VA Kinesiotherapy Combines Rehabilitation and Whole Health Care for Veterans
When Vietnam Veteran Ralph Heintz, 74, was transferred in May to a VA hospital outside of Chicago after being at a community care hospital where he had been diagnosed with COVID -19, he was really having a difficult time battling the virus. However, the committed work of VA’s Hines’ Physical Medicine and Rehabilitation Services Kinesiotherapy Team enabled him to be discharged in early August after months of specialized rehabilitation and care.
Kinesiotherapy (KT) is a rehab profession that provides evidence-based therapeutic exercise and holistic interventions to improve well-being and functional abilities. It has been used to help Veterans on an ongoing basis since WWII. Today, the VA is the single largest employer of Kinesiotherapists (KTs), treating more than 100,000 Veterans in Fiscal Year 2019.
During the recent challenges from COVID, Kinesiotherapists (KTs) quickly shifted necessary outpatient evaluations and treatments to virtual care to ensure Veterans’ safety while also providing specialized rehabilitation for inpatient Veterans requiring extended physical reconditioning.
The use of KT was especially helpful to Heintz, who served in the Army from 1965-67. Heintz was a patient at the Edward Hines, Jr., VA Hospital outside of Chicago, one of the first VA facilities to open a post-COVID unit.
He spent more than three difficult months battling the debilitating virus, receiving care from the Hines’ Physical Medicine and Rehabilitation Services KT and Physical Therapy (PT) team to help him recover.
When he first arrived, the team coordinated a coverage schedule for the Intensive Care Units (ICU) and COVID units. The KT team was the first in the rotation that began treating COVID patients. KTs worked with Heintz all of May. The PT team then rotated in and worked with him in June, and KT rotated back in for July coverage when he was transferred to the Community Living Center at the Hines VA Hospital, where he continued to receive KT until his discharge home, the first week of August.
“I am so grateful to (KTs) Joe [Neczek] and Kelly [Masterson] for my therapy,” Heinz said. “They were the first people to get me out of bed and they did not give up on me. I am getting therapy now at home, and they are very happy with my progress and so am I.”
Kelly Masterson, a registered KT who was providing rehab for Heintz at the time of his discharge home stated that the one thing Heintz would frequently ask for was “to eat a cupcake and drink a cup of coffee.” He was on a feeding tube for a great majority of his hospitalization.
On his last day, Kelly got clearance to bring him a homemade cupcake and a cup of Dunkin Doughnuts Coffee. She brought it out to him when he was getting into his car for the ride home. His eyes lit up and his family said that it was a very touching moment.
And KT has played major roles helping Veterans at other VA facilities, such as Johnnie Steele, a 78-year-old male Veteran currently enrolled in the Home Based Primary Care (HBPC) Program at the James A. Haley Veterans’ Hospital in Tampa. Steele is legally blind and has dementia.
His wife, Yolanda Steele, is his caregiver and takes care of most of his needs, including any VA hospital appointments. One of her concerns during the COVID pandemic was being able to get the [adaptive] equipment her husband needs considering that some of the appointments would be virtual.
To help with that, Steele’s HBPC, Bernadine Sanchez, spoke with his wife via phone on several occasions trying to address some of his needs. Mrs. Steele had expressed another concern with her husband that he was “falling and getting around in the house.” She stated that her husband’s KT requested to do a “video visit to see what was going on and how the VA could help.”
Sanchez used VA’s Video Connect (VVC) virtual technology. Mrs. Steele stated that she “could not figure out which buttons to push to do the video call” but trusted her therapist would be able to walk her through what she needed to do. Mrs. Steele stated that “all she had to do was hit a button and the next thing she knew her KT was on the other end of the phone.”
Steele stated that she was able to show the mobility issues and from there “Bernadine knew exactly what to do”. Recommendations were made for safety. Mrs. Steele had been concerned that although she cannot leave her
husband at home for long periods of time, at least she can now get out of the house to take care of things without worrying about him getting hurt while she is gone.
KTs across the VA healthcare system today are educated and specialty trained at the undergraduate and graduate level to support the complex needs of the Veteran population by focusing on skilled rehabilitation, improved function and quality of life.
Their unique holistic approach involves the Veteran as well as their family and caregivers emphasizing the psychological as well as physical benefits of therapeutic exercise within acute, post-acute, outpatient and home-based rehabilitation services. They also provide health and wellness coaching, disease prevention and comprehensive whole health practices.
These are a few of the recent examples of how KT has helped Veterans. KT first was used during WWII, when KTs implemented whole health therapy to accelerate the return of soldiers to active duty within physical reconditioning units established by the U.S. Armed Forces.
Tampa KTs were also able to save Veterans valuable and costly travel time even before the pandemic utilizing telehealth. Todd Keanan, Registered Kinesiotherapist and Certified Driver Rehabilitation Specialist (pictured in Tele-KT Driver Rehab Clinic photos) was able to evaluate Veterans living in Jacksonville to recommend adaptive driving equipment for a new vehicle utilizing VA Video Connect (VVC) virtual technology.
Determination for appropriateness for driver rehabilitation evaluations utilizing virtual technology is always made on case-by-case basis, but when the Veteran is well known to the therapist from previous on-road assessments and the Veteran’s Primary Care Physician has documented medical clearance with no cognitive, visual or physical changes that would require a face to face evaluation, the Veteran is a good candidate for VVC.
Using VVC, Keanan has been able to observe Veterans transfer safely into their vehicles, stow their wheelchairs, and demonstrate basic operational controls (such as making turns and using gas/brake) in a parked position without the Veteran having to come in-person to the VA hospital for the KT Driver Rehabilitation Clinic outpatient appointment to make recommendations for the same adaptive equipment to be placed in a new vehicle as well as final fittings/ inspections once the adaptive equipment was installed.
National Kinesiotherapy week was earlier in September, and VA celebrates the profession of Kinesiotherapy and the KTs who are dedicated to the health and wellbeing of our Service members and Veterans.
For more information on VHA KT, please visit www.rehab.va.gov/KT/ and inquire about KT services within your local VA facility Physical Medicine and Rehabilitation Service.