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Exercise: The Ideal Post-Rehabilitation Prescription

Jan 31, 2011 ● By Aaron Unger and Marianne Vuckovich

America is facing unprecedented epidemics of obesity and widespread physical inactivity. And chronic diseases remain the leading cause of death and disability in the United States, despite the fact that most of those diseases can be prevented with regular exercise and healthy lifestyle choices. So where do people typically go for relief once these illnesses catch up with them? To the doctor.

Yet , due to current health-care and insurance limitations, patients are not always fully recovered upon discharge by their health-care providers, and are not sure of what to do next. 

According to the Health Resources and Services Administration for the U.S. Department of Health and Human Services, approximately 85 percent of today’s population has undergone some sort of physical therapy for an ailment or injury. The challenge to the health-care professional is to provide the best care within the guidelines set by the insurance company. To do what is best for his or her patient, the health-care professional may suggest setting up an after-care or post-rehab program with someone the patient feels comfortable with. For many people, this means physical therapy. However, physical-therapy patients are generally discharged once their pain becomes manageable and/or they achieve range-of-motion and strength measurements that are within functional limits for daily living. At this point, however, many of these discharged patients are confused about how to proceed. Do they join a health club? Find a personal trainer? Resume the exercise program they followed prior to injury? Hope they have the discipline to maintain the exercises they were given in physical therapy?  

A few progressive physical-therapy centers are taking a proactive approach and developing exercise-based post-rehab programs within their facilities to enhance and extend the healing process. This approach helps to improve or maintain the gains made in physical therapy, in-patient rehabilitation or other rehabilitational experiences. Such programs take post-therapy patients beyond simple functional limits, to safely bring their bodies and their functionality as close to 100 percent as possible.  These programs are led by therapists who have knowledge of the injury process and the dynamics involved. These rehab teams may include registered kinesiotherapists, occupational therapists, physical therapists and certified fitness specialists who help individuals of all ages entering exercise-based rehabilitation programs.

Exercise-based rehabilitation programs focus on patients’ injuries or ailments and look into the pathomechanics that may have caused them. Therapists develop a total-body program to avoid exacerbating injuries and point out bodily deficiencies that either led to or were caused by injuries. Through careful, individualized evaluation, therapists create one-on-one rehabilitation programs involving postural realignment, gait training, corrective strength and flexibility exercises, as well as hands-on treatments such as soft-tissue therapy and other modalities to meet patients’ needs and goals.

These post-rehabilitation services have improved the strength, flexibility and endurance of patients who have suffered from a range of challenges, including strokes, traumatic brain injuries, back pain or muscle spasms and strains, shoulder impingements, arthritis, joint reconstructions, neck and shoulder problems, tennis and golf elbow, fibromyalgia and osteoarthritis. Patients with other special concerns—such as diabetes, cardiac issues, breast cancer, multiple sclerosis and Parkinson’s disease—also can benefit from participating in such exercise programs.

According to a paper published in the Annals of Internal Medicine, 92 percent of patients agreed or strongly agreed with the following statement: “If my doctor advised me to exercise, I would follow his or her advice.” What’s more, a public opinion survey conducted by the American College of Sports Medicine (ACSM) found that nearly two-thirds of patients (65 percent) would be more interested in exercising to stay healthy if so advised by their doctors and given additional resources. The prescription pad is a powerful tool, and doctors can use it for more than just ordering medications. They can prescribe exercise.

Aaron Unger is a kinesiotherapist and the owner of Just Be Fit, Inc., a center for exercise-based rehabilitation, physical therapy, and personal training, located at 420 Lake Cook Rd. in Deerfield. Marianne Vuckovich is a kinesiotherapist at Just Be Fit. For more information, contact 847-444-1348 or [email protected], or see