Are you looking to recover from an injury in a safe and supported manner but don’t know how to go about it? Are you unsure about timelines, who will be treating you and what goals you should be making?
Well, you’re in luck, many of these questions can be answered in a treatment plan created by you and your rehabilitation clinician. For the purpose of this blog, I’ll focus on the creation of a treatment plan by a kinesiologist for the purpose of active rehabilitation.
What is an active rehab treatment plan?
A treatment plan is a structured plan either written in a document or discussed verbally that outlines the course of treatment for you, the client. The treatment plan is typically created by healthcare professionals such as doctors, nurses, psychologists, and therapists. The purpose of a treatment plan is the creation of a personalized roadmap for your care, including goals, interventions, and evaluation measures.
Why is it important to have a treatment plan?
Having a treatment plan is a necessary part of active rehabilitation because it ensures that you get the most specific and targeted care for your needs. Having a direction and outlining specific interventions to meet your goals makes it more motivating to get better and improves the overall success of the treatment. Treatment plans are also used by account managers and case managers of insurance companies such as RBC insurance and ICBC to stay on top of a client’s progress and coverage.
Anatomy of an active rehab treatment plan
1. Assessment
The starting point of any good active rehab treatment plan is the initial assessment. Usually an hour, the assessment allows the clinician to get a snapshot of your goals, abilities, and limitations.
Assessments include a ‘discussion’ portion where the clinician will ask questions about your health history, in the case of active rehab, which areas are bothering you, and what your day-to-day routine is like. For example, the clinician might ask about sleeping habits, participation in recreational activities and if you are able to perform activities of daily living like laundry, self-care, or cleaning dishes.
Then comes the ‘moving’ portion of the session. Here the clinician will look at how you move and the range of motion you have. Range of motion refers to the extent of which a joint can move in various directions. If the client comes in with a shoulder injury, the clinician will measure the range of which that shoulder can move with a tool called a goniometer (this looks like a large protractor with arms) and compare the range with the unaffected shoulder and normative data for a healthy individual. Most often used for the assessment of musculoskeletal injuries, limited range of motion leads to functional impairments in our day-to-day, so clinicians make sure to include improving functional range of the affected joint as focus in their treatment plans.
In addition to joint measurements, the client will also be led through a series of functional movement exercises related to their injury/goals. Examples of this are squats, pushups, single leg balance, plank holds, and glute bridges. Although these exercises may seem simple in nature, they are the building blocks of many of the actions we do at home. We need to squat to sit down on a chair, bend down to play with our kids and have good balance to reduce falls.
Having an assessment is really important because it provides a starting baseline for treatment and highlights areas that need to be worked on. If we don’t know where we are, we don’t know where to go!
2. Goals
A goal is a specific and measurable outcome that you will be able to complete in a certain timeframe. Goals are a focus in treatment plans because they provide motivation, focus and direction when it comes to recovering from an injury.
Specific types of goals that are often used in the rehab setting are performance and process goals. Performance oriented goals are linked to meeting a certain standard. This can mean being able to lift a certain weight such as squatting with 20 pounds for 10 repetitions, or walking a certain distance without pain.
Process oriented goals are the least intuitive but arguably the most important. Process related goals help set you up to achieve your performance and outcome goals. An example is completing meditation at 8am on Monday and Wednesday each week to help with pain relief. This type of goal is something that we have the most control over in our day-to-day lives.
In some cases where rehabilitation takes longer than expected, micro goals act as stepping stones along the way. Completing goals in our treatment plans are a chance to celebrate, but also a time to re-evaluate a new baseline. Are you not meeting your goals? That’s okay! It might mean that a different approach or reflection of current efforts is necessary.
3. Intervention
This is the main bread and butter of the plan. Based on the initial assessment, the client and the clinician will work together to find an appropriate behavior change and treatment as an approach that will reach the client’s goals in the most effective and targeted manner.
An active rehabilitation intervention includes:
- how many times you will meet with the kinesiologist/week or month, how long the sessions will be
- what techniques will be used to address your issue: what ratio of resistance training, Flexibility, or Relaxation and mindfulness training will be the most effective?
- where the client will meet with the kinesiologist (in the gym, in the pool)
4. Re-evaluation
We can’t forget to stop and pause to look at how far we’ve come and re-assess if the chosen intervention is helping. The re-evaluation is a simplified version of the initial assessment where the kinesiologist will review the client’s goals, progress, and symptoms.
The re-evaluation sets a new baseline. To do this we celebrate our wins to date and modify components of the plan that are not as effective or are now redundant due to improvement in symptoms. Re-evaluation usually happens in units of 4-6 weeks of our initial assessment which should be enough time to see some measurable progress. Questions asked during a re-assessment are: Do we continue as planned? Are there parts to remove or modify? Is the client ready to graduate from the program? Can we push the envelope further?
Take a peek into the back end: ICBC active rehab treatment plans
Treatment plans are not only for you and your kinesiologist. If you have coverage from ICBC after a motor vehicle accident, regular treatment plan updates are required to continue treatment. After a car accident, you are allotted 12 sessions of kinesiology that are pre-approved within the first 12 weeks of the crash. If further treatment is required, your clinician will write up a treatment plan and send that in to ICBC for session approval.
This treatment plan will include your improvements with treatment to date, your current functional limitations, your goals, and what further progress will be made with additional sessions.
Collaboration with other health professionals
With your consent, written treatment plans are also really great ways to connect with other medical professionals on the client’s health team. Collaborations with physiotherapists, doctors, and psychologists makes treatment the best it can be for you. Keeping all of the health practitioners in the loop creates a streamlined approach on all fronts and because each practitioner can provide insight to the plan based on their expertise.
I have an active rehab treatment plan, now what?
Great work on coming this far already. You’ve created a baseline and have worked together with your kinesiologist to create solid goals and a plan of action. Now it’s time to get moving! When you work with a kinesiologist you’ll be participating in active treatment which means you’ll be taking initiative and responsibility for making changes in your movement habits. Your kinesiologist will be with you every step of the way with guidance and support so that you can stay consistent and recover with ease.
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