Rehabilitation Programs and Services

Rehabilitation Programs and Services 1

Contents 4 Musculoskeletal 10 Pain and Chronic Fatigue 12 Cardiorespiratory 14 Neurology 20 Oncology 21 Falls Prevention 22 Driver Rehabilitation 23 Vocational Rehabilitation 24 Community 26 Specialist Directory (lift out) 26 Our Locations 2

Rehabilitation at Epworth Epworth HealthCare provides multidisciplinary, individualised programs for patients requiring inpatient, outpatient and community rehabilitation programs. Our programs are tailored to our patients needs and work towards returning individuals to as independent and functional a lifestyle as possible. 3

Musculoskeletal 4

Orthopaedic Multi Trauma Orthopaedic (MTO) We offer a comprehensive, individually based orthopaedic rehabilitation program involving a multidisciplinary team including specialists in rehabilitation medicine, nursing, physiotherapy, occupational therapy, social work and dietetics. Intensive inpatient and outpatient programs aim to return the individual to optimal independence. Across all four rehabilitation sites, dedicated rehabilitation therapists specialise in joint replacement, fractures, spinal surgery and musculoskeletal dysfunction. The orthopaedic rehabilitation team assesses each patient and devises a specific rehabilitation program based on the needs and goals of the patient and his/ her family. Epworth Brighton Epworth Hawthorn Epworth rehabilitation has expertise in orthopaedic trauma. Inpatient and outpatient rehabilitation programs are offered to patients who have sustained traumatic orthopaedic injuries, minor brain injuries and complex wounds and burns following motor vehicle and work-related accidents. Rehabilitation programs are specifically designed to meet individual needs. Staff in orthopaedic trauma work as an interdisciplinary team; skilled to support, guide and encourage patients towards independence. Other services offered in the Orthopaedic Trauma Program include: Vocational services (return-to-work) Driver Rehabilitation Program High Level Mobility - Running Group Hydrotherapy Bike Education Hand Therapy Epworth Hawthorn 5

Hydrotherapy High Level Mobility Running Group Hydrotherapy is an adjunctive therapy to landbased therapy in the management of a multitude of conditions. The pool is set at a constant temperature of 34 C. Access is provided via wide, shallow steps or a hoist for those unable to walk. Therapeutic benefits include: Exercising in a weight assisted environment, thereby allowing for early mobilisation following injury Buoyancy that assists with strengthening, coordination and balance problems and improves movement control Warmth of the water that promotes muscle relaxation, increasing joint range and mobility and relieving pain Increasing cardiovascular fitness Epworth Brighton The Physiotherapy Department at Epworth conducts a running group for patients with high level mobility problems. The purpose of the running group is to: Teach people how to run, if only for a few steps Improve high level mobility skills in order to access social, leisure and sporting activities Improve community mobility to allow people to keep up with peers when walking, accessing public transport and crossing roads as well as to develop the endurance to walk longer distances Improve mobility to promote health, fitness and weight loss Epworth Hawthorn 6

Hand Therapy Hand Therapy for the rehabilitation of conditions affecting the hand and upper limb is available for both inpatients and outpatients. Therapy includes the assessment and treatment of non-surgical and surgical conditions. Following a detailed assessment, treatment may include: Condition specific exercises Oedema management Desensitisation Sensory re-education for nerve injuries Custom splinting Education regarding adaptive techniques Provision of adaptive equipment Return to work Scar management All interventions are supported by the use of clinical outcome measures to accurately document progress. Epworth Brighton Epworth Hawthorn 7

Amputee Program The primary aim of the Amputee Program is to return patients home, into their community and functioning well. This comprehensive program is offered to both inpatients and outpatients. The team goal is to meet the patient s identified needs, and thereby optimise the individual s functional independence. The dedicated rehabilitation team includes onsite: Specialists in rehabilitation medicine Pain management physicians Prosthetists Rehabilitation nursing staff Physiotherapists Exercise physiologists Occupational therapists Clinical psychologists Social workers Dietitians Pharmacists Pastoral Care staff Epworth Hawthorn 8

Bike Education Program Arthritis Rehabilitation Program The Exercise Physiology team conducts a Bike Education Program for all appropriate patient populations, including acquired brain injury, multitrauma orthopaedic and amputee. The aims of the program include: Increased independence Providing patients with a mode of transport to assist with community activities of daily living Providing social and recreational opportunities Ongoing means of improving health and fitness Epworth Hawthorn The Arthritis Rehabilitation Program is designed for people who have diagnosed arthritis or other conditions affecting their muscles, bones and joints. The program includes a combination of exercise and education and is designed to cover a range of topics to help people manage their symptoms, lessening the impact of arthritis on their life. Patients who may benefit from this program include those with: Osteoarthritis Rheumatoid arthritis Osteoporosis Spondyloarthritis Ankylosing spondylitis Psoriatic arthritis 9

Pain and Chronic Fatigue 10

Chronic Pain Program Chronic Fatigue Program Epworth s pain management program is for individuals with persistent pain that has resulted from illness, work injury or road trauma and has not responded to standard treatment. A central aim of the program is to assist and support clients in the long term management of their pain so that they can improve their day to day functioning and independence. Rehabilitation consultants work closely with all allied health services, including physiotherapy, occupational therapy, psychology and exercise physiology to ensure a tailored service is provided to each individual. WorkSafe, TAC, DVA and private individuals are accepted pending a medical referral and approval by the relevant health fund. Epworth Brighton Epworth s Chronic Fatigue Program is patient and family-focussed, drawing on the skills and resources of the multidisciplinary team of medical, nursing and allied health staff. The initial point of contact following referral is a telephone review and appointment booking via the inpatient or outpatient coordinator as appropriate. Following admission, each patient is assigned a case coordinator to assist in care planning and community liaison. Program objectives include: To assist the individual to maintain functional independence and self management To re-establish and maintain the ability of an individual to participate in all activities required to maintain a desired lifestyle Epworth Brighton 11

Pulmonary Rehabilitation The Pulmonary Rehabilitation Program is designed to maximise health through exercise, education and support. The program is provided for inpatients and outpatients and aims to: Decrease disability by regaining strength and endurance lost as a result of inactivity and steroid-induced muscle weakness Reduce symptoms of breathlessness and fatigue by improving exercise capacity and teaching pacing, as well as energy conservation strategies Target mood disturbances such as anxiety and depression, as well as providing practical coping strategies and counselling to improve competence and mastery Improve overall quality of life, including increased participation in physical and social activities Specific issues such as medications and their use, nutrition, home oxygen therapy, sputum clearance techniques, home set-up and support services and community supports are also addressed as part of the Pulmonary Rehabilitation Program. Epworth Brighton Cardiorespiratory 12

Sleep Studies Cardiac Rehabilitation The Sleep Unit offers comprehensive overnight studies to observe and diagnose a wide range of sleep disorders such as periodic limb movement disorder, narcolepsy and insomnia. Sleep analysis is conducted in comfortable soundproof private rooms with advanced non-invasive monitoring equipment. Additional services provided by the Sleep Unit include a Continuous Positive Airway Pressure (CPAP) Therapy Clinic and multiple sleep latency testing. Epworth provides comprehensive cardiac rehabilitation aimed at: Maximising physical functioning and recovery Assisting and encouraging behaviours that minimise the risk of further cardiac problems Improving confidence, psychological and social functioning Enabling patients to resume a normal lifestyle The intensive programs provide education, encouragement and opportunity to practise lifestyle changes in daily activities as well as help to build community support networks for patients and their families. Epworth Brighton 13

Neurological Interdisciplinary neurological rehabilitation is provided to patients with a range of neurological diagnoses including: Stroke Brain tumour Multiple Sclerosis (MS) Guillain Barre Syndrome Parkinson s disease The team is dedicated to providing individuallytailored programs based on the individual needs and goals of the patient and their family. The aim is to maximise patients physical and cognitive independence while supporting them and their families following their neurological disorder. The team provides discharge planning and organisation of ongoing services, including referrals for outpatient therapy programs. Epworth Brighton Neurology 14

Acquired Brain Injury Spasticity Clinic The specialised Acquired Brain Injury (ABI) Unit is internationally recognised for its expert care and innovative research programs with academic links to all Victorian universities. The inpatient and outpatient programs provide treatment for people from the early stages after emerging from a coma through to addressing issues relating to their return to community living. Therapy teams include specialists in rehabilitation medicine, nurses, physiotherapists, psychologists, speech pathologists, occupational therapists, social workers, dietitians and vocational counsellors. They work to develop goals with patients and their families aimed at maximising a person s level of independence following ABI. Using a patient-orientated system of teamwork, individual and group therapy programs are instituted for both inpatients and outpatients using the latest techniques and equipment for both cognitive and physical rehabilitation. Two community-based programs are also available for brain injury patients; the Community Integration Team (CIT) and the Transitional Living Centre (TLC). A key element of the program is that patients are followed up for many years following initial presentation, enabling early identification and management of difficulties that can occur following resumption of normal life. The Spasticity Clinic is a specialised interdisciplinary clinic run by a rehabilitation physician, physiotherapist and an occupational therapist. Its purpose is to provide comprehensive assessment and long term management for individuals with either upper limb or lower limb spasticity as a result of a neurological condition. Adults and adolescents with a neurological condition such as stroke, traumatic brain injury, multiple sclerosis, spinal cord injury, cerebral palsy and neuropathies are suitable for management in the Spasticity Clinic. Treatment initiated in the clinic includes physiotherapy and occupational therapy as well as the use of oral medications for generalised spasticity or botulinum toxin where appropriate for individuals with focal spasticity. For those who have required botulinum toxin, concomitant therapy and home exercises are required to maximise effect. Epworth Hawthorn 15

Olfactory Impairment Clinic Parkinson s Program Epworth Rehabilitation is the first rehabilitation facility within Australia to offer an Olfactory Impairment (OI) Clinic. This specialised clinic provides assessment and education for individuals who have suspected changes in their olfaction (sense of smell). Most commonly individuals who attend the clinic are those whom have smell changes post traumatic brain injury, however services are also provided to individuals with facial fractures, Parkinson s disease, stroke and other neurological conditions as needed. The OI Clinic aims to assist individuals by: Completing a comprehensive assessment of their smell function Providing clients with an objective score of severity of impairment Providing targeted education on changes to smell and associated taste changes Assisting clients to access resources and treatments for changes The program is managed by speech pathologists that specialise in this area. Additional referrals to other allied health services will be made as required. Group consultations with other individuals experiencing similar loss can be arranged, for instance cooking groups with local chefs experienced in flavour enhancing techniques. A multidisciplinary inpatient and outpatient program has been developed for patients with Parkinson s Disease (PD). This service aims to ensure that every opportunity is provided for patients to achieve their full potential by promoting independence and assisting with strategies to assist patients and their families cope with a change in health status. Epworth employs speech pathologists certified in the delivery of the LSVT (Lee Silverman Voice Treatment) LOUD program. This is an intensive program targeting increasing vocal loudness, intelligibility, facial expression and confidence in Parkinson s patients. The LSVT BIG program is also offered by trained occupational therapists and physiotherapists, which focuses on improving the size of movement. Many patients with PD are affected by slow and small movements. The LSVT BIG program is especially beneficial for these individuals. Well defined links with Epworth Clinic (mental health service) enables a holistic approach and provision of care for those patients who require additional support. Epworth Brighton 16

Vestibular Rehabilitation Program The Vestibular Rehabilitation Program is for individuals with symptoms of dizziness and/or imbalance as a result of damage to the inner ear or brain. This is a specialised multidisciplinary service with skilled therapists specifically trained in managing vestibular disorders. An individualised treatment program is developed to address the patient s specific goals. The physiotherapist assesses and treats any physical problems that may occur as a result of the dizziness, including issues with mobility, balance, falls or fear of falling and vestibular exercises. Impairments to the reflexes associated with the vestibular system are also reviewed. Occupational therapy focuses on the assessment and treatment of functional issues in any daily activities that arise. The psychologist helps address any primary or secondary psychological issues related to the problems of dizziness, including fear of falling or depression. A neurologist oversees individual care coordination; liaising directly with the treating therapists to ensure the best possible outcome for the patient. Epworth Brighton 17

18 Oncology

Enhance Breast Cancer Rehabilitation Program RECON Program The Breast Cancer Rehabilitation program provides specialist support for women with localised breast cancer following the completion of their acute treatment. It is specifically tailored to women experiencing physical limitations such as fatigue and loss of strength, as well as any emotional issues related to the treatment or their future post breast cancer. It is designed to empower women to regain their sense of self through education related to diet, finances, relationships, body image, supports and exercise. Epworth Hawthorn Patients who undergo treatment for cancer often become deconditioned. The RECON program (Neurological REhabilitation with CONcurrent radiation/tmz for glioma) offers neurological inpatient rehabilitation while providing simultaneous oncological treatment. This collocation facilitates effective rehabilitation, helping people minimise the deconditioning that often occurs during radiation and chemotherapy treatment. It aims to maximise a person s physical and cognitive independence, in preparation for resumption of normal life following treatment. 19

Falls Prevention 20

Falls Prevention and Balance Program Balance Disorders Clinic Epworth runs a comprehensive, multidisciplinary Falls and Balance program, accepting both inpatient and outpatient referrals. This program aims to: Improve physical wellbeing Increase confidence and independence, especially with mobility and community access Minimise risk of falling and the consequences of falls in the at-risk populations The program includes physiotherapy and occupational therapy, as well as psychology services and dietetics as required. The program involves individualised balance retraining, stretching and strengthening exercises, and gait re-education. Gait aids are prescribed when required. Education and practice of safety strategies for completing activities of daily living is also included. A home assessment, community access training and prescription of modifications and aids may also be covered. Epworth Brighton Our Balance Disorders Clinic at is run by specialist neuro-otologists and neurologists who diagnose balance disorders that affect the vestibular system and cerebellum. The clinic offers cutting edge technology including infra-red and high speed video-oculography. These are diagnostic, non-invasive video based methods of measuring eye movements, which can rapidly identify and quantify vestibular and cerebellar causes of imbalance. The clinic is suitable for all patients who present with dizziness, vertigo, gait disturbances or problems with coordination. Following diagnosis, some patients will then be referred on to our Vestibular Rehabilitation Program, which is offered at three sites,, Epworth Brighton and. This is a specialised multidisciplinary service with skilled therapists specifically trained in managing vestibular disorders. 21 21

Driver Rehabilitation Program Following an injury or illness, physical and cognitive problems may affect a person s ability to drive safely. Epworth was the first facility in Australia to commence occupational therapy driver assessment and rehabilitation. The Driver Rehabilitation Program aims to assist people to return to driving when they are safe and ready. All referrals to the program must also include a medical clearance report. The program includes: Off-road assessment which reviews vision, physical problems, reaction times, driving history and knowledge of road laws On-road assessment in a dual control car with a driving instructor and an occupational therapist A report is forwarded to VicRoads with recommendations which may include: return to driving, driving lessons, a restricted licence or licence suspension if the driver is considered to be unsafe The most advanced driving simulator has recently been acquired, providing a safe and stress free environment for patients to learn the use of vehicle modifications. It can also provide basic driver training for learner drivers with a disability, but does not replace on-road driver assessment and training. Driver Rehabilitation Epworth Hawthorn 22

Vocational Rehabilitation Vocational rehabilitation involves transitioning individuals back into the workforce following their injury or illness. The vocational occupational therapist is a return-to-work specialist whose role involves coordinating the return-to-work program by liaising with individuals, their employer and their treating team. This service involves assessment of the workplace and duties, and development of a written graded return-to-work plan. Regular reviews are conducted in the workplace to monitor progress and new return-to-work plans are then prepared that outline any changes to work hours and responsibilities. Vocational counselling can also be provided to explore alternative employment or work related course options for those who are unable to return to their previous employment where appropriate. Epworth Brighton Epworth Hawthorn Vocational Rehabilitation 23

24 Community

Transitional Living Centre Community Integration Team This service provides a unique rehabilitation program assisting persons with brain injury regain skills to enable them to return to live at home and function in the community. The Transitional Living Centre (TLC) is staffed by a skilled specialist team comprising allied health and rehabilitation specialists. This residential program is tailored to meet the needs of individuals and builds on their ability to regain skills. The program may be provided in conjunction with other therapy. The TLC is available for patients who have a brain injury, with and without insurance cover. 4/33 Pender St Thornbury VIC 3071 Phone 03 9416 9820 Email tlc@epworth.org.au The Community Integration Team is comprised of dedicated Rehabilitation Specialists and allied health professionals who implement home or community based therapy programs for people with brain injuries, which include the following: Providing individual therapy at a person s home, work, school, gym or local community Providing training in improving every day living skills Preparing people for return to study or the work force Counselling for individuals and their families Assessing and revising the need for support/ services/equipment within the home Assistance to find local community services Review and provision of therapy services for clients with lifetime support needs Neuropsychological assessment and intervention The program may be provided in conjunction with other therapy. 25

Our Locations 26

48 Epworth Brighton CARPENTER ST Middle Brighton MALE ST DURRANT ST WILLIAM ST HAMPTON ST NEPEAN HWY TOORAK RD No access North bound on Burke Rd BURKE RD TURNER ST HIGH RD WILSON ST HALIFAX ST CENTRE RD 72 PARK RD 85 Wilson Street Brighton Vic 3186 Phone: 03 9592 9200 Fax: 03 9593 1276 Email: rehab@epworth.org.au DENDY ST 888 Toorak Road Camberwell Vic 3124 Phone: 03 9809 2444 Fax: 03 9889 6756 Email: rehab@epworth.org.au Epworth Hawthorn CHURCH ST DENHAM ST West Richmond HIGHETT ST FREEMAN ST BRIDGE RD Yarra River 75 48 BURWOOD RD 75 BARTON ST Hawthorn Station ELGIN ST POWER ST HODDLE ST ERIN ST NORMANDY PL 20 BRIDGE RD BOWEN ST LEIGH ST LENNOX ST 50 Burwood Road Hawthorn Vic 3122 Phone: 03 9415 5777 Fax: 03 9415 5788 Email: rehab@epworth.org.au 89 Bridge Road Richmond Vic 3121 Phone: 03 9426 6666 Fax: 03 9427 0353 Email: rehab@epworth.org.au 27

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