Recreational Therapy & Adaptive Sports Program At WRNMMC

Recreational Therapy &Adaptive sports Program atWRNMMC2

DisclaimerThe views expressed in this presentation are those of the author(s)and do not necessarily reflect the official policy or position ofWalter Reed National Military Medical Center, the Departmentof Defense, or the U.S. Government.3

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Learning Objectives1. To develop insight into Recreational Therapy & Adaptive Sport and its impact on theservice member’s (SM) mind, body and spirit.2. To develop an understanding of the Wounded Warrior’s spirit & resilience while ontheir road to recovery.3. To develop a clear understanding of how we provide appropriate adaptive programs,modifications and equipment based on the individual’s medical needs.5

Recreational Therapy/Adaptive SportsGoal – To engage patients in treatment and programs that will enhance socialinteractions, community reintegration, cognition, physical health and wellnessObjective(s) Re-establish a sense of purposeMaximize physical function post injuryAssess need for adaptive equipmentEnhance cognitive skillsReintegrate into the community to improve social competence and reduceisolationImprove emotional regulation and patience (self-control)Build relationship skills/trust/confidenceRelax the hyper vigilant survival stateTransition6

Areas of FocusLife Skills Interpersonal Skills - relationships and communication Coping with illness - relapse prevention, stress and anger managementLeisure Skills Adaptive - Physical Fitness, sports and equipment Leisure Education - leisure planning, community resource education, and leisureexplorationCommunity Reintegration Skills Simulated Integration Commissary Shopping Public Transportation Community Navigation Community Accessibility Community Resource Education7

Patient DemographicsWho we serve: US Active Duty Service MembersVeteransDependentsState Department OfficialsNATO coalition ForcesSecretary of Defense DesigneesAverage Length of Stay: 6 months - 4 years8

Mechanisms of Injury BlastsGun ShotThermalAccidentalOccupationalRecreational9

Results from MOI’s AmputationTraumatic Brain InjuryOrthopaedic InjuriesGun Shot WoundsPTS/PTSDMaxillofacial TraumaVision lossHearing lossPsychological10

Associated Signs & Symptoms11

Treatment Tools, Programs and ProcessesInterventions provided: Assessments and evaluationsIndividual sessionsGroup TreatmentCommunity ReintegrationAdaptive SportsAdaptive EquipmentAdaptive Field & StreamCreative Arts & MusicService Dog TrainingRisk Assessment12

Recreational Therapy/Adaptive SportsRisk Assessment is the process where you: Identify hazards. Analyze orevaluate the risk associated with that hazard. Determine appropriate ways toeliminate or control the hazard.Levels of risk: High/Moderate/LowExamples:a. Weather conditionsb. Equipment malfunctionc. Fallsd. Fatiguee. Crowdsf. Exhaustiong. Dehydrationh. Environmental Hazardsi. Altitude Sickness13

Determining Course of Treatment Type of InjuryMulti- Disciplinary ApproachPatient directed goalsTherapist directed goalsPrecautionsProgress OutcomesResources availableComplianceTransition plan14

Recreational Therapy/Adaptive SportsPROGRAMS OFFEREDSkiing / SnowboardingGolfArcheryWheelchair BasketballAir RifleBowlingBrazilian Jiu-JitsuBoxingKayaking/CanoeingFitness TrainingStaff EducationTherapeutic RidingFly-fishingSeasonal ClinicsDay Range ShootsYogaSwimmingSUDS-scuba divingCyclingHuntsTriathlon TrainingSled Hockey15

Spring / Summer Programs16

Fall / Winter ProgramsWRNMMC THERAPEUTIC RECREATIONADAPTIVE Winter 2015 ProgramsEVERY MondayEVERY TuesdayEVERY WednesdayEVERY ThursdayEVERY FridayWEEKENDSBOWLINGBowling CenterBuilding 561300-1430Non-ContactBOXING1000-1200F.A.T.S. Rm B332OutdoorARCHERY1000-1400Ft. Belvoir, VAHORSEBACKRIDING**Every other Thursday0830-1230CommunityReintegrationDC, MD, & VA1030-1600AdaptiveSKIING/SNOWBOARDINGTwo Top AdaptiveAdaptiveCYCLING1300-1500Bldg 226AdaptiveYOGAMATC OT Clinic1200-1300FLY FISHINGMain OT Clinic1200-1300Project Healing WatersAdaptiveYOGAMATC OT Clinic1200-1300SWIMMINGMWR PoolBuilding 171400-1600SWIMMINGMWR PoolBuilding 171400-1600Brazilian JIU-JITSU(Floor Grappling)1330-1500F.A.T.S. Rm B332AdaptiveBASKETBALLMWR Gym1300-1500TuesdayCooking GroupKAYAKINGMWR Pool1600-1800MetroTrainingAdaptiveSCUBAAmerican Building1330-1700TriathlonTraining withharveyCertified Therapeutic Recreation Specialists (CTRS)Interested ? Please see a staff member PRIOR to participatingCara Navarro, CTRSAmerica Bldg—Basement—Room: B332Office: (301) 400–2762 /BB: (202) 374-6891Cara.A.Navarro.civ@mail.milKaren Noel, CTRSAmerica Bldg—Basement — Room: B332Office: (301) 400-0504/ BB: (301)412-2985Karen.R.Noel2.ctr@mail.milAmy Blaszczyk, CTRSInpatient Bldg 9 — Room; 3221Office: (301) 400-2379Amy.M.Blaszczyk.ctr@mail.milAdaptive Sports Rehabilitation ProgramHarvey Naranjo, COTA/LAmerica Bldg—Basement Level — Room: B332Office: (301) 295-8524Harvey.G.Naranjo.ctr@mail.mil17

Monthly Schedule18

Community Re-IntegreationShoppingMoviesService DogTrainingMetro TrainingCooking19

Adaptive Sports20

Adaptive Sports21

Firearms Training Simulation FATS Soldiering TasksSequencing skillsEnhance the weapon handling and firing skillsAssist with developing safety plansBeretta 9M pistol and M4 carbine are actual weapons disabled andadapted with a light bore system installed in each weapon22

Field & StreamAllows the Service member to participate in weapon safety instruction andshooting techniques under the supervision of WRNMMC medical staff (CTRS)as an extension of the patient’s rehabilitation23

Field & StreamProvides adaptive opportunities for wounded warriors to participate inoutdoor sporting adventures Offers Service members, who previously enjoyed the outdoors, as well asthose expressing interest in traditional outdoor sports, are introduced orre-introduced to recreational opportunities on the road to recovery24

Benefits from RecreationalTherapy/Adaptive Sports Interventions25

Benevolent ResourcesAmerican Red CrossUSO - United Service OrganizationsDisabled Sports USAAchilles InternationalTeam River RunnerWounded Warrior Project WWPSemper Fi FundUSA TriathlonVail VeteransChallenged Athletes FoundationRappahannock Bird Dog Club RBDCShenandoah Valley Sportsman Club SVSCChallenge Aspen Military OpportunitiesSoldiers Undertaking Disabled Scuba SUDSYellow Ribbon FundNavy Safe HarborUSA Warrior Sled HockeyHealing Waters Fly FishingCatch A LiftAmerican LegionsUSA Warriors Boxing & FitnessWounded Warrior Outdoors WWOTwo-Top MountainRainbow Riding CenterSalute America Golf Association SMGAStoney Creek Hunting ClubCAMP Paralyzed Veterans of America PVAAmerica’s Fund26

Case Study27

Thank YouWhat You Do Matters!Karen, Cara, and Harvey28

Questions29

Contact InformationKaren Noel, CTRSRecreation TherapistOccupational Therapy Dept.Office: (301) 400-0504 BB: (301) 412-2985karen.r.noel2.ctr@mail.milCara Navarro, CTRSRecreation TherapistOccupational Therapy Dept.Office: (301) 400-2762 BB: (202) 374-6891cara.a.navarro.civ@mail.milAmy Blaszczyk, CTRSRecreation TherapistOccupational Therapy Dept.Office: (301) 400-2379amy.m.blaszczyk.ctr@mail.milHarvey Naranjo, COTA/LOccupational Therapy AssistantOccupational Therapy Dept.Office: (301) 295-8524harvey.g.naranjo.ctr@mail.mil30

Recreational Therapy/Adaptive Sports Goal - To engage patients in treatment and programs that will enhance social interactions, community reintegration, cognition, physical health and wellness Objective(s) Re-establish a sense of purpose Maximize physical function post injury Assess need for adaptive equipment