Marissa Wheeler, SPT

#PT582 #NM bit.ly/2zUiFsg 88% PTs in this study use friction technique(84% of the time for tendinopathy). Based on their clinical expertise I would use cross friction to treat this. It is unlikely to cause harm & can encourage proper tissue healing and pain modulation.

#PT582 #RP Risk of OA that our pts can regulate are obesity, infection, joint injuries, occupation & smoking. Do you think repetitive poor running mechanics could indirectly lead to OA via joint injury & if so would you try to alter their form knowing how hard it is to do so?

#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.

#PT582 #MR bit.ly/2KRHj1O APTA is pushing for PTs to be allowed to make a return to sport call in all states. Concussion is in our scope of practice. We are extensibly trained in neuro & Vest. system & can diagnose concussions so we have the education to make that call.

@nathan_nwm27 #PT582 #NM I'm not sure if it's a "last resort" but, if we could achieve some needed stability w/ core stabilization exercises (CSE) - why not give that a shot first? Some Pts may not know this is an option.Also,surgery should be followed with CSEs to try & prevent reoccurrence.

@mpwheeler47 Nice post Marissa! With many individuals going for additional fusion, do you think lumbar fusion should be an absolute last resort for individuals with LBP? #PT582

#PT582 #NM bit.ly/2zaZ7j2 Long term FU of Pts w/ Lumbar Fusion shows 44% currently have LBP, 15% had a repeat surgery. This suggests it may not be very effective. Adding trunk stab Ex can bring support to areas that need it in the spine & increase the positive outcomes.

#PT582 #AB Other than doing a separate cardio session prior to PT the Pts could practice holding a stab. pose (plank,bridge, etc) for extended time & gradually increase holds w/ endurance capacity. Or complete a higher # of reps to increase endurance like we learned in TherEx.

@BRIngitON5555 #PT582 #TO Briana, do you think certain conditions would be better suited for group PT? I know that in pts with Parkinson's a lot of the PWR and BIG therapy is in a group setting vs other conditions are not often treated in groups. I also think this can be an efficient tx idea!

This could mean that patients enjoyed this treatment and would be beneficial to have in your back pocket. ncbi.nlm.nih.gov/pubmed/21732807

#PT582 #TO #ThursdayThoughts While the study below had equal improvements between groups in terms of functional outcome measures, it did show high attendance in the aquatic group!

#PT582 #KS bit.ly/2Myo6yG Pts with mild/moderate HF Aqua rehab can be useful. Also as BP does not rise so pts w/ hypertension can also benefit from this. There is still a large stress placed on CV system so the key is to monitor closely and use case by case basis.

@noriamitchell #PT582 I had the same initial thought! I also remember Jason describing that as long as the plyometric is performed at a greater speed than the pt is used to then it can have benefits. So, I think that for those older pts who may move very slowly this could have a large benefit.

Initially I thought that it might be difficult to perform plyometrics at an adequate speed in the water. But aquatic based plyometric exercises may help improve vertical jumps in athletes and therefore can be useful with some of our patients #PT582 #BW bit.ly/2ludyot

#PT582 #KR One approach could be hosting a drop in breathing/body awareness clinic each wk if the facility saw a lot of pts. w/ CP. This could also create community w/in those w/ CP. Also, educating them on how to use the tecnhs. at home to focus on other things during tx time.

#PT582 #RJ bit.ly/2E5idbz This article shows a collaborative care model for pts. w/ MS & CP. The key is to keep the pt at the center of the care & understand what they individually need vs a cookie-cutter tx(psychologist, pain expert, spiritual leader, care manager etc.)

#PT582 #CG nyti.ms/2HPxtqP This article in the NYT's discusses that under treating an ankle sprain (AS) can lead to chronic instability and recurrence. I do not feel that taping would provide the stability to protect an acute AS especially for immediate return to sport.

#PT582 #LG Our pts don't realize how many activities use the PNF type patterns. I would educate them on how the movements can be practiced in everyday tasks (unloading a dishwasher). Manual contact can help cueing & is helpful when learning the patterns. bit.ly/2l8Ag5B

#PT582 #JH In young athletes strength training can be beneficial/promote healthy adult lifestyles however having the correct training loads and proper form are imperative. The focus should be on skill and technique to build a foundation for future training.bit.ly/2qkEtIo

#PT582 #ES This article bit.ly/2sNUipu has a multifaceted take on increasing activity. It discusses clinicians treating PA as a vital sign to stress it's importance and open up conversation on the topic. Begin w/ small changes that can be built on (i.e taking the stairs)

@BRIngitON5555 #PT582 Bri, this is true. It could cause athletes who need the EStim for rehab to not have as much access to it if it became an issue.

#PT582 #MW #thursdaynightthoughts I do think that Russian e-stim can be considered cheating when it is used for strength gains without a previous injury. While it is controversial, it could become a slippery slope into overuse of other modalities for performance enhancement.

@Victoria_Ignace #PT582 I agree with this Victoria, from everyone’s replies I’m not sure it’s worth the effort to regulate it when the evidence isn’t strong.

@nathan_nwm27 @NAUPT582 #PT582 I agree that many people may not even be aware of possible benefits. Another difference is that you still have to be training and putting in effort during alt. Training versus passive Estim.

@mpwheeler47 @NAUPT582 #PT582 #MW While alt. training does offer performance benefits, it may not be comparable to russian stim since alt. training is widely used. I imagine there aren't many weightlifitng athletes who are familiar with russian stim. Your question is quite interesting to think about!

@NAUPT582 #PT582 #MW W/ e-stim potentially serving as a viable adjunct to weightlifting for improved performance (bit.ly/2sshJEB) it may be unethical for healthy athletes to use for a competitive edge. It may be cheating, however I don’t know how it could be regulated.

@Bri_RedaSPT @KSandifer_SPT @TayKit_SPT #PT582 Bri, I also think that this maybe should be regulated or considered in sports that emphasize a need for power rather than endurance. What do you think?

@KSandifer_SPT #PT582 This is interesting as @TayKit_SPT said. I too did not find anything definitively stating it made them better just that it was theorized that it could in conjunction with exercise. Definitely an interesting debate and I wonder if it is currently under watch or not?

#PT582 #MW bit.ly/2slmeBA Yes stimulation use should be monitored. This article claims that doping is defined as "the use of any unauthorized means to increase sport performance" so I believe its use should be tracked like we do for blood doping or the use of steriods