Treatment Guide

This interdisciplinary guideline is designed to bridge the gap between clinical hands-on care and the client's home environment. By integrating Clinic-Based Physical Therapy (PT) with Virtual Occupational Therapy (OT), we ensure a seamless transition from "recovering" to "living."

1. Program Philosophy & Interdisciplinary Structure

The core of this program is the "Dual-Site Continuity" model. While PT focuses on the physiological and mechanical aspects of recovery in a controlled clinical setting, OT uses tele-health to translate those physical gains into the client's specific living and working environment.

PT (Clinic-Based): Focuses on manual techniques, high-level balance equipment, and supervised progressive loading.

OT (Virtual): Focuses on "In-Situ" recovery,modifying the home environment, ADL/IADL instruction in real-time, and ergonomic workplace assessments.

ST (Virtual - As Indicated): Addresses post-surgical cognitive "fog," swallowing dysfunction (if applicable), or communication barriers impacting recovery.

2. Clinical Treatment Guidelines

A. Tissue Integrity & Edema Management

Post-surgical healing begins with managing the environment of the surgical site.

Scar Management: PT initiates soft tissue mobilization (STM) once the incision is fully closed. OT provides virtual education on self-massage techniques and silicone sheeting application.

Edema/Lymphedema:

PT: Manual Lymphatic Drainage (MLD) and measurement for compression garments.

OT: Virtual monitoring of limb girth and education on elevation positioning during daily tasks.

B. Pain Management & Wellness

Moving away from a purely pharmacological approach to a multi-modal recovery.

Desensitization: For clients with nerve sensitivity, OT guides the client through sensory re-education using home items (textures, temperatures).

Healing Literacy: Both disciplines educate on "hurt vs. harm" to reduce fear-avoidance behaviors.

Wellness: Integration of sleep hygiene, hydration, and anti-inflammatory lifestyle habits.

C. Mobility, Balance, and Fall Risk

Clinic PT: Focused on gait training, strength, and reactive balance. Transitioning from assistive devices (walker/cane) to independent ambulation.

Virtual OT: Conducts a Virtual Home Safety Assessment. This involves the client moving their camera through their home to identify trip hazards, lighting issues, and the need for grab bars in the bathroom.

Community/Work Re-entry: PT simulates community distances; OT assesses the ergonomics of the client's actual workstation via video call.

D. ADLs, IADLs, and Precautions

This is the primary domain of the Virtual OT, ensuring the client adheres to surgical precautions (e.g., weight-bearing limits, hip precautions) while performing real-life tasks.

ADLs: Toileting, dressing, and bathing using adaptive equipment.

IADLs: Meal preparation, laundry, and light housework. The OT oversees the client performing these tasks in their own kitchen and provides real-time ergonomic corrections.

3. Virtual Speech Therapy (ST) Integration

ST is added if the client exhibits "Post-Operative Cognitive Dysfunction" (POCD); has been in the hospital for a long period of time, or if the surgery involves the neck/throat area. Speech Language pathologists may also work with individuals on respiration needs and managing vocalizations.

Cognitive Rehab: Managing "brain fog," memory strategies for medication management, and executive function for returning to work.

Dysphagia: Virtual swallow assessments and diet texture modification for clients post-intubation or cervical surgery.

Respiration, vocalizations and social communication: Educating clients on managing respiration and endurance to improve vocalizations. Helping clients respond socially during the recovery period.

4. Collaborative Communication Protocol

To ensure the "Interdisciplinary" nature of the program, the following touchpoints are required:

5. Discharge Criteria

The client is ready for discharge when:

Safety: They demonstrate a 0% fall rate in the home and community.

Independence: They can perform all essential I/ADLs within the confines of their permanent restrictions.

Self-Management: The client is independent in their home exercise program (HEP) and scar management.

Functional Capacity: Mobility levels meet the requirements for their specific vocational or avocational goals and home living environment.

Self Management- Demonstrates the ability to use strategies, manage recovery and responsibilities independently.

| Frequency | Action | Participants | | ------------------ | ---------------------------------------------------- | -------------- | | As often as needed | Collaboration regarding precaution progression. | All Therapists | | As often as needed | Joint goal review (Update ADL vs. Physical metrics). | All Therapists | | Monthly | Progress Report to Surgeon/Primary Physician. | All Therapists |

Program Overview

Program Overview

Our post-surgical rehab program focuses on recovery and regaining strength, function and independence in all ADLs. Our OT & PT will coordinate & address the individual's needs, equipment needs and adaptation along with joint protection, body mechanics and pain reduction strategies. ST services may be clinically indicated for post-surgical rehab that impacts speech and language and/or communication.

Post Surgical Rehabilitation Program Script

Post-Surgical Recovery

Services: Physical Therapy (PT) - Occupational Therapy (OT) - Speech-Language Pathology (SLP/ST)

First, I'd like to let you know that at our specialized clinics, we'll provide you with personalized, evidence-based treatment to support your recovery after surgery and maximize your functional independence. This includes neuromuscular strengthening and range of motion restoration, post-surgical pain and swelling management, scar tissue and soft tissue mobilization, postural and movement re-education, gait and balance training, and adaptive techniques for activities of daily living.

Our Physical Therapists will work directly with you in the clinic and Occupational Therapists will work with you virtually using evidence-based post-surgical rehabilitation approaches, such as task-specific training, graded activity progression, constraint-induced movement therapy where indicated, and compensatory strategy development, to rebuild strength and motor control, restore joint mobility, manage post-operative pain, and rebuild the physical and functional foundation necessary for meaningful participation in daily life.

In addition to in-clinic PT, you will receive Occupational Therapy (OT) sessions from the comfort of your home, through telehealth with no need to travel. A licensed Occupational Therapist will guide you on safely performing daily activities with your current level of post-surgical function, implementing adaptive techniques and assistive technology during real-life routines, modifying your home environment to maximize safety and independence throughout your recovery, managing post-surgical pain and fatigue through the day, and reviewing therapeutic exercises and functional strategies to support ongoing recovery within your everyday life.

When clinically indicated, particularly for patients recovering from head or neck surgery, or procedures involving prolonged general anesthesia, Speech-Language Pathology (SLP/ST) services are also available virtually for telehealth. A licensed Speech-Language Pathologist can evaluate and treat swallowing difficulties (dysphagia), voice and communication changes, and post-surgical cognitive challenges such as memory, attention, and processing speed. SLP services are delivered via telehealth for convenience and can be coordinated alongside your PT and OT care for a fully integrated recovery experience.

Our Post Surgical Rehabilitation program focuses on your everyday life, maximizing your independence, preserving function, and improving your overall quality of life across all areas, no matter where you are in your surgical recovery journey.

Benefits of Occupational Therapy via Telehealth for Post-Surgical Rehabilitation

Personalization in your real environment

The therapist will assess your home via video, identifying barriers to safe and independent functioning, such as bathroom hazards, bedroom layout, kitchen accessibility, stair navigation challenges, or difficulties with reaching, bending, and lifting due to post-surgical precautions, joint pain, or weight-bearing restrictions. This allows for personalized environmental modifications and adaptive strategies tailored to your actual living space and post-surgical presentation, something that simply cannot be replicated in a clinic setting.

Education in adaptive techniques, joint protection, and activity modification

You'll learn practical strategies to perform daily activities safely and efficiently with your current post-surgical abilities, such as one-handed techniques and joint protection following upper extremity surgery, weight-bearing precaution strategies following hip or knee replacement, pain-pacing and energy conservation approaches for managing post-operative fatigue, and adaptive approaches to dressing, bathing, toileting, cooking, and home management.

This bridges the gap between clinical gains and real-world function, preserving independence, reducing caregiver burden, and building confidence in navigating daily life after surgery.

Convenience and accessibility

With telehealth, you save time on travel, which is especially critical when transportation is difficult due to post-surgical restrictions, pain, limited mobility, or the use of mobility aids such as walkers, crutches, or wheelchairs. Sessions are flexible, scheduled around your energy levels and availability, and you receive ongoing follow-up in the familiar, comfortable environment of your home, reducing anxiety, promoting consistent post-surgical progress, and ensuring that therapeutic gains translate directly into your daily routines without interruption.

Comprehensive post-surgical management and long-term quality of life support

Includes strategies to manage post-operative fatigue and pain flares (significant factors across all post-surgical recoveries), ergonomic and body mechanics education to protect surgical sites during daily activity, caregiver training and education, assistive technology and adaptive equipment recommendations, fall risk reduction, and tools such as home exercise guides, activity progression logs, and home safety checklists to support routine, safety, and independence.

When swallowing, voice, or cognitive changes are present, SLP services are available to address these needs alongside OT, ensuring truly comprehensive care.