Perspectives Summer/Fall 2016

32 • NOVA SOUTHEASTERN UNIVERSITY Physical Therapy TAMPA Fitness Initiative Fights Obesity After Brain Injury BY ANDREA KOUTSKY, FOURTH-YEAR STUDENT PHYSICAL THERAPIST, HYBRID D.P.T. PROGRAM The Florida Institute for Neurologic Rehabilitation (FINR) Wellness Program was established to promote weight loss and an active, healthy lifestyle for clients with various degrees of brain injury living at the institute. As a physical therapy intern at the FINR, I had the opportunity to participate in developing a unique, interdisciplinary team that addresses obesity. Because the population is people with brain injury, we consulted a neuropsychologist to identify appropriate incentives and program duration that would maximize patient adherence. We selected four weeks in order to maintain client interest and to allow for a tangible reward upon completion of the program. Cash-based incentives will be awarded to individuals with the best adherence and behavior during group sessions. The incentives will be bestowed based on greatest participation in the group and individual exercises, best sportsmanship, and most weight loss. In addition, all clients who maintain at least 80 percent participation and compliance throughout the four- week program will be invited to participate in a group day-trip. To be eligible for the program, clients must be ambula- tory, no longer receiving physical therapy services, and have a body mass index (BMI) of 30 or greater. Partici- pation in the program is strictly voluntary. At baseline, we collect the following data: weight, BMI, results of a six-minute walk test, and the Health Status Question- naire—a quality-of-life instrument. The wellness program consists of three main compo- nents: group exercise sessions, individual exercise, and nutrition in-services. Separate boys and girls exercise sessions are held twice per week and led by a physical therapist. They include 30 minutes of generalized endurance and strengthening exercises modifiable to all fitness levels. For the individual exercise portion, clients are instructed to engage in 20 minutes of continuous aerobic activity and a set of specific strength exercises an additional two times per week. A registered dietitian holds nutrition in-services for clients once a week, with emphasis on making healthy food choices. The initial four-week program is still in progress, so out- come data is not yet available; however, participation rates in the group exercise sessions have surpassed 90 percent. Although initially concerned about adherence, clients have shown a sincere interest in making better lifestyle choices in regard to exercise and nutrition. They have expressed good sportsmanship, positive attitudes toward wellness, and a willingness to learn how to incorporate healthy decisions into their everyday lives. As a student physical therapist, I have applied my know- ledge in health promotion, exercise, and brain injury in a way that has positively affected clients at the FINR. n