Case Summary

RECTH 4320: Recreational Therapy and Physical Medicine

Josilyn Gatrell & XXXX XXXXXXXX

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 Facility Overview: MossRehab

● Located in Elkins Park, Pennsylvania

● Part of the Einstein Healthcare Network
● Mission Statement:
○ “With humanity, humility and honor, to heal by providing
exceptionally intelligent and responsive healthcare and education
for as many as we can reach.”
● Population(s) Served
● Facility Resources
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 Unit Overview:
Inpatient CVA/Stroke
● Typically 27-30 individuals are on the unit
● Average length of stay is ≈ 21 days
● Typical pt. age is 60’s to early 80’s
○ However the unit serves all adults, ages 18+
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 Unit Overview:
Therapeutic Services
● 1 Recreational Therapist in the unit
● Other therapeutic services include:
○ Physical Therapy
○ Occupational Therapy
○ Speech Therapy
● RT Unit Resources
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 RT Supervisor: Jeff McCormack, CTRS

● Has worked in the therapeutic recreation field for the past 26 years
○ With MossRehab for the past 8
○ Worked at Magee Rehabilitation Hospital prior to that
● Specializes in working with patients in physical medicine and rehabilitation
● Favorite modalities
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 Case Study - John
Demographics - 47 year old male
Diagnosis - Left MCA Stroke / Right Hemi

● Reasons for Admission

○ Communication impairments
○ Difficulty with balance and ambulation
○ Limited movement in RE’s
○ Difficulty with visual scanning
● Length of Stay: July 9th-Sept 10th
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 Case Study: John
(cont.)
● Interactions on Unit = positive
○ Staff
○ Other Patients
○ Recreational Therapy
● Changes during stay
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 RT Assessment
● What information is gathered from the facility’s assessment?
○ Communication method ○ Home environment/living situation
○ Pain interference ○ Prior level of functioning
○ Impairments to ○ Leisure involvement & history
comprehension/expression ○ Actual and perceived deficits
○ Cognitive communication ○ Notes
○ Motor control ○ Goals/Objectives
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 Planning
● What information is relevant to planning interventions?
○ Their needs and goals
○ Personal leisure interests & patterns
○ Individual strengths and weaknesses
○ Social/relationship needs & abilities
○ Access to leisure resources at home/community
○ Pt.’s personal long-term goals
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 Implementation

Intervention 1: Dominoes

● Played on a tabletop, tiles must be played so the

number of dots match.
● Adaptations:
○ Colored domino sets
○ Domino holders
● Expected Outcomes:
○ Increased scanning to affected side
○ Fine motor coordination
○ Cognitive processing/following directions
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○ Dynamic balance (with modification)

 Implementation

Intervention 2: POKENO

● Played on a tabletop, very similar to BINGO, but

played with playing cards instead of a BINGO sheet.
● Adaptations:
○ Using a large card set
● Expected Outcomes:
○ Scanning Strategies
○ Fine motor coordination/Grasping
○ Cognitive processing/following directions
○ Identifying and memory
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 Evaluation and Documentation
● Takes place during and after the intervention
● How did the patient respond to the interventions?
○ Pt. actively participated throughout the session and expressed
excitement to be in recreational therapy. Pt. was observed using the
pincer grasp they had worked on in previous sessions in the RUE. Pt.
required minimal verbal prompting from the therapist as a reminder to
utilize the right playing fields in the activities. Pt. is regaining fine
motor control in RUE and is utilizing scanning strategies. Pt. will
continue to attend RT services on the MWF individual schedule.
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 Closing
Thank you!
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