Specialty Outpatient Programs and Services

Specialty Outpatient Programs and Services Offered
 

San Joaquin Valley Rehabilitation provides outpatient physical rehabilitation services to help patients return to active lifestyles and achieve their highest possible level of function following a disabling illness, injury or surgery.

Services are available by physician prescription and are offered at multiple San Joaquin Valley Rehabilitation sites in Fresno, Clovis and Oakhurst.
A wide range of services are offered including physical therapy, occupational therapy, speech therapy and neuropsychology. A variety of short term therapies, psychological services and interdisciplinary therapy services are provided for people with functional impairments due to neurological or orthopedic injuries, surgeries or disease processes.
In most instances you will need a referral from your physician to schedule an appointment at one of our 5 outpatient locations. We will take care of verifying your insurance benefits and medical paperwork.
Please call 559.436.3670 to speak with our outpatient registration representatives to get started or ask your physician for a referral. 
 

  • Balance and Dizziness Center
  • Hand Therapy
  • Physical Therapy
  • Osteoporosis
  • Brain Injuries
  • Speech-Language Therapy Services
  • Pediatric Speech
  • Supervised Long-Term exercise
  • Aquatic Therapy
  • Female Urinary Incontinence
  • Aqua Moms
  • Mommy Fitness
  • Community Fitness Program
  • Migraine
  • Low Vision
  • Sports Medicine
  • Amputee/Prosthetic Training
  • Migraine/Headache Therapy


Speech and Language Therapy

Speech-language pathology is defined as the study of speech, language, and voice disorders for the purposes of diagnosis and treatment.  San Joaquin Valley Rehabilitation Hospital provides evaluation and therapy by a licensed speech-language pathologist (SLP) to individuals who have had a stroke, brain injury, neurological disease, or post surgery in which their speech and language skills or voice production and cognitive functioning have been affected.   


San Joaquin Valley Rehabilitation Hospital offers the following speech therapy rehabilitation services:

  • Expressive/ Receptive Aphasia – Communication disorder in the area(s) of auditory comprehension, verbal expression, reading comprehension, and written expression.
  • Apraxia – Motor planning/sequencing disorder characterized by difficulty in articulation of speech, formation of letters in writing, or in movements of gestures.
  • Dysarthria – Motor speech disorder which affects respiration, articulation, phonation, resonation, and/or prosody.
  • Cognition – General concept encompassing the various modes of knowing, including perceiving, memory, thinking, judgment, and reasoning.
  • Lee Silverman Voice Treatment (LSVT) is a specialized speech program which restores oral communication in Parkinson patients beyond what pharmacological and surgical interventions can offer. The treatment targets vocal loudness as well as compressive motor organizing. Treatment enables patients to become more effective and engaged in communication.
  • Laryngectomy – Alaryngeal speech options for individuals post surgery.  We offer preoperative consultation, alaryngeal speech therapy, and voice prosthesis management.
  • Dysphagia - Difficulty with swallowing, resulting in aspiration/silent aspiration, (food/liquids entering the lungs), which may develop into aspiration pneumonia. Therapy will decrease the likelihood of individual developing aspiration pneumonia by altering one’s diet, teaching swallowing strategies/postures, and providing a strengthening exercise program. A therapist conducts therapy sessions for those with difficulty swallowing.  We also offer a Modified Barium Swallow Study.
  • Pediatric Speech Therapy Program provides specialized treatment and training of children with articulation and language delays and/or disorders. The program is designed for children who do not qualify for school-based programs.  Goals are created for each child to achieve their maximum potential of speech and language development.  SJVR’s team of professionals provides the family with support and guidance throughout the therapeutic process.

Hand Therapy
The Hand Therapy program at San Joaquin Valley Rehabilitation provides specialized treatment and training of patients with hand and upper/lower extremity injuries. Our goal is to increase function through exercise programs that work on dexterity, motion, and strength.
 
Evaluation and Treatments
A Certified Hand Therapist will evaluate range of motion, strength, sensation, swelling and pain. The therapist will then develop a customized treatment program to meet each patient’s needs by utilizing a variety of treatment methods to address the conditions each patient presents. Treatments include, but are not limited to: Range of motion, strengthening, splinting, sensory re-education, modality and work hardening.
 
Osteoporosis Program
Osteoporosis is a disease of progressive bone loss associated with an increased risk of fractures. The term osteoporosis literally means “porous bone”. The program at San Joaquin Valley Rehabilitation is a comprehensive program consisting of physical and occupational therapy for all patients diagnosed with Osteoporosis.  This includes the patient recently diagnosed with no outward signs of the effects of the disease, to the patient who is showing signs of postural deformity and having difficulty with Activities of Daily Living (ADL) and balance.

For those who have been newly diagnosed or at risk of developing osteoporosis, physical therapy for osteoporosis is one of the best ways to fight this disease. Fortunately there is an opportunity to improve. Therapy for osteoporosis begins with a thorough physical evaluation where the therapist identifies restrictions, imbalances and, specifically, what activities and movements the patient is capable of or is limited to doing. The evaluation serves as the basis for the creation of a customized physical therapy program.

Physical therapy for osteoporosis patients without a fracture includes strengthening exercises and resistance exercises intended to increase bone mass and make bone-supporting muscles stronger to help prevent fractures. Your occupational therapist will teach you about body balance, body mechanics, proper posture, lifting and bending to ease the stress on your bones. They may also recommend helpful tools such as reachers and braces to maximize safety. Lastly, your occupational therapist will assess your lifestyle, home environment and activities of daily living to make sure you can safely do the things you want and need to do.

If you are suffering from a fracture, your therapy will involve specific exercises and other treatment methods to help with pain relief and bone strengthening as well as prevention of future fractures.
 

Female Urinary Incontinence and Pelvic Pain

Accidental release of urine is known as urinary incontinence and over 12 million American are affected by it.  Incontinence is not a disease but a symptom of a problem with the lower urinary tract and affects millions of people, young and old. Typically, urinary incontinence does not cause major health problems, but it can be embarrassing and can affect a woman's self-esteem and confidence. 

This treatment is also helpful after surgery to help strengthen the pelvic muscles. 

Types of incontinence responsive to pelvic floor physical therapy:

 Stress incontinence - urine loss during physical activities that increase abdominal pressure such as coughing, sneezing, laughing, or physical exertion.

 Urge incontinence - urine loss associated with an abrupt and strong desire to void.

 Mixed - a combination of stress and urge incontinence.

 Why does pelvic pain occur?

Pelvic pain syndromes occur for a variety of reasons. Like urinary incontinence, they can be the result of weak pelvic floor muscles, injury, pregnancy, or surgery. They can also occur as a result of muscle spasm, joint instability, or tight structures. Pelvic pain can also be related to low back and hip conditions.

  Components of Pelvic Floor Physical Therapy

 Exercise—Kegel exercises are the beginning of the pelvic floor rehabilitation. These are performed by tightening the muscles of the pelvic floor. These are the muscles you would use to stop urinating, stop a bowel movement, or stop from passing gas. As you progress, you will learn specific exercises to improve the coordination, strength, and endurance of these muscles.

 Mobilization Techniques—Tight structures in and around the pelvic region can cause pain, restrict normal motion, and impair muscle activity. Mobilization of these structures can relieve tension and pain and promote normal muscle and joint function.

Biofeedback—Sometimes, awareness and control of the pelvic floor muscles can be difficult. Biofeedback records the electrical activity of these muscles and provides a  visual or audible signal that will tell you if you are contracting the proper muscles.

 Electrical Stimulation—If exercises and biofeedback are not enough to strengthen the pelvic floor muscles, direct stimulation of the muscles with a mild, comfortable electrical current can cause them to contract and improve their strength.

 Other Modalities—Other modalities such as superficial heat and therapeutic ultrasound may be employed to prepare the tissues for the above therapies.

         The Balance & Dizziness Center
Balance problems, dysequilibrium, vertigo and dizziness are common to the elderly and young alike.  If untreated, these disorders often diminish quality of life and may result in a serious injury.  Balance and Dizziness rehabilitation involves an exercise program designed to decrease dizziness, increase balance, improve visual motor control, increase activity level, and decrease the risk of falls.  The Balance & Dizziness Center is staffed by licensed physical therapists who are registered members of the Vestibular Disorders Association and has special training and certification in vestibular disorders.  Programs are designed individually for each patient.

Diagnostic Tools
The first step in balance and dizziness rehabilitation is to obtain an accurate diagnosis.  The Balance & Dizziness Center employs the latest diagnostic technology, including:

 Vestibular Autoration Test (V.A.T.)
The V.A.T. is a painless vestibular function test that measure the function of the horizontal and vertical canals by measuring the Vestibular Ocular Reflex (V.O.R.).  The Balance and Vestibular Center is the only therapy center in the Central Valley to offer this advanced testing technology.

Neurocom Balance Master
A computerized force plate system that quantifies normal versus abnormal postural sway.  The Balance Master is also a training tool, providing visual biofeedback to the patient to improve movement strategies.  Two key tests performed via the Neurocom Balance Master are:

Modified CTSIB (Clinical Testing for Sensory Integration and Balance).  This test assesses the patient’s ability to tolerate varied surfaces and gives information regarding interdependence of vision, vestibular (inner-ear) and somatosensory systems.
L.O.S. (Limits of Stability).  This test measures the patient’s ability to sway within their base of support.