Botkin Rehab Services, LLC

Progress in neuro rehab isn’t always measured in steps or seconds.

Sometimes it’s measured in half points of courage.

I’m working with a woman who had a stroke last year. Physically she’s come a long way, but the biggest barrier right now isn’t strength. It’s fear of falling.

In the time I’ve known her, she’s had two minor falls without injury. But that fear has taken up a lot of space in her brain and in her body.

Today we worked on standing without holding onto anything. I’ve been trying to sharpen my motivational interviewing skills, so I asked her to rate her confidence with this activity on a scale from 0–10.

She immediately responded, “Zero.”

Not a 2.
Not a 1.
A big FAT ZERO.

I asked her to look straight ahead and stabilize her gaze on the picture on the wall. Then I asked her to shift her weight back and forth between her stronger leg and her weaker leg.

By the end of the session, she had increased her confidence to 0.5/10.

I jokingly told her, “Wow! You’re practically unstoppable now.”

But here’s the thing some clinicians, caregivers, and even patients sometimes miss: confidence can grow the same way strength does — slowly and incrementally.

Half a point matters.

Before I left, I wrote her a little summary and she listed tasks she had already completed that increased her confidence (DEPOSITS INTO THE CONFIDENCE BANK):

Closing the closet door while standing
Wiping dust from a table

That’s evidence her brain can’t argue with.

On the right side of the page, I left a column for withdrawals — events that shrink confidence. Our goal is to keep that column EMPTY.

I also asked her to reflect on the unsupported standing and identify strategies to increase her confidence to 1/10 in the next four days.

In physical therapy, we talk a lot about meeting people where they are.

Today she was at 0.5.

And honestly, that’s a pretty great place to start.

Progress in neuro rehab isn’t always measured in steps or seconds.

Sometimes it’s measured in half points of courage.

Botkin Rehab Services is a Medicare provider and I have difficulty understanding the different "parts" so here's a little cheat sheet for you all.

I am a strong advocate for TRADITIONAL/ORIGINAL Medicare (parts A/B, "the red, white, and blue card) with a supplement. PART C (Medicare "Advantage") used to be called Medicare Replacament and that was a more accurate term. When you enroll in Part C (through a private insurance company), you give up PARTS A/B. While it looks appealing with less upfront and monthly costs and more "benefits", buyer beware.

Medicare Advantage is run by for-profit insurance companies that receive federal Medicare $ to "manage" your benefits. It's all shiny and great until you get sick and actually need coverage for a hospitalization, rehab stay, home health services, diagnostic tests and treatments. Then it becomes a complicated, frustrating process of prior authorizations, denials, appeals, etc.

Next Step Prosthetics of Ohio 🤝 Botkin Rehab Services, LLC- one stop shop for all your prosthetic and physical therapy needs. Tim and I are passionate about serving the limb loss community and we know that when prosthetists and PTs collaborate in real time, the patient reaps the benefits. That's why we share clinical space- come check us out 👀

Meet Tim — Co-Owner of Next Step Prosthetics Ohio and an ABC-Certified Prosthetist/Orthotist with over 30 years in the O&P field. Tim specializes in upper extremity prosthetics but can do it all! Inspired by his sister’s limb loss, Tim is passionate about finding innovative solutions to help every patient achieve comfort, confidence, and freedom.

Once you meet Tim, you are like family! He will go above and beyond to make sure you are comfortable and you will likely hear a joke or two while you are with him!

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🧠💪 Preventing falls with physical therapy results in an average net benefit of $2,144 compared to no intervention. That includes hidden costs like time, pain, missed life events, and the dollars spent on services.

We already know how effective our interventions are — now we have the numbers to back it up. PT for fall prevention isn’t just clinically sound, it’s economically smart.

Let’s keep advocating for increased access and coverage — and keep showing our value.

📢 More at ValueofPT.com

Great research highlighting the importance of older adults participating and being able to access physical therapy services. We improve the health and the economy of this country!

It's Older Driver Safety Awareness Week, and we want to remind all Ohioans about programs available to prevent serious injuries and fatalities among Ohio’s older drivers.

Learn more: https://aging.ohio.gov/driver-safety-2024

I received this beautiful hand written thank you note 2 years ago and it still is a constant reminder of my mission.