Bryn Mawr Rehab Hospital has
seen tremendous growth in its outpatient programs overall.
There are several reasons for this. Certainly, changing
reimbursement patterns promote limited inpatient stays to stabilize a
patient’s medical condition followed by more cost-efficient outpatient
services to facilitate maximum recovery.
In the area of neurorehabilitation, one of the most significant reasons
for an increase in patients is the better diagnosis and recognition of
concussion as a very real brain injury. While classified as a Mild
Traumatic Brain Injury, there are a number of individuals for whom
symptoms can last for weeks, months or even up to a year or more.
Symptoms including headaches, dizziness, fatigue, irritability, anxiety,
loss of concentration and memory, and noise and light sensitivity
dramatically impact a person’s ability to function at school, at work or
with one’s family.
Bryn Mawr Rehab Hospital treats thousands of
individuals each year on an outpatient basis. Many of these
patients are referred to Bryn Mawr Rehab by their primary care
physicians or surgeon for physical therapy following orthopedic injury
or surgery. Often, a standard course of treatment provided by a
physical therapist with extensive experience will result in the patient
having a smooth transition back into a pre-injury or pre-surgery level
of function and activity.
For those who have experienced a neurological event, the path is not
always as straightforward. For many patients, specifically those
who have experienced a stroke or brain injury, an outpatient course of
therapy is prescribed by their physician after an inpatient stay at a
community hospital or at Bryn Mawr Rehab Hospital. Multiple
services are required by these patients, and over a sometimes long
period of time, to ensure the greatest possible level of recovery.
Despite advances in the treatment of stroke and brain injury in an
inpatient setting, many patients leave the hospital or rehab hospital
with residual cognitive and sensorimotor impairments. They need
help in regaining function to return to their activities of daily life.
For other patients with neurological impairments, Bryn
Mawr Rehab Hospital is often seen as a place of last resort.
Our clinicians report that patients sometimes relate long periods of
time seeking help for symptoms relating to vestibular or balance
disorders, or concussion, with little success. Primary care
physicians may prescribe diagnostic tests, or indicate that symptoms may
resolve over time. A referral is made to a neurologist if symptoms
don’t improve. Unfortunately the wait to see a neurologist may be
longer than desired, which can mean additional stress on a patient whose
symptoms include cognitive, memory, visual and balance impairments as
well as depression until a referral is made to Bryn Mawr Rehab Hospital.
No matter what path brings a patient to Bryn Mawr Rehab
Hospital, patients with neurological conditions require a multiple
services. The evidence supporting the need for such services is well
established. At Bryn Mawr Rehab, patients are given the opportunity to
enhance their current abilities while addressing their limitations
through intensive practice. Patient-centered care provided within
meaningful and challenging activities promotes recovery towards personal
goals and enhances patient satisfaction. Interdisciplinary
evidence-based care provided by physical, occupational and speech
therapists, physicians, neuro-opthamologists, neuropsycholoigists,
psychologists and case managers in a synergistic manner has proven to be
an effective mechanism for increased outcomes, quality and
Every outpatient in our neurorehabilitation program is first assessed
using both technological tools and the expert assessment of our
clinicians. This extensive assessment determines the underlying
deficits and nervous system involvement. With that information,
the treatment team develops a comprehensive and individualized treatment
program to address the specific cognitive, behavioral, physical and
emotional difficulties that an individual is facing. The main
focus of all treatment is to help patients recover function, develop
strategies to compensate for deficits and manage stress and their own
Intensive therapy as early as possible after illness or injury maximizes
the return of function. For this reason, Bryn Mawr Rehab provides
individual and group therapies throughout a structured day to assist
patients in acquiring and building on functional skills.
It is not uncommon for a patient to receive 20-30 treatment sessions
over the course of their recovery, which may be over a number of
months. Of course, the individualized nature of each treatment
plan means patients’ experiences vary widely.
Bryn Mawr Rehab Hospital recognizes the complex
scheduling needs of patients who present with complex neurological
conditions and require multiple services. Fatigue issues
(cognitive and physical) are considered in the daily scheduling of
therapies. Further, some therapies may be discontinued during the
course of treatment when specific goals are met while other therapies
As the number of outpatients requiring neurorehabilitation has continued
to grow over time, Bryn Mawr Rehab Hospital has outgrown its Day
Treatment space which is where treatment was primarily provided.
Currently, a patient might have treatment sessions in as many as three
different areas of the hospital in a given day. This is not
convenient for the patients, and can pose a challenge given the physical
and cognitive impairments being treated, especially early in recovery.
For more information, call 1.866.CALL.MLH.