Stroke Rehabilitation Program

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Bryn Mawr Rehab Hospital excels in meeting the complex rehabilitation needs of stroke patients. Experience with thousands of patients during the last half century has shown us that recovery is different for each person, depending on the area of the brain affected.

The physicians, nurses and therapists caring for our stroke patients also realize that recovery usually is a gradual process requiring patience and understanding. In 2003, our Stroke Program was named a regional Center of Excellence by Philadelphia Magazine. It is fully accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and by the Commission on Accreditation of Rehabilitation Facilities (CARF).

Bryn Mawr Rehab Hospital provides the optimal physical environment for recovery as well. A new, state-of-the-art, 48-bed stroke unit built in 2002 is garnering rave reviews from patients and staff alike. Designed with a light-filled, open plan, the Oak Unit provides multifunctional spaces adjacent to the therapy gym and family areas for a broad range of therapy opportunities. For example, a fully equipped kitchen and simulated living areas make it possible to practice daily-living skills on the unit.

The Scope of Our Services

The hospital has developed a full continuum of lifetime care for people who have experienced a stroke. This system includes acute inpatient services, outpatient services, Day Treatment, community re-entry services and Family Support Groups. This comprehensive rehabilitation process ensures that all individuals receive the most appropriate program of care based on their injury and on their personal needs. Treatment can begin anywhere in the continuum — in intensive inpatient care, on an outpatient basis, or in our community re-entry services.

When stroke survivors arrive at Bryn Mawr Rehab Hospital, they usually require total or maximal assistance with daily activities. At discharge, most people still need some supervision and help, but the amount of help needed is significantly decreased. Our medical care, therapies and special services help each person build on strengths and compensate for any limitations. Because stroke patients often have low physical endurance, our therapies focus on conserving energy and building physical tolerance for exercise, walking and the tasks of daily life. Re-training is also provided to improve bowel and bladder control. Nutritional management is provided for individuals with swallowing disorders.

Patient Profile

Our stroke patients typically are between 42–97 years old, although patients as young as 18 have been admitted. Average inpatient stay is about three weeks, but can vary widely. Between 75–80 percent of stroke survivors return home after discharge from our programs. Many of our patients come to us from an acute-care hospital and are experiencing difficulties that affect their ability to function in areas including walking, speaking and eating. Sometimes, patients also have difficulties with attention or memory, vision, or continence.

The Right Treatment Team

A team of experts works with patients and families to address individualized goals and achieve the best recovery possible. Our inpatient treatment team typically includes a rehabilitation physician, internal medicine physician, rehabilitation nurse, pharmacist, physical therapist, speech/language pathologist, occupational therapist, psychologist and a case manager who serves as your family’s liaison to a wide array of community resources, including legal services and vocational rehabilitation. The team also may include a recreational therapist, cognitive remediation therapist and a registered dietitian, as needed. As requested, the patient’s personal physician will be advised of his or her patient’s progress.

Intensive Inpatient Care

All of our inpatients receive care 24 hours a day from physicians and from nurses specially trained in rehabilitation. In addition, our patients receive therapy services seven days a week. Additional services such as speech therapy, psychology, cognitive retraining, recreational therapy are provided based on our assessment of each patient’s individual needs.

This intensive level of care is family-focused and includes conferences with the treatment team, and ongoing participation in care giving. Family members are encouraged to participate in daily therapy sessions and to attend weekly physician/case manager rounds on the unit to hear discussions about their family member’s progress. A family conference is scheduled as needed by your case manager. For those traveling long distances, Bryn Mawr Rehab Hospital offers on-site family accommodations by reservation during your loved one’s stay to facilitate family education and training.

State-of-the-Art Equipment

Bryn Mawr Rehab Hospital’s Stroke Program is equipped with specialized safety equipment designed to reduce risks of injury during recovery of confused or impulsive patients, including an electronic Wanderguard Locating System and net enclosures around beds. We retrain patients to walk using a harness system that safely suspends them above a treadmill. At first, the harness supports about 40 percent of the patient’s weight and the treadmill is set on a low speed while therapists help move legs and torso through walking motions.

Gradually, the patient bears more weight and needs less assistance. Most patients eventually are able to walk in hallways using a portable harness system with wheels. Similarly, the Balance Master and Smart Balance Master are harness systems with computerized platforms designed to assist therapists in assessing and treating balance and mobility impairments.

Movement Induced Therapy

Through intensive physical and occupational therapy called Movement Induced Therapy, undamaged areas of the brain can be trained to take over for areas damaged by stroke. For example, we retrain patients to walk using a harness system that safely suspends a patient above a treadmill. Brain imaging has shown that remapping of the brain’s neurons occurs fairly rapidly with this kind of stimulation. Another form of Movement Induced Therapy involves forcing the use of the arm and hand on the weaker side of the body by restricting use of the “good” arm and hand.

Second Chance Program

The Second Chance Program is designed to meet the rehabilitation needs of stroke patients who may not have had the opportunity for comprehensive rehabilitation after their stroke. While early stroke recovery is a significant indicator of recovery potential, recovery can continue six months or more after stroke. These patients can reduce their dependence on caregivers and increase their mobility, self-care and feeding through intensive therapy.

Other Specialized Outpatient Services

We offer many specialized services that can enhance a program of care or can be requested individually. These include:

• Neurologic Day Program available full or half days
• Adapted Driving Program with evaluations, recommendations for adaptive equipment and training in their use
• Assistive Technology Program for specialized wheelchairs and electronic speech devices, and modifications at home and work
• Aquatic therapy in our heated indoor pool
• Laboratory and digital radiological services
• Neuropsychological evaluations
• Pain management
• RehabWorks Program for work-related injuries
• Vestibular (balance) therapy using a computer diagnostic system with a tilting platform
• Bryn Mawr Rehab Outpatient Network, providing physical, occupational and speech therapy services for patients of all ages at nine convenient locations

Education and Support Groups

At Bryn Mawr Rehab Hospital, we believe that education and support for families are vital components of treatment. Our library provides books, articles and videotapes about stroke and preventing a second stroke. The hospital’s Stroke Support Group, led by a psychologist, offers information, emotional support and social contact both for the person who has experienced a stroke and for family and friends. Call 484-596-5430 for more information.

The Referral Process

A referral to Bryn Mawr Rehab Hospital can be made by a physician, an insurance case manager, a social worker from an acute-care hospital, or a family member. Our clinical liaisons are available on-site at many acute-care hospitals in the Delaware Valley to review and evaluate medical records and to speak to families whose loved ones could benefit from our specialized services.

Family members are strongly encouraged to visit our campus and to tour our Stroke Unit and therapy facilities when making a decision about rehabilitation care. Family involvement is also encouraged and supported at every stage of rehabilitative care from the rehabilitation decision phase through therapy and discharge planning. This ensures that the work done in rehabilitation will continue to be effective in everyday life.

Want More Information?

• For more information about inpatient referrals, call 484-596-6000
• For information about outpatient referrals, call 484-596-3943
• For tours, call 484-596-5454