Neurologic Rehabilitation

Balance training

Balance training can consist of a number of different exercises focused on improving a person's balance to maintain safe functional mobility. Activities such as strengthening, stretching, proprioception exercises, and visual tracking are often prescribed to help address your concerns. 

There are many people who can benefit from balance training, including:

• Older persons with limited functional mobility

• Those who have fallen or are at risk for falls 

• Those suffering with vestibular disorders

• Post surgery

• Neurological conditions such as Parkinson's Disease, stroke, and diabetic neuropathy

LSVT Big

LSVT Big is an intensive program for individuals with Parkinson's Disease. The program trains people to use their body more normally when walking, performing self care tasks, and other functional tasks like getting up from a chair by encouraging “BIG” movement to increase amplitude. 

LSVT Big treatment is delivered one-on-one and is customized to each person's abilities and goals. It is an intensive program consisting of:

• 16 sessions (4x/week for 4 weeks)

• 1 hour long sessions

• Daily homework

The overall goal of the LSVT Big program is to reteach you how normal movement should feel to allow for a more active and independent life. 

Vestibular Rehabilitation

Dizziness, vertigo and imbalance are all symptoms that can result from a peripheral vestibular disorder (a dysfunction of the balance organs of the inner ear) or central vestibular disorder (a dysfunction of one or more parts of the central nervous system that help process balance and spatial information).  At Continuum Physical Therapy, we offer a comprehensive evaluation of the vestibular symptom to diagnose the cause of your symptoms and determine how physical therapy can help. 

Some of the common diagnoses we see at Continuum PT that cause dizziness are:

Benign paroxysmal positional vertigo (BPPV) - a condition resulting from loose crystals, called otoconia, that collect within the semicircular canals of the inner ear. In addition to head injury, BPPV can occur due to the degeneration of inner-ear hair cells during the natural process of aging.  This is often easily treated with 1-2 sessions of physical therapy to reposition the crystals through movement of the head. 

Cervicogenic dizziness - a clinical syndrome of disequilibrium and disorientation in patients with neck problems such as cervical trauma and arthritis.  Physical therapy can improve this type of dizziness through increasing neck ROM, strength and proprioception with exercise, manual therapy and modalities.

Vestibular hypofunction - a condition in which the vestibular (balance) system of one or both inner ears is not working properly.  This is most commonly caused by a bacterial or viral infection of the vestibulo-cochlear nerve.  Physical therapy can improve dizziness caused by this condition through vestibular rehabilitation therapy (VRT).  VRT is an exercise-based program primarily designed to reduce vertigo and dizziness, gaze instability, and/or imbalance and falls.

Biofeedback

We use biofeedback for patients having difficulty with activation of musculature as a result of an operation or an injury. We can use an EMG machine that provides audio feedback to the patient to help them restore normal activation of muscles.

Gait Training

Gait training is an activity which helps people improve the way they walk and stand by incorporating strength/endurance training, postural education, and patient education. Gait training is an important part of therapy that can increase confidence, improve endurance, minimize care needs, and reduce one's risk for falls.

After an illness or injury, people may have difficulty ambulating and will need to relearn how to walk properly with or without the assistance of an adaptive device such as a cane, crutch, or walker. Gait training can be helpful for a wide range of issues, including:

• Strokes and neurological disorders

• Joint injury and replacements

• Musculoskeletal disorders 

• Deconditioning

Postural Training

Postural training is an important part of one’s treatment program that begins with education to ensure a patient’s understanding of the importance of body positioning to reduce unnecessary stress to the spine and soft tissue. Postural training can be helpful for a wide range of issues, including:

• Neck pain and headaches

• Rounded shoulders posture

• Limited range of motion of neck and shoulders

• Muscle spasms

Treatment includes patient education, core and scapular strengthening, awareness training, modalities and manual therapy for reducing muscle spasms to provide pain relief and return to daily activities.

Specialty

Post- amputation rehabilitation/ prosthetic training

Undergoing an amputation, whether traumatic or non-traumatic, is a life-changing experience that can be a tremendous burden both physically and emotionally. Here at Continuum Physical Therapy, our goal is to help you navigate the rehabilitation process, making the transition into using a new prosthesis less stressful and ensure success with regaining strength, movement, and function following surgery. 

Physical therapy consists of targeted exercises to help condition and strengthen the residual limb, mobility skills, gait, balance, and prosthetic training, and improving flexibility to prevent contractures. All of our therapists are specially trained and knowledgeable in amputation rehabilitation and prosthetics, and work as a team alongside a prosthetist from Hanger Clinic in Rockport, Maine to find the best fitting prosthesis for your life situation and activity goals. 

Amputation Rehabilitation and prosthetic training can include;

• Learning wheelchair mobility and assistive device management 

• Learning how to care for the residual limb with skin checks and proper positioning/exercises for contracture prevention

• Learning proper techniques for putting the prosthesis on and taking it off 

• Learning to stand, balance, and walk with the new prosthetic limb 

• Targeted progressive strengthening and stretching exercises to prepare for return to recreational and sporting activities  

• Choosing the appropriate adaptive recreation equipment 

Womens Health

Women’s health is a rapidly growing field of physical therapy dedicated to promoting independence and empowerment to women throughout the lifespan. Women’s health in the physical therapy profression aims at addressing biomechanics and musculoskeletal disorders, with a specialized understanding of the physiological and hormonal changes present from young athletes to postmenopausal women.

Women’s health physical therapy encompasses a variety of conditions and treatments related to orthopedic injuries, including ACL tears, hip, SI joint, ankle, and low back pain, pelvic floor dysfunction, pelvic pain, prenatal and postnatal care, organ prolapse, incontinence, and osteoporosis. All conditions are evaluated by a therapist specially trained in pelvic floor anatomy, pelvic floor muscle examination, and obstetrical care.

Common Conditions Treated in Women’s Health Physical Therapy Include:

• Orthopedic related injuries (ACL tears, hip pain, SI joint dysfunction, knee, ankle and low back pain)

• Pelvic pain

• Incontinence

• Pregnancy related low back pain

• Diastasis Recti

• Osteoporosis

• Pelvic organ prolapse

• Neurogenic bladder

• Post-surgical pain

Common Treatment Methods used in Women’s Health Physical Therapy Include:

• Manual therapy

• Biofeedback

• Patient, dietary, and behavioral education

• Targeted strengthening exercise and muscle awareness activities

• Electrical stimulation

Mechanical Diagnosis and Therapy (Mckenzie Method)

Mechanical Diagnosis and Therapy (MDT) is a process of evaluation and treatment of orthopedic injuries or dysfunctions. Treatment through this method is based on an individual’s clinical response to specific motions or positions of the affected joint, as well as positive changes to the individual’s overall level of discomfort and function. The goal of MDT is to maximize personal independence in the treatment of conditions, and to promote healthy activity modifications so as to reduce the risk for future episodes. Common conditions that are assessed and treated through MDT include low back pain, sciatica, hip pain, and neck pain with or without headaches, but is also useful for other orthopedic conditions such as knee and shoulder pain. 

As a patient being assessed and treated using the MDT approach, you can expect to be educated on the important aspects of your diagnosis including the causes of your pain and what you can do to help relieve your pain. MDT will help you to become independent in the treatment of your injury, and give you the tools needed to help reduce your risk for future injuries.

Please visit the Mckenzie institute website for more information

Trigger Point Dry Needling (TDN)

Trigger Point Dry Needling (TDN) is an effective therapy to treat muscular tension and spasm which commonly accompanies conditions such as arthritis, nerve irritation, herniated discs, muscular strain, and ligament strains. 

TDN is the use of solid filament needles inserted through the skin and into the muscle belly to release painful myofascial trigger points. Dry needling results in the deepest tissue release allowing for improvements in range of motion and pain. It is called “Dry” Needling because nothing is being injected as with a hypodermic needle during a flu shot. With Dry Needling, the needle itself and the effects it produces within the tissue is the treatment.

TDN is often used in conjunction with other modalities to further help speed healing, decrease pain, and improve quality of movement. Stretching and exercise often follow up a TDN treatment as appropriate.

Some common problems appropriate for TDN treatments may be back pain, sciatica or hip pain, neck pain, migraines, knee or calf pain, plantar fasciitis, or shoulder pain. There are many other applications and diagnoses that TDN may help with.

TDN is NOT the same thing as Chinese acupuncture. The TDN approach is based on Western medicine principles, while acupuncture is based on traditional Chinese medicine theories. The only similarity is the type of needle used for both.

Telehealth Appointments

We are now providing patients with the option to complete their therapy through either zoom or google meet platforms. We will talk with you and perform a virtual evaluation and assesment of your condition and give you advice on how to deal with your condition through education and modification of your current activities, or addition of strengthening and mobility exercises.

Orthotic Fitting

Orthotics can be helpful in a variety of conditions to improve the position of your lower extremities and take excess strain off injured or irritated tissue. Orthotics can be used to correct flat feet (pes planus), or high arches (pes cavus), they can assist in positioning the heel properly, and can also be used to help with other painful conditions of the feet and lower extremities.

When indicated we use heat moldable orthotics to provide you with a semi-custom insert designed to alleviate foot, hip, knee, and even back pain.

Common conditions that orthotics are helpful for include:

• Plantar fasciitis

• Bunions (Hallux Valgus)

• Hip Pain/ Knee pain

• Patellofemoral pain syndrome

• ITB syndrome

Please check out the Vasyli website for more information on the type or orthotics that we use.