process. We need to keep our patients positive and motivated to persist in the face of uncertainty. We don’t know how long or if they will heal, but we need to keep trying until it becomes absolutely certain we have reached their potential. Engaging family, friends and their faith community to help keep their spirits up can make a huge difference. The gains in rehab are often slow. It can be frustrating to give it all you’ve got and then not see the functional improvements you expect. That is why keeping their spirits up, keeping them motivated, and giving them a goal can make such a significant difference. Live it!: When an individual experiences some form of paralysis, what type of exercises are typically used to help regain movement and how has new research changed that type of therapy? Dennis: The exercises really vary depending on the specific injury and the degree of paralysis. After we assess the patient and determine their functional impairments, we design an individualized exercise routine to address the specific issues. If the paralysis is not complete, we focus on standard strengthening exercises, often similar to exercises you would see being done in a fitness center such as leg press, squats or bench press. There has been a tremendous amount of research over the past years that has helped patients with paralysis regain some movement including a variety of electrical/neural stimulation, mirror therapy, constraint induced movement therapy, and a variety of medications that can help control muscle tone or spasticity. Live it!: After supervised therapy is completed, what can individuals do to maintain cognitive and physical strength on their own? Dennis: Most important, patients must continue with an individualized exercise program following their supervised therapy sessions. The recovery process often takes years to complete. With therapy, our goal is to regain as much functional mobility as possible. But that doesn’t mean they have gained everything when they leave therapy for the last time. That is what makes Bethesda so unique. We follow people from their inpatient rehab stay at Bethesda Club Suites and then will often do several sessions of home health therapy
once they return home. As they improve strength and mobility, they often transition into outpatient therapy at Bethesda Rehab, and then following discharge, they are able to complete an independent program at Club Bethesda. In addition, there are a wide variety of local support groups available that bring others who may be experiencing some of the same things together. This can provide encouragement, but also validation to the emotional responses that they may be feeling. Live it!: It must be satisfying to see clients make physical and cognitive improvements. What changes do you see in clients’ physical and emotional wellbeing after therapy? Dennis: Being a therapist is a great job. We often have a front-row seat to some amazing stories of perseverance and courage. It amazes me the strength some of our patients have. I’m not sure how I would respond if my mobility or cognition was affected by a severe accident or medical event. To see patients persist and push on, through often unimaginable circumstances, is so encouraging to us as therapists. To regain the ability to pick up their grandchildren, return to the golf course, return to work, or pick up a paint brush again can be life changing for patients. Live it!: Discuss shortcomings when it comes to accessibility for individuals who are permanently disabled and what communities can do to better respond to their needs. Dennis: This is something that has greatly improved over the years. The Americans with Disabilities Act prohibits discrimination against people who have disabilities. This extends into multiple different areas including transportation and accommodations. However, ask anyone who has a permanent disability and they will identify several shortcomings or tasks that are more difficult. The most important thing is to continue to educate community and business leaders and local citizens who can make a difference. It is difficult, but when you try and imagine yourself in their shoes, you quickly come up with many struggles and obstacles that could be addressed including accessible parking, handicapped-accessible bathrooms, access to elevators and automatic door openers, just to name a few.
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