Thanks to the intuition and persistence of nurses and staff at Spalding Rehabilitation Hospital in Aurora, stroke survivors in Colorado and across the country soon will have help with their recovery after leaving the hospital or clinic.
Spalding is sponsoring a "post rehabilitation exercise program," or PREP, at the Aurora Senior Center and is preparing to film an instructional video so the program can be shared with senior centers anywhere. The PREP class fills an important need, explained Spalding’s Chief Nursing and Operating Officer Marianne Dexter.
"We went out and met with a lot of different stroke focus groups and support groups, and what came back was, once they’re done in acute rehab – be it acute rehab inpatient or physical therapy, but physician-directed rehab – there’s really nothing for them," Dexter said.
"They’re not comfortable going to a gym. So where do they really get their mainstream exercise to continue with their programs? And in this day and age, when insurance is really cutting back, they get very little rehab overall. So what we wanted to do was put a class together that would encourage stroke survivors, that maybe would bridge that gap between going to a Bally’s or a 24-Hour Fitness, and acute rehab, where you’re really working with skilled therapy," she said.
The support groups reported that decreasing insurance reimbursements were drastically cutting down the time stroke victims had for inpatient rehabilitation, according to Dexter. She said inpatient stays used to be 30 days for stroke, and now the average is 10 to 15 days, if approved at all.
"So you have acute [rehab] and you’re doing exercises, and all the sudden all your supports are gone, there is no one coming into the home, and there is no where for you to go to get continued support and instructions on what exercises are good, what are bad," she said. "In talking to these people, for the most part, they were very uncomfortable going to a Bally’s. Even if they could, at a wheelchair level, get into one, obviously they don’t fit in with the type of crowd that goes to Bally’s."
The Spalding PREP program aims to get survivors out of the house and into a comfortable setting where they can exercise and interact with other stroke survivors and network for support. Two classes, an independent and an assisted exercise class, are offered at the Aurora Senior Center. Both six-week courses meet three times a week for an hour at a time. The cost is $30 per person, with proceeds used to pay the class instructors.
Organizers plan to film the program and create a "tool kit" to be offered through the American Stroke Association to libraries and senior centers. Dexter explained that the tool kit was designed so that only one person is needed to set up and run the PREP program.
"Anybody, any community center can pick it up. Within the tool kit, we have a video of someone doing the exercises. The goal is not to have a physical therapist. "Anybody, any volunteer could really pick this up and teach these classes," Dexter said.
The tool kit also contains instructional handouts for participants about dehydration and signs of fatigue.
"Once it’s up and running, it’s minimal," Dexter said. "The commitment from the community center is very minimal. It’s mainly an instructor, who can be anyone – and that’s what we want. We don’t want to have a [program that requires a] physician’s prescription. We want it so that anybody who feels they need this program can go."
Spalding serves patients with orthopedic, brain injury, stroke and other rehabilitation diagnoses. According to Dexter, 26 percent of rehabilitation admissions nationally are for stroke. Spalding’s population is 14 percent stroke victims, she said.
Dexter and Public Relations Specialist Melissa Francis got the program going at Spalding. Both are members of an American Stroke Association rehabilitation and survivor support committee.
The group was trying to figure out what to do to help stroke survivors, and wondering if they were able to continue recovering at home after leaving inpatient rehabilitation earlier than in the past. Francis thought it might be a good idea to do some research in the community and find if there was a program that could bridge the gap.
"We weren’t sure if it was a need, but we felt it was," Francis said."People who teach classes at senior centers typically don’t have a medical background," she said. "We want to get those people comfortable so they can better serve stroke survivors."
With new classes starting in January, the program is open for more participants. Patients or medical professionals can call the Aurora Senior Center for more information at (303) 739-7950. Dexter encourages nurses to call on behalf of patients they think might benefit from the program.
by Mike Liguori