Austin Kaiser

@RacineSpt Well said. The fear of movement will only exacerbate the aging process which will lead to more fear. The education you mentioned can interrupt that cycle.

@amkaiserSPT Great reference Austin, and a perfect example of how patient education w/ this population is essential for explaining how overload and proper exercise dosing can safely increase strength, balance, and power...factors that tend to decrease w/ age #PT582 #AK

#PT582 #KR Dale Avers' White Paper: Strength Training for the Older Adult--gold standard. bit.ly/2zVLtka We can ease fears and empower by explaining how strength, power, balance are lost with age and how overload/progression exercise is safe and can slow it.

@rwp47 For 'how much is too much?' we have to start somewhere and my guess is that people who have been inactive or already have OA can start with simple WBing exercises. Strength training for the LE will stabilize the joint... and compression/WBing will promote hyaline adaptations.

@amkaiserSPT #PT582 #AK Yeah, definitely makes sense. There's still a question though, it seems to me, about how much is too much. What if the forces people are putting through their knees are excessive or they do not have enough stability to handle them? What if people have OA already?

#PT582 #RP knowing that compressive forces stimulate hyaline cartilage and type II collagen adaptations, don't you think that some sort of loading must be preventative for OA of these WBing joints? Your thoughts?

#PT582 #RP Knee/hip OA risk is associated with high impact activity, occupations, obesity, amputations, and other factors. bit.ly/2LxMYpW We want patients to move and running doesn't have to be high impact; let's promote gradual, progressive programming.

#PT582 #KR Senior Rehab Podcast episode: Dale Avers discusses her White Paper with clinicians in a journal club. bit.ly/2uxWxP8 Two big points: 1) estimating 1RM is vital. 2) 10 rep 80%1RM better for strength than 15 reps 60% 1RM in frail older adults.

Do you struggle with Back Pain? Here is a technique that @NAU student Anthony Veglia is researching to help with back pain. @NAUResearch Full Story on our Facebook and Youtube.

@JMcCallumPT @DptShewantsthe Dr. McCallum, I really appreciate the input. This method and condition are unique among other mirror therapy methods shared. Do you think the perception of a 'healthy back' or 'healthy movement' with mirror use transforms body image in 1o motor/sensory cortices?

@DptShewantsthe #PT582 #AK Mirrors may help CLBP ncbi.nlm.nih.gov/m/pubmed/22699…

@KSandifer_SPT In that case... I think that this could be useful for countless neurologic and orthopedic conditions alike, don't you?

@amkaiserSPT Absolutely! The article also mentions that mirror therapy can help to break the link between pain and fear of movement. I think its can be used to address fear avoidance behaviors and help patients to perceive their painful limb movements instead as normal and painless

#PT582 #AK bit.ly/2meCLUB This article mentions how mirror therapy could also be used to correct disruptions in body image associated with pain such as in patients with small, withered hands or large, swollen body parts which can occur in many different conditions

@susansSPT What do you think is different about the acute to subacute phase that makes MT work better? In chronic state post-CVA, why do you think MT may work for mild/mod cases but not severe cases?

#AK #PT582 ncbi.nlm.nih.gov/pubmed/23419791 There is evidence to show that mirror therapy can be effective post-stroke if the pt is in the acute or subacute phase, or (if in chronic phase) if it is a mild-moderate level stroke.

@Victoria_Ignace Victoria, your mechanism for decrease pain is great! Thanks for sharing. It makes sense to me. Visual input can compete with and override the maladapted proprioceptive input, removing pain perception.

@madeleinetalk I agree that the mechanism should differ between motor function and pain reduction. Others have said that motor neurons are at work in motor gains. What sensory inputs and regions of the brain are involved in changing pain perception?

#PT582 #AK Mirror therapy may be beneficial for motor function recovery and reduce pain in patients with stroke or CRPS type1. The MOA is not very clear, but may be slightly different depending on whether the goal is motor function or pain control. bit.ly/2KSRB1P

@DptShewantsthe How would you set up a mirror for use in treating Bell's Palsy? Is there literature showing MT's effectiveness in treating Bell's Palsy?

@llg336 Laura, no one tonight has mentioned attentional deficits improvement as an outcome measure before you. Do you think that improvement of attentional deficit would amplify improvement in motor function over other therapies due to increased attention toward hemiparetic limbs?

#PT582 #AK There is interesting evidence regarding mirror therapy and rehabilitation for patients post CVA. This study found improvements in sensory and attentional defecits in pts paretic limbs. citeseerx.ist.psu.edu/viewdoc/downlo…

@nathan_nwm27 @NAUPT582 Thanks for sharing literature on LE motor function gains! Others shared literature on UE motor function gains. Would you use MT in neuro clinic this coming year with your pt's?

@NAUPT582 #PT582 #AK Mirror therapy also seems to be beneficial for recovering motor function post CVA bit.ly/2uiqLG2. It seems mirror neuron activation promotes neuroplastic changes in the movements observed in the mirror, thus reducing hemiparesis over time.

@mpwheeler47 That's great! I think that any changes we can make on the M1 cortex are going to have a profound impact on function and QOL.

#PT582 #AK bit.ly/2LccPUo This syst rvw looks at mirror therapy(MT) on stroke rehab. It was shown to increase motor fnct, ADL, and decrease pain. Evidence in the study suggests that MT can stimulate the M1 motor cortex to promote neural reorganization as possible mech.

@noriamitchell Thanks for sharing your experience trying mirror therapy with a patient post-CVA. What did your team specifically do in mirror therapy?

In neuro clinic we used mirror therapy with a pt s/p CVA but it was not effective. Research suggests that there is moderate evidence that mirror therapy can help UE function in pts post CVA in the subacute phase, however more research is needed #PT582 #AK bit.ly/2uttoUK

@TayKit_SPT Cool. If pain is created by the brain and projected onto the body, and the mirror box modifies the brain's construct of that limb, then what is that mechanism of interruption or modification?

#PT582 #AK Ramachandran describes pain as a sensation created by the brain which is then projected onto the body "pain is an illusion" and our "minds are a virtual reality machine" so by using the mirror box it modifies the brains construct of that limb and the pain experience.

@hmsteve04 Hannah! Thanks for sharing a mechanism of action! Do you think that the representation of a phantom limb or hemiparetic limb/side can grow in the primary motor and sensory cortices via mirror therapy?

bit.ly/2zBHTvq Mirror therapy can improve the symmetry of beta desynchronization between hemispheres for patients post-CVA. Similar to treatment for patients with phantom limb syndrome, it can be beneficial to stimulate the primary motor cortices #PT582 #AK