperson for the American Physical Therapy Association (www.apta.org). “A supportive caregiver who is willing and able to encourage and motivate their loved one can make a significant difference.”
Bell cites one study examining the effect a caregiver can have on someone’s ability to regain lost arm function after a stroke. It was demonstrated that caregiver support accounted for 5 to 9 percent of arm improvement. The study was published in Physical Therapy, the Journal of the American Physical Therapy Association, in Sept. 2010. Five to 9 percent might seem small, but Bell notes that can be extremely significant in terms of someone’s ability to use their arm functionally.
“As human beings, we benefit from having someone there to support us, to cheer us on, to push us a little when we start to feel like we can’t do anymore,” she said. “An engaged and supportive caregiver can be a vital member of the rehabilitative team. Caregivers also often notice things that a therapist might not in terms of how someone is reacting to their illness or injury and what works best for them. Someone who has a history with the patient or client can often lend a lot of insight into the rehabilitative process.”
Bell says the need for physical therapy varies: “The primary reason has to do with some alteration in movement. Physical therapists are primarily the movement specialists. So when an individual experiences difficulty with movement, whether due to pain, weakness, decreased flexibility, problems with balance, difficulty with breathing or limited endurance, a physical therapist is trained to identify the underlying issues and provide interventions to help an individual move with less pain, more efficiently, more safely, and more functionally.”
Yet when people are still in pain or discomfort, they might need the incentive of knowing it is worth doing the physical therapy and that there are possible negative consequences of not sticking with it.
“If a person doesn’t see the connection between what is happening in therapy and what is important to them in terms of their life goals, they will likely not continue,” Bell said. “We also know that self-efficacy is an important component. People need to feel that they have the capacity to succeed. For some patients, this means really challenging them in therapy so they feel that they have worked hard enough to make a difference. For others, it may mean taking things more gradually and slowly so they don’t feel as if what is being proposed is beyond their ability. Finally, it is important to find ways that people can integrate what is needed into their daily lives and make it meaningful and enjoyable. This way, whatever has been achieved through therapy can be maintained in a way that fits into one’s daily life.”
This can be no small task. Bell notes it can take “about 50 hours of exercise over a consistent time frame to truly impact fall risk in a meaningful way.”
The bottom line is, maintaining a routine with physical therapy is a “use it or lose it” situation.
“Continuity with physical therapy in the early phases is important because gains in strength, flexibility, endurance, balance are dependent upon incremental changes over time based on a commitment to a certain program or strategy,” she said. “Physical therapy, at its core, is about empowering people to take control of their health, wellness, and function.”
Still, depending on the reason for physical therapy, a caregiver can make a huge difference whether they are getting someone to appointments, scheduling physical therapy, or even participating in the physical therapy to help motivate someone and get them to a more functional and less painful state.
“It is often important for caregivers to incorporate exercise into their daily routine so they can stay healthy and well, and pain free,” she said. “As the exercise experts, therapists play a vital role in caregiver wellness.”