For many patients who have sustained a spinal cord or brain injury, the opportunity to participate in Locomotor Training (LT) can mean the difference between walking and life in a wheelchair. How LT is delivered is based on what we know about how the nervous system learns or relearns a motor skill, and requires a truly multi-disciplinary approach from a highly-trained team.
Our NeuroRecovery Network (NRN) LT Team includes physical and occupational therapists, physicians, nurses, speech and language pathologists, psychologist, and case managers. This multi-disciplinary approach is necessary to ensure patients maintain the principles of LT not just during sessions, but in every aspect of their lives. These principles include 1) maximizing weight-bearing; 2) optimizing kinematics; 3) optimizing sensory cues; and 4) maximizing recovery while minimizing compensation.
Each LT session is conducted by a clinical team consisting of one therapist and three highly-skilled therapy aides. These 90-minute sessions require extensive verbal and non-verbal communication between all members of the team to ensure top-quality delivery of therapy.
To ensure the patient is receiving the most out of every session and is poised for success post-discharge, the team meets weekly to discuss both clinical and administrative issues. LT clinicians meet with case management, the scheduler and outpatient supervisor to discuss insurance issues, upcoming discharges and the list of potential candidates. A smaller, clinician-only meeting is held to discuss patient progress, brainstorm strategies for addressing challenges and exchange ideas for a fresh perspective.
The entire team consistently updates patient goals according to progress and life outside of therapy (children, work, functional goals), making collaboration across specialties exceedingly important. The OT emphasizes recovery and carryover of the LT principles during sessions and is frequently consulted for ideas on improving upper extremity positioning and scapular mechanics during movements. The team psychologist provides insight into patients' emotional recovery, and strategies to assist with their coping during sessions. The team nurses help perform skin checks and follow-up care regarding bowel/bladder management. The team SLPs advise therapists on how to best teach the LT principles to patients with cognitive issues. Patients' family members are also key members of the team, as they are essential for ensuring carryover of the LT principles outside of therapy sessions. The ways in which the team relies on the strengths and knowledge of the varying specialties is endless-and one of the primary reasons the team achieves such success with patients' rehabilitation and recovery.
Our team is not just composed of health care specialists at our facility; it is also a part of an interdisciplinary team across the entire NRN. This network includes PTs, OTs and activity-based technicians from six clinical centers and five community fitness and wellness facilities. Members from each team participate in monthly conference calls and an annual meeting to standardize care, problem solve and share ideas, ultimately improving patient outcomes.
Our NeuroRecovery Network Locomotor Training Team embodies the principles of a multi-disciplinary team, and positions patients for success through teamwork, communication and collaboration.
Our team members are:
Elizabeth Watson, PT, DPT, NCS
Melania Dieterick, PT, DPT
Robin Cvitanov, PT, DPT, NCS
Amanda Laarz, PT, DPT
Andrew Stamatelos, PT, DPT
LauraJean Wright, PT, DPT
Andrea Weaver, MS, OTR/L
Joann Rudi, RN, CRRN
Janice Hutton, MS, CCC-SLP
Masako Suzuki, MSW, LSW, CCM
Barbara Watson, PsyD
Guy Fried, MD