SAKONNET AREA — The sensation of a plush, vibrating toy pressed below baby Marcus' ear tickled him. He squealed and squeezed the toy against his neck, just as any 15-month-old would. The play pleased his physical therapist because bowing his head to the left stretches the right side of Marcus' body, which slouches due to scoleosis.

Marcus Torre was the first of three babies born to Julie and Anthony Torre on Mother's Day, 2002. At 12:13 a.m. Marcus was born, followed by Isabella, and a minute later came baby Wyatt. Crunched for space in the womb, Marcus was afflicted with scholeosis, and his brother Wyatt developed idiopathic scoleosis in his foot, also a result of his prenatal positioning.

Therapist Noni Horowitz holds Marcus Torre during a therapy session. PHOTO BY RICHARD W. DIONNE JR.

Noni Horwitz is the family's physical therapist, assigned by Visiting Nurse Services of Newport and Bristol Counties. Ms. Horwitz has worked with children for over 30 years, and now she works with Marcus and Wyatt each for an hour a week at the Torre's home in Tiverton, within earshot of recess bells at Fort Barton Elementary School.

Over the last five months of therapy, Ms. Horwitz has come to recognize slight asymmetries in the triplets' movements. The therapy she prescribes is individualized and uses what the children know — play. Because it is like play, the therapy is not unpleasant.

"It probably looks like I just play with them, at least from the child's point of view, but I encourage stretching and incorporate therapy into play," Ms. Horwitz said, dipping into her pocket for Cheerios and sprinkling them on the couch. Marcus stretched up from a crouch toward the cereal. This time Ms. Horwitz held Marcus' left foot to the carpet so that he pushed up with his right foot, instead of his left foot like usual.

"Watch," she said, "He always gets up with his left foot first, but if I restrain it, he'll shift his weight and strengthen his other side."

As Ms. Horwitz determines new "games" that encourage even use of limbs, she shows Julie too. After all, Ms. Horwitz only visits once a week, and it's up to the parents the rest of the time.

Ms. Horwitz downplays her part, but Julie, and her parents Virginia and Walter, disagree.

"No, not true! No! ... These home visits are invaluable," Ms. Torre said. Her mother agreed, saying that her help is appreciated and convenient, especially when it takes three or four hours to load all three kids into the family wagon and get going.

Visits help many here

The physical therapists also enjoy the home visits, traveling to as many as seven patients a day. Last year in Tiverton, 280 patients received 6,442 visits from Visiting Nurse Services. Over 1,000 of those visits were from physical therapists and another 400 were from occupational therapists. Of those 1,400 visits, one-third were pediatric patients and the remainder were elderly.

Working one-on-one with patients outside of the clinical atmosphere is just what the doctor ordered. Therapists say entering a patient's living quarters is a personal experience, and the houses they see are as diverse and unique as the personalized care.

From the front porch of a patient's house on Grinnell Street in Tiverton, physical therapist's assistant Tracy Potvin motioned toward the residence and said, "Here, you get the whole picture by seeing their whole house. You are really getting to know the person and their activities of daily living."

Ms. Potvin and her supervisor, Evelyn Sullivan, came to Grinnell Street to work with Barbara Beaulieu, who suffered a stroke this past Labor Day weekend. Often, stroke patients experience cognitive dysfunction, but Ms. Beaulieu was more fortunate — she only lost balance. On leaving the hospital, her doctor referred her to a physical therapist, and, true to their policy, Visiting Nurse Services responded within 24 hours.

Two weeks have passed since her stroke, and Ms. Beaulieu has excercise list stuck to the refrigerator door. Her husband of 23 years, Russell Beaulieu, set about making their home easy to navigate with grab bars and smaller steps. Her physical therapist, Ms. Sullivan, arrives with Ms. Potvin once a week to check on her progress, technique, pain, medications, equipment needs, upcoming doctor's appointments and so on.

"We do an assessment each week to see if their needs have changed," said Ms. Sullivan. "We encourage them, and that makes a difference ... They appreciate us coming and every little thing we do."

So true.

The patients who benefit from the support of Visiting Nurse Services praise the agency's caring nature, no matter how simple or complex the case. From hip replacements, cardiac and pulmonary diseases, strokes and birth defects, physical and occupational therapists help restore people's abilities to lead functional lives. According to Ms. Sullivan, the area of therapy is the fastest growing division of the Visiting Nurse Services agency.

"In the last ten years, I've seen growth of therapy just go gang-busters. Everybody's living longer now. Modern medicine has come so far," Ms. Sullivan said.

Nevertheless, nearly 50 million Americans are disabled, and most Americans will require at least one rehabilitation service at some point in their lives. Although Visiting Nurse services are covered by insurance when initiated by a doctor's referral, sometimes patients contribute a co-pay. Sometimes, services are provided by donations, and to that end, voters at Tiverton's town financial meeting approved a contribution of $10,000 to Visiting Nurse Services, down from $12,000 the year before.

By Chelsea Wonacott-Mershon

chelsea@eastbaynewspapers.com