Nathan Turley

#PT582 #AJ In this study they found Estim can be used to prevent or reduce shoulder subluxation early after stroke. However, it should not be used to reduce pain or improve upper arm motor function after stroke. ncbi.nlm.nih.gov/pmc/articles/P…

#PT582 #SK Some of the major contraindications for TENS include Pregnancy, epilepsy, and if they have a pacemaker. ncbi.nlm.nih.gov/books/NBK53718….

#PT582 #EB In this study they found that Hippotherapy showed functional improvement in gait speed, width, bilateral symmetry, and balance in people with Down Syndrome pubmed.ncbi.nlm.nih.gov/31342817/

#AS #PT582 A major risk factor that will increase the risk of tendinopathies is when there is a change in load. When someone who is inactive suddenly exercises or if someone is increasing the frequency, intensity, and duration of their exercise. As PTs we can look our for these.

#PT582 #TM In this article looking at lumbar strengthening in amputees with low back pain, they did many of the same exercises that anyone could do. Dead bugs, supermans, cobras, etc. We could progress these with ankle and wrist weights. ncbi.nlm.nih.gov/pmc/articles/P…

#PT582 #DA In the research that I found, it appears that aquatic could be a safe alternative exercise for someone in early stages of Congestive Heart Failure. However, I appears that more research needs to be done. ncbi.nlm.nih.gov/pmc/articles/P…

#PT582 #MH I could not find anything saying dry needling is superior to other treatments. However, I does seem to provide some similar outcomes. In the end, I think patients preference should determine its use. pubmed.ncbi.nlm.nih.gov/28158962/

#pt582 #KJ In this study they found that even very mild exercise has been shown to improve depression. It says most studies have seen benefit in aerobic exercise but that resistance may also be good. ncbi.nlm.nih.gov/pmc/articles/P…

#PT582 #DB Virtual reality has been proven to improve balance and gait for individuals with Parkinson's disease. I think it is a great way to get this population moving! ncbi.nlm.nih.gov/pmc/articles/P…

#PT582 #KD Visualization prior to exercise has been shown to improve performance in muscular strength activities. I think it could be beneficial for all of our patients. ncbi.nlm.nih.gov/pmc/articles/P…

Thank you for the great discussion! Here is my review. #PT582 #NT

@ds_DPT #PT582 #NT So as a PT would you want to incorporate PNF into the treatment of all of your patients w/o contraindications? Or only certain patient populations?

@NathanTurley4 #PT582 #NT However, PNF can be used throughout training to assist in achieving that desired ROM. While it may decrease strength/power immediately after, most individuals will not need that anyways. In this case all groups could use PNF as tolerated w/o contraindications. (2/2)

Looking forward to this evenings twitter discussion! Here is my question! #NT #PT582

@AnnaLeighSPT #PT582 #NT Great point! What are some situations where as a PT you would pick PNF over static and vice versa for your patients?

@NathanTurley4 #NT #PT582 I think in part this is influenced by Pt preference and/or their activities! Do they have an activity where they need to hold a static stretch? Studies I'm seeing show static and PNF stretching both have a role. DOI: 10.1007/s00421-011-1879-2

@TsaiJames_ #PT582 #NT I could see how a Pt could get discouraged if their strength is decreased so Pt education is very important!

@NathanTurley4 This principle is applicable in efforts of strength, so not all activities. It may be atypical for a Pt to perform a 1RM right after PNF, but PT should still educate Pt that their strength following PNF may decrease, but that it is not indicative of their progress. #PT582 #NT

@HubbertKaytlin #PT582 #NT Great points! Are there situations where PNF should be done pre workout? Or should it always be done post workout?

@NathanTurley4 Some situations w/ a pt where you might not want to use PNF stretching include the pt feeling p! w/ joint mobility, hypermobility/ instability in the pt or if the pt has inflammation. PNF should be done post workout for more added benefits, similar to static stretch #PT582 #NT

@RyanOli22855873 #PT582 #NT Great points! Are there any sports where it may be appropriate to do PNF stretching prior to the event?

#PT582 #NT PNF stretching should occur after a workout while dynamic stretching should occur before sport. A contraindication for PNF is if the moving joint is unstable as this may increase the rate of injury due to hypermobility.

@EmilioA43040616 #PT582 #NT I agree that in most cases PNF to increase ROM may be appropriate but are there cases in when it may not be appropriate?

In a clinical setting, we rarely require Pts to exert maximal force production. Using PNF techniques on our athletes to increase ROM seems appropriate. However, they need to develop strength in their new ROM to avoid injury during competition. #PT582 #NT

@manderslat #PT582 #NT In this case would you progress directly from PROM to PNF or would you progress to other stretching techniques prior to PNF?

@KristenD_SPT #pt582 #NT Great points! In these instances would you want to start out with non-PNF stretching and advance to PNF stretching once they don't have contraindications? What type of stretching would you recommend to people with these contraindications?

#PT582 #NT Instances when you would rather use non-PNF stretching techniques could be any pos-op surgery where ligaments or tendons are not fully healed where PNF could be too intense. Also, anyone with acute inflammation, hypermobility, or joint instability.

@Kiernan20732093 #PT582 #NT In order to gain the full benefits of PNF post exercise it needs to be performed correctly and consistently. If a patient cannot perform them properly, they will not get the benefits. Are there populations where PNF may be better than static stretching post exercise?