Whittier Rehabilitation Hospital moved into its 110,000-square-foot building in Ward Hill over the weekend. Waiting for patients was a substantial space dedicated to the hospital's new stroke recovery program.
"Stroke recovery takes a long time. Each patient is different. If you break a bone, you're put into a cast for about 12 weeks. The cast comes off and you're arm is healed. But the brain doesn't work that way. Stroke patients continue to recover years out, with the appropriate training," said Dr. Joan Breen, a neurologist and head of the stroke program.
Breen specializes in stroke rehabilitation. She coordinates neuro-rehabilitative care with the treatment team at Whittier and communicates with the patient's primary-care physician, primary neurologist and other medical providers.
Breen was medical director of the neurology day rehabilitation program at Portsmouth Regional Hospital and medical director for the Seacoast Visiting Nurse Home Health Agency in North Hampton, N.H. She has been responsible for many publications and presentations at national and international medical meetings.
"She is one of those physicians who not only has vast experience in the field, but a great bedside manner. She makes sure her patients understand what they are getting into. Having a neurologist like her and the space we'll have in the new building is really going to expand the program," said Jeff Ventola, director of marketing and communications for Whittier.
The new building has space for two key therapeutic components: Whittier Way and aquatic therapy.
Whittier Way is a strip mall within the facility. There is an actual automobile; curbs with street lights; a movie theater; a mini Shaw's supermarket; a little cafe and patient apartments, so staff can see how they do on their own before they go home.
"It's another level of rehabilitation we can give to stroke patients. Whittier Way helps them adjust to normal everyday activities without the pressure," Ventola said.
Aquatic therapy allows patients to move effortlessly in water, which puts less pressure on their limbs. It helps patients with movement or strength issues without extra pain in their joints.
"It's so helpful for stroke patients because it 'unweights' them. For people with pain, the therapist can do more movement and repetitions. Patients can end up with secondary injuries from repetitions and the pool will help stop that," Breen said.
Patients who cannot walk independently can use the new Body Weight Supported Treadmill Training.
Impaired walking is common following a stroke. The treadmill training is a neuro-rehabilitation technique where the patient is suspended over a moving treadmill in a harness that helps the patient practice repetitive and rhythmic stepping. it also promotes weight-bearing exercise in the lower limbs as well as cardiovascular exercise.
According to Breen, stroke patients can be out of shape and develop osteoporosis because they cannot put weight on the bones. The treadmill and harness help them walk and become healthier.
"If you want to walk again you need to retrain the brain. Research shows the best way is to walk them and the treadmill is great for that. It's excellent for people who are paralyzed and want to try and walk again. We've had patients who couldn't walk for over a year, walk again," Breen said.
Whittier also offers VitalStim, a vital treatment for patients with dysphagia — a disorder that affects swallowing in 75 percent of stroke patients and 90 percent of patients with neurological disorders.
Electrodes attach to muscles in the neck and small electrical stimulation is given to strengthen throat muscles so patients can swallow easier. Physicians must be certified specifically for VitalStim to use it. Ventola said some patients report a difference in just a few days, but improvement is generally seen after six to 20 treatments.
"This is something we just started using. It's very high-tech and the only FDA-approved method of rehabilitation with that type of electrical stimulation," Ventola said. "We pride ourselves on being cutting edge. The new technology helps cut down rehab time because it can do what a therapist can't do."
Whittier offers a new day rehabilitation program, an outpatient program for people with a catastrophic injury or condition. The goal is to maximize independence. Patients receive the same services as inpatients without the overnight stay.
Patients are scheduled to attend two to five days a week depending on their needs, for about four hours a day.
On a typical day, patients attend individual and small group sessions with the physical, speech and occupational therapists. Time is scheduled with the neuro-psychologist, nurse and social worker as needed.
The rehabilitation team also addresses issues related to the injury such as depression, skin breakdown and adjustment to disability.
"This is the ideal place for stroke patients. These people are not into the work, they're into the patients," Breen said.