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Physical medicine and rehabilitation

Our Physical Medicine and Rehabilitation staff, to include physiatrists, nurse practitioners, physician assistants, registered nurses, physical therapists, occupational therapists, kinesiotherapists, psychologists, social workers, speech-language pathologists, recreation therapists, and other support staff, work closely with Veteran patients and their families, to provide a long range of inpatient and outpatient services designed to preserve and increase mobility and independence.

Care we provide at VA Houston

VA is the world’s largest and most comprehensive provider of physical medicine and rehabilitation. Veterans enrolled in the VA health care system and referred by a physical medicine and rehabilitation provider can receive a full range of services and equipment, such as:

  • Artificial limbs 
  • Durable medical equipment
  • Drivers rehab training
  • Physical therapy, occupational therapy, kinesiotherapy, aquatic therapy, recreation therapy
  • Acupuncture and chiropractic services
  • EMG services, spine rehab, TBI, and musculoskeletal services 
  • We follow the VA Core Values of “I CARE”: Integrity, Commitment, Advocacy, Respect, and Excellence
  • Patients will be treated with dignity, compassion, and respect as an individual in a safe environment that maintains privacy and allows them to honor their personal, cultural, psychosocial, and spiritual values.  

VA Houston Healthcare System provides:

Acupuncture is one of the complementary and integrative health (CIH) approaches within the VHA Whole Health System of care. Acupuncture is one of several techniques that make up the system of care provided by those trained in traditional medicine from China and other Asian countries. Acupuncture may refer to this whole system approach to health care or define the technique of acupuncture treatment. Acupuncture is used to restore or maintain health.

Admission Criteria

VA Houston has a Comprehensive Integrated Inpatient Rehabilitation Program (CIIRP). As a rehabilitation candidate, you are screened according to how stable your medical condition is, what you were able to do for yourself before your illness or injury, and what you are able to do now.

You will be accepted into the rehabilitation program if we think we can help you become more independent. You must have the ability to take an active role in your rehabilitation.

Patients in the following categories are not candidates for the Comprehensive Integrated Inpatient Rehabilitation Program:

  • Patients on ventilators
  • Patients receiving parenteral nutrition (TPN)
  • Patients requiring seclusion or four-point restraints
  • Patients receiving pain medications through a PCA pump
  • Patients who are unable to follow instructions or participate in therapies

All rehabilitation services are time limited. If your medical needs become greater than your therapy needs, or if you are no longer benefiting from inpatient rehabilitation, we will assist you in moving toward a different level of care.

  • Your spouse, family members, or caregivers are not able to stay overnight on the rehabilitation unit due to shared spaces. Your social worker can give you information on places to stay in the community. We are unable to pay lodging expenses for your family.
  • Transportation to and from the VA Medical Center for rehabilitation is generally not available through the hospital.

CIIRP Report Card

  • 98% of patients were discharged to their home upon completion of rehabilitation. (1.6% to skilled nursing and 0.4% to subacute setting.)
  • 72.7% of patients are discharged home to their family/relatives. (4.4% to friends, 22.5% alone, 0.4% other)
  • 91.2% of patients accepted into CIIRP between 2018 and 2020
  • 96.2% of patients were satisfied with our services
  • Patients average length of stay is 7.5 days

The interdisciplinary team aids in the recovery of Veterans from amputations.  We also seek to prevent limb loss, reduce limb loss, or avoid the complications of limb loss.

VA Houston is a Polytrauma/Amputee Network Site (PANS) that:

  • Uses gait analysis equipment to evaluate both technology and clinical intervention.
  • Obtains and maintains equipment necessary to fit, adjust and train patients on the latest technology limbs.
  • Maintains accessibility to pain, wound care, orthopedic, and mental health specialists.
  • Provides state-of-the-art equipment for physical rehabilitation.
  • Maintains an accredited Prosthetic Lab with certified prosthetists or contracts with the private sector.
  • Provides a certified prosthetist for all Amputation Clinics that is not a contract vendor.
  • Provides adequate staffing for the amputation program, which includes a designated amputation rehabilitation coordinator.
  • Actively involves all team members in the prescription, fabrication, provision, management, and prosthetic training of high technology limbs.
  • Collects outcome measures to evaluate the effectiveness of rehabilitation interventions and uses these outcomes to improve patient care and the overall amputation program.
  • Demonstrates a strong team approach in both the inpatient and outpatient areas.   

Amputee Report Card

  • 100% of amputee patients return home after discharge 
  • Reason for admission: 
    • Ortho 77%
    • Stroke 16%
    • Cardiac 0%
    • Amputee 2%
    • Brain Dysfunction (T) 1%
    • Other 4%
  • Average age: 63
  • 96.2% of patients were satisfied with our services
  • Patients average length of stay is 10.9 days

Chiropractors work closely with your interdisciplinary health care team to diagnose and manage muscle and joint conditions, including treatment and care of spine-related neuro-musculoskeletal conditions to eligible beneficiaries.  

The chiropractic approach to health care is holistic. Natural drugless, non-surgical methods of chiropractic treatment rely on the body's inherent recuperative abilities to promote healing. Chiropractic care restores, improves, and maintains your function, activity, and health.  

We work with your primary care provider and other specialty care providers to provide a complete health care treatment plan for you.  We offer many treatments, including:            

  • Spinal manipulative therapy to relive pressure on your joints, reduce inflammation, and improve nerve function.
  • Electrical stimulation therapy, which reduces pain by sending mild electrical pulses through your skin to help stimulate injured muscles or manipulate nerves.
  • Soft-tissue mobilization, which uses gentle pressure or massage to relax tense muscles, reduce scar tissue, or stretch connective tissue.

Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (motor neurons). EMG results can reveal nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission.

Musculoskeletal disorders are conditions that affect your body’s muscles, joints, tendons, ligaments, bones, and nerves.  The pain and discomfort associated with these conditions can create limited physical functioning and affect your overall quality of life. Our highly skilled physiatrists are physicians who specialize in diagnosing, treating, and directing an interdisciplinary rehabilitation plan for Veterans with acute and chronic pain to maximize the Veteran’s functional status.

Neurorehabilitation is a treatment program supervised by Physiatrists for Veterans with diseases, injuries, or disorders of the nervous system, such as stroke. Neurorehabilitation can reduce symptoms and maximize the Veterans’ function.  

Polytrauma/TBI System of Care is an integrated network of specialized rehabilitation programs dedicated to serving Veterans and servicemembers with both combat and civilian related Traumatic Brain Injury (TBI) and polytrauma. Services available include: interdisciplinary evaluation and treatment, development of a comprehensive plan of care, case management, patient and family education and training, psychosocial support, and application of advanced rehabilitation treatments and prosthetic technologies.

Understanding TBI

TBI is a common occurrence and a major health concern. The brain is highly vulnerable to damage as a consequence of falls, motor vehicle accidents, or assaults.  More recently, the concerns about TBI related to the Iraq and Afghanistan conflicts and about sports concussions have led to increased interest in the prevention, diagnosis and treatment of TBI related health conditions. 

What is Polytrauma?

When TBI is associated with a significant secondary injury (amputation, burn, fractures) or with mental health conditions (post-traumatic stress, depression, anxiety, substance use), the resulting “polytrauma” can have devastating effects that compound those seen in TBI alone.
In the recent military conflicts, polytrauma is primarily caused by proximity to an explosive event.  Advances in military medicine and protective gear have help save lives. Rehabilitation works to optimize recovery and facilitate return to independent living and higher quality of life. 

Specialty wheelchair and powered mobility assessments are performed by the Physical Medicine and Rehabilitation interdisciplinary clinical team.  While a consult is not required to access this clinic, an appointment is required. To schedule an appointment, please call the Physical Medicine and Rehabilitation Clinic directly at 713-794-7168. The clinic is open Monday – Friday, 8am to 4pm, excluding Federal holidays.

Specialty wheelchair and powered mobility devices may be issued at the discretion of the interdisciplinary team.  This decision is based on the clinical assessment performed by the team. If Veterans are deemed eligible, an appropriate prescription is given to meet his/her medical and physical requirements. Education on the device(s) will also be provided to the Veteran. 

Spine evaluations are performed by the Physical Medicine and Rehabilitation interdisciplinary clinical team.  While a consult is not required to access this clinic, an appointment is required. To schedule an appointment, please call the Physical Medicine and Rehabilitation Clinic directly at 713-794-7168. The clinic is open Monday through Friday, 8:00 a.m. to 4:00 p.m., excluding Federal holidays.

The PM&RS Spine Center provides a non-surgical, evidence-based approach to accurately diagnosing and treating painful spine conditions using minimally invasive procedures.  Our clinicians create customized treatment plans of care for Veterans.

Therapy Services

Aquatic therapy involves utilizing the pool as a mechanism for conducting an aerobic exercise program for patients with pain, in particular chronic back and lower extremity pain.  Aquatic therapy is just one of many innovative treatment methods offered to Veterans dealing with chronic pain and is designed to help Veterans improve their function and bring exercise back into their life. Veterans with chronic pain who have found most workout regimens too difficult have been able to participate in aquatic physical therapy. The class incorporates aerobic and strength building exercises. 

Veterans and servicemembers with disabilities are entitled to the opportunity to learn to drive a motorized vehicle on the nation’s public highways.  Depending upon the severity of the disability and the available adaptive equipment designed for today’s motor vehicles, the disabled Veteran should enjoy the independence and freedom of mobility offered to all citizens.

The Driver rehabilitation services can be provided to the inpatient and outpatient Veteran, and include evaluation, consultation, and assessment of a wide range of physical and mental disabilities related to driver rehabilitation, both as a driver or as a passenger.

The services may include evaluation of a Veteran with various disabilities, driver simulation, behind-the-wheel training, equipment recommendation/prescription, assessment and inspection, caregiver training, and assistance with the various state motor vehicle requirements.
The Drivers Training professionals work closely with the patient to provide input on driving skills and task needed to compensate for their disability and the needed adaptive equipment that is necessary for their specific disability.

A prescription is developed for eligible Veterans so Prosthetics service can work with the vendor to provide the needed adaptations for the Veteran or the Veteran can obtain the needed devices on their own.

Services also include assistance with vehicle selection if needed, as well as assessment for appropriate adaptive equipment.

Kinesiotherapy is the application of scientifically based exercise principles adapted to enhance the strength, endurance, and mobility of individuals with functional limitations or those requiring extended physical conditioning. Kinesiotherapy treats the effects of disease and injury through therapeutic exercise and education.

Kinesiotherapists evaluate and modify therapeutic exercise programs and fitness activities to increase strength and endurance. KT provides mobility aids and equipment training for you and your family.
 

Occupational therapy increases your independence and safety during daily activities, such as bathing, dressing and household tasks after injury or illness. Occupational therapists evaluate upper body function and your ability to re-learn self-care skills. OT provides adaptive equipment and training to allow you to fully participate in self-care and daily household activities.

Occupational Therapy (OT) involves the therapeutic use of everyday life activities with individuals or populations for the purpose of participation in meaningful and purposeful occupations and roles in home, school, workplace, community, and other settings. 

Occupational Therapy provides services that promote health and wellness to Veterans who have, or are at risk for developing, an injury, illness, disease or condition spanning physical, cognitive, sensory, and psychosocial domains.  Occupational Therapy evaluation and treatment supports Veterans' engagement in everyday life activities that affect their physical, and mental health and well-being.

Physical therapy improves your mobility by focusing on areas such as your balance, coordination, pain control, strength and endurance after injury or illness. Physical therapists work on your ability to get around your environment. They teach you exercises and train you and your family to use adaptive equipment to increase your independence in these areas.

Physical Therapists are health care professionals who diagnose and treat individuals of all ages with medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Physical therapists examine each individual and develop a treatment plan.

Evidence-based services are used to decrease disability, reduce pain, improve function and independence, prevent illness, promote wellness and restore quality of life to the Veterans and Servicemembers they serve.

The therapeutic recreation specialist evaluates your leisure interests prior to admission, your ability to continue those activities with or without adapting them, and helps you explore new areas of interest. This often includes activities to increase your interaction with others and help with community re-entry.

Learn more about Recreation Therapy at VA Houston.

Speech Pathologists diagnose, treat, and manage a wide range of speech, language, voice, cognitive, and swallowing disorders which may result from cancer, stroke, brain injury, Parkinson’s disease, or other medical or neurological conditions for inpatients and outpatients.

These specialists provide a full range of diagnostic and rehabilitation services include:

  • Diagnosing, treating, and managing speech, language, voice, cognitive-communication, and swallowing disorders
  • Instrumental evaluations of swallowing (modified barium swallow study, endoscopic evaluation of swallowing)
  • Videostroboscopy for evaluation of voice
  • Evaluation for augmentative or alternative means of communication
  • Alaryngeal speech rehabilitation
  • Interventions for cognitive-communication disorders after brain injury
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