Recreational Therapy: Restoring Activities and
Quality of Life
Stella Arzadon Husch, MSA, CTRS, CBIS
(Strive Recreational Therapy Services, Inc.)
www.OrigamiRehab.org
517-336-6060
Speaker
Stella A. Husch, MSA, CBIS, CTRS
7111 Dixie Hwy #123
Clarkston, MI 48346
(248) 922‐ 1236 ph Recreational Therapy... Opening Doors
(248) 922‐ 1235 fax
[email protected]
www.StriveRecTherapy.com
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What is Recreational Therapy?
Primary Purpose of Recreational Therapy
 Using recreation services to help people with potentially limiting conditions
• Physically
• Mentally
• Emotionally • Socially
 Restore… to previous life function
 Focus on quality of life issues through the use of recreation, leisure & sport.
 Rehabilitate… to health or wellness
 A therapy process that includes • Assessments
• Planning • Implementation
• Evaluation
 Remediate… to improve function/ independence
 Reduce… illness or effects of disability/ injury
 Eliminate secondary issues  An adjunct service that can assist other therapies & healthcare professions Taken from American Therapeutic Recreation Association.
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What does Recreational Therapy have to offer???
 Therapy:
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To enhance independence
Make participation in activities of interest possible
To indentify problem areas
Set goals
Implement plans
Evaluation of progress
 Education:
How does one become a Certified Therapeutic Recreation Specialist?
• Bachelor’s degree in TR program
• Therapeutic Recreation coursework • TR Field Work Experience
 Teach skills to be used throughout life
• Internship (sometimes two)  Enhance attitudes to self and others
 Provide resources to learn, grow and improve
• National Certification Exam with NCTRC
 Recreation:  Promote health and wellness  Achievement in a rewarding and enjoyable manner
• Licensure depending on each state 5
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2016 Origami Brain Injury Symposium of Mid-Michigan
Why is Recreational Therapy needed?
 Gap between the hospital and home setting.
 Designs specific individual’s needs or issues.
 Individuals have too much time on their hands!
 Help increase quality of life. TR helps introduce how to “live again”.  Decrease re‐ hospitalizations and secondary health issues.
Types of Recreational Therapy Programs
 Aquatic Exercise/ Aquatic Therapy
 Exercise and Strength Training activities
 Sports specific adaptations
 Community Integration
 Volunteer involvement
 Soft vocational activities/ Light duty vocational work
 Introduce alternative therapies and methods (CAMs)
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What is Aquatic Therapy?
Why Aquatic Therapy?
• Water‐ based treatments or exercises of therapeutic intent.
• Can include relaxation, fitness and physical rehabilitation.
• Treatments/ Exercises are performed while floating, partially submerged or fully submerged in water. •
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Low Impact activity/ non‐ weight bearing
Relaxation
Fitness
Pain and temperature tolerance issues controlled
Provided in a controlled atmosphere
Treats of a variety of disabilities/ issues
Heart rate of 17‐20 beats/minute lower than on land. 9
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Why it helps?
• Buoyancy: force acting in the opposite direction of gravity. Felt as an upward thrust. Weightlessness and pain free mobility. Challenging postural alignment.
• Hydrostatic Pressure: force exerted on immersed body by fluid molecules. Equal pressure everywhere. Depends on depth. Strengthen diaphragm. Stimulate sensory input. • Resistance: water is “thicker” than air. Turbulence good for balance/ postural training. Strengthen weak muscles.
What’s involved with Aquatic Therapy?
• Requires attendance by trained therapist.
• CTRS, PT, OT, etc.
• Usually performed in a specialized temperature‐
controlled pool. • Water temperature is usually an average of 92 degrees (air temp 3‐5 degrees warmer)
• Rehabilitation commonly focused on improving physical function. 11
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2016 Origami Brain Injury Symposium of Mid-Michigan
Typical Types of Aquatic Therapy
Benefits of Aquatic Therapy
• Ai Chi
• Balance/ Coordination improved
• Aqua Running
• Weight bearing improved
• Bad Ragaz
• Muscular endurance/ strength improved
• Cardio respiratory/ Cardio vascular/ pulmonary improved
• Burdenko
• Pain Management abilities improved
• Halliwick
• Motor skills/ motor control improved
• Watsu
• Psycho social relaxation controlled
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Exercise and Strength Training
Adaptive Fitness
• Done in gym or In‐ home exercise program
• UBE or Arm Cycle
• Increase mobility
• Gripping Gloves
• Increase bone density
• Cuff weights/ Dumbbells
• Medicine Ball (with or without handles)
• fitness timer
• Total Gym XLS
• Theraband
• Improve body image/ self esteem
• Yoga/ Pilates
• Cardiovascular system improvements
• Strength conditioning & cardiovascular equipment
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Sports Specific Adaptations
Community Integration
• Golf (golf cart, club)
• Take client into community
• Basketball (wheelchair, lowered rim, league)
• Community resources/ partnerships
• Running/ Cycling (handcycling, recumbent)
• Maneuver within environment/ lifestyle
• Hunting (all‐ terrain equipment, paved paths)
• Time/ Money management
• Tennis (wheelchair, lowered nets)
• Transportation
• Boccia (indoors or outdoors, adaptive equip)
• Socialization/ communication/ initiation/ appropriateness 17
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Volunteerism
• Gateway back to employment or different vocational opportunity
• Use of soft vocational skills to apply towards getting back to work.
Barriers to Activity
 Don’t want to be a bother family/ friend
 Lack of Transportation
 Lack the skills (always worked, never had leisure time)
 Why? My life is over anyways.
• Endurance
• Time Management
 Depression. Poor self image.
• Decision making  Family not being involved or OVER involved.
 Poor perception of recreation
• Multi‐ step processing
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TR treatment plans can include:
Barriers to Recreation continued…
Client‐ centered treatment plan & goals
Community‐ based re‐integration
Health and wellness
Endurance and strength goals
Awareness of community resources Return to work goals
Cognitive skill development
Improve appropriate social interactions
Safety
Time/ Budget management
 Lack of importance placed on leisure time needs  Lack of awareness of programs/ activities
 Don’t want to be “labeled” or “stereotyped”
 Physical and Program Accessibility
 Lack of feeling involved= lack of confidence
 Previous negative encounters with customer service
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Decrease Secondary Health Issues Such As:
• Pain
• Decreased independence/ self‐
worth
• Emotional/ mental issues
• Stress management
• Re‐hospitalizations
• Depression
• Decreased self esteem/ changes in affect
• Decreased initiation/ inhibition concerns
• Obesity/ health and wellness issues
• Substance Addiction
Examples of Disability Specific Benefits…
Population
/ Disability
Examples of barriers to life
Re‐ integration back into society.
Fear.
Veterans/ Battling Addiction.
PTSD
Military Sexual Trauma.
Dementia.
Family involvement or lack of.
Lack of peer support.
Anger issues.
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How TR helps
Benefits seen
Increased mental Connects to appropriate capacity.
support groups.
Increased self worth.
Establishes new Positive self esteem.
connections.
Activity.
Introduce activities of Decrease anger issues.
interest.
Identify community Manage stress.
resources.
Focus on wellness.
Develops programs/ groups Recognize when as needed.
assistance is needed Keeps active and healthy.
and asks. Introduce adaptive sports.
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Examples of Disability Specific Benefits…
Population/ Disability
Examples of barriers to life
How TR helps
Benefits seen
Boredom DEFEATED! Establish activities of Increase in muscle interest. Fear of falling.
Keep Senior active and strength & endurance.
Dementia.
healthy. Increase brain Memory Issues.
Increase social networks. stimulation. Strength & Endurance.
Removes Senior from Increase social Decrease social interactions.
familiar surroundings. interactions. Breathing problems.
Develop cognitive skills Decrease in hypertension Diabetes issues. through activity and and obesity. Depression.
sport. Decrease depression. Decrease muscle mass. Increase in positive Decrease brain stimulation. Introduce new activities. Adapt previous activities. affect. Prevention of degradation of functions.
Seniors/ Geriatric
Examples of Disability Specific Benefits…
Population/ Disability
Examples of barriers to life
Stigma of disability.
Difficulty holding a job.
Medication issues.
Difficulty identifying issues.
Poor socialization skills.
Behavior changes.
Fear or anxiety.
Depression.
Guilt and shame.
Anger and irritability.
Poor family support.
Overbearing family.
Mental Illness 25
How TR helps
Benefits seen
Connects to appropriate support groups.
Establishes new connections.
Introduce activities of interest.
Identify community resources.
Develops programs & groups as needed.
Develop healthy leisure lifestyle.
Improve quality of life.
Improve self‐esteem.
Decrease recidivism.
Community reintegration.
Promote intrinsic motivation.
Increase socialization.
Increase coping skills.
Encourage self‐
expression.
Promote a well‐balanced lifestyle. 26
Examples of Disability Specific Benefits…
Population/ Disability
Examples of barriers to life
How TR helps
Benefits seen
Spinal Cord Injury
&
Amputees
Accessibility.
Strength.
Endurance.
Mainstream concerns.
Independence. Pain issues. Inactivity. Fatigue. Fear.
Poor self‐ esteem.
Apathy.
Community Re‐Entry. Safety in public setting.
Teach appropriate interactions. Introduce activities to assist with pain management. Activity Training.
Leisure Resource Planning program.
Adapt pre‐ injury activities. Aquatic Exercise. Resource development. Introduce new volunteer skills. Soft Work Skills development. Increased muscle endurance & strength. Positive self worth. Positive Affect. Proper initiation. Stress management. Soft vocational training through activity/ volunteerism. Exercise and activity!
Examples of Disability Specific Benefits…
Population/ Disability Barriers to life
How TR helps
Benefits seen
Team Work. Being the Leader & Follower. Patience. Problem Solving. Communication Skills. Integrates social skills needed to succeed in Overcoming Fears. school and life Core Strengthening. Hand‐Eye settings.
Coordination. Flexibility. Fine & Gross Motor Skills.
Teach age‐
Improving ROM.
appropriate skills Improving body awareness. through recreation/ Increasing balance. sport/ leisure. Increase mobility skills.
Safety in public settings.
Increase social appropriateness.
Autism Spectrum
&
Cognitive Impaired
Communication Issues.
Behavior Issues.
Social Issues. Intellectual Issues.
Learning Difficulty.
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Examples of Disability Specific Benefits…
Population/ Disability
Traumatic Brain Injury
Examples of barriers to life
How TR helps
Benefits seen
Socialization concerns. Inhibition of behavior. Concentration. Safety. Money & time mgmt. Fatigue. Laziness. Various Cognitive issues.
Poor judgment. Anger & Memory issues. Get active outside home. Teach appropriateness in real‐life situations. Assist in budgeting. Increase Exercise.
Increase memory.
Assist in cognitive issues.
Aquatic Exercise.
Stress management.
Introduce CAM therapies.
Increased appropriate socialization. Recognition of safety. Independence in public. Initiation in activities of interest. Decreased stress. Decreased anger. Decreased health concerns.
Questions?
Contact:
Stella Husch
7111 Dixie Hwy #123
Clarkston, MI 48346
(248) 922‐ 1236 phone (248) 922‐ 1235 fax
[email protected]
www.StriveRecTherapy.com
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2016 Origami Brain Injury Symposium of Mid-Michigan