Outpatient Rehabilitation

Balance disorders can cause a person to feel unsteady, imbalanced, or dizzy and may result in falls. This can occur when the muscles, joint, heart and nerves are not working properly.

Similarly, disruption to the vestibular system can cause dizziness, vertigo, trouble with balance, posture, vision and other symptoms that can interfere with daily life.

Those experiencing the following symptoms can benefit from balance and vestibular rehabilitation:

• Balance issues
• Benign Paroxysmal Positional Vertigo (BPPV)
• Cervicogenic dizziness (headaches that originate from the neck or the spine)
• Concussion
• Dizziness
• Frequent falls
• Gait instability
• Headaches
• Labyrinthitis
• Migraine
• Multiple Sclerosis
• Parkinson’s disease
• Peripheral neuropathy (disease affecting the peripheral nerves and causes weakness, numbness and pain in feet and hands)
• Stroke
• Traumatic brain injury
• Vertigo (feeling like your surroundings are moving or spinning)
• Vestibular migraine (a migraine that may involve headaches in combination with vertigo, imbalance, nausea and vomiting)
• Vestibular neuritis

Balance and vestibular rehabilitation consist of a comprehensive clinical assessment including a detailed history of symptoms and how these symptoms affect daily living.

Treatments for vestibular disorders may include:

• Head position and manual maneuver to help relieve symptoms
• Reduction of dizziness through repetitive movements or exercises that retrain the brain or vision
• Balance exercises to improve strength and reduce risk for falls

Treatment for balance disorders may include:

• At-home exercise program
• Balance retraining exercises
• Fall prevention
• Lifestyle changes
• Patient education
• Stretching and strengthening exercises

Certified Hand Therapists (CHT) at Yale New Haven Hospital are physical or occupational therapists who evaluate and treat musculoskeletal or neurological problems related to the upper extremity, from the hand to the shoulder. Our hand therapists rehabilitate patients through conservative and non-operative treatment options, post-operative rehabilitation and preventative care.

Treatments and services include:

• Adaptive equipment and activities of daily living (ADL) training
• At-home exercise program
• Custom and off-the-shelf splints
• Electrical stimulation
• Fine motor coordination
• Manual therapies
• Scar management
• Sensory re-education/de-sensitization
• Ultrasound
• Work-related assessment
• Wound care

A concussion, or mild traumatic brain injury, disrupts the function of the brain and can be caused by a bump, blow or jolt to the head, neck or upper body. Symptoms range from mild to severe and last for hours, days, weeks and even months. Symptoms include but are not limited to:

• Confusion
• Delayed response to questions
• Dizziness
• Double vision
• Fatigue and drowsiness
• Feeling as if in a fog
• Headache or pressure in the head
• Memory loss
• Nausea
• Ringing in the ears
• Sensitivity to light and noise
• Slurred speech
• Temporary loss of consciousness
• Vomiting

Our skilled therapy team includes physical, occupational and speech therapists who customize treatment based on your specific needs. Concussion therapy aims to:

• Decrease dizziness and improve balance using targeted exercises
• Focused activities to support brain attention, organization and processing
• Guide ‘return to normal’ activities or sports while allowing your brain to heal
• Reduce headaches through hands-on techniques, stretching and eye, motion and strengthening exercises
• Restore strength and endurance through a therapeutic exercise program

Yale New Haven Hospital’s Fall Prevention Program helps patients manage underlying risk factors in order to reduce the number of accidental falls from occurring.

Anyone can benefit from a fall prevention program. Primarily, we treat adults ages 65 and older, those who have poor balance and a history of falls, and individuals with neurological or orthopedic issues that impact mobility.

Fall prevention identifies and addresses many risk factors including:

• Balance impairments
• Environmental hazards (area rugs, poor lighting and clutter)
• Foot problems and unsafe footwear
• Impaired mobility (difficulty walking and moving from surface-to-surface)
• Polypharmacy (multiple medications)
• Postural Hypotension (blood pressure issues with positional changes)
• Sensory deficits (vision, hearing, cognition and neuropathy)

Therapy Treatment for Fall Prevention

Therapists determine and prioritize your risk factors for falls through an evaluation of general mobility and fitness, review of medications and home environment, and assessment of strength and balance.

Treatment will include balance training, strengthening exercises, stretching, postural training and mobility activities based on specific deficits. Treatment may also involve safety education related to vision, footwear, home environment and mobility as well as recommendations for assistive devices and specialist consultations.

LSVT consists of physical, occupational and speech language therapy programs designed to help patients diagnosed with Parkinson’s Disease, multiple sclerosis and those who have suffered a stroke, traumatic brain injury, neuropathy and other neurological disorders. LSVT is provided by certified LSVT practitioners and includes LSVT BIG and LSVT LOUD.

LSVT BIG

LSVT BIG is a physical and occupational therapy program for those with movement disorders, weakness, balance impairments and difficulties with daily activities. The goal is to restore normal movement patterns by learning how to recalibrate movements. LSVT BIG helps improve small motor tasks like buttoning a shirt, or large motor tasks like maintaining balance while walking. It also teaches patients how and when to apply extra effort to produce bigger movements.

LSVT BIG treatment is customized to each patient's specific needs and goals. Treatment can help at any stage or severity of the condition but is most effective in the early or middle stages when the patient can better improve function and potentially slow symptom progression.

Generally, the program is four consecutive days per week for four weeks. Sessions are typically 60-minute one-on-one therapy sessions in combination with daily at-home exercises. The program may be modified based on individual needs. Once treatment is complete, patients are encouraged to continue practicing at-home to maintain new skills.

LSVT LOUD

LSVT LOUD is a speech therapy program that improves communication for daily living by training patients to speak louder and clearer. LSVT LOUD benefits those with Parkinson's Disease and other neurological conditions, including speech issues resulting from stroke or multiple sclerosis as well as children with cerebral palsy or down syndrome. The program includes tailored exercises that strengthen the voice box and speech system. Patients experience improvements in loudness, tone, clarity and facial expressions.

LSVT LOUD includes four 60-minute therapy sessions per week for four weeks and may be modified to accommodate the individual needs.

Lymphedema is swelling caused by the accumulation of lymph fluid in the body. It most commonly affects the arms or legs, but can also occur in the chest wall, abdomen, neck and genitals. A person can be born with primary lymphedema, or secondary lymphedema can develop due to damage to the lymphatic system after surgery, infection, trauma or radiation.

Lymphedema management benefits those experiencing swelling, aching pain, tightness or difficulty moving the affected area. Non-surgical interventions include:

• Compression garments
• Compression therapy
• Education including self-management
• Exercises
• Manual lymph drainage

Lymphedema management also consists of a healthy, balanced diet, weight management and medication as prescribed by your physician. Therapists may provide recommendations to a specialist if needed.

Pediatric rehabilitation services offer examination, evaluation and intervention for children, from birth through adolescence, who are experiencing functional limitations or disability due to trauma, developmental issues or disease.

Yale New Haven Children's Hospital offers outpatient speech language pathology (SLP), occupational therapy (OT), and physical therapy (PT) to infants, children and adolescents.

Learn more about Pediatric Rehabilitation Services at Yale New Haven Children's Hospital

Pelvic health rehabilitation helps restore function to the muscles, nerves, and joints of the pelvis, hips and lower back. Pelvic health rehabilitation is provided by specially trained physical and occupational therapists that treat adult and pediatric patients.

Pelvic health rehabilitation can help patients experiencing the following symptoms:

• Abdominal pain
• Constipation
• Endometriosis
• Erectile dysfunction (ED)
• Inflammation of the bladder (Cystitis)
• Overactive bladder
• Painful intercourse
• Pelvic floor muscle incoordination
• Pelvic pain
• Pre- and post-partum musculoskeletal dysfunction
• Prolapse
• Testicular pain
• Urinary and bowel incontinence

Our physical therapists will complete a thorough evaluation and develop an individualized treatment plan to address each patient’s unique challenges and goals.

Treatment includes, but is not limited to:

• At-home exercise program
• Behavioral modification
• Biofeedback
• Dietary recommendations
• Manual therapies
• Patient education
• Pelvic floor muscle training (PFMT): a common intervention that includes functional exercises to increase muscle strength, endurance, power, flexibility or relaxation of the pelvic floor muscles to alleviate pain and restore function

Pulmonary Rehabilitation is a therapy program that focuses on education and exercises to improve lung function, decrease shortness of breath and increase awareness of chronic lung diseases. It is a program that may be based in a hospital, clinic or in your home with a home care therapist.

Therapy services are recommended for patients with lung diseases who frequently experience shortness of breath, have difficulty participating in activities, or have difficulty caring for themselves due to breathing issues. Patients with the following lung conditions could benefit:

• Asthma
• COPD
• Cystic Fibrosis
• Interstitial Lung disease (sarcoidosis and pulmonary fibrosis)
• Lung Cancer
• Lung Volume reduction surgery before and after a lung transplant

Pulmonary therapy programs may include the following:

• Education on your lung condition, symptoms and strategies to improve function with less shortness of breath (SOB)
• Instruction in breathing techniques, energy conservation, stress/anxiety management and pacing techniques
• Supervised exercise including stretching, light weights, treadmill or stationary bike and balance training
  • Thorough assessment that may include a 6-minute walking test to measure activity tolerance