News From Terre Haute, Indiana


March 15, 2012

Relieving Pain

Indiana State professor, students expand rehabilitation services at St. Ann Clinic

TERRE HAUTE — After nearly three decades at jobs that kept him on his feet for entire shifts, Michael Shots developed pain and numbness in his right thigh that wouldn’t go away.

Now, after just two visits to the orthopedic rehabilitation center at Terre Haute’s St. Ann Clinic, the 50-year-old Clinton man is on his way to becoming pain free.

“I started feeling better after the very first treatment,” said Shots, a fast-food worker, who was previously employed at the U.S. Army’s former Newport Chemical Depot.

At St. Ann, Timothy Demchak, an associate professor of applied medicine and rehabilitation at Indiana State University, and David Roos, a junior athletic training major at ISU, work with Shots on stretching and other exercises to help relieve the numbness.

Shots, already undergoing treatment at St. Ann for a lung ailment, was pleased to learn the facility, an outreach of the Sisters of Providence, could also address his leg problem.

When Demchak began providing rehabilitation services at St. Ann, he knew the need was great. Graduate students conducted a study that documented that need and helped land a Focus Indiana grant, funded by Lilly Endowment and administered by the university’s Center for Community Engagement, to provide rehabilitation services at the clinic.

The rehabilitation center opened in February 2010 and patients haven’t stopped coming – and not just from Terre Haute, but from throughout the Wabash Valley. In fact, their ranks have only increased as word spread about the free services Demchak and his students provide to help make aches and pains go away.

Those services range from exercise regimens to help relieve strained muscles and put slipped discs back into place to laser therapy that has proven effective for a variety of ailments. Demchak treats about 85 percent of his patients with the Graston Technique, which uses stainless steel instruments to stimulate muscle healing.

During its first year of operation, the physical therapy unit at St. Ann recorded about 200 patient visits. Last year, that number shot up to 800 and Demchak secured additional Lilly Endowment funds to expand services from one day a week to two days each week.

That initial $8,000 grant Demchak obtained in 2010 has now been renewed twice. A separate $8,000 grant from a local foundation provided funding for equipment. By the end of 2012, it is very likely those grants, which add up to $32,000, will have provided for a total of 2,000 patient visits, he said.

Patients, lacking insurance, are the unemployed and working poor who struggle just to make ends meet, let alone tend to even basic health care needs, Demchak said.

“These patients have nowhere else to go,” he said, “and (therapy) is important to recover from an injury. The sooner we start the rehabilitation process, the sooner they’ll get better. It will prevent further injury and permanent changes in the body.”

Not only are patients coming for treatment, they’re coming back to continue that treatment once they find how effective it can be. The 82 percent “show rate” for patients of Demchak and his students compares with an average of 50 percent for patients of most free clinics, Demchak said.

“So once we get them in the door and get working with them and they start doing better, they keep coming back to finish up their rehab programs,” he said.

It’s not just the patients who benefit. Indiana State students, particularly those majoring in athletic training, see patients who are older and who have different health problems than the 14-to-22-year-old athletes for whom they have traditionally cared.

The patients’ health problems are often the result of decades of unhealthy lifestyles, including obesity, smoking, diabetes, and drug use, Demchak noted.

“It’s a great experience. I’m learning so much more working with Dr. Demchak and seeing different types of injuries I wouldn’t see if I was dealing with the college athletic population,” Roos said.

Patients, medical staff and ISU students all benefit from the clinic’s inter-professional approach, said Karen Smith, family nurse practitioner at St. Ann.

“We have many patients who have musculoskeletal problems. Rehabilitation therapy goes hand-in-hand with medication in strengthening muscles, strained ligaments and tendons,” she said. “It’s exciting to have us both under one roof.”

Smith said she and Demchak can refer patients to one another and develop a coordinated care plan. Patients also benefit by not having to schedule additional appointments at another location.

While many questions remain about implementation of health care reform legislation, Smith and Demchak agree the demand for free clinics such as St. Ann will likely continue to grow.

“With the economic problems we have right now, I do not see patients saying, ‘Hey, I got my job back, I got my health care back.’ What I hear is, ‘I lost my job. I lost my insurance. My husband lost his job. I lost my health care’ or ‘I’ve been without my medicines for a year and I didn’t know there was a place like St. Ann’s to come to,’ ” Smith said.

Volunteers at the clinic include physicians, physician assistants, nurses, pharmacists, athletic trainers and dentists — all of whom work together to treat the whole patient.

The inter-professional approach is one Indiana State students are getting to know, Demchak said.

“On campus, we have students from different disciplines take classes together. Our senior athletic training students are taking classes with master’s students in physician’s assistant studies. We’re trying to combine different majors into one classroom to help them understand one another and what each one does.”

Nancy Rogers, associate vice president for community engagement and experiential learning at Indiana State and director of the university’s Center for Community Engagement, said the rehabilitation clinic at St. Ann demonstrates how powerful community collaborations can be.

“Through a relatively modest financial investment from the university, an investment of space and staff support from St. Ann, and an investment of time from ISU faculty and students, the quality of life of many patients at St. Ann has been dramatically improved,” she said.


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