Customer

COS believes in a client-centered approach, catering to the needs of the individual client. Accordingly, all treatment programs are different, as they correspond to the goals set by the client in consultation with the rehabilitation team. COS serves a range of clients from various cultures, all having different rehabilitation and lifestyle needs. To meet the full range of client needs, we provide a team of highly trained professionals including physiotherapists, occupational therapists, kinesiologists, physicians, dieticians, insurance consultants, and Ministry of Health representatives. We also accept referrals from outside health care professionals.

Why Choose Us?

Goals of Our Practitioners

The rehabilitation team at COS consists of highly qualified professionals who believe in delivering client-centered care to individuals based on their specific needs and goals. The team jointly determines the best treatment plan for the client, coordinating interdisciplinary needs with the client and his or her family. The rehabilitation specialists at COS believe not only in treating the condition, but also in educating and empowering clients and giving them ownership of the rehabilitation process. COS rehabilitation professions work together, seamlessly providing treatment, preventing re-occurrence, and maintaining current function.

Private Practice Occupational Therepist

Occupational therapists are essential in any rehabilitation process. But, if they work in isolation, without the support of a multidisciplinary team such as ours, some client needs outside their scope of practice may go unmet. COS can provide highly educated rehabilitation assistants (RAs) and kinesiologists to help meet the needs of OT clients at private facilities. The kinesiologists and RAs will work under the direction of the occupational therapist, keeping accurate and records of appropriate outcome measures. This allows the team of rehabilitation professionals to monitor and evaluate progress and make any needed adjustments to the client’s program.

COS will take care of billing insurance providers and fee payers to ensure no work is added to the load of the private practice occupational therapist.

Insurance Companies

• Billing Information
• MSP Plan and Insurance Provider
• ICBC Rates
• WCB Rates

Physical Therapists

The body is made up of hundreds of bones and joints with corresponding tendons and ligaments that work in balance to maintain body mobility and function. After sustaining an injury or illness, the body may no longer work in a coordinated way, necessitating special treatment to regain mobility. A university-trained, licensed physiotherapist works one on one with the client to restore function and mobility. The physiotherapist helps the COS rehabilitation team assess and diagnose musculoskeletal conditions. Based on a thorough orthopedic assessment, the physiotherapist will develop a treatment plan aligned with client goals. The physiotherapist aims to decrease pain and restore function, allowing the client to resume activities affected by the injury. Using various treatment modalities, manual techniques, education, and therapeutic exercise, the physiotherapist aims to restore the client to pre-injury status or better, so he or she can return to work and normal activities as soon as functionally able. The physiotherapist will prepare the client by simulating normal activities with work- and activity-related exercises; these help prevent re-occurrence of injury and allow for smooth resumption of normal activity patterns.

Services

Therapeutic Exercises

What are therapeutic exercises?

Therapeutic exercises are carefully designed and selected by the physiotherapist to accommodate the client and his or her injury. These exercises are designed to restore function, increase strength and range of motion, and decrease the risk of re-injury.

How do the Exercises Work?

The exercises are introduced progressively, first orienting the client to the movement and only then gradually increasing the intensity level. As the as the individual improves in strength and range of motion, the exercises become more functional and can simulate work- and activity-related movements for efficient body mechanics and posture.

Manual Therapy

Soft Tissue Therapy

What is Soft Tissue Therapy?

Soft tissue therapy is a broad category of techniques for tissues such as muscle, ligament, and tendon and includes such areas as trigger point techniques, myofascial therapy, massage therapy, friction massages, and other specialized techniques. Therapists uses their hands or specialized instruments to address clinical abnormalities such as increased muscle tone, trigger points, abnormal or delayed healing, and degeneration.

Joint Mobilization

What is joint mobilization?

Mobilization consists of small passive movements applied as a series of gentle stretches in a smooth, rhythmic pattern to individual joints or vertebrae. Pressure can be applied at various positions depending on the condition. The goal of the treatment is to relieve movement restrictions, decrease pain, and restore range of motion. Different degrees of pressure can be applied depending on the specifics of the injury: gentle mobilization is used for sensitive or acute patients; slightly stronger grade-two mobilization is administered for pain relief; grade-three mobilization is applied for pain relief and to improve range of motion in stiff joints; while grade-four mobilization is for stretching tight tissues and restoring motion in more chronic conditions. Mobilization is performed slowly and one can ease up on the pressure if it becomes uncomfortable for the patient. It is excellent for the elderly because it is a safe and gentle alternative to joint manipulation.

Joint Manipulation

What is Manipulation?

Manipulation is passive grade-five mobilization involving a high-velocity thrust movement to restore passive range of motion and decrease musculoskeletal pain. This technique is only used on chronic conditions as it is more aggressive. The technique uses of force-time phases and produces an audible clicking sound caused by changes in joint pressure. Both spinal manipulations and vertebral manipulations should only be performed by qualified professionals who have undergone proper training and certification.

Visual Gait Analysis

What is Visual Gait Analysis?

Lower body impairments can alter the kinetic chain, affecting gait and coordination. By observing posture and gait, the physiotherapist can determine what orthopedic conditions are affecting the client and the compensation patterns made in response. Identifying posture and gait problems allows the physiotherapist to correct faults in alignment or provide aids that will help the client improve walking skills and mobility.

Education

Why Educate the Client?

Educating clients about their condition or injury empowers them and makes them part of the rehabilitation process. When clients understand what is affecting them, they can work to develop adaptive methods and become more independent in their daily lives. Education builds understanding, which gives clients the confidence to return to activities sooner and recover faster.

Modalities

Ultrasound (US)

What is ultrasound?

Ultrasound is produced by applying an AC current to a quartz crystal. The current causes mechanical deformation of the crystal, creating oscillation that produces an ultrasound pressure wave. Ultrasound is administered using a round-headed wand applied to the skin over the affected area. Physiotherapists use a gel to reduce friction and facilitate the transmission of ultrasonic waves through the skin. A typical treatment uses a frequency in the range of 1 to 3 MHz.

How does it work?

Ultrasound is a used by physiotherapists to promote tissue relaxation, increase local blood flow, and break down scar tissue. Ultrasound offers thermal and non-thermal effects, both of which are useful. The non-thermal effects of US are cavitation and microstreaming. Cavitation is the tiny expansion and contraction movements of the body’s cells produced by the US vibration. Microstreaming is the movement of fluids around these vibrating bubbles resulting in microscopic changes at the cell level. This allows for the breakdown of scar tissue and tissue regeneration. The thermal effects of US are increased blood flow and increased collagen elasticity. Increased circulation helps the body bring blood cells and nutrients to the injury site, to break down scar tissue and repair injured tissues.

Inferential Current (IFC)

What is IFC?

IFC treatment is commonly used to treat muscle or ligament injury, stress incontinence, acute and chronic swelling, spinal cord lesions, circulatory disturbance, denervated muscles, and muscle spasm; it also improves circulation and promotes wound healing. The inferential current produces a medium-frequency stimulation current of around 3000–5000 Hz between paired electrodes placed on the skin. The two electric currents alternate and work together to inhibit transmission of pain signals at the spinal cord level.

How does it work?

IFC stimulation reduces skin resistance and allows for vibration of the soft tissue. The frequency range of the current has the ability to stimulate an innervated muscle, cause short-term analgesic effects, increase blood and lymph flow, and increase tone in the tissue and blood vessels. IFC can stimulate specific nerve fibres using different frequencies and pulse durations to block pain or stimulate sensory and motor nerves. The IFC device comprises two sets of four electrodes, with or without suction applicators, which create a field around the affected area. A physiotherapist will use different frequencies depending on the diagnosis.

Neuromuscular Electrical Stimulation (NMES)

What is NMES?

NMES is the electrical stimulation of a muscle to help build muscle strength and overcome inhibition by stimulating the alpha motor neuron. NMES is commonly used to retrain neuromuscular function after muscle inhibition, strengthen muscles after injury or surgery, reduce edema, stimulate denervated muscle, train pelvic floor muscles to alleviate urinary incontinence, and treat neurological conditions.

How does it work?

NMES is used to generate a muscle pump contraction. The goal of NMES after muscle inhibition is to stimulate the muscle and facilitate the patient’s own active contraction by creating the sensation of contraction. NMES is done using a small portable device with 2–4 electrodes. The pulse duration is longer than those of TENS or IFC so as to selectively stimulate motor nerves. The intensity of the contraction, which is controlled by the NMES pulse rate, contraction time, and ramp on and off time, is determined by the goals and needs of the patient.

Transcutaneous Electrical Nerve Stimulation (TENS)

What is TENS?

The TENS unit consists of electrical signal generators and electrodes. The electrodes deliver a pulsed current stimulus varying in strength, pulse rate, and pulse width. Amplitude is generally controlled at a low level just above or around patient threshold depending on the desired effect. Electrodes are placed on the skin over the painful area. An analgesic effect usually begins at the onset of stimulation but generally abates after removal of stimulus.

How does it work?

TENS works through inhibition at the presynaptic level, whereby low-threshold stimuli inhibit the propagation and transmission of pain signals. The analgesic effect can be explained by the gate control theory. When pain sensation is felt, the information carried by the C fibres reaches the T cells and opens the gate, transmitting pain to the thalamus and cortex. When the TENS device sends impulses to the myelinated nerve fibres, this inhibits the C fibres and temporarily closes the gate. TENS is also believed to reduce pain by stimulating the release of endogenous opioids at the spinal cord level. Like IFC, the TENS device also has the ability to stimulate specific types of nerve fibres.

Mechanical Traction

What is Mechanical Traction?

Traction therapy is based on the application of longitudinal force to the axis of the spinal column. Traction uses manual or mechanical forces to stretch and mobilize the spine. The traction force has the ability to lengthen tight spinal muscles that may be in spasm, mobilize soft tissues and joints, increase the space between intervertebral foramen, thus relieving pain associated with nerve impingement, as well as reduce herniated intervertebral discs.

How does it work?

Traction therapy is most commonly used for cervical spine instability. It is effective at realigning the cervical spine if it is dislocated or misaligned due to trauma or disease. The duration and force of traction depends on the individual. The goal of traction therapy is to reduce pain and increase function. Traction may be applied continuously or intermittently, and the exact regime used depends on the condition involved and the area of the spine under compression. A mechanical traction device uses a head halter with an over-the-head pulley system. Individuals with osteoporosis, rheumatoid arthritis, tumors, or infection in the cervical spine should abstain from using mechanical traction as a treatment option. Pregnant women and individuals with hernia or cardiovascular disease should also be excluded from mechanical traction treatment.

Hot & Cold

Heat: How does it work?

Physiologically, heat therapy produces metabolic, neuromuscular, haemodynamic, and connective tissue effects. Metabolically, heat increases the rate of chemical reactions, which increases cell activity, promotes cell growth, and increases the availability of oxygen. Haemodynamically, the heat increases temperature, causing increased dilation of the blood vessels, which allows the transfer of heat away from the injury. Heat also increases nerve conduction velocity, which is thought to reduce muscle spasm. Heat can cause a reduction in pain as well as promote soft tissue healing.

Cold: How does it work?

The application of ice to an injured area promotes healing in several ways. It helps increase blood viscosity, which decreases blood flow to an area, thus limiting swelling and inflammation. Cold also reduces nerve conduction velocity, minimizing the sensory and motor nerve sensitivity and limiting pain. Cold also slows the metabolic activity of the cell, reduces cellular oxygen requirements, and reduces the rate of chemical reactions. It is also postulated that ice helps limit secondary cell death immediately after an injury.

Special areas

Sport Physiotherapy

What is sports physiotherapy?

Sports physiotherapists have been trained in postgraduate courses designed to deal with athletic injuries. Or: Sports physiotherapists have received graduate-level training giving them specialized expertise to treat athletic injuries.

Sports physiotherapy aims to help the athlete operate at peak performance levels using up-to-date injury prevention and rehabilitation techniques. A range of treatments is used, including manipulation, massage, electrical stimulation, tapping, first aid, heat treatment, exercise prescription, ultrasound, cold application, and acupuncture. Treatment involves assessing and evaluating the strengths and weaknesses of the athlete and devising an individualized conditioning program to correct injuries, muscle imbalances, poor posture, or any other weak link in the kinetic chain. A sports physiotherapist is effective at preventing sport-related and overuse injuries, alleviating such injuries should they occur, and providing ongoing conditioning to prevent recurrence.

Women’s Health

What is Women’s health?

Physiotherapy can be helpful for a variety of medical and health conditions that specifically affect women, enhancing health in all stages of life. Some of the common conditions treated include osteoporosis, incontinence, fibromyalgia, dysfunction associated with child-bearing, pelvic floor pain, and lymphedema after breast surgery. Women face many health conditions associated with reproduction and aging, and a trained physiotherapist who specializes in women’s issues can design a treatment program tailored to the individual.

How can physical therapy help?

Physiotherapy can be very beneficial for the pregnant or post-partum woman. Because several dramatic changes occur in the musculoskeletal system during pregnancy, childbirth, and the postpartum period, it is important to understand what is happening to the body. Changes in posture, weight, and hormones can alter body biomechanics increasing susceptibility to injury and orthopedic problems. Certain lifting and twisting movements can cause trauma to the joints and spine. Pregnancy is often associated with back pain, pelvic pain, sensory changes in the legs, weakened bladder control, and sacroiliac dysfunction. A strength and postural assessment by a physiotherapist is a necessary step in designing an exercise program to prevent these conditions from occurring or to reduce pain that may already be present. After birth, weakness in the muscles of the pelvis and back can cause incontinence and back pain. A physiotherapist can help patients improve abdominal strength, increase strength and control in the pelvic floor muscles, adjust to posture change, deal with potential scarring and incision discomfort, and increase energy for everyday activities.

Vestibular Rehabilitation

What is Vestibular Rehabilitation?

This is a specific treatment developed to help individuals with vertigo, dizziness, and a sense of imbalance. Problems associated with dizziness and balance develop from the vestibule of the inner ear. Balance is controlled by the vestibule, working together with vision and sensation.

How does it work?

Several different techniques are used to treat dizziness and balance disorders, and a physiotherapist will individualize the treatment depending on the condition. Treatments include balance retraining, motion tolerance exercises to adapt the brain to specific movements, oculomotor exercises to improve coordination between the eyes and brain, and Epley maneuvers applied for vertigo.

Additional Rehabilitation Services

• Athletic Taping
• Equipment Rentals (Coming soon)
• Acupuncture (Coming soon)
• Massage (coming soon)

Kinesiologists

After completion of a rehabilitation program and discharge from physiotherapy it is important that the client continue with exercises to maintain their functional status. Maintenance is the key to preventing injury recurrence and is therefore essential to the rehabilitation process. For individuals needing ongoing guidance with their exercise programs, our university-educated kinesiologists will assist at a local fitness facility. The kinesiologist will communicate with the physiotherapist and develop an exercise program incorporating the rehabilitation needs and fitness goals of the client. This ongoing exercise program will improve client independence and contribute to an active, healthy lifestyle.

Physicians

For direct medical needs and medications, our site physician can support you throughout the rehabilitation process. The physician will consult with the rehabilitation team to establish a diagnosis and address the medical needs of the client.