Medical Machines

January 28, 2009 by Rebecca Deal  
Filed under Massage & Wellness, Physical Therapy

Modern physical therapy often involves the use of modalities. Modalities are anti-inflammatory machines designed to reduce swelling around an injured body part.   During the acute phase of an injury (generally lasts 1-6 days), inflammatory byproducts enter the traumatized area to remove debris and limit bleeding.   The inflammatory phase is characterized by heat, swelling, pain, redness, and loss of function.  The more quickly this phase is resolved, the lower the probability of joint destruction, excessive pain, swelling, weakness, immobilization, and loss of function.  Using anti-inflammatory modalities can accelerate patient progress toward more active participation in rehabilitation and expedite therapy goals for an early return to function.

Electrical Stimulation

Electrical stimulation has a wide variety of clinical applications in physical therapy.  Electrical stimulation is based on the principles of charged particles flowing to reduce inflammation and control pain.  Clinical units generally use two different types of currents to electrically stimulate muscles.  An interferential current is a waveform produced by the interference of two different medium frequency alternating currents from separate channels.  An interferential current is set up with four electrodes in an “X” pattern over a large body part.  A premodulated current uses one channel to deliver a continuous waveform with a medium frequency and a fluctuating current amplitude.  Premodulated electrical stimulation is delivered with two electrodes evenly spaced over a small, inflamed area.  Electrical stimulation treatments are often combined with temperature modalities (hot packs, cold packs) at the end of a physical therapy session for fifteen minutes to control swelling after activity.

Transcutaneous Electrical Neuromuscular Stimulation (TENS) is a popular electrical stimulation modality for controlling pain.  According to the gate control theory of pain, activation of A-beta nerve fibers can inhibit the transmission of the pain signal from the spinal cord to the brain.  Electrical stimulation, when set with appropriate parameters, can selectively activate the A-beta nerve fibers and block the brain from receiving the pain signal from the body.  TENS units deliver a low voltage current and the patient feels a strong, but comfortable tingling sensation.  Patient-friendly TENS units are available for home use at affordable prices.  A physical therapist can give you product recommendations and detailed instructions on how to set the TENS unit for maximum pain relief.  Contact the therapy team at North Tahoe Physical Therapy for pricing and information.

Ultrasound

Ultrasound is a medical machine that uses sound waves to penetrate into tissue for both thermal and non-thermal healing effects.  Ultrasound functions under the principles of piezoelectricity: the ability to change shape in response to an electrical current.  An electrical current is applied to the crystal in the ultrasound “wand” called a transducer.  The piezoelectric crystal responds to the current by expanding and contracting, creating an ultrasound wave.  This wave is able to penetrate through skin using a conducting gel to tissue depths of 1-3mm to bring blood to the injured site and stimulate healing.  Macrophages are cells that work to localize the inflammatory process and recruit repair cells.  The ultrasound machine increases macrophage activity to consolidate inflammation and accelerate the cellular repair response.

Ultrasound treatment can be performed using either a continuous or pulsed setting for duration of eight minutes. Continuous wave ultrasound is used to produce heat and warm the tissues.  Pulsed wave ultrasound recruits macrophages is recommended for anti-inflammatory effects.  During the ultrasound treatment, the patient may feel a minimal sensation from the ultrasound wave.  The patient may perceive warmth from the ultrasound conductive gel.  Ultrasound can be done for a single session or repeated in consecutive treatments to produce the desired anti-inflammatory effects.

Iontophoresis

Iontophoresis is transdermal anti-inflammatory drug delivery using a low voltage direct current to move charged ions across the skin barrier. Ions are transported through skin pores to deliver Dexamethasone (a corticosteroid recommended for the treatment of inflammatory conditions) in the manufacturer recommended 40mA.minutes dosage.  This machine is set up with the medicated, active electrode over the inflamed tissue and a ground electrode at a distant site.  The patient perceives a light tingle under the medicated patch for the duration of the treatment.   Iontophoresis can be done one time, for several sessions consecutively, or in combination with other modalities to produce an overall anti-inflammatory effect.

Modern physical therapy now has several anti-inflammatory modalities from which to choose during the acute phase of healing.  Other medical professionals (MDs, chiropractors, and acupuncturists) may introduce you to similar tools in treatment designed to control inflammation.  Now that you understand the concept of inflammation and how each modality works to reduce swelling and decrease symptoms you can help your medical team make an educated decision about what combination of medical machines will work best for your body under each condition.

Testimonials

December 28, 2008 by admin  
Filed under Uncategorized

What just a few of our satisfied clients have told us…

“North Tahoe Physical Therapy is an excellent clinic.  The staff is especially friendly, and, at the same time, very professional.  The therapist’s knowledge and hands-on experience in Myofascial Release have been a God send for me in terms of controlled pain.  I highly recommend North Tahoe Physical Therapy.”

-Joan Graham, Incline Village

“My experience at North Tahoe Physical Therapy has been thoroughly positive.  The entire staff is knowledgeable and helpful.  I especially appreciate the professional skills of my therapist and her undivided attention to my concerns during our sessions.  She has effective therapeutic techniques and broad interests and experience in the health field.  Since beginning therapy, my health has steadily improved and I look forward to a full recovery.”

-Shirley Altick, Incline Village

“This is my second visit to the fine people of North Tahoe Physical Therapy.  First my knee, now my Achilles,  I can only say they are the best and are why I recover so fast from my skiing injuries.  “Simply the best” describes the team here.  “Simply the best.”

-Lynnie Groundwater, Incline Village

“I notice I have been walking straighter.  My pain level is much better.  I am getting in & out of bed easier without help the way you all showed me”, her daughters state, “Her mobility is much better improved and her step is quicker”.

-Edna Smith and daughters, Reno

“I have found NTPT to be a very positive experience.  I always leave feeling definite relief from my pain and have a more positive attitude. I would not hesitate to recommend any of their services to anyone”.

-Terri Nielsen

“Great experience, very helpful and patient staff.  I would recommend NTPT to anyone in need of excellent treatment”.

-Katherine Lyons

“From the first day of therapy I felt comfortable with the staff and surroundings.  NTPT is very accommodating, friendly and professional”.

-Cindy Keenly

“I have experienced Physical Therapy at numerous facilities in 3 different states and feel these clinicians are the most experienced, competent and professional practitioners I have worked with”.

-Sandy Wexler

“Improving every day with physical therapy.  Would recommend the crew at NTPT to anyone”.

-Dr. Tim Heilman, MD

“My experience with NTPT was excellent! All staff was real friendly and caring.  Thank you with appreciation”.

-Trudy Rosenberg

“NTPT has been extremely instrumental in my healing.  The team of therapists offer a unique and positive experience that works with decreasing pain and improving physical wellness”.

-Maggie Schumacher

Contact Us

December 28, 2008 by admin  
Filed under Uncategorized

North Tahoe Physical Therapy
889 Alder Ave., Suite 105
Incline Village, NV 89451
775-831-6600 office
775-831-6697 fax

We are located on the ground floor of the Lakeside Medical and Professional Building, across the street from the hospital.

Please download, print, and fill out the relevant patient paperwork below before your visit:

Your Name (required)

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Your Message

Massage & Wellness

December 28, 2008 by admin  
Filed under Uncategorized

Wellness Center, Therapeutic Tune-ups and Massage

More than just Physical Therapy

You do not need to be injured to enjoy our Wellness services. We offer programs to help you stay well.

Our services include:

• Myofascial ReleasePost-Surgical
• Recovery and Rehabilitation
• Pilates-Based Movement Therapies
• Massage
• Personal Training
• Cardiovascular conditioning
• Sports-specific training
• Weight control and management
• Classes and workshops

Therapeutic Tune-ups (Save Time and Money)

Get 15 minutes of treatment and pay a small fee without worrying about doctor’s prescriptions or insurance issues.

These are minor treatments for pains, strains, and sprains. Have you ever awoken with a kink in your neck and wished someone could treat your discomfort for just 15 minutes that day? Or perhaps you twisted your ankle or flared up your knee during a hike and wished you could get some minor attention to prevent this from getting worse. Then you realize that a massage is costly and takes time. In general, to see a Physical Therapist, you would need to see your doctor first, get a prescription, then call the PT office and schedule. Perhaps your insurance does not cover Physical Therapy.

What if you could just walk into the PT’s office, get 15 minutes of treatment and pay a small fee without worrying about doctor’s prescriptions or insurance issues. Well, that is exactly why we created Therapeutic Tune ups. Now, you can walk into North Tahoe Physical Therapy, talk to the therapist about your issue, and receive a 15 minute treatment for only $35. Treatment may consist of massage, Myofascial Release, craniosacral therapy, ultrasound, electrical stimulation, stretches or spinal mobilizations. It just depends on what your body needs.

Benefits:

1) Direct Access to a therapist. No need to see an MD first
2) Less waiting time between injury and treatment
3) The sooner treatment occurs means quicker recovery time.
4) No insurance issues
5) Low cost
6) Brief appointment times

Orthopedic Massage

Orthopedic Massage is a form of manual therapy that specializes in the treatment of musculoskeletal pain and dysfunction.  In addition to the benefits of traditional massage such as relaxation and increased circulation, orthopedic massage has several other treatment goals.  These include increasing the range of motion, decreasing and managing pain, and normalizing musculoskeletal function.  The therapist works to dissolve adhesions in muscle and connective tissue, lengthen connective tissue, balance muscle function by strengthening weak muscles and releasing tight ones, as well as normalize the position of soft tissue, restore joint function, release entrapped nerves, and facilitate normal neurological function.

A session typically lasts from ½ hour to 1 hour.  The work will be both gentle and deep.  For lasting results, the therapist will want to see the patient 2-3 times a week initially, as frequency is the key.  During the course of a session, the therapist will evaluate the entire body and address the body as a whole, to see how is responding to the injury.  The therapist will then specifically address the area of trauma to increase the fluidity in the tissue and range of motion in the effected joints.   This can be done by a postural evaluation, checking passive range of motion, or movement analysis.

Simply call 775-831-6600 and schedule your appointment
Walk-ins welcome

Women’s Health

November 29, 2008 by admin  
Filed under Uncategorized

Our Women’s Health Program offers assistance to clients within a caring and private setting. Jane K. O’Brien, MSPT, member of the American Physical Therapy Association, Section on Women’s Health, will create a treatment program tailored specifically for the individual needs of the client.

  • Pelvic Floor Dysfunction (PFD)
  • Overactive Bladder ( OAB)
  • post Breast Surgery Care
  • Fibromyalgia
  • Osteoporosis
  • Pre and Post partum Care
  • Lymph edema/breast cancer
  • Pre natal Fitness
  • Abdominal Rehab ( post surgical/ diastasis)

Pelvic Floor Dysfunction

PFD includes a myriad of diagnoses which affect both men and women. Symptoms may limit a person’s ability to perform daily activities, cause one to change exercise habits and create embarrassment.

Pelvic Floor Muscle Weakness

  • Urinary and fecal incontinence
  • Pelvic organ prolapse
  • Post prostatectomy

Pelvic Pain

  • Levator Ani Syndrome
  • Penetration Pain
  • Hips, Abdomen, Low Back, buttocks
  • Sacroiliac ( SIJ) pain
  • Painful intercourse
  • Dysmenorrhea ( painful periods)
  • Vulvodynia
  • Endometriosis, Abdominal Adhesions

Both men and women can benefit from our services for PFD. We have answers and solutions. PFD is common but not normal. You can take control of your symptoms and often relieve them completely.

Incontinence Helpful Hints

  1. Allow no more than 2-4 hours between voiding.
  2. Avoid bladder irritant of tea, fruit juices, acids
  3. Consume adequate water and fiber
  4. Squeeze before you sneeze
  5. Avoid liquids 2-3 hours before bedtime
  6. Avoid tendency to go “Just In Case” ( JIC pees)
  7. Do your Kegels 10 seconds each 30-80 times per day.

Physical Therapy

November 29, 2008 by admin  
Filed under Uncategorized

More than just Physical Therapy

At North Tahoe Physical Therapy, we offer a unique combination of Myofascial Release, Hands-on soft tissue mobilization, skeletal mobilizations, Pilates- based exercises, Education and Self Management.
Our therapists are highly trained, experienced professionals. We provide a strong interaction between you, your doctor and your physical therapist.  North Tahoe Physical Therapy uses a 1-on-1 approach to Physical therapy with exceptional customer service. We treat you as a whole person, not just your injury.

Each client obtains a thorough explanation of their condition. Your physician receives timely reports regarding your progress. We empower you to become active partners in your recovery and health maintenance. Our personalized approach results in your wellness and satisfaction. Click here for client testimonials.

The cornerstone of our approach is Myofascial Release. Find out more about Myofascial Release

Our Treatment Philosophy

Our treatment philosophy is based on the pelvis, the base of the spine.  We believe the pelvis is the foundation of the body.  This foundation must be level for the head and neck to sit properly and for the legs to hit the ground evenly.  When a client comes to us with “low back pain”, we begin by assessing the pelvis for symmetry.  If the pelvis is rotated or if the trunk is shortened on one side, the surrounding soft tissues will attempt to stabilize the system.  This may lead to muscle spasms, pain, or tension of the nerves and the discs which sit atop the pelvis. Additionally, the spine may rotate and side bend in response to the un-level base below.  Consequently, the head which sits atop the spine will be un-level.

Our bodies are smart.  If our spine is rotated, we naturally adjust our head to have our eyes level. This may lead to issues of muscle spasms, muscle tension, TMJ/jaw disorders and headaches. So, for a person who comes to NTPT complaining of TMJ, headache or neck pain, our treatment starts at the pelvis.

Like a house if the foundation is not level, the roof will crack and the windows won’t easily slide open or close. Therefore, it only makes sense to balance the pelvis, which is the foundation of the body.

Self empowerment
A maintenance program of Home exercises, education about how to avoid aggravating your condition, and awareness of how you can help yourself are important components of your care. North Tahoe Physical therapy, we empower you to be an active participant in your health and wellness. You may spend 1-3 hours a week with our team of therapists at North Tahoe Physical Therapy. There are 168 hours in a week. What are you doing the other 165 hours?

Get well
• Orthopedics
• Sports Injury Care
• Back and Neck care
• Incontinence/Pelvic Floor Dysfunction
• TMJ/Migraines/Headaches

Stay Well
• Myofascial Release therapy
• Massage
• Personal training
• Medically Supervised gym
• PILATES
• Classes and workshops

Address the Symptoms, look elsewhere for the Cause
At North Tahoe Physical Therapy, we treat the cause of your problems. Our evaluation is a full body assessment. We look for Pelvic imbalances, fascial pulls, and postural abnormalities. We then determine how these deficits may have created your symptoms. For example, neck or jaw problems may arise from an unlevel pelvis. Knee issues may be due to a pelvis imbalance. If we only treated the symptomatic jaw without leveling the pelvis, the issues will return because the problem has not been corrected. By treating the cause, we are able to address and decrease the symptoms.

Myofascial Release

November 29, 2008 by admin  
Filed under Uncategorized

An Amazing Breakthrough in Pain Relief

Myofascial Release is a relatively new addition to the techniques of the physical therapist. Because it is somewhat different from traditional physical therapy, many people are unaware of what it is and how it works.

Myofascial Release (MFR) works on releasing the restrictions in the connective tissue called fascia. Fascia runs head to toe in a continuous sheath and surrounds every muscle, organ, nerve, cell, and blood vessel of our body. Restrictions can occur in the fascial system from trauma, surgery, poor posture and stress. When these restrictions occur, they can pull with forces of greater than 2000 pounds per square inch. Such tension acts like a “straight Jacket” and can lead to decreased range of motion, pain, headaches, poor posture and lack of mobility.

For many years, therapists have ignored the importance of the fascial system. This omission is now being recognized as the missing link to effective and lasting results in physical therapy.   The effects are profound throughout the body because the fascial system is ingrained in all of our bodily tissues.

When fascia scars and hardens in one area (following injury, inflammation, disease, surgery, etc.), it may create tension on adjacent pain-sensitive structures as well as on structures in far-away areas.  Often, medical professionals find that their clients have bizarre pain symptoms that appear to be unrelated to their original injury or to their primary complaint.  For, many, these symptoms can now often be understood as arising in the fascial system. Because this fascia of the body is all interconnected, a restriction in one region can theoretically put a “drag” on the fascia in any other direction.

During MFR treatments, a client may be treated in areas unrelated to their condition.  The physical therapist has a thorough understanding of the fascial system and will release the fascia in areas that she knows have a strong “drag” on the area of injury.  This is, therefore, a whole body approach to treatment.  A good example is the chronic low back pain patient: although the low back is primarily involved, the patient may also have a significant discomfort in the neck.  This is due to the gradual tightening of the muscles and especially of the fascia, as this tightness has crept its way up the back, eventually creating neck and head pain.  Experience shows that optimal resolution of the low back pain requires release of the fascia of both the head and neck; if the neck tightness is not also released it will continue to apply a “drag” in the downward direction until fascial restriction and pain has again returned to the low back.

Often remarkable improvement is noted immediately during or after a treatment.  Sometimes pain in new areas will be experienced.  There is sometimes a feeling of light-headedness or nausea, and at times a patient experiences a temporary emotional change.  Occasionally, a client may report a temporary increase in their discomfort followed by tremendous relief.  All of these are normal reactions of the body to the profound, but positive, changes that have occurred by releasing fascial restrictions. In general, acute cases will resolve with a few treatments.  The longer the problem has been present, generally the longer it will take to resolve the problem.

It is felt that release of tight tissue is accompanied by release of trapped metabolic waste products in the surrounding tissue and blood stream.  It is highly recommend that clients “flush their system” by drinking a lot of fluid during the course of their treatments, so that reactions like nausea and light-headedness will remain minimal.

Myofascial release can greatly help reduce headaches, neck and back pain, shoulder pain, pelvic and hip pain. Besides pain, MFR can help lengthen muscles to gain increased power. It is useful for restoring poor range of motion. Clients with poor posture can also gain amazing results from this technique. Lastly, MFR feels great and leaves a client with restored energy. It is a wonderful form of body work to receive instead of a traditional massage due to the lasting effects which are created. Many clients have regular Myofascial sessions to prevent dysfunctions. Others may come in for minor Tune-ups.

About Us

November 26, 2008 by admin  
Filed under Uncategorized

Our Mission

Our highly skilled team at North Tahoe Physical Therapy is focused on helping you to achieve your optimal state of health through exceptional therapy, education and personalized treatment programs designed to return you to the lifestyle that you desire.

Our Staff


Jane O’Brien,
MSPT
Advanced Myofascial Release Practitioner
Women’s Health Therapist

Jane is the owner and director of North Tahoe Physical Therapy. She received her Master of Science Degree from Boston University in 1992. She has over 15 years experience in treatment of orthopedics, women’s health, and pain. Jane has extensively trained in manual therapies such as Myofascial release, Craniosacral therapy, and spinal and joint mobilizations, dynamic stabilization exercises and strength and conditioning.

Since 2000, Jane has been an instructor for John Barnes’ Myofascial Release Seminars. While living in Sedona, Jane trained and worked with Barnes at his clinic.  She presents several workshops annually on the Myofascial Release technique.

Jane is currently in pursuit of the Certificate of Achievement in Pelvic Physical Therapy (CAPP). This honor is granted to physical therapists that have completed the required training and testing through the American Physical Therapy Association (APTA) Section on Women’s Health. The CAPP demonstrates dedication and advanced training in the field of Women’s Health. She expects to complete her studies and receive the CAPP in Spring 2009.

Memberships:
APTA-American Physical Therapy Association, Section on Women’s Health
AAUW- American Association of University Women
Hobbies: Belly dancing, skiing, hiking, rollerblading,

Brian Hrindo, MT
Brian graduated from Bowling Green State University in northwestern Ohio with a Bachelor of Education in Kinesiology, where he studied Early Childhood Development and Effective Movement in Athletes. He has been practicing as a Massage Therapist since graduating from the Utah College of Massage Therapy. Brian specializes in injury massage, Russian Sports Massage, Craniosacral Therapy, and Deep Tissue Massage. He has trained under John F. Barnes, international lecturer and authority on Myofascial Release, and has become a highly skilled Myofascial Release practitioner. In his spare time, Brian enjoys relaxing on his boat on Lake Tahoe, skiing, mountain biking, and rafting the rivers of the Wild West.

Rebecca L. Deal, MPT
Rebecca received her Master of Science degree from California State University, Long Beach in 2005. She holds a bachelor’s degree in Exercise Science and a minor in Nutrition from the University of California, Davis. She believes in helping people by educating and empowering them to take responsibility for their health.In her spare time, she enjoys snowboarding, snowshoeing, and hiking the Tahoe trails with her dog.

Our Location

889 Alder Ave., Suite 105
Incline Village, NV 89451
775-831-6600 office
775-831-6697 fax

We are located on the ground floor of the Lakeside Medical and Professional Building, across the street from the hospital.

Our History

North Tahoe Physical Therapy was established in the 1980’s in Incline Village, NV. by Claudia Dill, PT. Ten years later, Thom Werner, PT, bought North Tahoe Physical Therapy and operated the clinic for 14 years.

In 2003, Jane O’Brien, MSPT, became the 3rd owner of North Tahoe Physical Therapy.

Jane O’Brien, MSPT, director and owner of North Tahoe Physical Therapy, says, “Many people think of physical therapy as exercise and hot packs. We want to change that perception. We believe that a hands-on, intuitive approach combined with movement is the key to healing and restoration of function. Our staff has dedicated many years learning to use our hands as tools for healing.”

Physical Therapy Hows & Whys

October 22, 2008 by Jane O'Brien  
Filed under Physical Therapy

Is Physical Therapy a good way to get started on an exercise program if you have been inactive for a long period of time or is a personal trainer a better option?

It is always best to consult with your doctor before beginning an exercise after prolonged inactivity. Your doctor will perform a complete physical and determine if you will be at risk or if you are safe to begin an exercise program. If the MD gives you the “Go Ahead”, physical therapy is your best option for proceeding.

The PT will evaluate your body before developing an exercise program. Tests may include an assessment of muscle strength in your arms, legs and core. He or she will assess your flexibility, your ligamentous stability, your range of motion in your joints, your endurance level, and your current fitness level. The PT will measure our blood pressure and your heart rate at rest and determine an appropriate activity level for your exercise program. He or she can tailor the program towards your specific fitness goals, for example, weight loss, improved endurance, strength gains, toning or others you may have in mind. If you wish, the PT can also measure your body fat level and develop a plan to reduce that level.

One benefit of beginning a fitness program with a PT is that you are being medically monitored. As you proceed with your fitness program, the PT will assess your heart rate and blood pressure before, during and after activity. Your exercises will be adjusted accordingly. If you have any previous injuries, alert the PT so that area can be protected in your program to prevent a flare up. Additionally, the PT can add exercise to your program to rehabilitate the injured area.

One last advantage of a fitness program which is performed under the direction of a Physical Therapist is the price. A medically guided program may be covered under your health insurance. This means that you may only need to pay for your copayment or coinsurance. If, however, you do not have insurance, many Physical Therapists provide personal training to their clients. The cost may be slightly higher than the fee a personal trainer may charge (about $10-$20 on average). But, the Physical Therapist is a medical professional who has either a Masters or a Doctor of Physical Therapy degree and is trained in the biomechanics of the body, muscle structure and function, injuries and rehab, anatomy and physiology, orthopedics, and strengthening and conditioning.
North Tahoe Physical Therapy works with many clients for reconditioning programs both through insurance and on a cash payment basis. We also offer personal training and Pilates exercise programs.

-Jane O’Brien, MSPT

Hip Replacement Care

September 14, 2008 by admin  
Filed under Physical Therapy

My relative is getting ready to come home from the hospital after a total hip replacement surgery. What do I need to know to set up my home and make them most comfortable during their recovery?

After a standard posterior approach total hip replacement, most surgeons instruct the patient (and all involved caregivers) in three major hip precautions. Familiarizing yourself with these three rules will allow you to promote a speedy and safe recovery for your family member:

1. Avoid hip flexion more than 90°- Lifting the leg out in front beyond 90° puts excessive stress on the posterior joint capsule of the hip as it attempts to heal. Exercises that require excessive hip flexion such as marching and straight leg kicks are not recommended after a total hip replacement surgery until the medical professional instructs the patient in the proper form.

2. Avoid hip adduction- If a line were drawn down the middle of your body from head to toe, the affected hip cannot cross over this midline. This rule is particularly difficult to abide by when rolling over in bed. Using a pillow between the patient’s knees can prevent them from crossing the midline.

3. Avoid internal rotation- Do not allow the patient to turn the toes on their affected leg inward. Again, placing a pillow between their feet can prevent the patient from being able to internally rotate their hip.

Depending on the surgeon, physical therapy can begin soon after the patient awakes from the surgery. Specific questions should be directed to the doctor or physical therapist directing the patient care. As the caregiver, remember you are an important part of the rehab team and helping to communicate with the medical professionals can best promote a safe and speedy recovery for your loved one.

-Rebecca L. Deal, MSPT

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