Physical Therapy & Occupational Therapy Inpatient Division
Cardiovascular
Our inpatient cardiac rehab focus is on patient education for exercise prescription, endurance training and pacing activities of daily living. We integrate basic cardiac rehabilitation techniques with special tests, such as the 6-minute walk, to determine intervention strategies. Our primary patient populations include;
- Status post myocardial infarction (heart attack)
- Heart arrhythmias (irregular heart beat)
- Congestive Heart Failure
- Pacemaker implantation
- General cardiac conditions
Cardiothoracic Surgery
Rehabilitation is a key part of the thoracic surgery program at Duke Heart Center. Therapists provide patients with the precautions and exercise/activity guidelines to recover from major chest surgery. We are consulted to provide care to patients who have had;
- LVAD implantation (left ventricular assist device)
- Heart and lung transplantation
- Valve replacement
- CABG (bypass)
General Medicine
General Medicine therapy services integrate a team approach to the medically complex patient. Our therapists take into account the patient’s various health problems and create an individualized intervention plan specific to each patient’s goals. We provide care in the intensive care unit as well as the general medicine intermediate units. Some of the patient diagnoses include:
- COPD (chronic obstructive pulmonary disease)
- Gastrointestinal bleeding and inflammation
- Liver cirrhosis
- Peripheral vascular disease
- AIDS/HIV
- General de-conditioning
Orthopedics
The orthopedic service provides care to patients with a wide variety of conditions including:
- Fractures
- Bone and joint infections
- Sports injuries
- Bone Cancer
- Orthopedic trauma
Duke’s Total Joint Program focuses on the rehabilitation of patients after hip or knee replacement. Care begins with an interdisciplinary pre-operative educational class. The class helps prepare patients for their surgery, hospital stay, and discharge.
Free-vascularized fibular graft (FVFG), a procedure for the treatment of avascular necrosis (AVN) of the hip, was pioneered by a Duke surgeon.
Trauma
Duke Physical Therapists and Occupational Therapists provide Level I trauma care. Patients are admitted to the trauma service with injuries from:
- Motor vehicle collisions
- Assaults
- Gun shot wounds
- Falls
Our therapists are trained to evaluate and treat multi-system trauma which may also include;
- Traumatic Brain Injury
- Spinal Cord Injury
- Multiple bone fractures
General Surgery
General surgery at Duke Hospital includes primary abdominal surgery. Our therapy intervention places an emphasis on mobility and ADLs to aid in the return of gastrointestinal motility. Therapists instruct patients in precautions to prevent abdominal strain. The types of patients we see are:
- Colo-rectal cancer
- Pancreatic cancer
- Liver, kidney, pancreas transplantation.
Vascular
Duke is also one of the few places where Isolated Limb Perfusion is performed to treat Malignant Melanoma. After this procedure, Physical Therapy will help you regain use of the leg and avoid potential complications.
Duke Hospital performs various vascular surgeries such as:
- Leg bypass
- Carotid Endartectomy
- Abdominal aneurysm repair
- Amputation: Therapy plays an important role in the care of the amputee to avoid joint tightness, resume mobility and ADLs in preparation for eventual prosthetic fitting.
Pulmonary
Pulmonary care touches a broad range of diagnoses including;
- Pulmonary hypertension
- Sarcoidosis
- Cystic Fibrosis (CF)
- Chronic Obstructive Pulmonary Disease (COPD)
- Pre and post lung transplantation
- Pneumonia
- Acute Respiratory Distress Syndrome (ARDS)
Therapy places an emphasis on exercise tolerance and instruction in compensatory strategies for energy conservation. We also incorporate other airway clearance techniques such as the therapy vest, acapella, and active cycle breathing. We have a daily pulmonary rehabilitation group for pre and post lung transplant patients.
The physical therapy team at Duke Hospital is one of a handful in the nation that continues to perform manual chest physical therapy (CPT) for the management of pulmonary secretions.
Neurology/Neurosurgery
Physical and Occupational Therapists play an active role in the Neuroscience Center at Duke. Many of the patients admitting with neurologic impairments are in need of ongoing rehabilitation. Our team is trained to provide intervention to a vast array of patients including:
- Traumatic Brain Injury
- Brain Tumors (operative and non-operative)
- Neuromuscular diseases such as Parkinsons and Multiple Sclerosis
- Spinal Cord Injury
- Normal Pressure Hydrocephalus
Duke Hospital is an accredited Stroke Center, Our therapists have been trained to apply the NIH-stroke scale into their practice and implement standardized tests such as the Fugel-Meyer, Tinetti, Berg, Short Blessed Cognitive Assessment to drive treatment intervention strategies.
Oncology Services
Increasing mobility and performing activities of daily living are proven means for increasing the physical, spiritual and psychological well-being for patients undergoing cancer treatment. Oncology strategies may encompass:
The Oncology Therapy Services provide care for:
- Solid tumors
- Leukemias and lymphomas
- Stem cell (bone marrow) transplantation
- Cancer related fatigue
- Tumor cord compression
- Recovery from curative and palliative surgeries
- Pulmonary and balance disease or treatment side effects
- Steroid myopathy
Patients on our Bone Marrow transplant unit have access to their own personal gym and are closely supervised by our team.
Speciality Interventions
Wound Management
Duke Hospital Wound Management Center provides wound care services to all specialty areas and units of the hospital. Our team partners with vascular, orthopedic, diabetic, pain management, and plastic surgery specialists to identify standards of care, develop more effective wound therapies, and improve patient outcomes.
Our physical therapists are certified wound specialists who provide bedside pulsed lavage for wound irrigation and debridement, dressing changes, excisional debridement, and therapeutic interventions.
Lymphedema Management
Lymph node disruption can occur as a side effect of surgical and/or radiation treatments which can cause excessive swelling in the extremities and genitalia. Duke's Occupational Therapists are certifeid in the treatment of lymphedema. The goal of treatment is to treat, manage, and prevent edema from interfering with mobility and activities of daily living. Our therapists provide manual lymph drainage, compression bandaging, instruction on skin care and exercise programs.
Hypberbaric Lung Lavage
Duke's Center for Hyperbaric Medicine has been in the forefront of research and treatment over the past thirty years. It also has a unique partnership with the Diver's Alert Network, which provides emergency assistance and evacuation after diving accidents.
Physical Therapists are involved in the hyperbaric chamber to assist with the treatment of patients with Pulmonary Alveolar Proteinosis (PAP). Treatment may entail a whole lung lavage, where one lung is repeatedly washed with a mild salt solution while the other lung is ventilated with oxygen. During the lung lavage, a therapist performs focused chest percussion to loosen any surfactant. Afterwards, the therapist will follow-up and instruct on airway clearance techniques.
Splinting and Casting
Occupational Therapists at Duke Hospital provide care in joint positioning and protection. Therapists fabricate protective and positional devices with low temperature plastic materials. Customized splints are created to support extremities after major trauma or extensive surgery. Duke inpatient therapists also have direct access to our certified hand therapy team for consultation with more advanced dynamic splinting.
|
