Addy Brown

Here's the link! cochranelibrary-wiley.com/doi/10.1002/14…

#PT385 #NM Article below didn't find any significant differences in pain reduction for ITB friction syndrome btw. deep transverse friction massage with PT intervention compared to PT alone. Seems like deep friction could cause pain to an already sore tendon so pt. dependent!

#PT582 #KR This article shows effectiveness of Interval Aerobic Training in improving cardiorespiratory fitness geriatric pts. 6MWT distance increased significantly for participants and there was a 94% adherence rate without any adverse events. The key is enough rest for them!

@dannyspt13 Yeah I definitely think that could mean that more focus should be done on the quad strengthening to improve it post op more!

@addybAZ #pt582 Thanks Addy! Do you think that because quadriceps strength was not improved post-op that PT should have a greater focus preoperatively on strengthening the quad?

#PT582 #DS But I do believe the improvements that were found are worth supporting the benefit and importance of prehab in pts receiving TKA. Reducing overall costs to the healthcare system and improving patient performance in a few areas is positive!

@BarnetteKailey I think the good ol glute buster on the bosu ball is great! @houseofstark22 @n_skotak We could also do jumps and land on the contralateral leg (if it's strong and stable enough) so you get the power without the impact!

#PT582 #KB We need focus on patient PLOF and goals when answering this. If they weren't jumping before, we don't need them to jump after total joint arthroplasty. There are still many plyo exercises that don't involve jumping that could benefit patients and increase power!

#PT582 #DS This article found that prehab significantly decreased length of hospital stay and improved knee ROM and sit to stand test performance in pts post TKA. Didn't find improvement in quad strength, 6minuteWT, pain or functional recovery.

#PT582 #KB I also think that completely discouraging plyo movements or jumping could increase patient fear of movement so we need to choose exercises that will motivate them to move and benefit their strength and power.

@PaigeJohnsonSPT I'm a little sad I didn't get a shout out today... although the #twittertuesday probably threw you off. Cheers to the finish line of your 1st rotation! Miss ya

@houseofstark22 @NAUPT582 Love this anti-cookie-cutter approach Benjamin! I think it's super true that we can always push our pts more than we traditionally think we can!

Addison! Great question. I think that if our patients can't tolerate a cardiovascular activity before therapy we have to change the dynamic of our workout. Instead of prescribing just 3x10 maybe we do 3 sets until fatigue. Pushing our patients to do more. @NAUPT582 #PT582 #AB

@TommyLittlePT Sweet, thanks Tommy! Another good option to make our treatments different and exciting for patients as well. I agree that HIIT would be a good option considering that a long endurance workout is inappropriate but we could tailor exercises specifically for the pt.

...is inappropriate. Applying high intensity resistance exercises (or plyos if appropriate) can also provide fatigue to target muscle groups in a time-efficient manner, but again is relative to the patient you are working with.

#PT582 #AB Degree of energy expenditure to reach fatigue varies based upon the patient, but like you said traditional cardio may be difficult or inappropriate for these individuals. HIIT principals under various exercises can be applied to patients who prolonged endurance...

@RacineSpt Thanks Kevster! Pretty cool to know! Do you think this works for patients who have both flexion and extension dysfunction?

Increasing patients' fatigue threshold in the lumbar paraspinals can help reduce injury risk due to fatigue increasing the flexion moment arm. Endurance exercises performed to fatigue/failure can achieve this. sciencedirect.com/science/articl…. #PT582 #AB

@hmsteve04 @NAUPT582 Thanks Hannah, great ideas there! Do you think that aqua therapy can provide any additional benefits to spinal stabilization? You're gona be a stellar PT

@NAUPT582 Pts can participate in exercise in the pool, if accessible, to achieve a fatigued state and provide less load/stress on their joints before engaging in stabilization exercises. A hand cycle or other forms of exercise can also achieve this effect w/o LBP #PT582 #AB

@katburdettSPT Thanks Kat! I totally agree!

#AB #PT582 I think that the patients who don't have the ability to perform typical cardio, will fatigue easier. It may be a matter of working them hard throughout the treatment, and once they are tired, you can perform additional exercises in this fatigued state.

@krs572 @NAUPT582 Thanks for sharing this article Kat! This article is great, really interesting to read a little more about how fatigue affects the neuro system and can therefore lead to improved endurance. Also how this can help train other muscles to contract and reduced risk of re-injury.

@NAUPT582 #PT582 #AB As a PT we are able to adjust to variable circumstances. For some, going to a light walk, doing the arm bike, doing some band/mobility work in bed is a great way to tire out pts. ncbi.nlm.nih.gov/pmc/articles/P…

@n_skotak @NAUPT582 Nate thanks for the reply! I agree that creativity is the answer here. The krank cycle looks like a sweet ride, pretty cool that you can adjust it for sitting or standing!

@BarnetteKailey @NAUPT582 Thanks Kailey! I agree that we've got a pretty sweet job ahead of us. It's true that each patient is going to require different circumstances and will reach a level of fatigue differently than others, that's why we just gotta take them as they come and use the ol' noodle.