Developing a Standardized Continuum of Care

Movement Disorder 2 revised imageA RehabCare team has developed a three-tier protocol to provide a standardized approach for treating patients with movement disorders. The protocol for the treatment of balance deficiencies and lack of coordination also aims to create a continuum of care for the patient across different levels of functional abilities. It borrows principles from four well-established treatment methods:

• Neurodevelopmental Treatment (NDT) – Developed in the 1940s for the treatment of children with cerebral palsy, this treatment recreates movement patterns emphasizing midline and symmetry, mobility on stability patterns, proximal to distal progression and recreating the ‘feeling’ of normal movement

• Proprioceptive Neuromuscular Facilitation (PNF) – This process facilitates muscle elongation for the rehabilitation of patients with spasticity and weakness

• LSVT BIG – Developed in early 2000s as an intensive amplitudebased exercise program for the limb motor system, this therapy focuses on re-education of the sensory motor system using principles of neuroplasticity and neuroprotection as treatment rationale

• Tai Chi – Based on Taoist philosophy dating back to the 1500s, this is the synergistic practice, integration and interaction of meditation, martial arts and health.

The plan is for the protocol to be utilized as a standardized approach in outpatient and SNF settings for evidence-based best practices and measurable outcomes. Protocol developers hope that the programming will maximize treatment efficacy and positive outcomes – while expanding the toolbox for therapists.

The movement disorders protocol was rolled out in Kansas and Missouri in Q4 and all clinical performance specialists were trained in it at the end of last year. It will be used by physical and occupational therapists at first and will then expand to speech language therapy.

The team that developed the protocol includes April Rice, PT, DPT; Staci Freudiger, PT, MBA; Leta Kant, PT; Lauren Kriz, MA, LMT; Julie Thornton, OTD, OTR/L; and Misty Coleman, MHS,

Pictured: From left: Staci Freudiger and April Rice