Outpatient Stroke Rehabilitation

Once you return home after a stroke, you will continue your therapy on an outpatient basis at EvergreenHealth Rehabilitation Services, which provides coordinated physical, occupational and speech therapy in one setting under the care of licensed therapists.

The focus of outpatient rehab is to return you to as close to your previous level of function as possible.

Considering therapy in your home? Here's why outpatient therapy is more intensive than therapy you receive at home:

Getting up, getting dressed and getting in and out of the car to come to therapy provides vital rehab.
An outpatient facility's rehab equipment is also beyond what is available in the home setting.

Getting Started

Outpatient therapy begins with a thorough evaluation. This full hour, one-on-one session with a licensed therapist looks at what's most important to you and helps us customize a rehab plan for each therapy area.

Speech Therapy

Speech therapy covers a wide range of post-stroke challenges, including difficulties with swallowing, issues with speech and understanding, and concerns with cognition.

Swallowing

Swallowing problems can impact your overall recovery from a stroke by preventing you from eating and drinking safely. This can lead to malnutrition and dehydration, and in severe cases, can lead to food entering the lungs.

If you have issues with swallowing, your speech therapist will have you perform a series of swallowing tests that will help them create an individualized treatment plan to help you regain your swallowing skills and show you techniques to help compensate for any lost function.

Speech

Stroke can cause language impairment due to damage to the areas of the brain involved in processing language or due to loss of muscle control and muscle weakness in the mouth and throat. You might be able to speak just fine, but not be able to understand what is being said to you. Or you might understand just fine, but not be able to form words and speak.

Your speech therapist will use a variety of activities to help you recover your speech, learn to speak more clearly, or help you develop new ways of communicating to compensate for limitations caused by the stroke.

Cognition

Cognitive skills are your thinking abilities. It's how you use your brain to talk, read, write, learn, understand, reason and remember. These skills are key to managing everyday tasks and regaining your independence after a stroke. Cognition therapy will help you improve mental abilities and language skills damaged by a stroke.

Your speech therapist will give you a series of tests designed to measure your brain function, and will then work with you to restore the functions that can be restored, and help you learn how to do things differently when functioning cannot be restored to your pre-stroke level.

Occupational Therapy

Occupational therapy helps you relearn skills and activities so you can lead a full and independent life. This can be things as simple as dressing, bathing and doing your finances to more complex tasks such as preparing meals, driving and returning to work.

Your occupational therapist will help you set goals which will be broken down into smaller, more manageable tasks that build your confidence and abilities.

Occupational therapy begins with a multi-page checklist that looks at everything you need to do, and what you need to do it. It starts with basic activities of daily living, such as who will help you dress, who will help you bathe, what equipment you might need in the home, what type of diet you'll need, what medications you'll need and how you'll know when to take them.

Your occupational therapist will also evaluate your upper extremity function, looking for any weakness, loss of sensation, loss of coordination, or loss of fine motor skills.

Your therapist will also ask about your routines, hobbies and home environment to get a better understanding of how to help you. If you worked prior to the stroke, we'll try to get you back to work. If that's not possible, we'll work with you on skills so you can get a different job.

Specialized Programs

Kitchen. Our outpatient rehab facility has an actual working kitchen, similar in design to most home kitchens. Your therapist will take you step-by-step through meal preparation, from reading a recipe and getting the ingredients to cooking and clean up, and offer strategies to help you be successful.

Bathroom. Our facility has a non-ADA bathroom, similar to the bathroom you have at home. Your therapist will help you with strategies to navigate the bathroom with walkers and other assistive devices.

Bedroom. Our bedroom will help you learn to safely get in and out of bed, get dressed with minimal assistance and best organize your home closet for any access challenges. Your therapist will show you how to use reach bars and other adaptive equipment.

Community Safety Assessment. This program evaluates your access to the community, whether that's by driving or using local transportation options such as a bus.

Adaptive Tools. We keep a variety of tools and braces on hand so patients can try them before making a purchase for home.

Rehab Equipment

We have a full range of rehabilitation equipment, some of which are unique to our program and won't be found in other rehab centers.

Computerized dynamic posturography system
Dynavision Light Training Board
LiteGait Treadmill System
GAITRite Gait Assessment Lab
Easy-access exercise bikes, ellipticals and pulley systems
Lift system to aid with walking

Physical Therapy

The main goal of physical therapy is mobility so you can return to your roles at home, in the community and at work. Physical therapy gets stroke patients to use limbs that have been weakened or paralyzed so they can walk, sit, stand, and get in and out of bed, a chair, and a car safely and all on their own.

After examining you and evaluating your condition, your physical therapist will develop an individualized plan to help you work toward goals and achieve the best quality of life you can. Your goals will be broken down into smaller, more manageable tasks that build your confidence and abilities.

For example, your goal may be to play tennis like before the stroke. That's the goal, but that's not what we start with. We'll start with “Can you safely get out of bed? Can you safely go to the bathroom? How far can you walk safely?” All of that would come before we work on the levels of activities you did before the stroke.

How much recovery you will make after a stroke, and how long this takes, is different for everyone. It depends on the amount of damage done by the stroke, on your general health before the stroke, and how you apply yourself to your rehab program.

Our Rehabilitation Equipment

At EvergreenHealth outpatient rehab, you'll be working with your therapist on state-of-the-art equipment. If your movement is impaired, we have standing frames, ceiling lifts and parallel bars to help with balance and mobility – things you would not have in a home therapy program.

Other specialized equipment includes:

MotoMed Movement Trainer. This movement therapy machine combines arm and leg therapy and can be used passively, actively or assisted.
Functional Electrical Stimulation. Mimics the action of healthy muscle to improve function and aid in retraining weak muscles and normal movement in the arms or legs.
Nu-Step Bicycle. The swivel seat makes this arm/leg workout easily accessible to any mobility.
Parallel bars. Helps patients progress in a stationary environment with two hand-holds before progressing to a walker that moves.

Splinting

It's possible for weakness in a limb to develop into other orthopedic issues. For example, weakness in your knee could result in hyperextending the knee, leading to an unstable knee. Your physical therapist will look at what type of splinting might work best, and will help you order and get the appropriate size.

Your Stroke Rehabilitation Care Team

Your EvergreenHealth rehab team will partner with you, your family and your caregivers to help you work toward your rehab goals.

Your team will include doctors and nurses who specialize in stroke rehab, as well as rehabilitation therapists such as:

Physical therapist to help with problems with movement, balance and coordination.
Occupational therapist to help you practice eating, bathing, dressing, writing and other daily tasks.
Speech therapist to help you relearn language skills and also help if you have problems with swallowing.
Neuropsychologist to help you deal with your emotions.
Dietitian to help you plan a healthy diet to help prevent future strokes.
Social worker to help you and your caregivers arrange for the help and equipment you may need at home.

Family Involvement in Therapy

Family support is key for patient success, and we encourage family members to be involved so they can learn about safety issues and understand the rehab plan in order to help with your home therapy program.

We do understand that some patients might not want their family involved. If that's the case, we will respect your choice.

Why choose EvergreenHealth outpatient rehab?

Care by Licensed Therapists. We take pride in providing hands-on, one-on-one care with a licensed therapist for your entire appointment. At most other rehab centers, the majority of your time is spent with aides or personal trainers.
Comprehensive Care. EvergreenHealth outpatient rehab has the benefit of offering all therapies—physical, occupational, speech and physiatry—in the same facility. This means the therapists collaborate to provide care that is individualized for each patient and keeps moving them toward their goals. If a patient is dealing with coping issues, we also offer neuropsychology counseling. If secondary issues develop, such as pain, swelling or incontinence, we can refer directly to other EvergreenHealth programs for care.
Team Approach. With all therapies available under one roof, staff can talk with each other and help point out concerns and offer suggestions. We also make sure that we aren't overlapping services, or neglecting an area of therapy. This might go unnoticed when the therapies are done at different locations.
Monthly Reviews. Therapists from all disciplines meet monthly with our medical director, a physician specializing in rehabilitation medicine, to discuss your progress and decide on the best next steps for you.
Individualized Scheduling. Outpatient therapy schedules are individualized to meet your needs. Have multiple appointments? We'll schedule them for one convenient visit.
Custom Dynamic Splinting. We offer on-site custom dynamic splinting to assist weak muscles or serve as a substitute for absent or significantly decreased muscle power.

Tour Our Facility

Take a virtual tour of our facility at DeYoung Pavilion.

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Our Facility

Rehabilitation Services covers the entire second floor of the DeYoung Pavilion.

The vibrant space is designed to enhance the patient experience and promote well-being, and offers state-of-the-art equipment to make it a high-tech as well as high-touch rehab center.

The DeYoung Pavilion is located on the southwest corner of the EvergreenHealth campus. Free parking is available in the surface lot or in the underground garage, which has direct access to Rehabilitation Services.

To Begin Outpatient Rehabilitation

You will need a physician referral for outpatient rehabilitation. Ask your provider to complete and sign our referral form [PDF]. You can drop off the referral form at our office or fax it to (425) 899-3670.