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
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.
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
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
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
Presentations on Therapeutic Exercise for various diagnoses!
Prescribing appropriate and specific treatment is our job as physical therapists. Exercise is arguably the most significant portion of this responsibility. Our class was tasked with creating presentations focusing on therapeutic exercise.
We used problem-solving to form a treatment plan for an assigned diagnosis. We demonstrated an understanding of evidence-based research to justify the use of various therapeutic exercises and treatments. We calculated dosage parameters for the therapeutic exercise program or home exercise program. The topics assigned fell under the major categories of musculoskeletal and neuromuscular conditions: Adhesive Capsulitis, Kyphoscoliosis, Patellofemoral Dysfunction, Duchenne’s Muscular Dystrophy, Shoulder Dislocation, Total Hip Replacement, Carpal Tunnel Syndrome, Thoracic Outlet Syndrome, Athetoid Cerebral Palsy, Concussion, Phantom Limb Syndrome, and Multiple Sclerosis.
Here are the links:
Athetoid Cerebral Palsy (Dyskinetic)
Carpal Tunnel Syndrome
Duchenne’s Muscular Dystrophy
Patellofemoral Pain Syndrome
Phantom Limb Syndrome
Thoracic Outlet Syndrome
Total Hip Replacement