Duke Health Center at Lenox ba

Duke Health Center at Lenox Baker


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Physical Therapy Services

Occupational Therapy Services

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Physical Therapy Services


Womens Health Care

Pelvic Pain

Pelvic Floor Physical Therapy is a specialized branch of physical therapy. We
have experience with the treatment and management of such conditions as urinary/fecal incontinence and pelvic pain.
Disorders of the pelvic floor can result in pain, constipation, urinary/bowel incontinence and difficulty with sexual relations. Women may experience pelvic pain as a result of various disorders including endometriosis, dysmenorrheal and post-surgical scarring. Pelvic pain disorders can include:
  • Vaginismus
  • Vulvodynia
  • Vestibulitis
  • Vulvar vestibulitis
  • Dysparenia
  • Dysmenorrhea
  • Gynecological/oncology issues
  • Post-surgical issues
The Women’s Health Physical Therapy team handles many different types of pelvic pain. Management techniques provided by our therapists include:
  • Biofeedback for relaxation and/or strength training
  • Manual techniques including trigger point work
  • Therapeutic exercise to address weak and/or tight musculature
Our pelvic floor therapists have many years of experience treating pelvic floor dysfunction and have dedicated their careers to this area of rehabilitation. If you and your physicians agree that you would benefit from an evaluation, please call 919-684-2445 to schedule an appointment. We look forward to working with you.


Pregnancy, childbirth, and child care are all events that result in important physical changes and new stresses on a woman’s body. For example, increases in blood volume can cause swelling, while hormonal changes can contribute to foot and back pain. Incontinence can be the result of stress to the pelvic floor during labor and delivery. Musculoskeletal issues can become a greater problem as new baby care introduces stressors into the new mother’s routine.
The Department of Physical Therapy and Occupational Therapy provides a vast array of services for the pregnant or postpartum patient. We provide a number of services to treat the following:
  • Incontinence
  • Pelvic pain
  • Back and neck pain
  • Sacroiliac pain
  • Headaches
  • Leg and foot pain
  • Hand and wrist numbness or swelling
Services are also available for pregnant women who have not experienced any musculoskeletal complaints. Intervention for women with problem-free pregnancies include:
  • Prenatal and postnatal exercise prescription
  • Musculoskeletal screens
  • Pelvic floor exercises
  • Education regarding positioning and body
  • mechanics

Urinary Incontinence

The Department of Physical Therapy and Occupational Therapy has extensive experience in treating patients with urinary and fecal incontinence. Our therapists have experience treating women, children, and men suffering from these conditions. Services are carried out in private treatment rooms and may include:
  • Biofeedback
  • Pelvic floor muscle strengthening and relaxation
  • Bladder diary
  • Extensive patient education
Urinary incontinence can be the result of trauma, surgical interventions, or muscular weakness and can be classified in the following ways:
  1. Stress: leakage during normal activities such as coughing, sneezing, laughing, or exercising, which may increase abdominal pressure.
  2. Urge: leakage occurring when the patient has a strong need to urinate even though the bladder may only contain a small amount of urine.
  3. Mixed: a combination of both stress and urge incontinence.


The Department of Physical Therapy and Occupational Therapy is an integral part of Duke University Health System’s Lymphedema program. Treatment options we provide consist of:
  • Manual lymph drainage
  • Compression bandaging
  • Proper exercise and dietary instruction
  • Extensive patient education
  • Recommendations for compression garments
The patient populations that may be at risk for lymphedema include:
  • Surgery involving the lymphatic system
  • including lymph nodes
  • Radiation therapy
  • Infection
  • Trauma
  • Congenital defect of the lymph system
  • Vascular disease
The result is a thorough yet individualized program designed for your patients that will allow them greater independence in the management of their lymphedema. All of the physical therapists and occupational therapists who work with this patient population are certified lymphedema therapists.


The Department of Physical Therapy and Occupational Therapy is dedicated to helping patients with osteoporosis maintain and increase their function. We provide individualized exercise programs including:
  • Weight-bearing exercise
  • Workouts in our handicapped accessible therapeutic pool
  • Resistance exercise training
  • Body mechanics
  • Postural education
Research shows that appropriate regular exercise can reduce the likelihood of bone fractures
associated with osteoporosis. Studies show that exercise requiring muscles to pull on bones can help retain bone density.

Oncologic Rehabilitation

  • Lymphedema management
  • Post mastectomy treatment
  • Bone marrow transplant rehabilitation


We are pleased to offer Aquatic Physical Therapy (ATP) at Lenox Baker Hospital Pool. APT services are provided by physical therapists (PT), physical therapy assistants, or physical therapy students under the direct supervision of a PT. Using water properties such at buoyancy, viscosity and hydrostatic pressure, therapists guide patients through an individualized exercise program based on physical impairments and functional goals.

The Facility

  • Pool is fully handicapped accessible with a ramped entry, water wheelchair and hoyer lift.
  • Water is kept at a therapeutic 92 degrees F; perfect for those with arthritis or other painful musculoskeletal problems.
  • Water depth varies from 2.5 to 4.5 feet. Numerous assistive devices are available to allow non-swimmers or those fearful of the water to rehabilitate safely.

The Referral

The initial physical therapy evaluation is conducted in a land-based clinic. Based on the patient’s diagnosis, impairments and functional limitations, the land-based therapist may then send the patient on to the pool. A referral to APT is appropriate in the following situations:
  • patient can not tolerate land-based therapy
  • patient has weight bearing restrictions
  • patient will get better faster with APT
  • the pool is a safer environment for exercise

Indications for Aquatic Physical Therapy

  • arthritis
  • chronic or acute pain
  • profound weakness
  • status post orthopedic surgery
  • obesity
  • balance impairments
  • profound deconditioning

Contraindications for Aquatic Physical Therapy

  • large open wounds
  • water or air borne infectious disease
  • incontinence
  • cardiac failure

Precautions to Consider

One of the notable benefits of APT is increased venous and distal lymphatic return due to hydrostatic pressure. In healthy individuals this is a desired effect as the end result is an increase in cardiac output. However, for individuals with compromised cardiac or renal function, the added central fluid volume may pose a problem. Such individuals are monitored closely during their APT session. (Patients undergoing renal dialysis have successfully participated in aquatic therapy).

Goals of APT

As therapists, our desire is to make all our patients well, however this is not always a realistic goal. Our primary goal for APT is to provide patients with enough information, training and experience to either advance to land-based therapy or to continue an aquatic exercise program independently in a community setting. Number of pool visits averages between 6 and 8 visits depending on the patient’s needs. Each session lasts approximately 45 minutes.

Making a Referral

A prescription for a Physical Therapy Evaluation is needed. A brief note, “for pool” or “for aquatic exercise” would be helpful. Appointments for evaluation can be scheduled by calling 684-2445. For more information about the pool program, please call 684-0875.


We offer out-patient adult neurological rehabilitation at Lenox Baker Hospital. Physical and Occupational Therapist specialize in the treatment and management of individuals with a variety of neuromuscular disorders and diseases. We focus on functional limitations in the following areas:
  • Strength or motor control
  • Fine motor control
  • Balance and coordination
  • Muscular/cardiovascular endurance
  • Flexibility
  • Activities of Daily Living
  • Perceptual Skills
  • Cognitive processing/integration
  • Sensory processing/integration
  • Movement strategies
  • Wheelchair or equipment needs
Examples of these conditions may occur in individuals with the following diagnosis:
  • Stroke
  • Multiple Sclerosis
  • Brain Injury
  • Parkinson’s Disease
  • Spinal Cord Injury
  • Muscular Dystrophy/ALS
  • Brain Tumor
  • Post-polio syndrome
  • Upper Extremity Amputation
  • Lower Extremity Amputation
  • Chronic Illness/Deconditioning
  • Multiple Trauma

Physical Therapy Services

Physical Therapists perform comprehensive neurological and musculoskeletal-based evaluations and provide a course of treatment toward specific, attainable goals. Services include but are not limited to:
  • Comprehensive examination to establish baseline function and document change over time.
  • Instruction in the Duke Axial Mobility Program for treatment of Parkinson’s Disease
  • Functional assessment and instruction in optimal movement strategies
  • Falls’ Risk assessment and prevention
  • Vestibular rehab
  • Orthotic assessment and training
  • Prosthetic assessment and training
  • Mobility Equipment assessment (power or manual wheelchair)
  • Assessment and recommendation for assistive devices(walkers, crutches, canes)
For appointments for Neurological Rehabilitation Services at Lenox Baker, please call 684-0873.


Physical Therapists with advanced certification in neurology and geriatrics have extensive experience evaluating and treating individuals with balance impairments and fall risks. Therapist use validated objective balance assessment measures and intervention techniques to address a myriad of balance issues. Interventions may include:
  • strengthening, flexibility, balance, vestibular and coordination exercises
  • the selection of an assistive device
  • education about proper footwear
  • recommendation for orthoses
  • patient and family instruction for safe strategies at home.
Referrals for balance and falls evaluations can be made at 684-0873.


Patients with lower extremity amputations can receive instruction in prosthetic gait training at Lenox Baker Hospital. Patients will also be taught to care for their prosthesis and residual limb. Therapists work closely with prosthetists to ensure good prosthetic fit and function. Our goal is to support and direct patients during the early learning phases and later challenge them to achieve their highest level of function with the prosthesis.
Early prosthetic training may include:
  • independence with applying the device and adjusting sock ply as needed
  • progression of walking with various assistive devices (parallel bars ® walker ® canes ®no device if appropriate)
  • negotiation of community barriers (stairs, curbs, ramps, grass)
  • discovering balance changes with a prothesis
Later prosthetic challenges by include:
  • high level balance activities
  • community-based exercise programs (pool, weight machines)
  • return to work, school, leisure activities and/or sports.
Physical therapists are also able to provide lower extremity orthotic evaluations and recommendations using biomechanically-based assessments. Training with the brace and advancement of exercise programs and functional activities will be addressed.


Physical Therapists in the Neurological Rehabilitation Services at Lenox Baker can provide evaluations for manual wheelchairs and power equipment such as scooters and power wheelchairs with and without power seating. Therapists work with local DME vendors who will often provide an opportunity try a piece of equipment in the individual’s home environment prior to purchase. Therapists will communicate equipment needs to the physician and will draft a letter of medical necessity for the equipment. Therapists will also provide training and instruction in the use of the equipment as necessary.
Wheelchair and seating evaluations can be made by calling 684-0873.

Occupational Therapy


Services Overview

Occupational Therapists perform comprehensive neurological and musculoskeletal-based evaluations and provide a course of treatment directed toward specific, attainable goals to improve functional outcomes.
Services include, but are not limited to:
  • Treatment of all neurological conditions: congenital, newly acquired, and chronic.
  • Upper extremity rehabilitation (Gross and Fine motor control).
  • Assessment and treatment of functional activities (daily living activities, homemaking, functional cognition, community re-entry, and use of assistive devices.
  • Assessment and instruction in adaptive equipment.
  • Driving Evaluations: Visual acuity, visual-perceptual skills, memory/cognitive skills, reaction time, physical functioning, understanding of traffic signs and road regulations.
  • Low Vision Rehabilitation evaluation, treatment, and adaptive device recommendations.
  • Upper Extremity Prostheses: biomechanical-based assessment, recommendations and training.
  • Upper Extremity Splinting/Orthoses evaluation and fabrication.

Obtaining a Referral

Occupational Therapy services require a referral and prescription from your primary care physician or specialist, depending on your insurance coverage. If your insurance company requires precertification, this will need to be completed before an appointment is scheduled.

Driving Evaluations

A very important part of an individual’s return to independence following an injury, illness or accident is the ability to return to driving with safety.
Common diagnosis referred but not limited to are: stroke, brain injury, Parkinson disease, cognitive decline, upper extremity loss of function, spinal cord injury, cerebral palsy.
The Clinical Driving Evaluation is performed within the clinic. The evaluation is used to assess various components of the driving process.  
What is evaluated?
  • Visual acuity
  • Visual Perceptual skills
  • Memory/cognitive skills
  • Safety/judgment skills
  • Understanding traffic signs
  • Understanding of on the road regulations
  • Physical functioning
  • Eye-foot and eye-hand reaction time speed
  • Adaptive equipment needs
Referrals for behind the wheel, on-the-road driving evaluations are made as needed to a local Driving School agency. All on the road driving evaluations are performed by a state certified driving instructor.
* All testing is done within the clinic, and takes approximately two to three hours to complete. Please have clients bring eyeglasses and a list of medications.

Neurological Rehabilitation

Our Occupational Therapists specialize in the diagnosis, treatment, and management of individuals with a variety of neurological disorders and diseases. Persons may have limitations in any of the following areas:
    • Strength
    • Activities of daily living
    • Fine motor and gross motor control
    • Visual Perceptual skills
    • Balance and coordination
    • Cognitive processing
    • Muscular /cardiovascular endurance
    • Movement Strategies
    • Flexibility/range of motion
Examples of such diagnoses include but are not limited to:
  • Stroke
  • Muscular Dystrophy
  • Brain injury
  • Brain Tumor
  • Multiple Sclerosis
  • Post-polio syndrome
  • Parkinson’s Disease
  • Chronic illness/deconditioning
  • Spinal cord injury
  • Multiple trauma

Low Vision Rehabilitation

Low vision is a visual impairment, not corrected by standard eyeglasses, medication, or surgery that interferes with the ability to perform everyday activities. Low vision can cause difficulty in seeing detailed letters and numbers when reading, distinguishing between similar colors, recognizing the slope of a curb or identifying steps. Adults who have these problems may have trouble maintaining their independence and completing typical day-to-day activities.
It is possible for people with vision impairments to continue to live independent and meaningful lives. Occupational therapists can help people with low vision to continue living in their own homes and complete daily tasks, such as showering, dressing, cooking, grocery shopping, managing finances, and getting around in the community.
What an occupational therapist can do?
  • Educate a person on compensatory strategies for their work and/or home environment to maximize remaining vision.
  • Help a person identify items used every day that need to “stand out” by marking them with bright colors so they can be easily found.
  • Educate a person on how to compensate for vision loss by using other senses, such as touch, hearing and smell.
  • Recommend and train a person to use assistive devices that can aid in completing daily activities, such as magnifiers, audio equipment, and voice-activated computers.
  • Evaluate a person’s ability to drive and determine whether a person with low vision can adjust his or her driving so that he or she can continue to get around safely or should develop alternative ways to get around.

Functional Capacity Evaluation

Functional Capacity Evaluation (FCE) is a systematic process of assessing an individual’s physical capacities and functional status. The FCE establishes the physical level of work an individual can perform. The FCE is useful in determining job placement, job accommodation, or return to work abilities after injury or illness.
What are the components of the FCE?
The FCE is a tool that can be used to make objective and reliable assessments of the individual’s condition. Assessments are performed in the following areas:
coordination/hand function
cardiovascular condition
movement ability
body mechanics
Who Should Be Referred for an FCE?
  • Individuals who have achieved maximum medical improvement but continue to have issues related to re-injury and return to work.
  • Individuals who need quantification of their physical capacities for determination of disability status.
  • Individuals who need their function quantified prior to vocational job search and /or return to work.
  • Individuals who require quantification of their physical function for medical legal reasons, as with determination of disability; short or long term.
*The FCE is scheduled for a 4-hour time frame. Referred clients should wear comfortable clothing and shoes. Please have clients bring their glasses and a list of medications.

Contact Us & Directions

Making An Appointment

Hours: 8am - 5:30 pm, Monday-Friday
Appointments: (919) 684-2445 or (919) 684-0873
Fax: (919) 681-5555


Parking is free and signs are posted for visitor and patient parking.

Directions through Google maps

Duke University Health System
Department of Physical and Occupational Therapy
Duke Health Center at Lenox Baker
DUMC 3120, 3000 Erwin Road
Durham, NC 27705

This article comes from Division Physical & Occupational Therapy   http://ptot.duhs.duke.edu
The URL for this story is:   http://ptot.duhs.duke.edu/modules/ptot_op_locs/index.php?id=6