First blog post

Here Goes Nothing.

 

The reason for starting this blog is very simple. I think my fellow Doctor in Physical Therapy students need to be informed.

The idea for a blog throughout PT school has been on my mind since I began the coursework back in August, because I have always had a blog of some sort. During my first year, I am technically a second year student now, I saw hardships, joys, and even successes and failures that many other students go through not unfamiliar to our predecessors. The big issue I saw was that as students we do not fully understand our own capacity to make change. Many students feel that if they speak up on issues they may be reprimanded, afraid to ask questions for feeling inferior to others, or even lack the motivation to be active in the profession of Physical Therapy. Let me be clear, these are not problems. These are normal reactions to being in a graduate level program. The purpose of this blog is to hopefully shed some light on some of the topics and maybe controversies I have encountered and act as a resource for others who may be in a similar boat.

I hope to have this blog as a resource for learning materials, insights into dealing with PT school, and as well just be informative to many of the issues I and the profession are facing and will face. I hope to do this with my own writings, questions and submissions from clinicians, and lastly a video series I am calling PT Talks.

Group Exercise for Patients with Parkinson’s Disease

Moving away from tradition is considered an exciting thing within the realm of physical therapy. Especially now, we have more evidence geared towards outcomes of treatment and their overall effectiveness. One innovative idea is that individuals diagnosed with Parkinson’s Disease (PD) need a different type of treatment than standard physical therapy.

Anna Knorr discusses an idea she had about the management of people diagnosed with PD during some of her clinical experiences. Anna discusses how the use of group exercise classes (including but not limited to Tango, balance training, etc.) in conjunction with treatment from a physical therapist can be used to increase a patients functional outcomes. She also touches on the benefits of having a new and exciting treatment activity to help patients with the psychological aspects of their disease.

We as physical therapists are psychologically inclined when treating patients because of the amount of time we are spending with them. We are known for this! What I want to point out is that we often do not use this to our advantage in treatments.

I think we can offer more to our patients by forming a relationship with them. What this allows us to do is know our patient so well that we can determine best treatment. That was Anna’s point. Figuring out what treatments most positively affect a person’s overall health. This includes measures of functionality we use day-to-day, psychological measures, and other things like nutrition. Offering a program like Anna is discussing addresses all those aspects of health.

Group Exercise for Patients with Parkinson’s Disease

Proprioceptive Neuromuscular Facilitation and Gait Outcomes

Nick Weiss, a second year in my DPT class, presented on proprioceptive neuromuscular facilitation (PNF) and how it influences gait outcomes.

Nick did a great job not only describing what PNF is, but also outlining how it is beneficial to patients who need gait training. Nick emphasized that some outcomes and treatments we use as physical therapists only focus on one perspective of a patient’s health. For myself, this was a big take-home point. He discusses and outlines how the future of health outcomes should be divided into 4 major categories: heath behaviors, clinical care, physical environment, and social and economic factors.

Scope of practice may limit a healthcare providers ability to directly address all 4 of these categories. Specifically, changing a patient’s social and economic factors is often out of our hands as physical therapists. I do think it is important as future or current practicing clinicians that we at least try to address the other 3/4 factors, and have an awareness of social and economic barriers.

Clinical care is the easiest to control in that it stems directly from the clinician. A clinician is responsible for staying up-to-date on current best practices, evidence-based treatments, and overall new healthcare changes. Health behaviors can be tricky, but at the core of the medical system, isn’t the goal to help people achieve health? I think so. It is my ethical and professional responsibility to discuss health with my future patients. Topics such as diet, genetics and even sleep quality can be on the table. Why? These factors affect potential for healing and risk for sustaining new injuries. Lastly, the physical environment is often overlooked. We are taught as students to ask about peoples daily lives; how they get to work, if they have stairs in their home, and more. We explain to people how to work within their environmental constraints, but do not typically help change them. It is simple, we should be doing this more as physical therapists! Helping a patient effectively change their environment so they can function at their best should be a bigger part of our goals, treatment, and practice.

The Arizona Prospective Physical Therapy Student Panel

On Monday, September 26, the Phoenix Biomedical Campus in downtown Phoenix opened its doors to 100+ prospective physical therapy students. The event was catered to individuals seeking information about program applications, interviews, and PT school survival skills.

Guest Author: Maggie Delaney, 3rd year Student Physical Therapist at Northern Arizona University in Phoenix

On Monday, September 26, the Phoenix Biomedical Campus in downtown Phoenix opened its doors to 100+ prospective physical therapy students. The event, coined #AZPTpanel, was catered to individuals seeking information about program applications, interviews, and PT school survival skills. Attendees included students from ASU, NAU, GCU, U of A, various community colleges, and even local high school students.

The #AZPTpanel is a recent effort by the Arizona Physical Therapy Association and Arizona Student Special Interest Group to educate future students about the benefits of pursuing a DPT in the state of Arizona. We are lucky to have 4 programs in the state of Arizona, with options for obtaining an education in Flagstaff, downtown Phoenix, Mesa, Glendale, or Goodyear.

#AZPTpanel began with an overview of the basic application and interview process. Emphasis was placed on preparing the strongest possible application, and managing the realistic financial situation PT students find themselves in.

Afterwards, the event was opened up to Q&A. 11 panelists, current students from every DPT program in AZ, discussed their experiences and connected with students facing similar situations. The purpose was to provide a united front of all DPT programs, and offer up unbiased advice.

Questions varied:

“Is it possible to work during PT school?”

“How difficult was the transition from undergraduate school to graduate level school?”

“How do you stand out in an interview?”

“What do you do if you are struggling in a class?”

“What if I don’t meet the minimum requirements to apply for my dream school?”

And so on. Every panelist was able to offer a personal experience, story, or solution to each question. Several attendees lingered after the event for up to 45 minutes to speak individually with panelists with more specific questions.

A brief survey was sent out to attendees to assess their satisfaction with the event. Majority had heard about the event from a teacher or classmate, and none had heard about the event from Twitter. This showed myself, Cruz Romero, and Beth Horn (the event planners) that social media was not necessarily the outreach tool of choice for future students. It turns out, connections through our own faculty, undergraduate Pre-PT clubs, and professors who teach exercise science or kinesiology were our best medium for marketing. At the end of our event, however, we made sure to point these students to all relevant AZ and student PT social media accounts and hashtags.

Attendees were asked on a scale of 1-10, how likely would they recommend this event to another person interested in PT school? 6.7% of the respondents scored the event 7/10, 20% scored it 9/10, and 73.3% scored it 10/10. There were 15 total respondents. We were thrilled with the overall positive response.

There are hopes that the event will be an annual occurrence, as was expressed by panelists and attendees alike. Many of the DPT students on the panel were either friends already, or were excited to connect with students from other programs. When more applicants are educated about the PTCAS process, the more competitive they become. Programs will have a more prepared pool of applicants to choose from.

The presentation used to educate the attendees is linked here.

Thank you to all panelists, listed below. Special thanks to Cruz Romero (event moderator) and Beth Horn (this event was her idea).

Panelists:

NAU Phoenix: Maggie Delaney, Cruz Romero, Beth Horn

NAU Flagstaff: Lauren Brill

AT Still: Ariana Jones, Jenn Chalanycz, Kyle Flood

Midwestern: Kate Schriock, Catch Hurst, Daniel Nowland

Franklin Pierce: Sarah Mitchell, Ken Toves

Manual Therapy and Therapeutic Exercise in the Treatment of Chronic Neck Pain

Arizona Core Ambassador, Daniel Strauss, conducted a riveting presentation. It explored how manual therapy in conjunction with therapeutic exercise could benefit those patients diagnosed with chronic neck pain. Neck pain can be very complicated and often has many contributing factors.

Most interestingly, his presentation found different outcomes for short-term and long-term benefits for a treatment protocol using both manual therapy and therapeutic exercise. This is an interesting concept; it does play into potential outside factors contributing to neck pain. It raises an interesting question, one I which I hope can be answered in the future.

Why does manual therapy in conjunction with therapeutic exercise in the long-term have the same treatment outcomes as therapeutic exercise alone, but are different in the short-term?

Manual Therapy and Therapeutic Exercise in the Treatment of Chronic Neck Pain

Pedaling for Parkinson’s

Mikaila Foster, working with other student physical therapists, came up with a very unique way to treat a patient. Hint: it involved pedaling.

I began cycling while I lived with my previous college roommate. He was a member of the NAU triathlon team for a period of time, and has ran multiple marathons. Because of him I really started to appreciate what cycling could offer to my own health. A very close friend of mine actually took time to help me build a bike from the ground up. It is one of the most fulfilling experiences I have ever had.

I do not claim to be an expert by any means, but I do feel that I have some knowledge on the subject. My knowledge of cycling and my genuine passion for it predispose me to seek out research and treatment practices that pertain to it.

Enter: Pedaling for Parkinson’s.

The reason this is great, similar to therapeutic climbing and some other posts coming up, this type of therapy is fairly new and exciting! In essence, the project is centered around the idea that repetitive motions, such as pedaling, can generate the amount of repetitions  necessary for neural adaptation. It goes without saying that the current amount of repetitions are vastly lower than what should and could be offered. Unfortunately, our healthcare system is not efficient enough to offer patients the most beneficial practices all of the time.

What Mikaila and the other SPTs did was just short of extraordinary. She is proposing a new and unique exercise treatment for individuals with Parksinson’s. It’s an aspect of therapy that many have not considered as a viable option. I love what they did and I know I will consider it as a treatment option, especially because of my own positive experiences with cycling.
Pedaling for Parkinson’s

Interventions in Treating Patients with Low Back Pain

Sara Patterson, a second year classmate of mine, presented on the effectiveness of traction versus manipulation as a treatment for low back pain (LBP).

This hatches an interesting debate. I personally would love to see more evidence comparing the two as Sara emphasizes in her presentation.

Interventions in Treating Patients with Low Back Pain

Therapeutic Climbing for LBP

Tori Orlowski, a second year in my class presented on the therapeutic effects that climbing could have for people diagnosed with Low Back Pain (LBP). 

The theorized traction and postural muscle strengthening has very possibly real effects. I think it creates a new and exciting experience for our patients within a controlled environment. 

What makes climbing more interesting as a possible treatment, is that it can create a culture of competition. What patient doesn’t want to improve? When Tori was asked about the cost of a climbing system, she said it would be relatively cheap. The most expensive thing would be the hand holds. 

Tori did a great job introducing and selling a new possible treatment technique to me; I hope you all take the time to decide for yourself!

Therapeutic Climbing for LBP

Negative Pressure Wound Therapy in Diabetic Foot Wounds

For one of the other PICO presentations on 09.09.16, Stephanie Muther presented on the topic of wound care. More specifically, treatment of diabetic foot wounds.  Most people do not consider this a glamorous part of a physical therapist’s job, but I want to make sure everyone understands it is a very necessary part of our job, and that I am thankful for those physical therapists treating these patients.

In my opinion, they alone are making everyone’s job a heck of a lot easier! They are extraordinary at this type of care. I hope to learn more about wound care because I understand that it can be an instrumental part of my future job depending on what setting I choose to go into.

Negative Pressure Wound Therapy in Diabetic Foot Wounds

Providing Care with a Language Barrier

One of my classmates, Sarah Bade, gave a wonderful presentation about working with a patient when a language barrier is present.

Before you read the presentation, I will emphasize that this was done well. Sarah explored a topic that most people inherently know, but often do not have the resources or knowledge to do anything about. It is simple: when treating a patient who speaks a different primary language than yourself, it is better to have another healthcare professional as a translator. I failed to realize that it truly affects treatment.Incorporating more bilingual providers into the system may seem like a daunting task, but this could change the shape of not only our profession, but of healthcare as a whole.

Personally, I have worked with this patient intermittently throughout the last year. As a person of Hispanic decent with very little knowledge of Spanish,  I can confidently say that communication was strained without my Spanish-speaking classmates present. I agree with Sarah and her conclusion. I think we as practitioners should strive to provide the best care for the people we are serving, any way we can.

Lastly, although this entire presentation is about a language barrier, I want to stress the capabilities we all have. As physical therapists we often have the skills necessary to interact, communicate, and even motivate people psychologically. I think these skills, often ignored or forgotten, are still our biggest assets. I want to say that although  language barriers can be present, we can still have a relationship with our patient that fosters the same genuine care for them and their diagnoses.

Providing Care with a Language Barrier

4 Things you can Expect at the Arizona Fall Confernce

Date: Friday, October 14th-15th

Location: A.T. Still University, 5850 E. Still Circle, Mesa, Arizona  85206

Time: 8:00 AM

Facebook: Moving the Profession Forward! PT Pub Night

5 things you can expect at the Arizona Fall Meeting

1.A broad and diverse topic list.

  • Topics range from Pediatrics to Geriatrics, and also including Orthopedics, Neurology, Women’s Health, Sports and Nutrition.
  • This includes 24 different sessions that you can pick and choose from, with experts in each field presenting.

2. Interactive symposiums on Education , Legislation, and Association direction where you can help shape the future of your profession.

  • This includes a Delegate Motion Development breakout session, which means that you are aiding in the process of coming up with new ideas to progress our profession.
  • An education panel dedicated to answering the question about PT education and if it is preparing recent graduates for the demands of the profession.

3. PT Pub Night = Friday night social event where you can meet and greet old colleagues and new.

  • PT Pub Night – R.T. O’Sullivan’s Sports Bar & Grill

4. Networking.

  • This event is designed with the specific purpose of drawing in all Arizona Physical Therapists, assistants and students.
  • We hope to have representation from all the DPT programs here in Arizona.

 

Also, a quick shout out to Jennifer Howe (@jenniferhowept on Twitter) who was a major contributor to this post and as well some others that will be coming out!