Build bridge from therapy to independent exercise
Self-pay program is a community service
Patients who are discharged from outpatient therapy but not quite ready to exercise on their own now have another option at Crozer-Keystone Health System’s Healthplex facility in Springfield, PA.The Healthplex Transitions Program is designed to take patients who have been discharged from outpatient physical therapy and help them continue their exercise regime with supervision until they are able to exercise on their own, says Jef Hewlings, ATC, who directs the program.
Fitness center is on campus
The Crozer-Keystone campus includes Springfield Hospital, a 32-bed hospital with an emergency department, surgery center, outpatient rehab department, medical office pavilion, and the Healthplex Sports Club, a for-profit fitness center partly owned by Crozer-Keystone Health System, a not-for-profit system. (For details on the Healthplex and other hospital-operated health clubs, see Hospital Rehab, November 1995, pp. 141-146.)The Healthplex staff started the Transitions program in November 1996 as a response to a decrease in the number of outpatient physical therapy treatments being approved by managed care companies in the area, Hewlings says.
"We were seeing patients for less and less time in the formal treatment setting. We saw a need to bridge the gap between what they are able to do in physical therapy and what a patient is able to do in a health club setting," Hewlings says.
The Transitions program includes a regime of supervised exercises designed to help patients recover from their injuries, along with a cardiac conditioning program, an overall fitness program, and a weight loss component.
"We do emphasize the injured body part. For instance, if they have been treated for a knee injury, we work them hard in the legs, but we also focus on total body conditioning," Hewlings says.
Many of the patients recovering from injuries simply are not ready to go into an independent exercise program after a few physical therapy sessions, he adds.
For instance, patients who have had major knee or hip surgery tend to get better over a six- to eight-month period, but managed care limits outpatient treatment to two months, Hewlings says. These patients also benefit from a supervised exercise program before going out on their own, he adds.
Some outpatient physical therapy patients are overweight or in poor overall physical condition, but physical therapists can’t address the problem because they are obligated to follow physician referrals and treat only the injured body part, Hewlings says.
Transitions staff members also have found that patients referred to the program have other problems that can be corrected by exercise but aren’t serious enough for a formal therapy program.
Initially, the only referrals have been patients who were finishing outpatient therapy. But with eight months of experience under his belt, Hewlings is looking to take clients who might ot need a formal physical therapy program but could use some supervised exercise.
The Transitions program is staffed by certified athletic trainers and involves only exercises. Passive and electrical modalities used in the physical therapy outpatient program are not a part of the Transitions program.
Clients who join Transitions are counseled by a certified athletic trainer, who sets up an individual program based on the referral from the outpatient physical therapist. The referring therapist provides the patient’s background, prognosis for recovery from the injury, and physical history.
"We get a nice picture of how they have progressed and what has been successful and use that in setting up a program. We don’t do a formal evaluation because we have good background from the therapist. This means that the first day of the Transitions program is also an exercise day," Hewlings says.
Often the first day mimics what was going on in physical therapy from an exercise perspective.
Transitions is offered at regular intervals during the day and is limited to small groups, usually six people at a time.
The certified athletic trainer is responsible for seeing that each client progresses according to the individual plan and addresses nutrition, weight loss, and upper body strengthening while working on the injury.
The program uses a combination of weight training and cardiovascular equipment, all of which is located in the health club. A few clients have used the health club track.
Transitions is a self-pay program at present. Patients may attend twice a week for four weeks at a time for a cost of $50 or three times a week for $60. The sessions last an hour.
Patients may join the Transitions program for a maximum of 12 weeks. After that, they may join the health club, YMCA program, or a wellness program. "Many of the people who stay in our program for 12 weeks have tended to join the health club. These are people who other-wise might never have gone to a health club," Hewlings says.
The program was designed not to be a money-maker but to offer a service to people in need, Hewlings says. Fees for the program merely cover the costs.
[Editor’s note: For more information on the Transitions program, contact Jef Hewlings at (620) 328-8800, ext. 3520.]
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