All about functionality

"We'll perform an evaluation on a patient, whether it's physical or occupational therapy, and determine that a patient has a weakness in one or several muscle groups," said Cmdr. Frank Pearson, head of the Physical and Occupational Therapy Department.

"However, just strengthening muscles does not necessarily translate into improved function for them. We take it to the next level and integrate our findings with what a person needs to do to restore their activities of daily living,"

The department, located near the pharmacy at the naval hospital, has 19 staff members who treat more than 1,900 patients each month.

HM3 James Mills, physical therapy/on the job training technician, monitors YN2 Lesley Bailey and AT1 Mathew Wells during their weekly gym physical therapy. Bailey and Wells are both assigned VP-30.

A patient may be treated anywhere between two weeks to six months depending on the injury. Often there are additional conditions or underlying circumstances which dictate certain patients are seen for an extended period of rehabilitation.

The physical therapists (PTs) work to improve each patient's ability to move and function, but also aid in their general fitness and health. They are specialists in evaluating and treating disorders of the human body by using physical means rather than drugs.

The hospital's orthopedic surgeons utilize therapy services as an adjunct or often as an alternative to patient's having surgery.

When a physical therapist sees a patient for the first time, they will examine them and develop a plan of care that promotes the ability to move, reduces pain, restores function, and prevents disability.

Physical Therapist Theresa Boblel performs joint mobilization on a patient's lower back.

CS1(SW) Terry Jackson is currently a physical therapy patient who had to learn how to walk all over again after a series of operations and medical procedures. His therapy started as an inpatient and continued after he was released.

"At the beginning I didn't think it worked at all for me," said Jackson. "I just knew that I was dependent on nurses and my wife in the Intensive Care Unit and I didn't like it. It's hard not being able to do for yourself and feeling like a burden. As time went by, I started seeing a little progress and with the encouragement of my physical therapist, I started being more independent."

"My biggest challenge was having enough energy and strength to get out of the bed. After being discharged and coming off convalescent leave, I started at the clinic and eventually moved to the gym," continued Jackson.

"Every two weeks I was working on a new program. I'm still not 100 percent, but working on my program every day gets me there."

Therapeutic exercise and functional training are the cornerstones of a PTs treatment at Naval Hospital Jax as well as evidence based medicine (EBM) according to Pearson. EBM emerged as a way to improve and evaluate patient care, according to The Journal of the American Medical Association. It involves combining the best research evidence with the patient's values to make decisions about medical care. Constantly reviewing all available medical studies and literature that pertain to an individual patient or group of patients aids a therapist in selecting the best plan and optimal treatment.

Gerardo Dumlao, a physical therapist technician at Naval Hospital Jacksonville, demonstrates how to perform an exercise as Lt. Joe Estrada watches.

"We're cutting edge here. We have a multitude of modalities and therapeutic tools including photo therapy, traction, manipulation, ultrasound, electrical stimulation, state-of-the-art exercise equipment and exercise regimens for strengthening and conditioning," said Pearson. "We have a tremendous amount of resources used to aid in diagnosing and treating different neuromusculoskeletal conditions."

One of the programs PTs offer is a strength training program at the gym. Patients are transitioned from the clinic to the gym setting to implement advanced conditioning and strengthening programs. Patients learn exercises to support and protect their once injured joints as well as to protect those joints by learning the correct techniques involved with weight and strength training.

"The key to effective strength training is making sure you have a variety in a workout," stated Tonya Sauls, one of the certified PTs in the clinic.

"I teach them the different techniques needed to use weights and to strengthen. There is no one right way to do an exercise, but there are wrong ways. We emphasize on how to properly perform an exercise. We really focus on limiting the range of motion and protecting the joints by using the right position during the actual motion."

Sauls, along with Lt. Jose Dominguez run weekly sessions at the gym. "What we do here in the six months following major surgery takes some of our civilian counterparts at least twice that time," remarked Dominguez. "We're getting our troops back to the deckplates in record time and they return in great physical condition."

HM2 Class Lanita Johnson, a physical therapist at Naval Hospital Jacksonville, works on strengthening National Guardsman 1st Sgt. Ronal Creel's knee.

Within the clinic are also the occupational therapist (OT) and her rehabilitation assistants. Sometimes their area overlaps with the PTs but it is all about teamwork and ensuring that the patients get the best quality care and treatment. OTs help patients perform all types of activities such as caring for those daily needs which include dressing, cooking, and eating. Physical exercises may be used to increase strength and dexterity while other activities may be chosen to improve visual acuity. Their specialty areas involve injuries to the hands and arms, carpel tunnel syndromes, broken bones, fractures, lacerated or cut tendons to name a few.

"You do have individuals who make amazing accommodations, but when you injure your hands there are huge concerns about your livelihood, personal hygiene and feed ability. Simple everyday activities can be impacted by the smallest injuries. Your hands are how you get around your world sometimes," said Lt. Cmdr. Kathleen Ditto, OT and hand specialist. "We deal with injuries for the hands. We make custom-made splints for such injuries and perform wound care. We work at getting people back from their injured state to doing the best that they can in their everyday lives. In general, we are all about functionality."

AEAN Ryan Dillon of VP-30 has been coming to occupational therapy for over four months working on dexterity strengthening on his hand and fingers and is pleased with his progress. "Before I came here I couldn't move my hand at all. I see a tremendous change in my hand," said Dillon as he practices rolling a wooden peg wrapped in Velcro across a board layered in Velcro to add resistance.

HM2 Kurt Porter assists retired Army Supply Sgt. Gloria Cuevas to strengthen her ankle with an ankle isolator.

HM1 Mauricio Salazar said the makeshift equipment is helping him re-educate his muscles to get back to normal.

"We are the only active duty clinic to provide upper extremity rehab services. We provide services to the Kings Bay and Mayport areas and Branch Health Clinic Jax," said Ditto.

Even though they maintain a steady flow of patients, they always ensure they take time to train every week to ensure they are on the cutting edge in order to provide the highest quality care for their patients. There is constant interaction and the morale is very high because everyone is in the decision making process.

"The dynamic care we provide is more of a patient /provider care relationship because we see the patients often and we typically treat them for a least a month. We work very well together as a team in our department and that's important to achieve our goals. I'm very proud of everyone who works here," said HM1 Jose Razo, leading petty officer of physical therapy.

One of the things the clinic prides itself on is that they have one of the highest patient satisfaction rates in the hospital. A big reason for this is because patients are grateful for their experience. Patients are led by a true team of professionals from start to finish and are able to see the fruits of their hard labor and return to improved function. It's obvious that it's a very rewarding process for the therapy staff and their patients.